Health related behavior

By : Asrat Zewdie (BSc,
MPH)
Department of Public Health
MeU
2.HEALTH RELATED BEHAVIOR
3/4/2022
HE by Asrat Z. (BSc, MPH)

2. Health related behavior
3/4/2022
2
Contents
• Definition of terms
• Role of behavior in health and disease
• Approaches to the diagnosis of health behavior
• Behavior change Process
• Behavior change models
o Health Belief Model(HBM)
o Theory of Reasoned Action...

Health related behavior…Definition of
terms
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Human behavior: Definition
What is behavior ?
 Behavior- is an action that has specific frequency,
duration, and purpose, whether conscious or
unconscious
 It is both the act and the way we act

Behavior ….
Example:
Action – drinking/smoking
To say a person has drinking/smoking
behavior
Duration –is it for a week/month?
Frequency- how it is repeated?
Purpose –is he/she doing consciously or not
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Components of behavior
Basically human behavior has 3 domains:
A) Cognitive domain (knowledge, perception )
 Encodes, stores, retrieves, processes
information
 purpose is manipulation of information
B) Affective domain= cognition +feeling
eg. Attitude, Beliefs
 purpose is to create arousal
C) Psychomotor domain - Voluntary muscle
 Psycho-mind , Motor – action
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Human behavior and health
1. Healthy behavior -can promote health
Healthy behavior is an overt behavioral patterns, actions,
and habits that relate to health maintenance, to health
restoration, and to health improvement
E.g. Physical exercise, BF, seeking treatment, ...
2. Unhealthy behavior - harms health
E.G smoking, chat chewing, excessive alcohol
consumption, unsafe sex, sedentary life style etc.
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Why we study human behavior?
Basic assumption of health related behavior study:
 Human behavior is a key factor in determining
health
 Substantial proportion of mortality and morbidity
is caused due to modifiable pattern of behavior
 Individuals are the major contributors of their
health
 Because human behavior is the main cause as
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Burden: mortality, morbidity and modifiable risk
factors
 The world is experiencing a shift in:
 Cause of ill- health: Bacteria to Behavior
 Risk factors: traditional risk to modern risk
 Disease burden: Communicable disease to
non-communicable –double burden (for
developing countries)
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According to WHO, 40% of deaths worldwide are due to
these 10 risk factors alone (behaviors)-Modifiable
Global life expectancy could be increased by 5-10 years
if we reduce these risks.
Eg. Tobacco-burden
 1 billion smokers in the world
6 trillion cigarettes consumed annually
6 million people die from tobacco use and exposure
each year,
By 2020, annual tobacco-related deaths =7.5 million
(17), accounting for 10% of all death
Smoking cause about 71% of all lung cancer deaths
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Health related behaviour
Behaviours important for health promotion are:
Preventive behaviors
Utilization behaviors
Illness behaviors
Compliance behaviors
Rehabilitation behaviors
Community action
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Stages of illness behaviors
Returning for follow up
Following advice and taking prescribed drugs
Doctor –patient consultation
Decision to go for treatment
Modern health care Traditional healers
Medication
Self-medication Home remedies
Reporting the symptoms to others in family
Becoming aware of symptoms/ Illness
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Complianc
e
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Behaviors in a Group
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A) Helpful behaviors
 Making suggestion
 Encouraging each other to talk
 Responding politely to the suggestion of
others
 Helping in making points clear
 Giving information
 Showing concern for each other
 Volunteering to help with work
 Attending meetings regularly and on time
 Thanking each other for suggestions given
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Non-helpful, non-functional behaviors
A. Blocking
1. Interfering with group process
2. Diverting attention by citing personal experiences unrelated
to the problem
3. Disagreeing and opposing a point without reason.
4. Arguing too much on a point that the rest of the group has
resolved
5. Rejecting ideas and preventing a decision
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Non-helpful, non-functional behaviors…
B. Aggression
 Criticizing/blaming others
 Showing hostility
C. Seeking recognition
 Call attention to the self by excessive talking and boasting
D. Withdrawing
 Becoming indifferent or passive
 Whispering to others
E. Dominating
 Excessive manipulation of authority
 Interrupting or undermining the contribution of others
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FACTORS AFFECTING HUMAN
BEHAVIOR
• Human behavior is influenced by a huge range of
factors
• Lawrence Green identified three categories of
factors affecting individual or collective behavior.
These are:
 Predisposing factors
 Enabling factors
 Reinforcing factors
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Determinants of human behaviors
Behaviors
Predisposin
g factors
Enabling
factors
Reinforcing
factors
Cultures/norms/traditi
ons
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Knowledge, attitude,
perception, beliefs,
values, self efficacy etc.
Availability,
affordability,
accessibility,
resources to
accomplish the
behaviors
Peer pressure,
influential people,
perceived social
pressures/significant
others/discourageme
nt/encouragement
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1. Predisposing factors (inside head factors)
 Are antecedents or prior to behavior that provide the
rationale or motivation for the behavior to occur.
 They are generally referred to cognitive variables
because they are inside the mind – inside head factors
and have to do with knowing or believing
 They are also called psychosocial because they are
socially influenced
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Predisposing factors…
 These include,
Knowledge
Attitude
Beliefs
Values
Confidence/self-efficacy (perceived)
Motivation
Previous experience (existing skills) that may form
‘perceived self-efficacy’, but not the actual one
(competence).
note: Perception predispose; competence
enables 3/4/2022
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Knowledge or awareness
• Knowledge is “A clear and certain mental
perception, understanding, the fact of being aware of
something, experience of acquaintance of familiarity
with information of, learning that is known, facts
learned or studied”
• Therefore, one`s knowledge of something include
some combination of ;
1. Simple awareness of facts and
2. understanding of how these facts relate to one
another (essential knowledge)
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ENCODING
Getting
information
into memory
STORAGE
Retaining
