Introduction [TOP]

Who or What is responsible for poor health profile of community: poor health practices of its residents or lack of health centre in the community? Or perhaps both? In an analysis of the question posed above, there is a possibility that one can attribute the poor health profile to actions and inactions of the residents (agents) or to the nonexistence of health centre. It is worth mentioning that current debate about what or who constitutes the cause reflects the ongoing debate in respect of the structuralism, humanism, post-modernism and post-structuralism (Barry, 2002; Norris, 1999; Pillow, 2000; Potgieter, 2008).

In situations where one subscribes to the former explanation, the individual is making the argument that premium should be placed on the role of the agents; this represents a humanist stand that the individual has the capacity and the freewill to make things happen to in their lives. Thus, the humanist position emphasizes that importance should be placed on “species-specific human capacities, tendencies or needs” (Crossley, 2005, p. 121) thereby emphasizing the person and privileging “the person over the social” (Dixon, 2010, p. 117). Similarly, Sartre (1948, cited in Crossley, 2005) points out that existence precedes essence; in other words, “we are what we make ourselves by way of our actions” and “our actions take shape in conditions of absolute freedom” (Crossley, 2005, p. 122). Giddens (1984, p. 14) views human agency is “the capacity to make a difference”.

In psychological theory, Maslow (1968) made a similar argument that humans have the capacity to determine what happens to them, a position that became known as the third force in psychology. This position suggests that what drives human behaviour is from within the person rather from without. Thus, Sartre’s (1948, cited in Crossley, 2005) brand of humanism (moral application of freewill and changeable nature of human) is very congruent with Maslow’s (1968) view of human potential and self-actualization. Lamsal (2012) presents the humanist stance as micro-level analysis or as placing premium on the internal motivation. Put another way, this implies that human actions stem from such internal motivations and humans are unconstrained by the societal factors.

However, endorsing the latter that the absence of health centre created the poor health profile amounts to subscribing to the structuralist perspective. The structuralist argues that the individual’s actions are determined by social, economic, linguistic etc. structures over which s/he has no control (Voss, 1977). Similarly, Lamsal (2012) presents this position as a macro-level analysis or external forces exerting influence on the individual. This suggests that human actions are determined by the societal forces over which they have no control. In this case, the residents have poor health outcomes due to the fact that they do not have access to health workers and facilities that can improve their health status. In the psychological theory, radical behaviourism exemplifies such structuralist position. The radical behaviourists make the argument that human behaviour is a product of the environment in which the individual operates (Hall, 2009; Schneider & Morris, 1987). According to Turner (1986), Giddens viewed structure as the rules (norms of society) and resources (material and nonmaterial possessions of a given society) that constrain or facilitate human actions.

In the ensuing paragraphs, an overview of Giddens’ structuration theory is presented alongside Bandura’s social-cognitive theory. Given that structuration theory seems new to psychological literature, examples of studies that have been conducted within this framework are also presented. An integrated model of structuration and social-cognitive models that is more comprehensive than any of its constituent models is presented. Propositions are derived from the integrated model whiles an illustration is also presented. Further, the mediating processes that explain the link between the person and the context on the one hand and the outcomes on the other hand are also explored. Thus, the purpose of the paper is to focus on the underlying psychological processes that explain the interplay between the context and the person in respect of specific outcomes of concerns.

Overview of Structuration Theory [TOP]

An explanation that focuses on only either structure or actions of individuals is woefully inadequate as both the structuralist (emphasis on structures of society) and humanist (emphasis on human agency) can provide very good explanations as to why there is poor health outcome within a given community. This suggests that these rival hypotheses are equally important in understanding human behaviour. Essentially, Giddens (1984) criticized the dualism or separation of structure and agency and rather argued for the duality or the recursive relationships between structure and agency. Thus, we cannot successfully account for human actions or develop interventions without an appreciation of the duality of structure and agency. Lamsal (2012, p. 113) wrote:

Thus, Giddens (1984) suggests that there is a recursive relationship between structure (external forces such as rules, resources, and social systems/macro) and agency (capability to make a difference/ micro). The essence of Giddens’ structuration theory is that both structures and agency are important and equal in their influence on the individual. He also makes the argument that agents produce structures while the structures reproduce and sustain themselves through actions of the agents. Thus, Giddens’ structuration theory is “intended to demonstrate the complex interrelations of human freedom (or agency) and determination (or structure) where “individual choices are seen as partially constrained, but they remain choices nonetheless” (Bratton, Callinan, Forshaw, & Sawchuk, 2007, p. 373). This implies that it is false to assume or to place more emphasis on only one of the factors.

