Systematic Review Of Observational Studies By Yusuf Abdu Misau
Models Of Health Behaviors By Yusuf Abdu Misau
-
Upload
yusuf-misau -
Category
Health & Medicine
-
view
9.114 -
download
10
description
Transcript of Models Of Health Behaviors By Yusuf Abdu Misau
Models of health behavior
Dr Yusuf Abdu MisauMBBS (ABU), MPH(UM), PhD Student(UM)
Department of Social and Preventive Medicine,
University of Malaya
Acknowledgement I wish to acknowledge A/P Nabilla Al-Sadat for
permission to use her slides in this presentation
Tuesday, April 11, 2023
2Models of Health Behavior_Yusuf Misau
Learning objectives:
1. Understand what is human behavior and its relation to health
2. Understand assumptions underlying theories as it is used in a scientific context
3. Describe the different models of behavioral change
4. Be able to apply these models in the development of preventive and promotive programmes towards health as well as effective doctor-patient relationship.
Tuesday, April 11, 2023
3Models of Health Behavior_Yusuf Misau
Contents of Presentation Definitions
Model Human behavior
Applications of models in health Theories/ Models of Health Behaviour :
The Health Belief Model Theory of planned behaviour (TPB) aka TRA Stages of Change Model -TTM Social Cognitive Theory/ (SCT) aka Social Learning Theory (SLT) Diffusion of Innovation theory Precede-Proceed Model
Case study
Tuesday, April 11, 2023
4Models of Health Behavior_Yusuf Misau
Case study 1 Lee is a 21 year old Malaysian student involved
in Intravenous drug addiction (IDA). There are many cases of IDA among Lee’s peers. However Lee thought IDA has harmed his life and wishes to change for the better.
Lee is also worried that his family views his IDA as an embarrassment to the whole family
How will you help Lee?
Tuesday, April 11, 2023
5Models of Health Behavior_Yusuf Misau
Case study 2 Women in the predominantly Muslim Northern
Nigeria are generally known to reject western style contraception techniques. As a public health specialist, you have been requested to design a study that will serve as a basis for addressing this issue.
Which of the models of health behaviors will best fit? Justify.
Tuesday, April 11, 2023
6Models of Health Behavior_Yusuf Misau
Case study 3 A 60yrs old Sudanese man who smoke cigarette
for over 30 years said he is still healthy despite smoking for long time. He also said he has never seen any one killed by cigarette smoking so he sees no harm in smoking.
Explain his attitude using one of the health models that you deemed right.
Tuesday, April 11, 2023
7Models of Health Behavior_Yusuf Misau
What is a model?
Tuesday, April 11, 2023
8Models of Health Behavior_Yusuf Misau
Model: literary definition A model is a conceptual framework which conveys
critical component of one's vision of the possibilities for human learning and development as well as defines the important variables to consider and the relationships among those variables.
It is a template which depicts a specific issue and entities that relate to it.
Tuesday, April 11, 2023
9Models of Health Behavior_Yusuf Misau
What is behavior ?What is behavior ?
Tuesday, April 11, 2023
10Models of Health Behavior_Yusuf Misau
BEHAVIOUR: Dictionary definitions
The way one reacts to external or internal stimulus (under natural settings)The way one behavesThe aggregate of all the responses made by an organism in any situationSpecific response of a certain organism to a specific stimulus or group of stimuliThe action, reaction, or functioning of a system, under normal or specified circumstances
Tuesday, April 11, 2023
11Models of Health Behavior_Yusuf Misau
BEHAVIOUR
The response of an organism to a stimulus
Tuesday, April 11, 2023
12Models of Health Behavior_Yusuf Misau
HUMAN BEHAVIOUR
A complex interaction between personal and environmental factors, often related to the situation.
Characterised by complex biological, behavioural and socio-cultural determinants that are imperfectly understood.
Tuesday, April 11, 2023
13Models of Health Behavior_Yusuf Misau
What is Health Behaviour?
Any activity undertaken by an individual who believes himself to be healthy, for the purpose of prevention or detecting illness in an asymptomatic state.
Tuesday, April 11, 2023
14Models of Health Behavior_Yusuf Misau
So far…. We have discussed about:
What a model is……… What is behavior…… What is human behavior….. What is health behavior……
Tuesday, April 11, 2023
15Models of Health Behavior_Yusuf Misau
What influences behavior?
Tuesday, April 11, 2023
16Models of Health Behavior_Yusuf Misau
Field Theory (1951)
Behaviour is the function of the psychological field which in turn, is the product of interaction between the person and his/her environment.
