Health Care S.Y.
2020-2021 (MT-2ndSEM) 1
Lesson Two
{HUMAN BEHAVIOR AND COMMUNITY HEALTH
EDUCATION}
 Externally visible activity of an animal, in
which a coordinated pattern of sensory,
motor and associated neural activity
responds to changing external or internal
conditions. (Beck et al. 19821)
 “A response to external and internal stimuli,
following integration of sensory, neural,
endocrine, and effector components.
 Behavior has a genetic basis, hence is
subject to natural selection, and it commonly
can be modified through experience.” (Starr
and Taggart 1992)
 “Observable activity of an organism’ anything
an organism does that involves action and/or
response to stimulation.”(Wallace et at.
1991)
1. Molecular and Molar Behavior
Molecular Behavior: The sudden behavior
that occurs without thinking (unconscious
behavior)
Ex. Man hits a stick on another person’s eyes
and the person has to close his eyes in
response.
Molar Behavior: Opposite of molecular; one
is aware (conscious behavior)
Ex. Counter attack in revenge
2. Overt and Covert Behavior
Overt: A behavior that is being manifested or
observable
Ex. Playing basketball
Covert: A behavior that is not visible or
observable
Ex. Thinking
3. Voluntary and Involuntary
Voluntary: Done with man’s full will and
discretion
Ex. Speaking, writing
Involuntary: Behavior that occurs naturally
or actions that are done automatically
Ex. Taking in oxygen and giving up carbon
dioxide
1. Biological Viewpoint
 Everything you think and feel is
controlled by electrical and chemical
activity in your brain and the rest of your
body. To these theorists, the body
controls the mind and not the other way
around.
Ex. Recurring bouts of depression is a
natural occurrence of chemical
imbalances in one’s brain and endocrine
system (lack of dopamine & serotonin)
 “Depression bouts at night
because serotonin levels
increase during the day because
of the sunlight.”
2. Intrapsychic Viewpoint
 The psychologists try to explain the
behaviors they’ve measured in terms of
mental processes such as perceptions,
motives, values, attitudes, and
memories. The mind dominates most
bodily activities.
 “So most psychologists now are into CBT
(Cognitive Behavioral Treatment) so they
do not rely mostly on medications, but
changing one’s pattern of thinking.”
Ex. The psychologist will try to teach a
depressed person to stop thinking about
herself and her situation in negative ways
and encourages her to set realistic
positive goals.
3. Social Behavioral Viewpoint
 One’s behavior can be explained in terms
of her physical, social, and cultural
environment. You are not an island unto
yourself. You grew up around people
who helped determine your ideas, your
values, your speech, and your behaviors.
Ex. If one’s depression is caused by a
broken relationship making her feel
unspecial since she was brought up by a
father who gave her extra attention and
special treatment.
1. Neuron
 The major purpose of individual nerve
cells, called neurons, is to communicate.
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 Health Care S.Y. 2020-2021 (MT-2ndSEM) 2

All 3 parts are necessary for transmitting cord. Most brain’s neural activity is carried on
necessary messages through your body. by inter neurons
Without these messengers, you could not
Nerve
perform the simplest of actions or think a
single thought. A large bundle of axons from many neurons
Parts of a Neuron:
1. Dendrites – the front end, or input side
of a neuron composed of a network of
fibers. Its major activity is to receive
information from other nerve cells.
2. Soma – main part or body of the neuron.
Its function is to receive inputs from other
neuron and is the neuron’s
“housekeeper”. Most complex chemical
reactions involved in cellular metabolism
which keeps the cell functioning in a
healthy fashion, takes place in the soma.
3. Axon – the action end or output system
of the neuron. It stretches out from the
Multipolar Neuron / Motor / Efferent Neuron
stoma like a branching telephone cable.
Bipolar Neuron / Interneuron
At the end of its cable are tiny fibers
Unipolar Neuron / Sensory / Afferent Neuron
which releases chemicals which affects
the dendrites and cell bodies of nearby
neurons, or muscles and glands.
 output area of the neuron because it is 1. Central Nervous System (CNS)
the axonic fibers that actually pass  consists of the brain and spinal cord
messages along 2. Peripheral Nervous System (PNS)
 nerves connecting the central nervous
system to the sense receptors as well as
to the muscles and the glands. This is
made up of:
a) Somatic Nervous System –
controls the voluntary muscles
b) Autonomic Nervous System
–takes care of most of the
normal body functions without
having to think about them
1. Sensory Neurons (Afferent Neurons) Ex. Involuntary Actions
Nerve cells that are involved in relaying (Breathing, Pumping of blood)
information to your brain from your eyes,
ears and other sensory receptors 1. Sympathetic Nervous System
2. Motor Neurons (Efferent Neurons)  Responsible for turning on or preparing
Nerve cells that are involved in relaying your body vigorous “FIGHT OR
messages from your brain to your muscles FLIGHT” activities
and glands Ex. Whenever you encounter an
3. Interneurons emergency, something enrages you,
Nerve cells that convey impulses from on frightens you, strong desires – SNS
neuron to another in the brain and spinal speeds up bodily activities such as
heart rate, breathing and sweating

