modul 8 - education diagnosis
TRANSCRIPT
EDUCATIONAL DIAGNOSIS: ASSESSING CAUSES OF
HEALTH BEHAVIORModule 8
HEALTH PROMOTION & EDUCATION (DEMA 3253)DIPLOMA IN ENVIRONMENTAL HEALTHVICTORIA INTERNATIONAL COLLEGE
PREPARED BY: MR KHAIRUL NIZAM MOHD ISA
PRECEDE FRAMEWORK
Health education components of health program
Predisposing factors: knowledge, attitudes, values, perceptions
Enabling factors: Availability of resources, accessibility, referrals, skills
Reinforcing factors: Attitudes and behavior of health and other personnel, peers, parents, employers, ect.
Nonbehavioral causes
Behavioral causes
Behavioral indicators: utilization, preventive actions, consumption patterns, compliance, self-care
Indirect communication: staff development, training, supervision, consultation, feedback
Direct communication: public, patients Nonhealth factors
Health problems
Vital indicators: Morbidity, Mortality, fertility, disability
Dimensions: incidence, prevalence, distribution, intensity, duration
Quality of life
Subjectively defined problems of individuals or communities
Social indicators: illegitimacy, population, welfare, unemployment, absenteeism, alienation, hostility, discrimination, votes, riots, crime, crowding
Dimensions: Earliness, frequency, quality, range, persistence
Phase 6Administrative diagnosis
Phase 4-5Educational diagnosis
Phase 3Behavioral diagnosis
Phase 1-2Epidemiological & social diagnosis
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
Enabling factors: Availability of resources Accessibility of health resources Community/government priority and commitment to health Health related skills
Reinforcing factors: Family Peers Teachers Employers Health provider
Specific behavioral problem
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Contributing influenceSecondary effectsApproximate 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 pattern1. 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 smokingGood : __ . x_ . __ . __. __ : BadPretty : __ . __ . x_ . __ . __ : UglyHappy : 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 patientsPeers supervisorsCo-workers teachersNurses
• 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:1. Identifying and sorting factors into three categories2. Setting priorities among categories3. 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
Setting priorities among categories▫ Classify the factors causing behaviors into positive or negative.▫ Example: Involve in waste recycling
Predisposing factorsPositive
Attitude, belief, value:Willing to use dustbin
NegativeAttitude, belief, value:Not important to take care on environment, feel that government should take that responsible
Enabling factorsPositive
Dustbin available in each house, apartment. Municipal provide recycling bins.
NegativeThe bins not accessible The bins are damaged
Reinforcing factorsPositive
Encourage by family, teachersNegative
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