The view presented above appears consistent with Bandura’s (1977) social-cognitive theory. Ryckman (1997, p. 612) wrote:

Thus, social-cognitive theory holds that both person variables (human agency) and environmental factors (family, schools, and a host of others) determine human behaviour and that human behaviour also affects both the human agency and the environment. Bandura’s theoretical analysis is captured as a triadic relationship among person, environment, and behaviour as shown in Figure 1.

The figure shows that there are recursive relationships among person (agency), environment (structure), and behaviour (outcome). These recursive relationships suggest that people create the environment (structures) which in turn shape the person; it is also expected that both the person and the structures will influence the behaviour. Thus, when cast within the original question of whether or not poor health profile of a community is due to poor health practices or lack of health facilities, we can conclude that both factors may be responsible.

Specifically, structuration theory suggests that the poor health practices of the community residents is as important as the absence of the health facilities in the community in understanding why health outcome is poor in the given community (See Figure 2). This suggests that it is possible that poor health practices may lead to poor health outcomes while poor health outcomes may limit the capacity of an individual to engage in good health practices. Similarly, absence of health facilities has the potential of leading to a situation where the community residents will engage in poor health practices whiles poor health practices could be the driving force that will ensure health facilities are constructed in the given community.

Similarly, in a study of poverty, structuration theory could prove very useful. It is not far-fetched to say that poverty is the outcome of both low practical intelligence (Sternberg, 2004, 2005) and lack of opportunities or discriminative practices. In other words, poverty may result from both lack of practical intelligence and lack of opportunities whiles poverty will deepen the poor person’s lack of opportunities due to social exclusion and this social exclusion leading lack of opportunities to acquire the essential skills to move out of poverty. This can also be captured in Figure 3.

The ongoing discussion clearly demonstrates that our understanding of and formulation of policies to address problems will be highly handicapped if we are unable to appreciate the duality of structure or the falsity of the dual nature of structure and agency. This then provides a more holistic approach to understanding society and social organizations. But in what ways has Gidden’s structuration theory been applied in research? The rest of this paper attempts to provide a narrative review of some of the empirical studies that have examined their variables of interest within the framework of Anthony Giddens’ structuration theory.

Towards an Integrated Model of Human Actions and Conditions [TOP]

Since its publication in 1984, Giddens’ theory of structuration has received a lot of research attention as a framework for carrying out empirical studies in the other social science disciplines other than psychology. One of the research domains that have appropriated Giddens’ theory is Information Systems Research (ISR). For instance, Jones and Karsten (2003) and Kort and Gharbi (2011) indicate that structuration theory has been greatly employed as theoretical framework in ISR, though in its original formlation, information systems was never mentioned. According to Pozzebon and Pinsonneault (2005, cited in Kort & Gharbi, 2011, p. 6),

In their study on the performance of call centre workers in Tunisia, for example, Kort and Gharbi (2011) employed structuration theory as the framework to guide the research method. They reported that (1) agent features such as motivation, role perception, stress, personality, and a host of others, (2) technological structures such as tools and equipment and (3) non-technological structures such as organizational structure, performance management system, task characteristics, work conditions, and others together determine the level of performance.