information
over time
RETRIEVAL
Taking
information
out of storage
 knowledge can be viewed as an accurate impression of some
phenomenon.
What one
knows
Perception
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Knowledge ….
 Knowledge is necessary but not sufficient in
behavior change
 It is necessary, because without adequate
knowledge:
 people may be unaware of and not concerned
about health problem
 People may be unable to manage their behavior
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Knowledge…
 Simple logic for the specific knowledge is that
before act voluntarily people need to know,
 Why they should act?
 What actions are needed?
 When or under what circumstances?
 How to act and where?
 Perception + Storage of information in the
brain = Knowledge
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Knowledge about/awareness vs How to /essential
knowledge
• Knowledge about/awareness: Knowledge about a topic
may be important in developing interest in the topic and
may even motivate the behavior
 How-to/ essential knowledge: Intentional behavior change
depends on it
 It is practical/applicable
E.g. Knowing about condom, its importance and benefits is
less important for behavior change than knowing proper
use or how-to use condom
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Knowledge …
 In general, knowledge about a problem is not as
critical to behavior change as knowledge how to
perform about the target behaviors
 How-to or essential knowledge is the major
components of skill
 Therefore, one of the main task in health
education is helping the learner to become
knowledgeable about some health topic and how
to do the behavior
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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
• It is highly subjective
28 Perception
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Perception is subjective …. and it influences
knowledge
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Skills
 Skill is the capability of accomplishing something with
precision and certainty
 Skills require practical knowledge and ability
 On many occasions inappropriate or ineffective health
behavior may result from the lack of mastery of specific
skills.
 Knowledge and skills are interrelated in that skills are the
practical application of essential knowledge
 Is a person’s ability to perform the tasks that constitute a
health related behavior E.g giving IV injection
Thus, main of task of HE: to improve or enhance skill
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Attitude
• Social psychologists define an attitude as an enduring
evaluation, positive or negative, of people, objects, or
ideas
• We are not neutral observers of the world; we
evaluate what we encounter
• Attitudes are often a matter of good or bad; as soon as
you know what something is, you start to know whether
you like it or dislike it
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Characteristics of attitude
1) Predisposition- exposure related to an attitudinal
object. No exposure, no attitude
2) Has directions- polar, positive or negative, good or bad
3) Evaluation-can be evaluated by intensity or judgment
e.g. Favorable or unfavorable
4) Changeability-can be changed, not static
5) Stability or consistency
Stability=related to time , constant over sometime
Consistency= sameness of attitude
e.g. “Mood” changed quite often
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Link between knowledge(K) and Attitude (A)
Knowledge
Feeling/sense of
like or dislike
Attitude
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Belief
• Is a conviction that a phenomenon or object is true or
real(accepted as true)
 Statement declared intellectually and/or emotionally
accepted as true by a person or group
 It is different from knowledge in that it is perceived
whereas knowledge is accepted objective truth
 Usually derived from parents, grand parents, and other
people we respect to listen and are accepted as true
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Beliefs…
 People usually do not know whether they are
true or false
 But we accept beliefs without trying to prove that
they are true or false
 Example belief of many people that cold may
cause respiratory problems
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Difficulty index of changing beliefs
It is usually difficult to change those beliefs that:
 are held by the whole community
 Have been deep rooted in the culture
 Come from highly respected and trusted sources
 Are part of the a religion or traditional medical
system
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Types of beliefs
 Harmful belief: is a belief which damage health.
 Helpful beliefs: is a belief which preserves
health.
 Neutral beliefs: is a belief which neither
damages nor preserves health.
 Health workers should try to change only the
harmful and encourage the helpful ones
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Beliefs Vs attitude ….
 Our beliefs about things affect our attitude towards it
 Our beliefs, in turn, are influenced by our attitudes
 The judgment as good or bad and worth carrying out a
behavior will depend on the beliefs about the
consequences of performing the behavior
 If an individual beliefs the behaviors have good
outcomes (positive beliefs)…………………… Positive
attitude
 If an individual beliefs the behaviors have bad outcomes
(negative beliefs)…………………… Negative attitude
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Value
• The relative worthy/preference/judgment
individual gives every thing around
 value is something held to be important or worth;
and prized by an individuals or community
 values that have advantages for the self and for
the society_positive values
 values that are harmful and disadvantageous_
negative values
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Examples of characteristics that can be valued by the
communities
• Being a good mother
 having many children/cattle
 Being approved by friends
 masculinity and sexual prowess
 Being attractive to opposite sex
 Having beautiful girl friend
 academically success
 Being a man of God /Allah, success in foot ball events , being
‘modern’ being healthy
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Value exert strong and
enduring influence on
behaviors.
It provides general guides to
behaviors.
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Value conflict and value clarification
 People value life, health. However, in opposite engaged
in unhealthy behavior, for instance, smoking
 This reveals conflict of values=inconsistencies
between two or more values
 In health education one shouldn’t seek to change values
rather should help people recognize inconsistencies
between and among their values
 But we can sometimes bring about changes by
emphasizing values which don’t involve health.
 We, often trying to encourage people to think about their
values (value-clarification )
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Difficult index;
In terms of difficulty of changing:
Knowledge Beliefs Attitude Value
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< <