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2. Parasympathetic Nervous System
 Turns off or slows down most activities
automatically aroused by the sympathetic
system
Ex. Slows down breathing and
promotes digestion and excretion;
conserves or builds up your body’s
resources
Synapse – the general area where two neurons
come in contact with each other. A neuron relay its
message or can communicate with another neuron
across a junction or microscopic gap called a
synapse.
At the end of each axon are button-like
swelling called terminal buttons which contain small
packets called synaptic vessels where
neurotransmitters are stored
Your neuro transmitters are released via synaptic
cleft. So your neurotransmitters will now be received
by your receptors from the next neuron.
 These are chemical substances released by
one neuron through the synapse and affect
or influence the receiving neuron. If
adequate number of neurotransmitters are
released by the transmitting neuron, the
receiving neuron will also fire.
 Responsible for sensation, perception,
cognitive and motor behavior. Excess of or
deficiencies of neurotransmitters have been
linked to disease and abnormal behavior.
*Particularly, mental diseases
1. Acetylcholine
 Controls muscle contraction. It is found in
the limbic system (forebrain) and is utilized
by the motor neurons of the spinal cord to
the muscles and glands of the body.
Health Care S.Y. 2020-2021 (MT-2ndSEM) 3
Deficiency of ACH causes paralysis,
forgetfulness and intellectual losses;
alzheimer’s disease
2. Dopamine (Dopaninergic)
 Involved in voluntary movements, learning,
memory, and emotional behavior. Located
in the midbrain
An increase can lead to schizophrenia
(mental disorder) and a decrease may lead
to Parkinson’s disease (no control over
muscles)
3. Serotonin
 An inhibitory transmitter which is involved in
body temperature, sleep, moods and pain
sensation.
Deficiencies causes: anxiety, mood disorder,
and insomnia. Foods rich in carbohydrates
increase serotonin that leads to drowsiness
in women and calmness in men
*When serotonin is active, it also support in
block pain sensation
4. Endorphins
 They occur in the brain and bloodstream
Deficiency: increases body pain. Excess due
to morphine, heroin and other opiates: inhibit
pain
5. GABA (gamma – aminobutyric acid)
 An inhibitory neurotransmitter that regulates
the excitatory action of the neuron
Deficiency: anxiety. Huntington’s disease
(an inherited disease) is a result of loss of
GABA activated neuron resulting to inability
to control the movement of arms and legs
with loss of cognitive abilities. Excessive
excitation: epilepsy – intense repetitive
convulsive seizure
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How does the pain you experience when you burn
your hand result so quickly in an action by your
muscles? Many animals respond to environmental
stimuli using specialized cells called neurons.
A stimulus is detected by the sensory receptor and
the body responds through motor effectors. These
cells, working together, allow you to respond very
quickly to threats. When you touch something hot,
heat receptors of a sensory neuron detect the stimuli
and send the information of heat to an interneuron in
your central nervous system. From there, a motor
neuron sends a response from your central nervous
system to the skeletal muscles in your arm, causing
them to contract and pull your hand away.
The fundamental process of neural transmission that
underlies this action occurs in all neurons of the
body. Neurons transmit this information through
changes in the electrical potential of the body.
Neurons transmit this information through changes
in the electrical potential of the membrane by the
movement of ions across the membrane. An
electrochemical gradient governs the movement of
these ions, resulting in an electrical impulse. The
resting membrane potential in a neuron, when the
cell is not firing an impulse, is established by the
Health Care S.Y. 2020-2021 (MT-2ndSEM) 4
unequal distribution of sodium ions outside of the cell
and potassium ions inside of the cell, making the
outside of the cell more positively-charged
compared to the inside. The electrochemical
gradient is established and maintained by an
enzyme called sodium-potassium ATPase. When
a neuron is stimulated, sodium ion channels open
and sodium ion flow into the cell. This leads to a
change in the electrical potential across the
membrane called depolarization. The depolarizing
electrical potential travels down the dendrites and
over the cell body. Multiple electrical potentials will
combine at the axon hillock in a process called
summation. If the depolarization is large enough,
an action potential is triggered. Action potentials
are all-or-none electrical impulses that maintain their
amplitude and strength down the length of the axon.
The action potential travels down the axon when the
depolarization of an area of a membrane causes
adjacent voltage-gated sodium ion channels to
open. The influx of sodium ions results in membrane
depolarization along the membrane. After a short
delay, potassium ion channels open and potassium
ions flow out, repolarizing the membrane. For the
neuron to fire again, the resting membrane potential
needs to be reestablishes. Sodium-potassium
ATPase is used to move sodium and potassium ions
against their concentration gradients, reestablishing