Researchers in geography have also drawn on Giddens’ structuration theory. For instance in a comparative study of children’s homes in Accra and Cape Coast, Kristiansen (2009) examined the quality of life of children living in residential child care facilities. In this study, Kristiansen (2009) adopted the theory of structuration as framework to investigate to what degree the children are able to act as competent social actors. Similarly, Asante-Sarpong (2007), using the structuration theory, also studied contraceptive usage in Koforidua and Asokore. She argued that “that contraceptive usage by women can be influenced by their personal reasons as well as by existing structures and institutions in the society” (Asante-Sarpong, 2007, p. 9). Giddens’ structuration theory has also been applied extensively in organization and management research as well (Albano, Masino, & Maggi, 2010; den Hond, Boersma, Heres, Kroes, & van Oirschot, 2012; Whittington, 1992).

What appears interesting is the fact that studies that have been conducted within the framework of Giddens’ structuration theory have only classified their explanation for the phenomena they studied into agent features and structural features. Despite its strength of projecting the need for equal attention to agency and structure, application of the theory in research has failed to live to expectation. This is because such an approach to research leaves out a discussion of the interactions between agents and structure which the theory emphasizes. Thus, there is a need to explicate in what specific ways that the interaction discussed by Giddens. It is against this background that Bandura’s social-cognitive theory is presented as the conceptual framework that can link the macro-focus of structuration theory to the micro-level agency and structures.

However, Giddens’ structuration theory is less known or applied in psychology. This is not due to the fact structuration theory is a sociological theory, but because psychology has its own framework that outlines the impact of both structures (social) and human agency (cognition). As indicated already, there exists Bandura’s (1977) social-cognitive theory which suggests that human behaviour is a function of both the environment (social) and person (cognition) with recursive relationships among the environment, person and behaviour. However, Bandura’s theory suffers from its focus on the immediate context and intrapersonal characteristics (but a little removed from the “empirical soil” as further operationalization is needed) and its neglect of the structures that define them; thus, the proximal context and the person is nested within the structure-agency interactions that structuration theory emphasizes.

Interestingly, Hemingway (1999) reviewed and recast social-cognitive theory in the framework of Giddens’ structuration theory. However, Hemingway (1999) did so within the information systems research domain but not as a psychologist. Similarly, in exploring women's participation in the Australian Digital Content Industry, Geneve (2009) identifies a typology of theoretical perspectives; from meta, critical, middle-range, operational to model building (see Table 1).

Thus, Geneve (2009) classified social-cognitive theory as middle-range theory; here are again, Geneve appropriated Bandura’s theory for use in the information systems research domain. She wrote:

It is also worth noting that ecological systems theory and social-cognitive career theory (Duane, 2002) also originated from psychological theorizing. There is no gainsaying that they appear as alternative theories in psychology. Thus, it is not far-fetched to infer that the application of structuration theory in psychological research may appear to be an “unnecessary intrusion” by a sociological theory. This may partly account for the relatively low awareness about Giddens’ structuration theory in psychology and psychological research. However, the other psychological theories are also as problematic as social-cognitive theory for they are operationalization of the former.

To sum, though structuration theory attempts to provide a “high-level” or meta-framework it suffers from divorce from the “empirical soil”. On the other hand, social-cognitive theory attempts to stay at the level of “empirical soil”, though it ignores the larger context that influences the observations at the micro-level. Thus, an integrated model provides a powerful framework within which psychological research may be conducted. This is because it will enable researchers to not only examine the relevant larger structural issues, the mediating processes that the link the person and the context on the one hand and the outcomes on the other hand can also be explored. Again, the integrated model draws attention to cultural variations as social institutions (though part of the resources may be given) which are inventions of societies; what is certain is that every society invents its institutions for its survival. Thus, it can be expected that person characteristics and micro-environmental factors will vary from society to society.

Within the integrated model, environment as proposed in social-cognitive theory can be nested in the structure proposed by Giddens (1984). This will expand the environmental influence on behaviour to include institutions that that affect the micro-environment that the psychologist may concentrate on. On the other hand, Giddens’s (1984) concept of agency may become the starting point of the psychologist’s quest to identify psychological variables responsible for the outcome experienced by an individual.

