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EDUCATIONAL DIAGNOSIS:

ASSESSING CAUSES OF
HEALTH BEHAVIOR
Module 8

HEALTH PROMOTION & EDUCATION (DEMA 3253)


DIPLOMA IN ENVIRONMENTAL HEALTH
VICTORIA INTERNATIONAL COLLEGE

PREPARED BY: MR KHAIRUL NIZAM MOHD ISA


PRECEDE FRAMEWORK
Phase 6 Phase 4-5 Phase 3 Phase 1-2
Administrative diagnosis Educational diagnosis Behavioral diagnosis Epidemiological & social diagnosis

Predisposing
Direct factors:
communication: knowledge,
public, patients attitudes, values, Nonhealth factors
perceptions
Nonbehavioral Quality of life
causes
Health education Enabling factors:
Availability of Health problems Subjectively
components of Behavioral causes
resources, defined problems
health program
accessibility, of individuals or
referrals, skills Behavioral Vital indicators: communities
indicators: Morbidity,
utilization, Mortality, fertility, Social indicators:
Indirect Reinforcing preventive actions, disability illegitimacy,
communication: factors: Attitudes consumption population,
staff and behavior of patterns, welfare,
development, health and other compliance, self- Dimensions: unemployment,
training, personnel, peers, care incidence, absenteeism,
supervision, parents, prevalence, alienation,
consultation, employers, ect. distribution, hostility,
Dimensions:
feedback intensity, discrimination,
Earliness,
duration votes, riots,
frequency, quality,
crime, crowding
range, persistence
EDUCATION DIAGNOSIS

• The educational diagnosis is an importance part of


determining how best to initiate the process of behavior
change.
• 3 factors causing health behavior:
▫ Predisposing – precursor to behavior that provide the
rationale or motivation for the behavior
▫ Enabling – precursor to behavior that allow a motivation or
aspiration to be realized
▫ Reinforcing – provide the continuing reward, incentive or
punishment for behavior and contribute to its persistence or
extinction
Predisposing factors:
Knowledge
Beliefs
Attitudes
Values
Selected demographic variables
1
6
Enabling factors:
Availability of resources
Accessibility of health resources 2 Specific
Community/government priority behavioral
and commitment to health 5 problem
Health related skills
4

3
Reinforcing factors:
Family
Peers
Teachers Contributing influence
Employers Secondary effects
Health provider # Approximate order in which the action usually occur
PREDISPOSING FACTORS
• Predisposing factors include:
▫ Knowledge
▫ Attitude
▫ Beliefs
▫ Values
▫ Perception

• Knowledge
▫ An increase in knowledge does not always cause behaviour to change.
▫ But can influence a positive associate between behaviour and health
effects.
▫ Health knowledge is necessary but not sufficient factor in changing health
behaviour.
▫ Only can motivate them.
PREDISPOSING FACTORS
• Belief
▫ Belief is a conviction that a phenomenon or object is true or
real.
▫ Faith, trust and truth are words used to express or simply
belief.
▫ Example of belief statements:
“I don’t believe that medication can work.”
“Exercise won’t make any difference.”
“It sure isn’t going to work for me.”
PREDISPOSING FACTORS

▫ Model of belief pattern


1. The person must believe that his or her health is in jeopardy.
2. The person must perceive the potential seriousness of the condition
in term of pain or discomfort, time loss from work, economic
difficulties and so forth.
3. On assessing the circumstances, the person must believe that
benefits stemming from the healthy behavior outweigh the costs
and are indeed possible and within his or her grasp.
4. There must be a cue to action or precipitating force that makes the
person feel the need to take action.
PREDISPOSING FACTORS
• Value
▫ Personal values are inseparably linked to choices of behavior.
▫ Values of life and health and desire must be considered to get a
better life.
▫ Helping people to sort through conflicts in their health-related
value is an important health education technique.

• Attitude
▫ A tendency of mid or relatively constant feeling toward a certain
category or objects, persons and situations.
▫ Attitude can always be assessed in terms of good and bad or
positive or negative.
PREDISPOSING FACTORS

• Technique to examine and understanding the attitude:


▫ Examine the concept toward the attitude. eg.
Concept: cigarette smoking
Good : __ . x_ . __ . __. __ : Bad
Pretty : __ . __ . x_ . __ . __ : Ugly
Happy : x_ . __ . __ . __ . __ : Sad
ENABLING FACTORS
• Enabling factors are the skills and resources necessary to
perform a health behaviour.
• The factors include:
▫ Resources – health care facilities, personnel, schools, out reach
clinics
▫ Accessibility of various resources
▫ Cost, distance, available transportation, open hours for use.
▫ Personal health skills (ability to perform the tasks that constitute
the desirable behaviour).

• Examine the resources, accessibility and skill possess by the


target population before start educational program.
• Failure to consider the these may lead to serious practical
problems.
REINFORCING FACTORS
• Reinforcing factors are those that determine whether health
actions are supported.
• Examples of reinforcing factors are:
Family fellow patients
Peers supervisors
Co-workers teachers
Nurses
• Sources of reinforcement depending on the objectives ad type
of program. For example:
▫ High school education programs: peers, teachers, school administrators
and parents
▫ Occupational health education programs: co-workers, supervisors,
family
REINFORCING FACTORS

• Assessing the reinforcing factors is important to make sure


that the program participants have maximum opportunities for
supportive feedback during the behaviour change process.
SPECIFYIG AND SELECTING FACTORS
DETERMINING BEHAVIOUR
• Three basic steps:
▫ Identifying and sorting factors into three categories
▫ Setting priorities among categories
▫ Establishing priorities within the categories

Identifying and sorting factors into three categories


▫ Informal methods
Assign a team to brainstorming the potential barriers to behavioral
change.
▫ Formal methods
Use survey questionnaires or records
SPECIFYIG AND SELECTING FACTORS
DETERMINING BEHAVIOUR

etting priorities among categories


▫ Classify the factors causing behaviors into positive or negative.
▫ Example: Involve in waste recycling
Predisposing factors
Positive Negative
Attitude, belief, value: Attitude, belief, value:
Willing to use dustbin Not important to take care on environment, feel
that government should take that responsible
Enabling factors
Positive Negative
Dustbin available in each house, apartment. The bins not accessible
Municipal provide recycling bins. The bins are damaged
Reinforcing factors
Positive Negative
Encourage by family, teachers Family, teachers, peers not taking part
SPECIFYIG AND SELECTING FACTORS
DETERMINING BEHAVIOUR

• The enabling factors that provide the services will have to


come first.
• Reinforcement factors cannot come into play until behaviour
have been evidenced.
• While, the predisposing factors would be translated into
interventions first.
• Some enabling factors may have to be developed over a long
period of time by means of community organizations,
legislation, policy and government.
SPECIFYIG AND SELECTING FACTORS
DETERMINING BEHAVIOUR
Establishing priorities within the categories
• Within the 3 categories of behavioral causes factors can be translated for
intervention using the same criteria as used in selection of initial behaviors
: Importance and changeability.

• Importance
• How widespread or frequent the factors
• If the factor identified is very widespread or occur often, it should
qualify for priority consideration.
• How compelling or urgent the factors
• Immediate consequence for people at high risk need to pay attention
first
SPECIFYIG AND SELECTING FACTORS
DETERMINING BEHAVIOUR

• Changeability
• Individual pass through stage level of changeability
• Awareness  interest  trail  decision  adoption

• Use these 2 criteria to rank the various cause of health


behavior in order of priority and to focus the health education
program that can totally give a good impact to the target
population.
Thank you

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