the resting membrane potential. As the action
potential moves down the axon, ions are diffusing
only a short distance, allowing the signal to move
quickly. At the axon terminal, the electrical impulse
passes to another cell at a cellular connection called
a synapse. The space between the presynaptic
neuron and postsynaptic neuron cell is called the
synaptic cleft. The presynaptic neuron contain
signal molecules called neurotransmitters that are
packaged inside vesicles. When an action potential
reaches the end of a neuron, neurotransmitters are
released by exocytosis from the neuron into the
synaptic cleft. Neurotransmitters bind to the adjacent
cell at receptor sites attached to ion channels. The
channels open, allowing the movement of the ions
into or out of the effector cell, which alters its
membrane potential thereby transmitting the signal
from the neuron to the effector cell. Because nerve
impulses move very rapidly down the axon of a
neuron and move from cell to cell across synapses,
you react quickly to a stimulus, like burning you
finger.
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 These glands exert their control system by
releasing chemicals called hormones into
your blood. Hormones alter activity by
affecting your nervous system like
neurotransmitters.
*There are some hormones that act like
neurotransmitters
Catecholamine
 Composed of epinephrine (adrenaline) and
norepinephrine (noradrenalin)
 Involved in wakefulness, learning process,
memory, eating, and regulation of moods
 Release is under the control of the
sympathetic nervous system
 Located in the hindbrain
 Deficiency: depressive moods
 Excess: arousal and wakefulness
Risk- probability of a specific event
 Weight about 3 pounds
occuring on a given time frame
 Master organ of the body
(Oleckno, 2002)
 Seat of self-awareness, the locus of
Modifiable Risk- aspects of
intelligence, compassion
health in which and creativity
an individual
LOWER MANAGEMENT: Hindbrain
has control & Midbrain
of. (Diet, smoking,
1. Spinal cord – lifestyle)
sedentary lowest level making
management decisions. When you touch a
Non-modifiable risk- aspects of
stove, sensory motor connections in your
health in which an individual has
spinal cordcontrol
withdrawNOyour hand of
control even before
(gender,
your highergenetic
levels of conscious
makeup, awareness
environmental
are notified.exposures)
2. Medulla – an enlargement of the brain stem
Risk factor- exposure that is
involved in regulating vital bodily function
associated with a disease
(breathing, heart rate, blood pressure) and
Risk Also Reduction- proactive
certain reflexes. involved in conveying
messages to higher brain centers. enable
process; behaviors that
individuals
3. Pons – a bulb-like to atreact
structure
the top of the
actual/potential threats to their
brain involved
health.in head movements (like
chewing or swallowing) and postural reflexes
(keeps your balance as you move or stand).
Also involved in conveying messages to
higher brain centers.
4. Cerebellum – distinct ball-like structure
behind the brainstem and below the
cerebrum; involved in coordination and
balance.
5. Midbrain – small structure above the pons;
plays role in arousal, vision, and hearing.
Damage to this part leads to movement
difficulties with Parkinson’s disease.
Health Care S.Y. 2020-2021 (MT-2ndSEM) 5
UPPER MANAGEMENT: The Forebrain
1. Cortex – the thin outer layer of the brain that
contains millions of nerve cells (neurons) that
influences most of what you think, feel or do.
2. Cerebrum – the cortical “peel” that covers
the biggest part of the brain where most of
the important mental functions take place.
Ex. Writing song lyrics, performing scientific
experiments
3. Thalamus – a structure deep within the brain
that conveys sensory information to the
cerebrum and other parts of the brain.
4. Limbic System – composed of the
hypothalamus, hippocampus, and
amygdala – important in motivation and
emotions. The latter two are also important in
memory.
Health Behavior – action taken by a person to
maintain, attain, or regain good health and to prevent
illness.
Risk and Health
 Risk- probability of a specific event
occurring on a given time frame (Oleckno,
2002)
 Modifiable Risk- aspects of health in
which an individual has control of. (Diet,
smoking, sedentary lifestyle)
 Non-modifiable Risk- aspects of health
in which an individual has control NO
control of (gender, genetic makeup,
environmental exposures)
 Risk factor- exposure that is associated
with a disease
 Risk Reduction- proactive process;
behaviors that enable individuals to react to
actual/potential threats to their health
to
Risk-
1. Biological and Age-Related Risks probabilit
 Several illnesses are associated y of with a
specific
either genetics or lifestyle patters
Ex. For cardiovascular diseases,event it can
often be traced through occuring
several
on a
generations of a family or can givenalso
timebe
associated by the lifestyle offrame
the family
 *Recent research findings support(Oleckno,the
positive effect of diet, exercise,
2002) and
stress management in delaying
cardiovascular diseases. So forModifi stress
level theory, coping strategies can be
able
identified to address each level of stress
Risk-
aspects
of health
in which
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 Health Care S.Y. 2020-2021 (MT-2ndSEM) 6

