2.

Health and Behavior

By : Habitu Birhan(Bsc, MPH)

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At the end of this chapter, students are expected to:

 Define behavior and related terms

 Describe the factors which affect human behavior
 List examples of behaviours promoting health and preventing diseases.

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 What is behavior ?

 Behavior- is an action that has specific frequency, duration,

and purpose, whether conscious or unconscious, overt or
covert
 Action – drinking/smoking
 Duration –is it for a week/month?
 Frequency- how it is repeated?
 Purpose –is he/she doing to attain a goal

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 Life style, Customs and Traditions

 Life style: refers to the collection of behaviors that make up a person’s way of life-
including diet, clothing, family life, housing and work.
 Customs: It represents the group behavior. It is the pattern of
action shared by some or all members of the society.
 Traditions: are behaviors that have been carried out for a
long time and handed down from parents to children.

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Behavior con…
 People stay healthy or become ill, often as a result of their own action or
behaviour.
 The following are examples of how people’s actions can affect their health:
• Using mosquito nets and insect sprays helps to keep mosquito
away.
• Feeding children with bottle put them at risk of diarrhoea.
• Defecating in an open field will lead to parasitic infection.
• Unsafe sex predisposes people to unwanted pregnancy,
HIV/AIDS and other STDs

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  Examples of behaviours promoting health and preventing
diseases

 Healthy behaviour-is an action that healthy people

undertake to keep themselves or others healthy and
prevent disease.
 Health behaviour is any activity undertaken by a person
believing him/herself to be healthy for the purpose of
preventing disease or detecting it at an early stage.
 Good nutrition,
 breast feeding, reduction of health damaging behaviours
like smoking are examples of healthy behaviours

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 Utilization behavior: - utilization of health services
such as antenatal care, child health, immunization, family
planning…etc
Illness behavior: - recognition of early symptoms and
prompt self referral for treatment.
Compliance behavior: - following a course of
prescribed drugs/informations.
Rehabilitation behavior: - what people need to do after
a serious illness to prevent further disability.

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  Well/healthy behavior can promote health
e.g. Physical exercise, BF, seeking treatment
 Unhealthy behavior can harm health
e.g. Smoking, chat chewing, excessive alcohol consumption,
unsafe sex , sedentary life style etc.

Study of health behaviour is based upon two assumptions

 A substantial proportion of mortality and morbidity is
caused due to a particular pattern of behaviour and that
these behaviour patterns are modifiable.
 It is recognized that individuals are the major
producers/contributors of their health.
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 Factors affecting human behavior

Discussion

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 Factors affecting human behavior can be classified
into 3 major categories

1.Predisposing Factors - any characteristics of a person or

population that motivates behavior prior to the occurrence of
that behavior
 Knowledge
 Beliefs
 Values
 Attitudes
 E.g. For an individual to use condom, he has to have knowledge
about condom and develop positive attitude towards utilization of
condom.

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 2.Enabling - characteristic of the environment that
facilitate action and any skill or resource required to
attain specific behavior
 accessibility
 availability
 skills
 laws (local, state, federal)

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 3. Reinforcing factors; are those factors subsequent to
a behavior that provide the continuing reward or
incentives for the behavior to be persistent and
repeated.
 They comprise the different types of feedback and
rewards received after behavior change which may
either encourage or discourage the continuation of the
behavior.
E.g.
Family, peers, teachers, employers, health providers,
community leaders, decision-makers, self or others who
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 Definitions of factors affecting Behaviors

1. Knowledge or cognition:
2. Attitudes (feelings). Evaluation of the behavior
either negatively or positively. E.g. I like to use
condom/ I do not like to use condom.

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 3. Beliefs
A belief is a conviction/an informal declaration that a
phenomenon or an object is true or real especially
without proof.

 They are usually derived from our parents,

grandparents, and other people we respect.
 Beliefs may be helpful, harmful or neutral. If it is not
certain that a belief is harmful, it is better to leave it
alone.
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 4. Values; important and lasting beliefs or ideals
shared by the members of the culture about what is
good and bad.
 They are the basis justifying one’s actions in moral or
ethical terms.
 They are standards.