Kurt Lewin
B = f(PE)
Tuesday, April 11, 2023
17Models of Health Behavior_Yusuf Misau
A Generally accepted assumption is that most behaviours are the products of multiple causes.They are influenced by a multitude of:
• social• environmental• psychological and• genetic factors.
Tuesday, April 11, 2023
18Models of Health Behavior_Yusuf Misau
Multiple Risks Behavioural Model(1982)
Behaviour is the function of direct, additive and interaction effects ofspecific behaviour intentions, social support, accessibility of information and services, personal autonomy and actual situation.
S.B.Kar
B=f(BI)+(SocSup)+(Acc IS)+(PA)+(AS)
Tuesday, April 11, 2023
19Models of Health Behavior_Yusuf Misau
THEORY
What is a theory ?A fully developed theory is one that is characterised by three major elements. It would explain:
1. The major factors that influence the phenomena of interest
2. The relationship between these factors3. The conditions under which these
relationships do or do not occur
Tuesday, April 11, 2023
20Models of Health Behavior_Yusuf Misau
DEFINITION OF A THEORY
Systematically organised knowledge applicable in a relatively wide array of circumstances devised to analyse, predict, or otherwise explain the nature or behaviour of a specified set of phenomena that could be used as the basis of action.
Tuesday, April 11, 2023
21Models of Health Behavior_Yusuf Misau
Notes:Notes:
Most health promotion theories come from the behavioural and social sciences: Psychology, sociology, management, consumer behaviour
Reflects diversity from simple human behaviour
Many theories used are not highly developed, nor have they been rigorously tested
They are more accurately referred to as theoretical frameworks or models
Tuesday, April 11, 2023
22Models of Health Behavior_Yusuf Misau
Why do we need health behaviour theories/ models?
1. Complex
2. Resistant to change
3. Influencing behaviour – beyond knowledge
Tuesday, April 11, 2023
23Models of Health Behavior_Yusuf Misau
Theories and models of human behaviour can guide the development and refinement of health promotion and education efforts.
Individual levelSocial/Environmental levelCommunity level
Why do we need health behaviour theories/ models?
Tuesday, April 11, 2023
24Models of Health Behavior_Yusuf Misau
The Nitti gritty: How do we translate the models/theories into
practice? At individual level:
Clinical decision Rehabilitations
Society/community level: Research(quantitative vs qualitative) Programme implementation/evaluation
Tuesday, April 11, 2023
25Models of Health Behavior_Yusuf Misau
So far…. We have discussed about:
Factors influencing human behavior……… What a theory is…… Why we need health behavior
models/theories….. How we can translate the theories into
practice……
Tuesday, April 11, 2023
26Models of Health Behavior_Yusuf Misau
HEALTH BELIEF MODEL
Tuesday, April 11, 2023
27Models of Health Behavior_Yusuf Misau
HEALTH BELIEF MODELGodfrey Hochbaum Irwin Rosenstock
HBM stipulates that a person’s health related behavior depends on the person’s perception of four critical areas:
- the severity of potential illness- the person’s susceptibility to that illness- the benefits of taking a preventive action- the barriers to taking action
Tuesday, April 11, 2023
28Models of Health Behavior_Yusuf Misau
HEALTH BELIEF MODEL
Premise:
Health behavior is a function of specific health belief; all must
be operating for a (risk reduction/
health promoting) behavior to occur.
