Behavior Domain Behavior Determinants and Behavior Change Health

Behavior Domain, Behavior Determinants and Behavior Change Health Behavior: CHAPTER 2 1

DESCRIPTION • This chapter will discuss domain of behavior, determinants of health behavior and the ways to change health behavior. Health Behavior: CHAPTER 2 2

OBJECTIVES General • Students know the domain of behavior, determinants of health behavior and how to change health behavior. Specific • Student can explain the behavior domains • Student can explain the determinants of behavior Health Behavior: CHAPTER 2 3

What BEHAVIOR is? In a simple definition, Behavior is the action or activity of individual or group who has a very wide expanse include: walking, talking, crying, laughing, working, writing, reading, and etc. Health Behavior: CHAPTER 2 4

• Human behavior is any activity or human activity, both of which can be observed directly (overt behavior), or which can not be observed by others (covert behavior) (Notoatmodjo, 2003). Health Behavior: CHAPTER 2 5

Skinner, (at Notoatmodjo 2003) • Behavior is a response or a person's reaction to stimulus or stimuli from outside. • Because of this behavior occurs through a process of stimulus to the organism, the organism is responding, then it is Skinner's theory called theory of S-O-R Stimulus – Organism - Response. Health Behavior: CHAPTER 2 6

The Type of Behavior (Notoatmodjo, 2003) : 1. Covert behavior – Covered person's behavior is a response to the stimulus in the form of covert or closed. – Response or reaction to the stimulus is still limited in attention, perception, knowledge, awareness, and attitudes that occur in people who received the stimulus, and can not be clearly observed by others. Health Behavior: CHAPTER 2 7

2. Overt behavior – Person's response to the stimulus in the form of action or open. – The response to the stimulus is already happened in the form of action or practice, which can easily be observed or viewed by others. Health Behavior: CHAPTER 2 8

BEHAVIOR DOMAIN 1. Cognitive (knowledge) 2. Affective (attitude 3. Psychomotor (practice) (Benjamin Bloom, 1956 in Notoatmodjo 20 Health Behavior: CHAPTER 2 9

knowledge comprehension application analysis cognitive synthesis evaluation recieving Behavior affective responding valuing responsible perception psychomotor Health Behavior: CHAPTER 2 guided response mechanism adoption 10

Knowledge / Kognitive • Knowledge is the result of the know, and this happens after a person doing the sensing of an object. • Without knowledge people does not have a basis for making decisions and determining actions to the problems. Health Behavior: CHAPTER 2 11

Factors influencing people knowledge • Internal factors: factors from themselves, such as intelligence, interests, physical condition. • External factors: external factors themselves, such as family, community, facilities. • Learning approach factors : learning efforts, such as strategies and methods in teaching. Health Behavior: CHAPTER 2 12

Six level of knowledge 1 • Knowledge interpreted as recall of a material that has been studied previously. 2. • Comprehension An ability to describe correctly the object is known and can correctly interpret the material. 3. • Application Defined as the ability to use a material that has been studied on the actual situation and conditions. Health Behavior: CHAPTER 2 13

Six levels of knowledge con’t 4. • analysis Is an ability to describe the material or an object into components but still within an existing organizational structure and relation to others. 5. • Synthesis demonstrated an ability to arrange the parts in a whole new form. 6. • Evaluation • This evaluation relates to the ability to carry out an assessment of the justification of a material / object. Health Behavior: CHAPTER 2 14

Attitude / Affective • Attitude is a reaction or response from someone who is still closed to a stimulus or object. • Allport (1954) explains that the attitude has three main components: – Belief, the idea, the concept of an object – Emotional life or evaluation of an object – Tend to behave Health Behavior: CHAPTER 2 15

Four level of attitude 1 • Receiving Accepting means that the person (subject) like and pay attention to a given stimulus (the object). 2. • Responding (responding) Provide an answer when asked, do, and completing assigned tasks is an indication of the attitude. 3. • Valuing Inviting someone else to do or discuss a problem is an indication of the third level of attitude. 4. • Responsible for everything that has been chosen with all the risks are the highest level of attitude. Health Behavior: CHAPTER 2 16

Practice/ Psychomotor • An attitude not automatically realize in an action (overt behavior). • To realize the attitude to be an action/practice, need supporting factors or a condition, facilities, and supporting factors Health Behavior: CHAPTER 2 17

Four levels of Practice 1 2 • Perception • Identify and select different objects with respect to actions • Guided Response • Can do things according to the correct order with the correct response 3. • Mechanism • If someone has been able to do something automatically, or behavior is already a habit 4. • Adoption is a practice or action that is already well developed. This means that action has been modified but still in the right way Health Behavior: CHAPTER 2 18

How to measure the behavior? • Interview of the activities that have been done a few hours, days or months ago (recall). • Direct measurement, by observing the actions or activities of the respondent. Health Behavior: CHAPTER 2 19

DETERMINANTS OF BEHAVIOR Lawrence Green (1980) Preceed – Proceed Theory by Lawrence Green (1980) • Green analyze human behavior from the level of health. That people health is influenced by two main factors, they are the behavioral factors (behavior causes ) and non-behavioral factors (non-behavioral causes). The behavior is influenced by : • Predisposing factor (knowledge, attitudes, beliefs, values, perception) • Enabling factor (attitudes and behavior of health personnel and other, peers, parents, employers, etc) • Reinforcing factor (availability of resources, accessibility, referrals, rules and laws, skills) Health Behavior: CHAPTER 2 20

Determinants of behavior Snehandu B. Kar (1983) 1 2 • Intention to act about health behavior or medical care (behavior intention). • Social support from surrounding communities (social support). 3 • The information about health or health facilities (accessibility of information). 4 • Personal autonomy of the individual to make actions or decisions (personal autonomy). 5 • Situation that enable for action (action situation). Health Behavior: CHAPTER 2 21

Determinants of behavior WHO (1984) WHO analyzed that people behavior was caused by : • Thoughts and feelings such as: knowledge, perceptions, attitudes, 1 2 3 4 beliefs and people value of an object (the health object). (1) Knowledge (2) Belief (3) Attitude • Role Model. Behavior of role model will be followed by someone • The resources, including facilities, money, time, energy and so on. • Norm, behavior, habits, values and use of resources within a society will produce a pattern of life (way of life) which is generally called a culture. (Notoatmodjo, 2003). Health Behavior: CHAPTER 2 22

The adoption of a new behaviors occur within the process 1 2. 3. 4. 5. • Awareness The people is aware in the sense of knowing in advance of the stimulus (object) • Interest Where people got interested in the stimulus • Evaluation Considering the good and whether or not the stimulus for himself. This means that the attitude of respondents was even better. • Try (trial) Where people have begun to try new behaviors. • Receive (Adoption) Where the subject has behaved in accordance with the knowledge, awareness and attitude toward the stimulus. Rogers (1974), in Notoatmodjo (2003) Health Behavior: CHAPTER 2 23

Test 1. 2. 3. 4. 5. What is covert behavior? Write an example! What is the overt behavior? Write example! How the people adopted a new behavior? Health Behavior: CHAPTER 2 24

References • Notoatmodjo, Soekidjo. Promosi Kesehatan; Teori dan Praktek. PT Rineka Cipta. Jakarta. 2005 • WHO, Ottawa Charter for Health Promotion First International Conference on Health Promotion Ottawa, 21 November 1986 - WHO/HPR/HEP/95. 1 • WHO, Health Promotion Glossary, WHO, Geneva, 1998 • Peggy Hickman, A Systems Approach to Health Education, Rural Health Institute Health Behavior: CHAPTER 1 25