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 Some Values in our community
 Being a good mother
 having many children/cattle
 academically success
 Being a man of God /Allah
 being healthy
 Generosity

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 5. Skills
A person’s ability to perform the tasks that constitute a
health related behavior.
e.g. giving IV injection
6. Culture e.g. FGC
7. Lifestyle: Consciously chosen, personal behavior of
individuals. E.g. Urban Vs rural life style

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 8. Norms – are social rules that specify appropriate
and
inappropriate behavior in given situations. They tell us
what we should and must do as well as what we should
not and must not do.
9.Perception: a process by which individuals organize
and interpret their sensory information in order to give
meaning it.
 Perception is a means of acquiring knowledge.
 And it is highly subjective

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 10. Perceived Behavioral Control – the individual’s
belief concerning how easy or difficult performing the
behaviour will be.
11. People who are important to us greatly influence
our behavior. Examples: parents, elders, friends,
experienced people, highly educated people, teachers,
etc.
12. Resources: facilities, money time, labor services,
skills, materials and their distribution and their location
affect behavior. Example: access to HC

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Behavior change
 Behavior change is a continuous process
Not all individuals go through the same steps of the process in the same order,
speed or time

 People at different steps require different messages and sometimes different

approaches.
 It is important to know what stage the person is before beginning a
communication process

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 Changes in behavior
 Natural change - our behavior changes all the time.
Some changes take place because of natural events or
processes such as age-sex related behaviors. E.g.
eating clay during pregnancy.
 Planned change - we make plans to improve our
lives or to survive for that matter and we act
accordingly. E.g. plan to stop smoking or drinking,
plan to become a health professional.
 Planned change in behavior can be faster or slower
depending on the response of the acceptor and adapter
of the behavior.
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Behavior change

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Learned behavior
 Learning is relatively permanent change in behavior
as a result of knowledge, experience or practice.
 Learning is acquiring new knowledge, behaviors, skills,
values, preferences or understanding, and may involve
synthesizing different types of information.
 The ability to learn is possessed by both in humans and
animals.

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 THEORIES OF LEARNING
There are four theories which explain how learning
occurs. They are
1. Classical conditioning(Ivan pavlov)
2. Operant conditioning
3. Cognitive theory
4. Social learning theory

Read for details!!!

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 Principles of learning

There are three principles of learning:

1. Learning by association
2. Learning by reinforcement , punishment and,
3. Learning by motivation
Learning by association - Connection between events
in time, place, etc.
 It is the most important part of the learning process.
 It is first formed in the physical environment.

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 Principles of learning
E.g.
 If we see lightening we expect thunder
 When we see a needle/syringe, we think of injection
 When we see pregnancy we expect delivery

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 Reinforcement & punishment

 Reinforcement; is used to enhance desirable behavior;

 Punishment; is employed to minimize undesirable
behavior.
1. Positive reinforcement; add something desirable such as
praise to increase the likelihood of a behavior
2. Negative reinforcement; subtract something undesirable
to increase the likelihood of a behavior.(prepare an out
reach program for a distant health facility for
immunization program/

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 Punishment
 Is the attempt to eliminate or weaken undesirable behavior. It
is used in two ways
 Negative punishment; subtract something desirable to
decrease the likelihood of a behavior.
e.g. a child fights with her brother and has her favorite toy
taken away.
 positive punishment; add something undesirable to decrease
the likelihood of a behavior
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Cont…

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  Motivation; desire or willingness to perform something.
 The concept of motivation is basic because, without
motivation learning does not take place or, at least, is not
discernible.
 An individual who is not motivated will gain or learn
nothing i.e. it can affect the learning process

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Quiz

1. List at list three examples of behaviours promoting health and

preventing diseases (1 point)
2. What are the major factors which affect human behavior with
examples?(2 point)
3. Differentiate reinforcement and punishment with practical examples (2
point)

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