This is to suggest that the researcher will be required within this integrated framework to identify the underlying psychological predictors of agency. An illustration with Figure 2 will suffice. Given that poor health practices have the potential of producing poor health outcomes, the psychologist may elect to determine what personality factors, attitude, perceptions, and reinforcement schedule underlie the poor health practices. In this manner, psychological research will have immediate and greater impact on public policy (see Figure 4 for illustration).

It is important that agency is not confused with generalized self-efficacy. This is because self-efficacy being the ability to achieve desired results (Colman, 2006) is only one of the correlates of agency (Zimmerman & Cleary, 2006). Agency is defined as “one’s capability to originate and direct actions for a given purpose” (Zimmerman & Cleary, 2006, p. 45). Others also view self-efficacy as a subjective indicator of human agency (Alkire, 2005). However, Zimmerman and Cleary’s (2006) view that self-efficacy is one of the determinants of agency is adopted in this integrated model as agency and self-efficacy are conceptually distinct. Thus, self-efficacy is considered one of the person characteristics.

Again, it is also worthwhile to distinguish intention and perceived behavioural control as indicated in the theory of planned behaviour (Ajzen, 1991; Armitage & Conner, 2011) from human agency as indicated in Figure 4. According Ajzen (1991, p. 181), intentions reflect “the motivational factors that influence a behavior; they are indications of how hard people are willing to try, of how much of an effort they are planning to exert, in order to perform the behaviour”. Given the conceptualization of intention, it is only plausible to suggest that it is distinct from agency. Perceived behavioural control is defined as “people’s perception of the ease or difficulty of performing the behaviour of interest” (Ajzen, 1991, p. 183). The current conception of perceived behavioural control is, however, most consistent with self-efficacy (Ajzen, 1991). Consistent with the theory of planned behaviour, intention is viewed within the integrated model as the mediator between agency and behaviour. However, perceived behavioural control is considered as part of the person characteristics.

It follows from Figure 4 that who one (person characteristics) is will influence whether or not one believes he or she can set and pursue goals (agency). It also follows that our belief that we can set and follow our own goals (agency) influences our determination to act (intention) whiles intentions will determine whether or not we take any actions. Again, our actions will produce results or outcomes. However, the social institutions (including rules, resources an, and systems) can shape the person characteristics as much as the person characteristics can shape the social institutions.

But how can we expect such recursive relationship to occur? It is possible that the social institutions will shape the conditions within which individuals are raised. However, continual negotiations between individuals and the custodians of the social institutions enable institutions to change. Similarly, the custodians themselves may, through soul-searching, reform the social institutions. On the other hand, the social institutions may influence the immediate physical and social contexts of the individual which may influence his or her determination to act (intention) whiles the individual’s behaviour may be influenced by his or her intentions.

It is important to note that relationships among agency, outcomes, micro-environment, person characteristics and social institutions can be expected. However, it is the mediating processes that are of particular interest as they will enable psychologists explore the level at which intervention should be targeted. Thus, it prevents the psychologists from targeting only person characteristics and micro-environment when the issues originate from the macro-level variables such as the presence, absence, or quality of social institutions.

So Who or What is Responsible for Poor Health Profile of a Community [TOP]

Having advanced an integrated model comprising structuration and social-cognitive theories, there is now room to consider the initial question posed in terms of the integrated theory. The illustration that follows is meant to show what can be done using such an integrated model rather than exhaustive. First, individual characteristics such as health efficacy, age, gender, and educational level may influence the individual health-related agency within the context of the social institutions of the given society. The health-related agency will influence the individual’s determination to engage in health-promoting behaviours (health-related intentions) while the health-related intentions will influence the individual exhibiting the health-promoting behaviours and therefore the expected health outcomes.

However, it is also expected that the physical living conditions and social relations will influence the person’s health-related intentions which will then influence his or her behaviour and therefore the expected health outcomes. It is also expected that the extent to which the physical living conditions and social relations will influence a person’s health-related intentions will depend the agency of the individual such that those with high agency may brave the odds to make a determination to engage in health-promoting behaviours (thus, it may weaken the relationship). On the other hand, the influence of living conditions and social relations on intentions will become more pronounced under conditions where individuals have low agency.