<
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Other concepts
1. Outcome efficacy (outcome expectation)
 The beliefs that undertaking the behaviors will bring a desired
health benefit
 Example, the belief that taking a prescribed medication will
reduce pain
2. Self-efficacy or self-confidence: It is your belief in your
ability or competence to perform a behavior.
 For example, can you remember to take the medication? And
can you discipline your self to exercise regularly?
3. Behavioral intention-is the willingness/ readiness to perform
a certain behavior provided that enabling factor is in place
4. Social Norms
 The influence of social pressure that is perceived by the
individual to perform or not perform a certain behavior
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2. Enabling factors
 Enabling factors are those antecedents to behavior
that facilitate a motivation to be realized
 They help individuals to choose, decide and adopt
behaviors and may be barriers and assets to needed
changes
 Sometimes a person may intend to perform but still not
do so
 This is because of the influence of enabling factors
such as time, money, equipment, skills and health
services
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Enabling factors…
They include:
 Availability, accessibility and affordability health care
 New skills
 Resources. Eg. Time, money, transportation etc.
 In behavior change communication be sure that enabling
resources are readily available in the community of
interest
1. What is enabling factors to prepare home made
ORS?
2. What are the enabling factors to promote condom
use?
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3.Reinforcing factors
 Reinforcing factors are those factors subsequent
to a behavior that provide the continuing reward
or incentives for the behavior to be persistent
and repeated
 positive or negative feedback and is support
socially or by significant others after it occur
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Significant others (influential people)
 These are people who are significant (determine or
influence) the behavior of others to encourage or
discourage to do something
E.g.
 The woman does not adopt FP because her
husband disapproves
 The young man who starts smoking because his
friends encourage him to do so
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Religious
leaders
I want to use FP, but…
Grand
parents
Friends
Husband
Traditional
healers
The influence of social pressure (circle of influence)
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50 Predisposing
factors
Reinforcing
factors
Enabling factors
create intention to
act
Realizes the
intentions
Encourage behaviors
to persist
Summary of factors affect human behaviors
Remember: Any given behavior can be explained as a function of
the collective influence of these three factors
Sustainable behavior
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Theoretical sequence to address determinants of behaviors
• Knowledge,
attitude,
beliefs,
values
Predisposing
factors
• Availability,
affordability,
accessibility
& others
resources
Enabling
factors
• Peer influence
& social
pressure
Reinforcing
factors
Behaviors
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In practice simultaneously
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Educational approaches to behavior
change
• Approaches to change
Determinants
of behaviors
•Direct communication with target individuals-
educational approaches
Predisposing
factors
• Organization change, avail services,
accessibility, advocacy , resource mobilization
Enabling factors
• In direct communication with the social
environments , influential peoples
Reinforcing factors
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Behavior change process
Our behavior changes all the time, some are
natural while others are planned changes
 Natural changes: When changes occur because
of natural events in the community around us, we
often change with out thinking much about it
(unintentional change)
 Planned changes: When changes occur
deliberately and/or planned. E.g. quitting smoking
(intentional change)
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Behavior change approaches
 The persuasion approach-the deliberate attempt to
influence the other person to do what we want them to
do. ‘directive’ / forcefully/coercion
 Used in situations where there is serious treat such as
epidemics and natural disasters, and the actions needed
are clear-cut
 The informed decision making approach- giving
people information, problem-solving and decision-making
skills to make decision but leaving the actual choice to
the person (open or ‘non-judgmental’ approach)-
empowerment
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Behavior change models
 Theory/ model –definition
 Importance of theory/model in health
education/promotion
 Commonly used theories/models
 Health Belief Model (HBM)
 Theory of Reasoned Action(TRA)
 Social Learning Theory (Social Cognitive Theory
(SCT)
 Stage of change theory (Trans theoretical model –
TTM)
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Theory definition
What is theory?
• A theory is a set of interrelated concepts, definitions, and
propositions that present a systematic view of events, in order to
explain and predict the events (Kerlinger 1986)
• Is a systematic explanation for the observations that relate to a
particular aspect of life (Babbie 1989)
• Theories explain what, why, when and how a particular behavior
occurs
• It can be tested, modified, or replaced, or they can become
obsolete
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Model
• Model is a subclass/simplified form of a theory
 It is a representations of theory and provide the
vehicle for applying the theories” to understand a
specific problem in a particular setting or context
 It is a diagrammatic representation of a
phenomenon
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1. HEALTH BELIEF MODEL (HBM)
 Developed in 1950s by Hochbaum Rosenstock
& to explain preventive health behaviour by
examining an individuals perception
 It was used to predict why people would or
would not use health services
 It emphasizes the intellectual dimension of
health behavior
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Health belief model…
 HBM holds that health behavior is a function of four main
beliefs;
1. Perceived susceptibility to the disease
2. Perceived severity of the disease
3. Perceived benefits of taking the recommended
action
4. Perceived barrier to take action
Recently added
• Self efficacy: the confidence in ones ability to
perform actions (recently added)
• Cues to action
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HEALTH BELIEF MODEL , Diagrams
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Perceived
threat to the
disease “X”
Perceived benefits of
preventive action
Minus
Perceived barriers to
preventive action
Likelihood of Taking
Recommended actions
Demographic variable
Socio-psychological
variables
Cues to action
Mass media, friends
, neighbors
Perceived
severity
Perceived
susceptibility

