Chapter 3
Understanding Health and Illness
Behaviours
© John Hubley & June Copeman 2013
PROBLEM,
BEHAVIOUR
or
SITUATION
Explanatory theory
Why does it happen?
What can be changed?
Change theory
Which strategies and
messages will change it?
How should the program
work?
Smoking
Family planning
Not becoming pregnant before 18
Using contraception until one wants
to have the first child
Using contraception to stop having
children
Not starting to smoke
Stopping smoking
Not starting up after quitting
Immunization
Bringing a child to clinic for
immunization
Allowing a child to be immunized
by a health worker
Just by defining the behaviour precisely you can
tell a great deal about the likely influences,
feasibility of change and appropriateness as a
target for a health education
Feeling something is
‘wrong’ – perception of
symptoms
Illness behaviour
Actions taken by individuals when
they perceive themselves to be ill
depends on
perceptions of symptoms
social networks
beliefs on prevention, cure
Seeking advice from
members of family or
others in the community
Self-medication
Approaching informal or
formal systems of health
care
Consultation with healer/
health-care provider
Actions after consultation,
use of medication,
compliance with regimes
Follow-up consultations
Cure/death
Health belief model
For a person to take action he/she must:
believe they are susceptible
believe the health problem is serious
believe that the advantages of taking action
outweigh the disadvantages
A trigger may be needed to encourage the person to act
Stages of change model
Maintaining
‘safer’ lifestyle
Making
changes
Ready to
change
Maintaining
changes
Thinking
about change
not interested
in changing
‘risky’
behaviour
Relapsing
Prochaska & DiClemente
Beliefs about the
consequences of
taking action and
judgement of
those
consequences
Attitude
Behavioural
intention
Beliefs whether
others in their
networks would
approve or
disapprove of
them taking action
Subjective
norm
Behaviour
change
Social networks
Influence
Information
pressure to act in
particular ways
on health, disease
and sources of help
Significant others in family
friends - peers
partners in relationships,
opinion leaders in
community
Support
help and support in times of crisis, difficulty and
solving problems
Social Networks influence health
• Social networks as sources of information
• Social networks as sources of pressure and
influence
• Social networks as sources of support
Investigating social networks
Who makes the decisions
in the family…
in the community…
about…
care of children?
use of health
services?
use of
medicines?
Concept of culture
• Norms: the shared characteristics of a
group
• Traditions: ideas, values and practices
that have been held for a long time and
passed on through to the next generation
• Systems of thought and ideas:
reinforced by language, religion and
systems of medicine
Is the health issue affected by culture?
•
Life course
•
Masculinity and femininity
•
Patterns of living and consumption
•
Patterns of communication
•
Health and illness behaviours
•
Religion and 'world view'
•
Patterns of social influence, social networks and political organization
•
Economic patterns
Intrapersonal
(individual)
factors
Knowledge
Attitudes
Beliefs
Institutional
factors
Rules
Regulations
Policies
Interpersonal
factors
HEALTH
BEHAVIOUR
Community
factors
Norms
Standards
Family
Friends
Peers
Public policy
Local and
national laws
Regulations