Tuesday, April 11, 2023
29Models of Health Behavior_Yusuf Misau
HEALTH BELIEF MODEL
A person motivation to undertake a health behavior can be divided into three categories:
- Individual perceptions- Modifying factors- Likelihood of action
Tuesday, April 11, 2023
30Models of Health Behavior_Yusuf Misau
-Perceived susceptibility to disease X -Perceived seriousness of disease X
- Age, sex, ethnicity - Personality - SES - Knowledge
Perceived threat ofdisease X
Cue to action- Internal (symptoms)- external (media)
Perceived benefits vs.Perceived barriersto behavioral change
Likelihood of taking action (beh. change)
Self-efficacy
HEALTH BELIEF MODEL
Individual PerceptionsModifying Factors Likelihood of Action
Tuesday, April 11, 2023
31Models of Health Behavior_Yusuf Misau
THEORY OF REASONED ACTION
Tuesday, April 11, 2023
32Models of Health Behavior_Yusuf Misau
THEORY OF REASONED ACTIONIcek AjzenMarten Fishbein
TRS states that individual performance of a given behaviour is primarily determined by a person’s intention to perform that behaviour. This intention is in turn determined by two major factors:
- the person’s attitude toward the behaviour (beliefs and values of the outcomes)
- the influence of the person’s social environment or subjective norms
Tuesday, April 11, 2023
33Models of Health Behavior_Yusuf Misau
THEORY OF REASONED ACTION
Premise:In order for the behavior to occur, one
must have an intention to change; intentions are influenced by two major factors:
- attitude toward the behavior- subjective norm about the behavior
Tuesday, April 11, 2023
34Models of Health Behavior_Yusuf Misau
THEORY OF REASONED ACTION
Beliefs and Evaluations of
BehaviouralOutcomes
Beliefs and Evaluations of
BehaviouralOutcomes
NormativeBeliefs
NormativeBeliefs
Attitude toward theBehaviour
Attitude toward theBehaviour
BehaviouralIntention
BehaviouralIntention
Subjective Norms
Subjective Norms
Behaviour
Behaviour
Tuesday, April 11, 2023
35Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORY
Tuesday, April 11, 2023
36Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORY
It suggests that most human behaviour is learned observationally from others. The theory focuses on the learning that occurs within a social context.
It considers that people learn from one another
including such concept as observational learning, imitation and modeling.
In this process learning occurs when individuals observes and imitate other’s behavior.
Tuesday, April 11, 2023
37Models of Health Behavior_Yusuf Misau
Nigerian culture: 1970 vs 2009
Tuesday, April 11, 2023
38Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORYThere are four processes that form the basis of Social Learning Theory which according to Bandura are the conditions that are necessary before an individual can successfully model the behaviour of someone else:
Attention Retention Motivation, and Motor Reproduction
Tuesday, April 11, 2023
39Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORYSOCIAL LEARNING THEORYi. Attention This is the first component of observational learning. The person must first pay attention to the model.
This process surrounds the acquisition of attention of learner.
Acquisition can be based on such factors as sensory capacity, arousal level and past enforcement.
Individuals cannot learn much by observation unless they perceive and attend to the significant features of the modeled behavior.
Tuesday, April 11, 2023
40Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORYii. Retention The observer must be able to remember the
behaviour that has been observed. Retention process involves the learner accessing
symbolic coding of the behaviour that has caught their attention.
In order to reproduce the modeled behavior, the individuals must code the information into long-term memory
Tuesday, April 11, 2023
41Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORYiii. Motor Reproduction
The ability to replicate the behaviour that the model had just demonstrated. This process includes the physical reproduction of the observed activity through physical capability, self-observation and feedback.
The observer must be able to reproduce the model’s behaviour. The observer must learn and possess the physical capabilities of the modeled behavior.
Tuesday, April 11, 2023
42Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORYiv. MotivationThe final process is motivation or reinforcement.
The observer/learner expects to receive positive reinforcements for the modeled behavior.
This process includes external, vicarious and/or self-reinforced motivation.
Tuesday, April 11, 2023
43Models of Health Behavior_Yusuf Misau
SOCIAL LEARNING THEORYGeneral principles of Social Learning Theory:
People can learn by observing the behaviors of others and the outcomes of those behaviours.
Learning can occur without a change in behaviour.
The consequences of behaviour play a role in learning.
Cognition plays a role in learning.
Tuesday, April 11, 2023
44Models of Health Behavior_Yusuf Misau
THE TRANSTHEORETICAL MODEL
Tuesday, April 11, 2023
45Models of Health Behavior_Yusuf Misau
THE TRANSTHEORETICAL MODEL THE TRANSTHEORETICAL MODEL
James O. Prochaska
and
Carlo C. DiClemente
“Habit is habit, and not to be flung out of window but coaxed downstairs a step at a time.”
Mark Twain
The TTM:
Behavior change is a process that takes place over time. Its never simple, nor straight forward.
People go through stages before final changes are made, and many things happen after they start to make changes.
This “Stages of Change” model suggesting stages of behavior change and processes that influence people’s progression through those stages
Tuesday, April 11, 2023
47Models of Health Behavior_Yusuf Misau
The TTMIs an Integrative Model of Behavior Change
Model of intentional change Change implies phenomena occurring over
time Focuses on decision making of the individual Involves emotions, cognitions and behavior Involves progress through a series of five stages
Tuesday, April 11, 2023
48Models of Health Behavior_Yusuf Misau
The TTM: Background
Consist of different stages which help identify where a person is regarding the change of behavior.
It may relate to several different things such as smoking, exercise, diet, sexual orientation, immunization, screenings, etc.