that families would go through in  Obesity/overweight statistics in the

sequence. If necessary, when families Philippines: 7 out of 10 women, and 1 out of
do not have an adequate variety of rules 10 men
to follow to respond to an event, then the  Obesity affecting Filipino adults is known
as the android or apple-shaped type
event will become stressful. where abdominal fat accumulation is
The Family Stress Theory of Lorenz, Wickrama measured using waist to hip ratio (WHR)
and Conger (2004) recommended by WHO
 Level 1- change in the more specific
patterns of behavior and transforming
processes, such as change in who
does which household chores
 Level 2- changes in processes at
higher level of abstraction, such as
changes in what are considered as
family chores
 Level 3- change in highly abstract
processes, such as family value

Risk
 One of the most effective techniques for -
assessing the patterns of health and p Metabolic syndrome (cluster of conditions-
illness in families is the genogram- is a r increase blood pressure, a high blood sugar
drawing that shows the family unit of o level, excess body fat- typically have apple-
immediate interest and includes several b shaped bodies, meaning they have large waists
a and carry a lot of weight around their abdomens.
generations using a series of circles, b
squares and connecting lines i An individual’s body weight is determined by:
1. Genetics and Family Health Risks l
o Genomics- study of all the genes in i  Metabolism
the human genome and their t  Genetics
interactions with other genes, the y  Behavior
individual’s environment, and the o  Environment
influence of cultural and f  Culture
psychosocial factors. a  Socioeconomic status
2. Environmental Risks s
o Social Risks- a family’s health risk p
increases if they are living in high e
crime areas, communities without c Risk- probability of a specific event
adequate recreation or health i occuring on a given time frame
 Filipino adults are generally inactive =
resources, communities with noise f (Oleckno, 2002)
92.7% have low leisure-related physical
pollution or chemical pollution. i
activity; 94.5% have low
Modifiable travelaspects
Risk- related (ex.
of
o Economic Risks- determined by c Walking health
or cycling);
in which 75.4% have low
an individual
the relationship between financial e non workhas related activities
control (ex.smoking,
of. (Diet, Chores);
resources of a family and the v 76.3% have low work
sedentary related activities
lifestyle)
demands on these resources. e
3. Behavioral (Lifestyle) Risks n Advantages ofNon-modifiable
Physical Activities
risk- and
aspects of
 Pattern of personal health habits and t Exercise health in which an individual has
behavior defines individual and family o o Achieve control
weight management
NO control of (gender,
lifestyle risk c o Increased energymakeup, environmental
genetic
c o Manageexposures)
stress; improve mood and self-
Risk- u esteem
 Diet is one of the most modifiable of probab
risk r Risk factor- or
o Prevent development exposure thatof isa
worsening
factors. ility ofi associated with
health condition a disease
a n o Better appearance
Risk Reduction- proactive
specifi g process; behaviors that enable
c evento individuals to react to
occuri n actual/potential threats to their
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 Health Care S.Y. 2020-2021 (MT-2ndSEM) 7

 Tool developed by Clean Air Asia to

assess the sustainability of walking in Risk-
 Drugs that act on the CNS and alter prits
Asian cities. normal everyday activity causing changes
Parameters ob
in mood, awareness and behavior. ab It
o Availability of walking paths/crossing disrupts the communication between
o Amenities (benches, pedestrians, ilit
neurons so abusing them can have short y
trees, and street lights) and long term effects on the brain
o Disability Infrastructure of
Categories a
o Security from crime 1. Depressants- lowers the body’s overall
o Obstructions on walking pathways or sp
energy level, reduce sensitivity to outside eci
pedestrians stimulation and in high doses, induce sleep
fic
Ex. Alcohol, barbiturates, benzodiazepines
“The first step is always the hardest.” Any form of 2. Stimulation- activates or excites ev the
exercise is better than none! nervous system- causes the nerve fibersento
release noradrenaline and other stimulating t
Risk- probability of neurotransmitters oc
 Insufficient sleep is associated
a withspecific
diabetes, Ex. Nicotine, caffeine, cocaine, cu
heart diseases, and obesity andeventmotor vehicle
occuring amphetamines rin
accidents. on a given time 3. Hallucinogens- also called psychedelics g
 Sleep hygiene that willframe help achieve (mind vision), can produce hallucinations, on
optimum sleep (National Sleep Foundation
(Oleckno, cause intoxication and lead to altered a
2010) 2002) perception and impaired judgement gi
o Avoid caffeine/nicotine close to Ex. LSD, psilocybin, mushrooms, and ve
Modifiable
bedtime; alcohol (can cause sleep morning glory seeds n
disruptions) Risk- aspects 4. Opioids (Narcotics)- are substances that ti
of health
o Finish exercising or vigorous in
activities act on opioid receptors to produce morphin- m
which
at least 3 hours before sleep an like effects e
o Retire and get up at theindividual
same time has Ex. Heroin and pain medications fra
every day control of. m
(Diet, smoking, Risk-e
o Large meals before bedtime - pro
“postprandial somnolence”sedentary (O
 Smoking is the foremost most preventableba
o Establish a regular, lifestyle)
relaxing lec
bili
bedtime routine (warm bath, etc) cause of death in the U.S. kn
Non-modifiable ty
 As of 2009, Philippines is included in the top
o Use the bed for sleep only. Do not read o,
risk- aspects of 14 smoking countries. (Global Adult Tobaccoof
or watch TV in bed 20
health in which Survey) a02
 The need for sleep is regulated by two
an individual
processes:  As of 2010, Lung Cancer is #2 as the top speten
)
has control NO
o Number of hours we are awake of
control causes of cancer-related deaths in the cifi
c
o Circadian biological (gender, clock genetic
in the Philippines. (DOH)
eve
brain- the suprachiasmatic
makeup, nucleus, #1 Breast Cancer ntM
responding to light. (sleepy at night
environmental #3 Liver Cancer occ
od
when it’s dark, and active during
exposures) the #4 Cervical Cancer uri
ifi
day when it is light)- Circadian rhythm #5 Colon Cancer ngab
is why we are sleepiest between
Risk factor-2 to 4  Prevalence rate of Filipinos aged 15 yrs oldonle
am and between 1 exposure
and 3 pm. that is and older – 28%, of which 48% are malesaRi
associated with a and 9% are females. giv
AGE SLEEP NEEDS sk
disease  The nicotine (toxic drug) in tobacco products
en
Newborns (1-2 months) 10.5-18 hours -
Infants (3-11 months) Risk and 30
9-12 hours, act as both a depressant and a stimulant. timas
minutesReduction-
to 2 hour naps  3 categories of the primary causes of epe
(1-4x a proactive
day) cigarette smoking related mortality fra
cts
Toddlers (1-3 years) process;
12-14 hours 1. Cancer (primarily lung) meof
behaviors that 2. Cardiovascular diseases (Ol
he
Preschoolers (3-5) 11-13 hours
enable (pneumonia, influenza, eck
alt
School-Aged Children 10-11 hours no,
individuals to emphysema, etc.) h
(5-12) 20in
Teens (11-17) 8.5-9.25react
hours to 3. Respiratory diseases
02)
Adults & Older Adults actual/potential
7-9 hours  Smoke can be inhaled directly by smoker w
threats to their (mainstream smoke) or it can enter the hi
health. ch
an
Moin
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 Health Care S.Y. 2020-2021 (MT-2ndSEM) 8

