1. International Health Policy Program -Thailand HEALTH BEHAVIOR MODELS Dr.Warisa Panichkriangkrai DDS, MPH

2. International Health Policy Program -Thailand 2 HEALTH BEHAVIOR the actions of individuals, group, and organizations as well as their determinants, correlates, and consequences, including social change, policy development and implementation, improved coping coping skills, and enhanced quality of life Parkerson and others, 1993

3. International Health Policy Program -Thailand 3 HEALTH BEHAVIOR MODELS Models draw on a number of theories to help understand a specific problem in a particular setting or context

4. International Health Policy Program -Thailand 4 TB screening program Program = no charge in mobile x-ray units located in various neighborhoods FAILURE

5. International Health Policy Program -Thailand 5 HEALTH BELIEF MODEL Those who had chest x-ray because Their beliefs that they were susceptible to TB Their beliefs in the personal benefits of early detection BELIEF ACTION NO ACTION + -

6. International Health Policy Program -Thailand 6 ConceptDefinitionApplication Perceived susceptibility Belief regarding the chance of getting a condition Population at risk Perceived severityBelief of how serious a condition and its sequel Specify consequences of the risk and the conditions Perceived benefits Belief in the efficacy of the advised action to reduce risk Define action to take: how, where, when: clarify expected positive effects Perceived barriersBelief about the tangible and psychological costs of the advised action Identify and reduce perceived barriers through reassurance, correction of misinformation, incentive Cues to actionStrategies to activate one’s “readiness” Provide how-to information, promote awareness Self-efficacyConfidence in his/her ability to take action Provide training, guidance Give verbal reinforcement Reduce anxiety

7. International Health Policy Program -Thailand 7 Example case: ALCOHOL Perceived susceptibility Perceived severity Perceived benefits Perceived barriers Still consume? Are they ready to change?

8. International Health Policy Program -Thailand 8 Stages of change StageDefinition PrecontemplationUnaware of the problem or not thought seriously about change ContemplationSeriously thinking about a change PreparationPlanning to take action and making final adjustment before changing behavior ActionImplements specific action plan to modify behavior and surroundings MaintenanceContinue with desirable action RelapseReverts back to old behavior

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10. 10 Health Behavior Model Individual Friends Family Boss Regulations Norm Advertisements NEWS

11. International Health Policy Program -Thailand 11 ECOLOGICAL MODEL Model of health behavior that identified multiple levels of influence 1.Intrapersonal 2.Interpersonal 3.Institutional factors 4.Community factors 5.Public policy

12. International Health Policy Program -Thailand 12 LevelDefinition IntrapersonalCharacteristics of individual (knowledge, attitudes, skill, intention) InterpersonalRelationships with family, friends, neighbors, coworkers Institutional factorsOrganizational characteristics ( school, work, professional group) Community factorsFace-to-face primary groups, mediating structures Public policyRegulatory policies, procedures and laws

13. International Health Policy Program -Thailand 13 Public policy Community Organizatio nal Interperson al Individual Policy change Environment Policy analysis research, Media, Food industry Help group Concern about obesity problem Ecological model and obesity solutions

14. International Health Policy Program -Thailand 14 Health Policy Direct attentionEvidence Process attention Social and organizational capacity Political attentionStakeholders awareness

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