Applications of the Integrated Model of Human Actions and Conditions [TOP]

This integrated model suggests that actions of individuals depend on human agency (capability to make a difference) whiles human agency is dependent on the demographic and psychological attributes of the agents (individuals). However, the micro-environment (family, peers, work environment, etc.) also influences the behaviour of the individual but this micro-environment depends on the structure (rules, resources, and social systems). Apart from being a comprehensive framework with greater explanatory capacity, the integrated model has implications for research and practice. In community or public policy practice, the model enables the psychologist to integrate both the micro- and macro-level factor in a single study or multiple studies as well as in proposed interventions. This is as a result of the fact that the integrated model combines a meta-theory (structuration theory) and a middle-range theory (social-cognitive theory). Against this background, it can be suggested that psychologists interested in macro-level problems such as poverty, health gradient, unemployment, and host of others can benefit from such an integrated model of human actions and conditions.

In terms of research, psychologists investigating social behaviours will benefit from the integrated model as it draws attention to personal agency and intentions as mediators between person characteristics and behaviour. On the other hand, the relationship between agency and outcomes (such as health status, economic status, career success, organizational effectiveness, etc.) is also highlighted in the model as being mediated by behaviour of the individual. Thus, the following can be proposed:

Similarly, the integrated model suggests that structure (rules, resources, and social systems) influence the micro-environment which has proximal influence on behaviour whiles the behaviour of the individual accounts for the relationship between the micro-environment and the expected outcomes. Thus, the following can also be proposed:

The integrated model also recognizes the duality or interaction between agency and micro-environment and its impact on behaviour and the expected outcomes. These interactions reflect how each of them can moderate the relationship between any of the variables within the model. This is to say that the relationship between agency and intentions can be moderated by micro-environmental factors. Suppose we want to explore the relationship between a patient’s belief that he or she can set and pursue health-related goals (agency) and his or her health outcomes (expected outcome). It can be expected that the relationship between her agency and health status may depend on the absence, presence or even quality of support the individual gets from the significant others. Owing to these, the following can be proposed:

These eleven propositions or hypotheses are meant to be illustrative of the various ways the model can be tested. Again, the variables in the propositions will need to be operationalized in specific research situations to make the model testable. For instance, a researcher investigating employability will have to define the behaviours of job-seekers of interest in the study (such as CV preparation, interview performance/behaviour, job-search strategies, etc.) whiles the person characteristics also need to be defined (such as educational level, generalized self-efficacy, personality, skill level, sex, age, socioeconomic status, ethnicity, prestige of university/college, knowledge about job availability, etc.). The micro-environment may also be operationalized as family support, university support, peer support, and community support whiles the structures may be defined as macroeconomic indicators, geographical location, general employer attitude, degree of fit between skills supplied and skills demanded by employers and a host of other indicators. This is to say that without such operationalization of constructs in the model, testability will be beyond researchers.

Conclusion [TOP]

This paper sought to examine the Anthony Giddens’ structuration theory as a framework for understanding the interdependent relationship between structure and agents. In providing the analysis, humanism and structuralism as philosophical positions were reviewed in the light of offering explanatory framework in social science research or policy formulation. Specifically, the theoretical formulation by Giddens was applied to the understanding of poverty and health outcomes.

In addition, examples of research domains such information systems, geography, and management science in which structuration theory has been applied were outlined. In the case of geographical research, examples of research carried out with structuration theory as the framework were presented. Again, efforts have been made within information systems (IS) research domain to recast social-cognitive theory in psychology in the light of Giddens’ meta theory of structuration; however, all these efforts originate from the IS research practice.

Despite this, structuration theory is either less known or applied in psychology; it is possible that psychologists are unaware about the potential contributions that such a framework can make in projecting psychology from a discipline with micro concerns to one that pays attention to both micro and macro concerns. To make structuration theory worthy of psychological inquiry, an integrated model comprising elements of both Giddens’ structuration theory and Bandura’s social-cognitive theory was proposed. A number of propositions were derived from the model as well.