It consists of several different processes but it is divided into five main stages.
Tuesday, April 11, 2023
49Models of Health Behavior_Yusuf Misau
THE TRANSTHEORETICALMODEL
Stages of change:
Precontemplation Contemplation Preparation Action Maintenance
Tuesday, April 11, 2023
50Models of Health Behavior_Yusuf Misau
PrecontemplationPrecontemplation
ContemplationContemplation
PreparationPreparationActionAction
MaintenanceMaintenance
RelapseRelapse
Tuesday, April 11, 2023
51Models of Health Behavior_Yusuf Misau
THE TRANSTHEORETICALMODEL
Stage 1: Pre-contemplation
Individuals are not intending to take action in the foreseeable future (usually measured as the next 6 months)
- unaware of the problem , unwilling tochange
- might not realize that change is possible, desirable, or relevant to them, - feeling discouraged/demoralised,- defensive about particular behavior, - has not began to contemplate change or need
for change,- least responsive to interventions.
Tuesday, April 11, 2023
52Models of Health Behavior_Yusuf Misau
Predominant Answer in pre-contemplation stage:
My weight is OK! I don’t need to exercise.
Smoking makes me feel cool, I wont stop!
I cant do HIV Test when I am feeling healthy, because it can be false positive!
Intervention: Increase awareness Provision of information
Tuesday, April 11, 2023
53Models of Health Behavior_Yusuf Misau
Stage 2: Contemplation
At this stage, the individuals are aware of the problem but not prepared/intended to change/take any action in the next 6 months.
- involve the process of self-reevaluation,- active consideration of the prospect
to change,- looking for more info. about the problem,- weighing pros and cons (costs and benefits)- evaluating options
The person has started the process of contemplating changes
Tuesday, April 11, 2023
54Models of Health Behavior_Yusuf Misau
Predominant Answer:
I know smoking is bad, but I’ve difficulties to quit.
I know early HIV test is good, but what happen to my
job if my employer knows?
Intervention: Motivation Goal setting Counseling
Tuesday, April 11, 2023
55Models of Health Behavior_Yusuf Misau
Stage 3: Preparation
The stage in which the person is intending to take action in the immediate future. He prepares to undertake the change.
- readiness to change (A & B)
- gathering info. About the change
- learned the previous lesson
- on the verge to take action
- initiate behavior change
- begin reducing their problem behaviorex: reduce/delay smoking
Tuesday, April 11, 2023
56Models of Health Behavior_Yusuf Misau
Predominant Answer in the stage of preparation:
I would like very much to reduce my blood pressure, and I am confident that I can do it.
In sha Allah I will stop smoking, but I don’t know when
Intervention: Action plan with specific strategies Goal setting Provision of assistance
Tuesday, April 11, 2023
57Models of Health Behavior_Yusuf Misau
THE TRANSTHEORETICALMODEL
Stage 4: Action
A new behavior has been adopted. Individuals have specific overt modification in their-lifestyle within the past 6 months.
- modification of the problem behavior
Tuesday, April 11, 2023
58Models of Health Behavior_Yusuf Misau
Predominant Answer in the stage of action:Currently, I am physically active, but not on regular basis.
Intervention: Social support Assist with feedback Reinforcement Motivation
Tuesday, April 11, 2023
59Models of Health Behavior_Yusuf Misau
THE TRANSTHEORETICALMODEL
Stage 5: Maintenance
The stage in which the individuals are working to prevent relapse
- Final stage in the process of change
- Maintenance occurs when the behavior has been incorporated into the person’s life
- The new behavior is not yet firmly established.
Tuesday, April 11, 2023
60Models of Health Behavior_Yusuf Misau
Predominant Answer:
I have stopped smoking for the last 6 months, and
I am putting on weight now.
Well…. I stopped for almost the 6months you recommended, but just yesterday, I had a stick because my friend offered to me and I feel I cant say no!
Intervention: Assist in coping Avoid relapse
Tuesday, April 11, 2023
61Models of Health Behavior_Yusuf Misau
Relapse??
The process is not yet complete and it may never be complete. Many things can affect behaviour change. A person may want to maintain a new behaviour, but other
things might make this difficult. It may later become hard to sustain:
- available resources might disappear - strong supporters might move away or withdraw support - a new situation might make old behaviour seem more
appealing.
For all sort of reasons, people might move back to the earlier stage of behaviour change and work through the stages again .