atmosphere from the lighted end of the other vital functions

cigarette and inhaled by others (side stream  Types of Drinkers:
smoke or second-hand smoke) o Heavy Drinking- consuming more than 2
 Second-hand smoke contains a much higher drinks/day (men), 1 drink/day (female)
concentration of toxic and carcinogenic o Binge Drinking- 5 or more (males) and 4
compounds compared to mainstream smoke and more (female) drink on a single
occasion
o Excessive Drinking- takes the form of
Risk- probability of a specific event heavy drinking, excessive drinking or
 Ethyl alcohol or ethanol
occuring on a given time frame both
 A “DRINK” is the 2002)
(Oleckno, amount of any alcoholic Short-term Risks (due
beverage delivering ½ an ounce of pure to binge/excessive
Modifiable Risk- aspects of healthto Long-term Risks
ethanol (around 15mL) which is equivalent drinking)
in
the following: which an individual has control
of. (Diet, smoking,
o 4-5 ounces (120-150mL) of wine sedentary Neurologic (Strokes,
lifestyle) Risky Sexual Behavior Dementia)
o 12 ounces (360ml) of beer
o 1.25 ounces (40mL0
Non-modifiable of distilled
risk- aspectsliquor
of Myocardial Infarction
(80 proofin
health of whiskey,
which anscotch, vodka,
individual has Violence (MI), GI disturbances
rum)
control NO control of (gender, genetic Motor Vehicle Accidents Hypertension
 Normally
makeup, environmental
the liverexposures)
can process CNS problems,
about ½ ounce ethanol/hour Falls/Firearms/Drowning anxiety, sleep
Risk factor- exposure that is associated
 Moderation defined by health authorities: disturbances, memory
with a disease
o Males: not > 2 drinks/day loss
o Females: not > 1 drink/day
Risk Reduction- proactive process; Miscarriage/Stillborn Cancer
BLOOD ALCOHOL behaviors thatSigns & individuals
enable Symptomsto
(%w/v) react to actual/potential threats to their Fetal Alcohol Syndrome
health. No obvious
0.01-0.05 impairment, some
changes may be
observable
Mild euphoria, some
0.03-0.12 impairment of motor
skills
Loss of critical
0.09-0.25 judgement, memory
impairment, diminished
reaction time
Mental confusion,
0.18-0.30 dizziness, strongly
impaired motor skills
(walk unsteadily,
 Males may experience testicular atrophy or
slurred speech) sterility, impotence, swelling of the breast or
Unable to stand, or tissues in males (Gynecomastia)
0.27-0.40 walk, vomit, impaired  Blood alcohol is measured using the breath
consciousness analyzer; determined by the concentration of
Coma and possibly the alcohol in the drink, the rate of drinking,
0.35-0.50 death rate of absorption (which is lower in the
presence of food), rate of metabolism
 Age limit of purchasing alcohol in the  Females are more affected by alcohol than
Philippines is 18 men because women have less alcohol
 Drug-related death: hen alcohol is combines dehdyrogenase (enzymes that detoxify
with HEROIN alcohol) activity except for males that do have
Both depress the part of the brain that controls chronic alcoholism
the basic functions of life- breathing, body
temperature, reflexes, blood pressure, and

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 Health Care S.Y. 2020-2021 (MT-2ndSEM) 9

