Social Processes Informing Toileting Behavior Among Adolescent and Adult Women: Social Cognitive Theory as an Interpretative Lens

Jeni Hebert-Beirne, Deepa R. Camenga, Aimee S. James, Sonya S. Brady, Diane K. Newman, Kathryn L. Burgio, Lisa Kane Low, Cecilia T. Hardacker, Sheila Gahagan, Beverly Rosa Williams

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Little is known about social processes shaping adolescent and adult women’s toileting behaviors. The “Study of Habits, Attitudes, Realities, and Experiences” (SHARE) examines adolescent and adult women’s experiences related to bladder health across the life course. Forty-four focus groups with 360 participants organized by six age groups were conducted across seven sites. A transdisciplinary team used social cognitive theory as an interpretive lens across a five-stage analysis. The act of observing was identified as the overarching social process informing women’s toileting behaviors in three ways: (a) observing others’ toileting behavior, (b) being aware that one’s own toileting behaviors are monitored by others, and (c) observing oneself relative to others. We found that underlying processes of toileting behaviors, seemingly private are, in fact, highly social. We suggest, given this social embeddedness that health promotion efforts should leverage interpersonal networks for “social norming” interventions and policies to promote healthy toileting behaviors.

Original languageEnglish (US)
Pages (from-to)430-442
Number of pages13
JournalQualitative Health Research
Issue number3
StatePublished - Feb 2021

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium is supported by the National Institutes of Health (NIH) - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) by cooperative agreements (Grants U01DK106786, U01DK106853, U01DK106858, U01DK106898, U01DK106893, U01DK106827, U01DK106908, U01DK106892). Additional funding from: National Institute on Aging, NIH Office of Research on Women’s Health and the NIH Office of Behavioral and Social Sciences Research.

Publisher Copyright:
© The Author(s) 2020.


  • United States
  • adolescents
  • focus group methodology
  • qualitative
  • women’s health


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