part 2. Health education and health promotion

Health education & promotion part 2

1. Professor Dr. Aida Mohey Community Medicine & Public Health Head of Community Medicine department [email protected] Chapter (4): Health Education

2. Part (2): The Scope of behavior Change

3. Define a behavior Identify factors that affect behavior and give examples for each Discuss how do people change behavior ? Discuss stages of behavior change Outline role of health educator at each stage of behavior change Learning Objectives

4. Behavior- is an action that has specific frequency, duration, and purpose , whether conscious or unconscious. Behaviors can be preventive or treatment behaviors. Action – drinking/smoking To say a person has drinking/smoking behavior Duration –is it for a week/month? Frequency - how it is repeated? Purpose –is he/she doing consciously or not What is a behavior?

5. WHAT ARE THE RISK BEHAVIORS THAT AFFECT HEALTH ?

6. WHAT ARE RISK BEHAVIORS ? Risk behaviors are actions that can potentially threaten your health or the health of others both in the present and the future. Centers for Disease Control and Prevention (CDC) identifies 6 health-risk behaviors for teens: Tobacco use Poor nutrition Inadequate physica l activity Consuming alcohol and illicit drug use Unprotected sexual behaviors Unintentional injuries and violence

7. Remember Behaviors that are: Still in the early developmental stage Have recently been established Have been changed by previous programs Superficially tied to established cultural patterns or life-styles can be changed easier than those maintained for a longer period or that which became habits.

8. There are three groups of factors namely: Predisposing factors. Enabling factors. Reinforcing factors. Factors that affect behavior and can be changed by health education

9. These factors provide the motivation for the behavior. They include knowledge, beliefs, perception, attitudes, and values. Can be changed through direct communication Example If a mother does not know what is meant by exclusive breast feeding and how it can protect the child from diseases, and does not believe in its benefits, she will not be motivated to exclusively breast feed her child. 1. Predisposing factors

10. These are factors that can enable the person to adopt and maintain the behavior. They include: Health related skills Income Availability of health resources Time Availability and accessibility to services Laws, rules and regulations 2. Enabling factors Examples If the mother lacks the skill of breast-feeding, she will not be able to continue breast feeding and she will resort to artificial feeding ( lack of skill ). Young couples believe in premarital examination, yet the service is not available ( lack of resource ). People may want to be screened for HIV but may not be able to afford the cost involved ( inadequate income ).

11. These are factors that will support (encourage) the new behavior . They comprise the different types of feedback and rewards received after behavior change which may either encourage or discourage the continuation of the behavior. They cover attitudes and behavior of others (health providers, peers, parents and family members, employers, teachers…. e tc ). Example If the mother started to breast feed her child exclusively, yet her mother/mother in-law discouraged her, she may stop breast feeding exclusively. 3. Reinforcing factor

12. Remember Demographic factors as age, gender, family size, socio-economic status affect behaviors but cannot be influenced by health education

13. How do people change?

14. How to Change Behavior? The 6- Stages of behavior change  

15. Stage 1: Unawareness (pre contemplation): In this stage individuals are not aware of the risk behavior and the changes that they need to make. They may have received information about the impact of the unhealthy behavior but were not interested and ignored the information received. Stage 2: Thoughtful thinking and intention to act (contemplation): In stage 2 the individuals have received information about the problem and risk behaviors attributing to it. Also they are interested and they evaluate the information and explanation received. Stage 3: preparation/Trials (actions): Individuals will set a goal or try the new behavior. It is important that they do it in a satisfactory manner in order to adopt the new behavior.

16. Stage 4: Relapse: In the relapse stage the individual returns back to the original behavior. He /she may fall into the unawareness stage or re/enter into the cycle of awareness, trial and maintenance. Stage 5: Adoption and maintenance: If the experimentations carried out by the person was successful, he will try to integrate the new behavior into his daily life .   Stage 6: Habit development (termination): In this stage the behavior is sustained and become a habit and even he/she will try to convince others about the benefits of their health related behaviors.

17. Role of health educator in each stage

18. Question 1 Which option best describes the aim of health education? Providing organizational activities and environmental supports Providing healthcare services to underserved people Improving access to health care facilities Teaching people about healthy lifestyle choices and disease prevention

19. Question 2 Which of the options provided, does not describe a behavior? Has a duration Has a purpose Has a frequency Being an inherent

20. Question 3 Which of the following describes a behavior that a health educator finds it difficult to change ? Superficially tied to established cultural patterns It has been changed by previous programs In the habit development stage Recently been established

21. Question 4 Which of the following is an enabling factor affecting health behavior? Knowledge Beliefs Time Values Attitudes

22. Question 5 Which of the following is a reinforcing factor affecting health behavior? Attitudes of friends Accessibility to healthcare services Money Health related skills Availability of skilled healthcare personnel

23. Question 6: Parents perceive diarrhea is a simple and self-limiting condition and not associated with child’s developmental milestones such as teething. This is an example of which factors affecting behavior? Predisposing Enabling Reinforcing

24. Question 7 Which of the following is a predisposing factor that can influence health behavior? Attitudes and values Physical environment Access to healthcare Availability of resources

25. Question 8 Which of the following is a reinforcing factor affecting health behavior? Accessibility of health services Values of the community and individuals Distance, availability of transport Behaviors of family members Community/government priority

26. 9. A mother who began supplementing her child’s feeds but stopped once her mother informed her that the child wasn't yet one year old. Only her breast milk should be given to him. At what stage of changing behavior is this woman? Unawareness stage Thoughtful thinking and willing to act Relapse Trial Adoption Questions 9 & 10

27. 10. What advice should the doctor offer to this woman? Same information again More information and support Reinforce messages and praise her Start again and carry out counseling Lose interest in the client

28. Question 11 Which stage of behavior change involves an individual actively engaging in new behaviors and strategies to sustain the desired change? Unawareness stage Thoughtful thinking and willing to act Relapse Trial Adoption

29. Question 12 Which stage of behavior change involves an individual not yet recognizing the need for change and having no intention to change his behavior? Unawareness stage Thoughtful thinking and willing to act Relapse Trial Adoption

30. Question 13 Which stage of behavior change involves an individual seriously considering making a change in the near future? Unawareness stage Thoughtful thinking and willing to act Relapse Trial Adoption

31. Thank You