Self-efficacy One’s confidence in

Risk- probability
 Most widely used psychoactiveofdrugs in the one’s ability to take
a specific
world action to reduce health
event
 Can be found in coffee, tea, chocolates,
occuring onsoft a risks
drinks and various medicationsgiven time
 Moderate doses (100-300 mg/day) Examples:
frame increase
mental alertness and probably have little
(Oleckno, Perceived Susceptibility
negative effects on the health 2002)  Perceived belief that one may contract the
 High doses can lead to insomnia, irritability, virus and manifest the disease
tremulousness, anxiety, cardiacModifiable
dysrhythmia, Perceived Severity
GI disturbances, and headaches
Risk- aspects  Realization that they may have the virus ->
of health in become a serious illness
which an
Ri Perceived Benefit
1. Health Belief Model individual s  In order to have less contact with the virus
 Developed by a group ofhas psychologist
control k and the probability of getting the disease,
to explain why the public of. failed (Diet,to - they do the advised action = benefit of not
participate in smoking,
tuberculosisp catching the disease
(Hochbaum, 1958) sedentary r Perceived Barriers
 Through their work, thislifestyle)
group found o  When advised action is done, barriers
that information alone b
Non-is rarely surface (Ex. Less resources for income)
enough to motivate one to
modifiable act – a
 Not a problem for stay-at-home jobs
individuals must know what to do and b
risk- aspects
i  Barriers include: Mental illness, possibility of
how to do it before they can take
of health in low immune system (immunity is best
action and the information whichmust an be l achieved if one is exposed to pathogen)
related to one’s needs individual has i Cues to Action
 It is based on the assumption control thatNO the t  When you start doing advised actions that
major determinant ofcontrol preventive y
of you perceive can give you benefits (not
o
health behavior is disease avoidance
(gender, contracting the virus)
f
 Limitation: it assumesgenetic only those a Self-efficacy
clients who have distorted makeup,
or negative s  When you are now confident that you will
perceptions of the environmenta
disease or p have a minimal risk of exposing yourself to
recommended health action l exposures)
will fall to e the virus because you are adhering to health
act Risk factor- c protocols
Key Concepts and Definition of the Human Belief Model i
exposure that is
Concept Definition
associated with a f 2. The Transtheoretical Model
One’s disease
belief regarding i  Combines several theories of
Perceived the chance of getting a c intervention, thus the name
Susceptibility Risk
given condition e Transtheoretical
One’s belief regarding v
Reduction-
 Based on the assumption that
Perceived Severity proactiveof a e
the seriousness
process; behavior change takes place
given condition n
behaviors overtime, progressing through a
One’s belief in the ability t system of changes – one may stop in
of an advised that action
enableto o
individuals to c one stage, progress to the next stage,
Perceived Benefits reduce the health risk or or return to the previous stage
react to
of a given c
seriousnessactual/potenti Reasons Why People Resist Change
u
condition al threats to  Be unpleasant/stressful
r
One’s belief theirregarding
health. i Ex. Exercising or eating new food
tangible and n  Require giving up pleasure
Perceived Barriers psychological costs of g  Jeopardize social relationship
an advised action o  Require change in self-image
Strategies or conditions n  Be painful
in one’s environment a  Not seem important anymore
Cues to Action that activates readiness g
to take action i
v
e
n
t
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Six Stages Characteristics Strategies Action

Precontemplation Denial, Encourage  Taking the action; individual has changed
ignorance of to rethink behavior for the betterment; sustained the
the problem behavior, change for a while
self- Maintenance
analysis/intr  hardest part (temptation); must sustain the
ospection changed behavior
Contemplation Conflicted Confirm Relapse
emotions or readiness  If sustaining of behavior FAILS, they go back
mixed-feeling; to change to their old behavior (precontemplation)
weighing pros and
and cons to encourage 3. The Theory of Planned Behavior & Theory
change confidence of Reasoned Action
Preparation Collect Goals;  Two basic assumptions that underlie the TRA
information; motivating are:
has plan of statements 1. Behavior is under volitional
action; control
experiment 2. People are rational beings
with small
changes  From the perspective of the TRA, we behave in
Action Take direct Reward a certain way because we choose to do so and
action to success; we use a rational decision-making process in
achieve goal seek social choosing and planning our actions
support
Constructs Description
Maintenance Avoid Develop
Behavioral Intention Perceived likelihood of
temptation; coping
performing the behavior
continue strategies;
Attitudes The product of the
achieved reward
behavioral belief
behavior system
multiplied by the
Relapse Feeling of Identify
evaluation of it
disappointment triggers; set
Behavioral Beliefs Evaluation of the
of failure barriers;
likelihood that
reaffirm
performance of the
your goals;
behavior is associated
COMMIT
with certain outcomes
TO
Evaluation of B.B. How good or how bad
those outcomes would
Examples: be
Precontemplation Subjective Norm The product of the
 Denial; no intention to take action toword normative multiplied by
changed behavior (Ex. Obesity: Denial, the motivation to
failed in past attempts/take action to comply
alleviate problem) Normative Behavior Perception of how
Contemplation much each personal
 Some intention to take action towards contact approves or
behavioral change; not doing but ONLY disapproves of the
simply planning behavior
Preparation Motivation to Comply Motivation to do what
 Intends to take action soon and will take each personal contact
steps towards behavioral change (Ex. person wants
Collecting information, asking for advice) Perceived Behavioral The product of the
Control control belief multiplied
by the perceived power