Summary…Key concepts and definitions of the HBM
64
Constructs Definitions Application
Perceived
susceptibility
Belief about the
chances of
experiencing a risk or
getting a condition
Define population(s) at risk, risk levels
Personalize risk based on a person’s
characteristics or behavior
Make perceived susceptibility more
consistent with individual’s actual risk
Perceived
severity
Belief about how
serious a condition and
its sequelae are
Specify consequences of risks
and conditions
Perceived
benefits
Belief in efficacy of the
advised action to
reduce risk or
seriousness of impact
Define action to take: how,
where, when; clarify the
positive effects to be expected
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…constructs and definitions of the HBM
65Constructs Definitions Application
Perceived
barriers
Belief about the
tangible and
psychological costs of
the advised action
Identify and reduce perceived barriers
through reassurance, correction of
misinformation, incentive
Cues to
action
Strategies to activate
“readiness”
Provide how-to information,
promote awareness,
use appropriate reminder systems
Self efficacy Confidence in one’s
ability to take action
•Provide training and guidance in
performing recommended action
•Use progressive goal setting
•Give verbal reinforcement
•Demonstrate desired behaviors
•Reduce anxiety
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Health belief model…Exercise (5
minutes)
 If this model was used to shape a public
promotion program for HIV prevention, what
beliefs would it be necessary for people to adopt
so as to minimize their risk of infection?
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HBM… answers
Individuals would need to believe:
 They are at risk of HIV infection
 The consequences of infection are serious
 The benefits of action to reduce risk will
outweigh potential costs and barriers
 In their ability to take effective action
 Risk minimization practices will greatly reduce
the risk of infection
 Receive supportive cues for action which may
trigger a response
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2. Social Learning Theory (Social Cognitive
Theory (SCT)
 Human behavior is the product of the dynamic
interplay of personal, behavioral, and
environmental influences
 Give due attention to the human minds, and
external environment
 SCT emphasizes reciprocal determinism in the
interaction between people and their
environments
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Social learning theory…
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Summary of the main constructs of SCT
70
Concepts Definition Application
Reciprocal
determinism
Behavior changes result from
interaction between person and env’t:
change is bi-directional
Involve the individual and relevant
others; work to change the
environment, if warranted
Behavioral capability Knowledge and skills to influence
behavior
Provide information and training
about action
Expectations Beliefs about likely results of action Incorporate information about
likely results of action in advice
Self efficacy Confidence in ability to take and
persist in action
Point out strengths; use
persuasion & encouragement;
approach behavior change in
small steps
Observational
learning
Beliefs based on observing, others
like self and/or visible physical results
Point out others’ experience
physical changes; identify role
models to emulate
Reinforcement Responses to a person’s behavior
that increase or decrease the
chances of recurrence
Provide incentives, rewards,
praise; encourage self reward;
decrease possibility of negative
responses that deter positive
changes