Tuesday, April 11, 2023
62Models of Health Behavior_Yusuf Misau
Pre-contemplation Contemplation Preparation Action Maintenance
Becoming aware
Emotional response
Environmental analysis
Thinking through the issues
Seeing other options
Self-efficacy
Social support
Helping relationship
Reinforcement
Seeing other options
Being in control
Social support
Processes influencing movement through the stages of change
Tuesday, April 11, 2023
63Models of Health Behavior_Yusuf Misau
Diffusion of innovation Theory
Tuesday, April 11, 2023
64Models of Health Behavior_Yusuf Misau
Diffusion of innovationRoger (1983) defined
– an innovation as “ an idea, practice or object that is
perceived as new by an individual or other unit of adoption”
– diffusion as “the process by which an innovation is
communicated through certain channels over time among
the members of a social system
The process of diffusion involves five stages:1. innovation development,
2. dissemination,
3. adoption,
4. implementation
5. maintenance
Tuesday, April 11, 2023
65Models of Health Behavior_Yusuf Misau
InnovatorsEarlyAdopters
EarlyMajority
LateMajority Laggards
Adopter CategoriesAdopter Categories
2.5%
13.5%
34% 34%
16%
Tuesday, April 11, 2023
66Models of Health Behavior_Yusuf Misau
Diffusion of tech in weaponry:
American drone in the 21st century
Nigerian warriors in the 18th century
Tuesday, April 11, 2023
67Models of Health Behavior_Yusuf Misau
Diffusion of tech in transport systems:
Local Water transport then
Local Water transport now
Tuesday, April 11, 2023
68Models of Health Behavior_Yusuf Misau
Diffusion of technology in transport:
Tuesday, April 11, 2023
69Models of Health Behavior_Yusuf Misau
Transition of cultural diffusions:
Tuesday, April 11, 2023
70Models of Health Behavior_Yusuf Misau
PRECEDE – PROCEED MODEL
Tuesday, April 11, 2023
71Models of Health Behavior_Yusuf Misau
PRECEDE – PROCEED MODEL Lawrence W. Green
Marshall W. Kreuter
Premise: The factors causing health behavior are seen to be of three distinct kinds:
- predisposing- enabling - reinforcing
Tuesday, April 11, 2023
72Models of Health Behavior_Yusuf Misau
PRECEDE – PROCEED MODEL
PredisposingFactors
EnablingFactors
ReinforcingFactors
Specific behaviorby individuals
Environment(conditions of
living)
HEALTHHEALTH
Tuesday, April 11, 2023
73Models of Health Behavior_Yusuf Misau
Predisposing factors:• Knowledge• Attitudes• Beliefs• Values• Perceptions
PRECEDE – PROCEED MODEL
Tuesday, April 11, 2023
74Models of Health Behavior_Yusuf Misau
Reinforcing factors:
• Attitude and behavior of health and other personnel, community leaders, peers, parent, employers, etc.
PRECEDE – PROCEED MODEL
Tuesday, April 11, 2023
75Models of Health Behavior_Yusuf Misau
Enabling factors:• Availability of resources• Accessibility of resources • Referrals• Rules or laws• Health related skills• Community/government, priority and
commitment to health• Engineering
PRECEDE – PROCEED MODEL
Tuesday, April 11, 2023
76Models of Health Behavior_Yusuf Misau
Case study 1 Lee is a 21 year old Malaysian student involved
in Intravenous drug addiction (IDA). There are many cases of IDA among Lee’s peers. However Lee thought IDA has harmed his life and wishes to change for the better.
Lee is also worried that his family views his IDA as an embarrassment to the whole family
How will you help Lee?
Tuesday, April 11, 2023
77Models of Health Behavior_Yusuf Misau
Case study 2 Women in the predominantly Muslim Northern
Nigeria are generally known to reject western style contraception techniques. As a public health specialist, you have been requested to design a study that will serve as a basis for addressing this issue.
Which of the models of health behaviors will best fit? Justify.
Tuesday, April 11, 2023
78Models of Health Behavior_Yusuf Misau
Case Study Ayesha is a 22 year old university student who lives with her
parents. When she was in school, she played several sports and got plenty of exercise by walking to and fro school. She now notices that she is not exercising anymore. She drives everywhere, even to close shops. As a result, she is aware that she is feeling unfit and is beginning to gain weight.
Why might Ayesha’s exercise behavior changed? How can you help her to exercise again?
Tuesday, April 11, 2023
79Models of Health Behavior_Yusuf Misau
Tuesday, April 11, 2023
80Models of Health Behavior_Yusuf Misau