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Control Belief Perceived likelihood of
each facilitating or
constraining condition
occurring
Perceived Power Perceived effect of
each condition in
making the
performance of the
behavior easier or more
difficult
https://www.youtube.com/watch?v=nZsxuD3gExe
*Why do we do what we do or act the way we act?
Let's start with an example say: you want to buy a
new smartphone. What exactly influences this
decision: you may start reading about available
phones out there and form an opinion about which
one is best for you. You may talk to friends and see
what they think about the phones currently on the
market. You may go to a store and test a few or get
some advice from a sales guy. You may even do all
of this and with everything that's available to you, at
some stage, you make a decision in buying one. A
good theory that explains and predicts how such
behaviors form is called the theory of planned
behavior. It's built out of a number of constructs.
The first one is the attitude towards the act or
behavior. That's an individual's belief of a certain
behavior or act makes a positive or negative
contribution to that person's life. Then the
smartphone example, it means that you either
believe that buying a certain phone makes sense for
you or not or which phone makes the most sense for
you. A second construct is called subjective norm
this construct focuses on everything around the
individual. In other words, his or her social network
cultural norms group beliefs and so on. Back to the
smartphone example: you will already have an
opinion or former believed as to what others think
about you having that phone or not having it and that
believe again influences your decision. A third
construct is called perceived behavioural control
and what this construct actually expresses is a
person's belief on how easy or hard it is to display
certain behavior or act in a certain way. Again, in the
smartphone case, you might pick up a few of them in
a store and form an opinion on how easy or hard it is
for you to handle each one. What the theory now
actually predicts is that a positive attitude towards the
act or behavior favorable social norms and a high
level of perceived behavioral control are the best
predictors for forming a behavioral intention and in
turn, lead to a displayed behavior or act. In other
words, it predicts that if you think a certain
smartphone is a good idea and you believe everyone
Health Care S.Y. 2020-2021 (MT-2ndSEM) 11
else thinks it's a good idea and you believe you can
actually handle it, you'll get that phone. If one of
those constructs is unfavorable, so if you think it
doesn't make much sense for you to get a particular
phone or you think others don't think it's a good idea
or you're going to be right out of your comfort zone
handling it, you're much less likely to get that
particular phone and the likelihood decreases if two
or even three out of these constructs are
unfavorable. Planned behavior is up to today, one of
the best predictors and theories used in marketing. If
we look into the tech world, we're seeing examples
everywhere. Information is abundant for us to form
our opinions and infomercials everywhere. We see
ratings, reviews and discussions about every,
product and service out there and we're, being told
that people who buy what we, are about to buy, are
also buying this other thing and finally we're
prompted everywhere to test almost every web
platform or service out there before we subscribe to
see if we can actually handle it and also if it makes
sense for us. All of this in combination contributes to
us making a decision and modern marketing needs
to master all these avenues to successfully place a
service or product to digital natives spending their
time on the Internet, you.*
4. Social Cognitive Theory
 This theory goes well beyond individual factors
in health behavior change to include
environmental and social factors. In fact, this
theory may be the most comprehensive model
of human behavior yet proposed,
 Based on the belief that learning takes place in
a social context- learning is promoted by
modelling or observing other people.
 The environment affects learning but learning
outcomes depend on the learner’s individual
characteristics (Bandura, 1977).
Ways in Which This Theory is Applied (for a
healthcare professional)
 By serving as a live model
 By giving detailed verbal instructions
 Using print or multimedia strategies for
health education
http://www.youtube.com/watch?v=UbruJh0MODI
Albert Bandura
 A Canadian-American psychologist who is
the David Starr Jordan Professor Emeritus
of Social Science in Psychology at
Stanford University
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 Asserts that most human behavior is
learned through observation
learning, imitation, and modeling
 If there is a good student who is motivated
and responsible and a student who does
not care about school in the same group,
then according to Bandura they will imitate
each other
Reciprocal Causation Model (Triangle)
 Person (Cognition, Self-efficacy,
Motives, Personality)
 Behavior (Complexity, Duration, Skill,
etc.)
 Environment (Situation, Roles, Models,
Relationships)
 Continuous interaction between behaviors,
personal factors, and the environment
*Here's a classroom example to help make this point
more clear. In the classroom, as the teacher presents
a lesson to the class students reflect on what the
teacher is saying this is where the environment
influences cognition. A personal factor, students who
don't understand raise their hands to ask a question
this is where personal factors influence behavior so
the teacher reviews the point behavior influences the
environment* WATCH THE VIDEOOO
Risk-
probabil
 The process of changing people’s
ity of a
knowledge, skills, and attitudes (KSA) for
specific
health promotion and risk reduction/disease
event
prevention occurin
 Empowering people to achieve goptimum on a
health and prevent disease by given bringing
about lifestyle changes and time reducing
exposure to health risks frame
 Ex. Teaching a pregnant woman on(Olecknthe need
for regular prenatal consultations o, 2002)or
instructing a family on methods of water
purification that can be done at home
 *As a student of a medical program = Mod moral
ifiable
obligation to disseminate the necessary
Risk-
information to our countrymen aspectswho are
deprived of receiving valuable information
of
that could improve their health status*
health
Key to Poverty Alleviation in
which
“It is more expensive to get sick than to stayanhealthy”
individu
al has
control
of.
(Diet,
smoking
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Health Care S.Y. 2020-2021 (MT-2ndSEM) 12
Skills of the Effective Educator
The educator needs to understand the basic
sequence of instruction. The ff. are steps that are
useful in planning an educational program:
1. Gaining the attention of learners
2. Tell the learners the objectives of the
instruction
3. Ask learners to recall previous knowledge
related to the topic of interest so they link new
knowledge with previous knowledge
4. Present the material in clear, organized, and
simple manner
5. Help learners apply the information to their
lives and situation
6. Encourage learners to demonstrate what
they have learned
7. Provide feedback to help learners improve
the knowledge and skills
The ff. list provides some criteria for assessing
the quality of internet health information (Van Biervlet
and Edwards Schafer, 2004)
 Authorship: Are the credential and
affiliations of authors and contributors listed?
 Caveats: Does the site clarify whether its
function is to provide information or to market
products?
 Content: Is the information accurate and
complete, and is an appropriate disclaimer
provided?
 Credibility: Does the site include the source,
currency, relevance and editorial review
process of the information?
 Currency: Are dates listed for when the
content was posted and updated?
 Design: Is the site accessible, capable of
internal searches, easy to navigate, and
logically organized?
 Disclosure: Is the user informed about the
purpose of the site?
 Interactivity: Does the site include feedback
mechanisms and opportunities for users to
exchange information?
 Links: Have the links been evaluated
according to back-linkages, content and
selection?
*Criteria for credible internet information*
 Health Care S.Y. 2020-2021 (MT-2ndSEM) 13