3. Stages of change (Trans theoretical model)
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It is developed by James Prochaska and Carols
Diclemente (1979)
…change is a process with stages not just an
event…
The core constructs of the model are:
1. The stages of change and
2. The process of change

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Stages of change (TTM)
1. Pre-contemplation
2. Contemplation
3. Decision
4. Action
5. Maintenance
6. Termination

Six stages of change
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1. Pre contemplation phase
Who has no intention to change a behavior (whether he/she
recognizes it or not), lack of knowledge + lack of interest
2. Contemplation phase
Who recognizes the problem and seriously thinking about
making changes. They are those who intend to change within
six months
They have no commitment to undertake action
3. Preparation phase
 Actively planning for change and intending to take action
in the next month
4. Action phase
Who are involved in consistent behavior changes for less
than 6 months/overt making changes

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Stages of change…
5. Maintenance phase: Who have been successful in
maintaining or sustaining a change for 6 months or more
6. Termination phase
It is the time when the individuals who have zero temptation
to return to their old behavior and have 100% self –efficacy
(lifetime maintenance) to resist relapse. Eg. Smokers
becomes non-smokers
Note: lapse/slip & relapse can occur at any stage except
the termination phase but behavioral lapses occur at
action or maintenance stage

Stages of change
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Action
phase:
making
changes
Maintenanc
e phase:
maintainin
g changes
Relapse:
relapsing
back
Contemplat
ion
Preparation
phase :
ready to
change
Pre-
contemplation
Not interested in
changing ‘risky’
lifestyle
Exit:
Termination
Maintaining
‘safer’ lifestyle

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Stage…
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77 Assumptions: No matter how time of change
differs among individuals the changes are the same
and sequential.
Note:
some people move more rapidly while others may
“stuck” at one stage for a long time.
 on which stage does someone lie? What
intervention do we need to move across?
we should carefully identify using definitions we
have for each stage

…stages of change model
78
Stage Definition Potential change strategies
Precontemplation Has no intention of taking action within the
next six months
Increase awareness of need for
change; personalize information
about risks and benefits.
Contemplation Intends to take action in the next six months Motivate; encourage making
specific plans
Préparation Intends to take action within the next 30
days and has taken some behavioral steps in
this direction
Assist with developing and
implementing concrete action
plans; help set gradual goals
Action Has changed behavior for less than six
months
Assist with feedback, problem
solving, social support, and
reinforcement
Maintenance Has changed behavior for more than six
months
Assist with coping reminders,
finding alternatives, avoiding
slips/relapses (as applicable)
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Stages of Change as applied to HIV/AIDS
Programme
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Pre-contemplation
Young man has heard
about AIDS but
doesn’t think it is
relevant to his life.
Contemplation
Young man
believes that he
and his friends
are at risk and
thinks that he should
do something.
preparation
Young man is
ready & plans to
use condoms
so goes to a shop
to buy them.
Maintenance
Using condoms
has become a habit
and young man
regularly buys uses
them.
Action
Young man buys
and uses condoms.
Termination

