behavior domain, behavior determinants and behavior change

Health Behavior: CHAPTER 2 1

Behavior Domain, Behavior Determinants and Behavior Change

• This chapter will discuss domain of behavior, determinants of health behavior and the ways to change health behavior.

DESCRIPTION

2Health Behavior: CHAPTER 2

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

OBJECTIVES



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.


• 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).


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 the theory of

S-O-R Stimulus – Organism - Response.


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.


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.


BEHAVIOR DOMAIN

1. Cognitive (knowledge)2. Affective (attitude3. Psychomotor (practice)

(Benjamin Bloom, 1956 in Notoatmodjo 2003


Behavior

cognitive

affective

psychomotor

knowledge

comprehension

application

analysis

synthesis

evaluation

perception

guided response

mechanism

adoption

recieving

responding

valuing

responsible


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.


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.


Six level of knowledge

1 •KnowledgeKnowledge interpreted as recall of a material that has been studied previously.

2. •ComprehensionAn ability to describe correctly the object is known and can correctly interpret the material.

3. •ApplicationDefined as the ability to use a material that has been studied on the actual situation and conditions.


Six levels of knowledge con’t

4. •analysisIs an ability to describe the material or an object into components but still within an existing organizational structure and relation to others.

5. •SynthesisSynthesis 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.


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


1 •ReceivingAccepting 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. •ValuingInviting someone else to do or discuss a problem is an indication of the third level of attitude.

4. •ResponsibleResponsible for everything that has been chosen with all the risks are the highest level of attitude.

Four level of attitude


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


Four levels of Practice

1 •Perception•Identify and select different objects with respect to actions

2 •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•Adoption is a practice or action that is already well developed. This means that action has been modified but still in the right way


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.

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)20Health Behavior: CHAPTER 2

Determinants of behaviorSnehandu B. Kar (1983)


1 •Intention to act about health behavior or medical care (behavior intention).

2 •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).

WHO analyzed that people behavior was caused by :


Determinants of behaviorWHO (1984)

1

• Thoughts and feelings such as: knowledge, perceptions, attitudes, beliefs and people value of an object (the health object).(1) Knowledge(2) Belief(3) Attitude

2 • Role Model. Behavior of role model will be followed by someone

3 • The resources, including facilities, money, time, energy and so on.

4• 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).


The adoption of a new behaviors occur within the process

1 •AwarenessThe people is aware in the sense of knowing in advance of the stimulus (object)

2. •InterestWhere people got interested in the stimulus

3. •EvaluationConsidering the good and whether or not the stimulus for himself. This means that the attitude of respondents was even better.

4. •Try (trial)Where people have begun to try new behaviors.

5. •Receive (Adoption)Where the subject has behaved in accordance with the knowledge, awareness and attitude toward the stimulus.Rogers (1974), in Notoatmodjo (2003)


Test

1. What is covert behavior?2. Write an example!3. What is the overt behavior?4. Write example!5. How the people adopted a new behavior?


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

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