just stay there. But if it is beyond their capabilities,

 Should be members of the community where
they work. They are selected by the
communities for their activities. Supported by
the health system but not necessarily a part of
its organization and have shorter training than
professional workers.
 Provide primary care services – vital signs,
physical assessment and simple differential
diagnostic techniques.
 Must have communication, interpersonal,
teaching, and organizational and advocacy
skills; possess knowledge of their community,
health issues and available resources.
 They must also be trained in providing health
services, such as basic assessment and simple
remedies for common health concerns.
(Niace, et al 8th
edition 1995)
A two-way referral system need to be
established between each level of health facility.
Ex. Barangay health workers refer cases to the
rural health team, who in turn refer more serious
cases to either the district hospital, then to the
provincial, regional or the whole health care
system.
then they will refer to the Rural Health Unit, if not,
then to the physician then secondary or tertiary or
vice versa.*
Topics That May be Discussed
 Family Planning,
 Alternative & Traditional Medicine,
 First-aid, Breastfeeding,
 Maternal & Child Care, Smoking
 Safe Sex Practices
 Alcoholism, Drug Addiction
 Environmental Sanitation and Prevention of
Communicable Diseases (boiling of water
using mosquito nets)
Basic Principles
 MESSAGE: Clear, information must be
understandable; consider factor that may
affect the learner’s ability to receive & retain
information (language appropriate and use
terms in the level of a community member)
 FORMAT: Most appropriate learning strategy
(Demonstration on boiling water)
 ENVIRONMENT: Physical environment
conducive to learning; therapeutic and
supportive relationship with the learner;
positive interpersonal relationships (common
ground)
 EXPERIENCE: Integrate positive and
meaningful learning experiences
 PARTICIPATION: Involve them in
discussions, group activities, soliciting
feedbacks, role playing
 EVALUATION: Objective feedbacks to the
learner using tools such as quizzes,
individual conferences, and return
demonstrations. Identifies areas of
instruction needed to be modified.

Risk-
1. Planning Phase pro
bab
 Organizing activities, appropriate
ility
methodologies, materials, resource
of a
person to conduct the topic, venue, send-
spe
out notice to the community members. cifi
 Planning the content of health education
c
and training activities (based on identified
eve
community needs) to correspond tontthe
*Ex. An individual would go to the barangay health knowledge, skills, and attitude (KSA) occ
station, if the barangay health station is capable of trainees should achieve. urin
addressing the health issue of an individual, it will  Identification of roles & tasks g
on
a
giv
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 Health Care S.Y. 2020-2021 (MT-2ndSEM) 14

 Identify: “Must be known”, “useful to

know,” and “nice to know”
2. Implementation Phase
 Conduct of the discussion/ training,
monitoring (feedback/interactions), and
documentation (highlights; reactions,
issues/questions)
 Opening prayer  get-to-know
participants  expectations  overview
 mechanics & house rules
 Relate topic to be discussed to the role of
community health workers and to them,
as community members  ask and draw
out the participant’s understanding of the
topic  summarize topic  reinforce 
action planning
3. Evaluation Phase
 Evaluation in the form of games, return
demonstrations, or exercises to establish
participants KSA; simple tests with
options for trainees to open notes to
reinforce learning.
 Open individual & group evaluation-
effective in identifying strength &
weaknesses of the training/discussion
(methodology, trainers, content, visual
aids, etc.)
 CHW performance evaluation and
conducted analyzing results of learning
process and impact. Includes 3 phases:
1. 1st Phase – CHW’s self-evaluation
2. 2nd Phase – oral evaluation &
skills assessment
3. 3rd Phase – written examination
4. Post-training Phase
 Discuss results of the evaluation- follow
up training activities in the future.
 Share the identified strengths and
weaknesses in relation to the activity.
 Encourage participants to re-echo what
they learned; follow-up support for
trainees.
“Always help even in small ways when given the
chance. What is small to you may be very big to
them already.”

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