4. Theory of diffusion of
innovation
 Developed by Everett M. Rogers
 5 times revised between 1962 and 2005
 Diffusion of innovation theory is a theoretical approach
which provides an explanation as to
 how innovation, or ideas perceived as new are
communicated (diffused) through channels among the
members of the social system
 how people create & share information (human behavior)
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Diffusion process
 The process by which an innovation is
communicated through certain channels over
time among the members of a social system
 There are five segments (adopter categories) in
the diffusion process based on the amount of
time it took to adapt an innovation
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Adoptor categories
I. Innovators
II. Early Adopters
III. Early Majority
IV. Late Majority
V. Laggards
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1. Innovators-2.5% of the population
 Are first to adapt an innovation (they want to be first to do
something)
 Are risk takers even if the innovation is unprofitable.
 they have higher socioeconomic status than any other
group
2. Early adopters -13.5%
 Are very interested in innovation, but they do not want to
be first to be involved.
 Opinion leaders/respected by peers
 Serve as role model for other members or society
 Role models: are individuals who can shape others
action either by compliance or compulsion
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3. Early majority-34%
 May be interested in innovation, but will need some
external motivation to get involved
 Interact frequently with peers (sociable and jockey)
 They are revolutionary. Actively adopt innovation if it is
pragmatic/practical or realistic
4. Late majority-34%
 Are skeptical/doubtful and cautious and will not adopt
an innovation until most people adopt
 Pressure from peers
 They are classical; they are evolutionary/after long time
progress as they adopt only after majority have
adopted it
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5. Laggards -16%
 Will be the last to get involved in an
innovation, if they get involved in an
innovation at all
 Possess no opinion leadership
 Isolated in the social systems
 Point of reference is in the past
 Suspicious of innovation
e.g. grandparents
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The Adopter’s categories
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Adoption process
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 Adoption process is the mental process
through which an individual passes from first
hearing about an innovation to final adoption“
 it pertains to an individuals
 It is the same to every adopters category
 Rogers breaks the adoption process down into
five main stages

Stages of adoption
Awareness
Interest
Evaluation
Trial
Adoption
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Stages of adoption (steps to behavior
change)
1. Stage of Awareness (Knowledge) - the individual is
exposed to the innovation but lacks complete information
about it
2. Interest (approval, acceptance) -the individual becomes
interested in the new idea and seeks additional information
about it
3. Evaluation (Intention, interest) - individual mentally
applies the innovation to his present and anticipated future
situation, and then decides whether or not to try it
4. Trial (Practice) - the individual makes full use of the
innovation
5. Adoption (Maintenance) - the individual decides to
continue the full use of the innovation
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Rejection
 An innovation may be rejected during any stage of the
adoption process
 Rejection: is a decision not to adopt an innovation either
before or after trial
 Before trial: t is irreversible, not perceived compatible or
has no outweighing relative importance than previous
practice
 After trial: it is discontinued as of observed
incompatibility, or replaced by other innovation or totally
disenchanted
e.g. Nano technology??? 3/4/2022
90

5. Theory of Reasoned Action (TRA)
 The theory of reasoned action was developed in the mid-
1960s by Fishbein and Ajzen
 The theory states that intentions are the basis and the
most immediate influences for the behavior to be
adapted
 Intention is a measure of motivation or readiness to
act and is excellent predictors of behaviors
 it is readiness to engage provided that enabling factors
are readily in place
 it is a function of two main determinants:(personal
(Attitude) & social factors (Subjective norm))
Intention= attitude + subjective norm 3/4/2022
91

Theory Reasoned Action…
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92
Behavior
Intention
Significant
others
Consequenc
e of
behavior
Subjective
norm
Attitude
Socio-demographic
variables

Determinants of intention
1. Person’s attitude toward performing the behavior
 Attitude: are determined by the perceived
consequences of performing the behaviors/evaluation of
the outcome and beliefs
 Attitude = belief * evaluation (value)
 If the person has strong beliefs that his /her behavior
results to positive outcome then he/she said to have
positive attitude about the behavior and vise versa.
 If the person has strong beliefs that his /her behavior
results to negative outcomes then he/she said to have
negative attitude about the behavior and vise versa.
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2. Subjective norm: the person’s perceived social pressure
exerted upon him or her to perform the behavior
 A person’s belief of others explanation on his/her behavior
& the tendency to fulfill the expectations
 Subjective norm : is influenced by significant others
(significant people such family, care givers, peers,
teachers etc.)
 if a person is strongly motivated with what he expects
others think he/she should perform a behavior, he will
have positive SN or otherwise negative
 SN= normative belief * motivation to comply
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THANK YOU!
3/4/2022
96

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