Modul 8 - Education Diagnosis

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 Administrative diagnosis

Direct communication: public, patients

Phase 4-5 Educational diagnosis

Phase 3 Behavioral diagnosis

Predisposing factors: knowledge, attitudes, values, perceptions

Phase 1-2 Epidemiological & social diagnosis

Nonhealth factors Quality of life

Nonbehavioral causes Health education components of health program

Indirect communication: staff development, training, supervision, consultation, feedback

Enabling factors: Availability of resources, accessibility, referrals, skills Reinforcing factors: Attitudes and behavior of health and other personnel, peers, parents, employers, ect.

Behavioral causes Behavioral indicators: utilization, preventive actions, consumption patterns, compliance, selfcare Dimensions: Earliness, frequency, quality, range, persistence

Health problems

Vital indicators: Morbidity, Mortality, fertility, disability Dimensions: incidence, prevalence, distribution, intensity, duration

Subjectively defined problems of individuals or communities Social indicators: illegitimacy, population, welfare, unemployment, absenteeism, alienation, hostility, discrimination, votes, riots, crime, crowding

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 Community/government priority and commitment to health Health related skills Reinforcing factors: Family Peers Teachers Employers Health provider

2

Specific behavioral problem

5 4 3

#

Contributing influence Secondary effects 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. 2.

3.

4.

The person must believe that his or her health is in jeopardy. 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. 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. 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 Peers Co-workers Nurses

fellow patients supervisors teachers

• 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 Attitude, belief, value: Willing to use dustbin

Negative Attitude, belief, value: Not important to take care on environment, feel that government should take that responsible

Enabling factors Positive Dustbin available in each house, apartment. Municipal provide recycling bins.

Negative The bins not accessible The bins are damaged

Reinforcing factors Positive Encourage by family, teachers

Negative 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