Behavior Domain, Behavior Determinants
and Behavior Change
Health Behavior: CHAPTER 2
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DESCRIPTION
• This chapter will discuss domain of behavior,
determinants of health behavior and the ways
to change health behavior.
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OBJECTIVES
General
• Students know the domain of behavior,
determinants of health behavior and how to
change health behavior.
Specific
• Student can explain the behavior domains
• Student can explain the determinants of
behavior
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What BEHAVIOR is?
In a simple definition,
Behavior is the action or activity of individual or
group who has a very wide expanse include:
walking, talking, crying, laughing, working, writing,
reading, and etc.
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• Human behavior is any activity or human
activity, both of which can be observed
directly (overt behavior), or which can not be
observed by others (covert behavior)
(Notoatmodjo, 2003).
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Skinner, (at Notoatmodjo 2003)
• Behavior is a response or a person's reaction to
stimulus or stimuli from outside.
• Because of this behavior occurs through a
process of stimulus to the organism, the
organism is responding, then it is Skinner's
theory called the theory of
S-O-R
Stimulus – Organism - Response.
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The Type of Behavior
(Notoatmodjo, 2003) :
1. Covert behavior
– Covered person's behavior is a response to the stimulus in
the form of covert or closed.
– Response or reaction to the stimulus is still limited in
attention, perception, knowledge, awareness, and
attitudes that occur in people who received the stimulus,
and can not be clearly observed by others.
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2. Overt behavior
– Person's response to the stimulus in the form of
action or open.
– The response to the stimulus is already happened in
the form of action or practice, which can easily be
observed or viewed by others.
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BEHAVIOR DOMAIN
1. Cognitive (knowledge)
2. Affective (attitude
3. Psychomotor (practice)
(Benjamin Bloom, 1956 in Notoatmodjo 2003
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knowledge
comprehension
application
analysis
cognitive
synthesis
evaluation
recieving
Behavior
affective
responding
valuing
responsible
perception
psychomotor
guided response
mechanism
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adoption
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Knowledge / Kognitive
• Knowledge is the result of the know, and this
happens after a person doing the sensing of
an object.
• Without knowledge people does not have a
basis for making decisions and determining
actions to the problems.
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Factors influencing people knowledge
• Internal factors: factors from themselves,
such as intelligence, interests, physical condition.
• External factors: external factors themselves,
such as family, community, facilities.
• Learning approach factors : learning
efforts, such as strategies and methods in
teaching.
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Six level of knowledge
1
• Knowledge
Knowledge interpreted as recall of a material that has been
studied previously.
2.
• Comprehension
An ability to describe correctly the object is known and can
correctly interpret the material.
3.
• Application
Defined as the ability to use a material that has been studied on
the actual situation and conditions.
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Six levels of knowledge con’t
4.
5.
6.
• analysis
Is an ability to describe the material or an object into components but
still within an existing organizational structure and relation to others.
• Synthesis
Synthesis demonstrated an ability to arrange the parts in a whole new
form.
• Evaluation
• This evaluation relates to the ability to carry out an assessment of the
justification of a material / object.
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Attitude / Affective
• Attitude is a reaction or response from
someone who is still closed to a stimulus or
object.
• Allport (1954) explains that the attitude has
three main components:
– Belief, the idea, the concept of an object
– Emotional life or evaluation of an object
– Tend to behave
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Four level of attitude
1
• Receiving
Accepting means that the person (subject) like and pay attention to a given stimulus
(the object).
2.
• Responding (responding)
Provide an answer when asked, do, and completing assigned tasks is an indication of
the attitude.
3.
• Valuing
Inviting someone else to do or discuss a problem is an indication of the third level of
attitude.
4.
• Responsible
Responsible for everything that has been chosen with all the risks are the highest
level of attitude.
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Practice/ Psychomotor
• An attitude not automatically realize in an
action (overt behavior).
• To realize the attitude to be an
action/practice, need supporting factors or a
condition, facilities, and supporting factors
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Four levels of Practice
1
2
• Perception
• Identify and select different objects with respect to actions
• Guided Response
• Can do things according to the correct order with the correct response
3.
• Mechanism
• If someone has been able to do something automatically, or behavior is
already a habit
4.
• Adoption
• Adoption is a practice or action that is already well developed. This means
that action has been modified but still in the right way
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How to measure the behavior?
• Interview of the activities that have been done a few
hours, days or months ago (recall).
• Direct measurement, by observing the actions or
activities of the respondent.
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DETERMINANTS OF BEHAVIOR
Lawrence Green (1980)
Preceed – Proceed Theory by Lawrence Green (1980)
• Green analyze human behavior from the level of health. That
people health is influenced by two main factors, they are the
behavioral factors (behavior causes ) and non-behavioral
factors (non-behavioral causes).
The behavior is influenced by :
• Predisposing factor (knowledge, attitudes, beliefs, values,
perception)
• Enabling factor (attitudes and behavior of health personnel
and other, peers, parents, employers, etc)
• Reinforcing factor (availability of resources, accessibility,
referrals, rules and laws, skills)
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Determinants of behavior
Snehandu B. Kar (1983)
1
2
3
4
5
• Intention to act about health behavior or medical care (behavior intention).
• Social support from surrounding communities (social support).
• The information about health or health facilities (accessibility of information).
• Personal autonomy of the individual to make actions or decisions (personal
autonomy).
• Situation that enable for action (action situation).
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Determinants of behavior
WHO (1984)
WHO analyzed that people behavior was caused by :
• Thoughts and feelings such as: knowledge, perceptions,
1
2
attitudes, beliefs and people value of an object (the health object).
(1) Knowledge
(2) Belief
(3) Attitude
• Role Model. Behavior of role model will be followed by someone
• The resources, including facilities, money, time, energy and so
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4
on.
• Norm, behavior, habits, values ​and use of resources within a society will
produce a pattern of life (way of life) which is generally called a culture.
(Notoatmodjo, 2003).
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The adoption of a new behaviors occur within the process
1
2.
3.
4.
5.
• Awareness
The people is aware in the sense of knowing in advance of the stimulus (object)
• Interest
Where people got interested in the stimulus
• Evaluation
Considering the good and whether or not the stimulus for himself. This means that the attitude
of respondents was even better.
• Try (trial)
Where people have begun to try new behaviors.
• Receive (Adoption)
Where the subject has behaved in accordance with the knowledge, awareness and attitude
toward the stimulus.
Rogers (1974), in Notoatmodjo (2003)
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Test
1.
2.
3.
4.
5.
What is covert behavior?
Write an example!
What is the overt behavior?
Write example!
How the people adopted a new behavior?
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References
• Notoatmodjo, Soekidjo. Promosi Kesehatan; Teori dan
Praktek. PT Rineka Cipta. Jakarta. 2005
• WHO, Ottawa Charter for Health Promotion First
International Conference on Health Promotion Ottawa, 21
November 1986 - WHO/HPR/HEP/95.1
• WHO, Health Promotion Glossary, WHO, Geneva, 1998
• Peggy Hickman, A Systems Approach to Health Education,
Rural Health Institute
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