Uht Ke3 Introduct.hp&He Rst 07
Transcript of Uht Ke3 Introduct.hp&He Rst 07
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Introduction to
Health Behavior,
Health Promotion &
Health Education
Kuliah UHT Rabu 24-10- 200707.00-09.00
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Introduction
Health problems havemult ip le & interrelated
causes, that are targets of
PH & HP programs.
Interventions aimed at onlyone cause is not likely to
be successful, because the
causes are interrelated
HP : set of changeprocesses directed
toward the causesof
health problem
Many public healthmeasures become the
ob ject ives of HPefforts,
because their
accomplishmentrequires behavior
change on the part of
patients, citizens,
technocrats, and policy-
makers.
HP objective can focus
on several societal levels
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Concept of:
Health Behavior:
the actions of individuals, groups, and
organizations and to those actions determinants, correlates, and
consequences, including social change,
policy development and implementation,
improved coping skills, and enhanced
quality of life (Parkerson et al, 1993)
To be continued
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Concept of:
Health Behavior:
Gochman (1982): personal attributes such
as beliefs, expectations, motives, values,
perceptions, and othercognitive elements;personality characteristics, including affective and
emotional states and traits; and overt behavioral
patterns, actions, and habits that relate to health
maintenance, to health restoration, and to health
improvement.
To be continued
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Concept of:
Health Behavior: (B)
Gochman (1982):
- cognitive elements .: Knowledge (K)- affective and emotional: Attitude (A)
- actions, and habits..: Practices (P)
To be continued
B = K.A.P
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Concept of:
Health Education(HE):
concern withpromoting healthfulbehavior &alteringthe condi t ion, thataffect: healthbehavior & health
directly
Health Promotion (HP):
Set of processes changecondi t ionsthat affect health
Concern specifically with thesociobehavioral processes for:
- improving personal healthbehavior
- implementing public
health measures
HP should be programmaticrather than incidental
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EVOLUTION of the CONCEPT
Health promotion beginswith people who are basically
healthy and seeks the development of community
and individual measures which can help them to
develop lifestyles that can maintain and enhance thestate of Well-being (Healthy People, 1979)
PHfocusing on measures that improve the general health
of population, e.g. water fluoridation, and directed at mostat risk pop. pregnant teenagers, eldest people etc
To be continued
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EVOLUTION of the CONCEPT
Equating H. behaviorchange with HP, (thesingle most damaging
misconception!!!),neglect the concept ofHP is change processconcerned withmultiple causes of
health problems.
Healthy People 2000emphasizing on healthbehaviorrather than onbehavioral change process has unfortunateimpediment to progress inH. Promotion i.e.
1. Blame personal behavior
2. Fails to emphasis changeprocesses for alteringrelated health services &environmental controls.
To be continued
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EVOLUTION of the CONCEPT
Green & Johnson(1983): HP is anycombinat ion of
educational,
org anizat ional, econom ic,
and environmental
suppo r ts for behav ior
conducive to heal th.
The emphasis on a rangeofsupports is good, because isneeded for improvement inPH., but the definition can befaulted in two ways:
1. behavior conduciveto health, rather thanon health itself.,behavior is only one ofseveral intermediateoutcomes!!!
2. Confusing objectiveswith measures orapproaches; educ ., org,
econom ic, and env.suppor tsare PHmeasures & HPobjectives,
but clearly they are not
HP processes!!!To be continued
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EVOLUTION of the CONCEPT
Bruce et al: HP is any combination of changeprocesses directed at educational,
organizational, economic, and environmental
supports conducive to health.
Minkler (1989): programs based on personal
H. Behavior, may be creative & effective, but
should not focu s on increas ing pro f its -or iented wellness p rogramm ing!!!
To be continued
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EVOLUTION of the CONCEPT
Dorothy Nyswanders admonition (1982) to focus HPon empowering individuals and changing systems. Thesuccess of HE programs would not be measured onthe amount of H. behavior or Health status change, butthe extent to which they increase meaning, control, andquality of life!
WHO definition of HP (1984) as a process of enablingpeople to increase control over and improve theirhealth as mediating strategy between people andtheir environments, synthesizing personal choice and
social responsibility in health. Minkler (1989) & Freudenberg (1981) are attempting
Nyswanders idea of focusing on health within thecontext of democracy and social empowerment.
To be continued
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EVOLUTION of the CONCEPT
According to Nyswander: HP is not only
measured by the improvement of H.
behavior, mortality, morbidity, but also by
changes in social structure, and theactual & perceived control that people
have over their lives ( control behavior,
and social & physical environmentsthat are most important, changeable, or
highest priority).
To be continued
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EVOLUTION of the CONCEPT
Dwore and Kreuter (1980): HP is theprocess ofadvocat inghealth in order toenhance the probability that personal
(individual, family, and community),private (professional and business), andpublic (federal, state and localgovernment) support of positive health
practices will become a societal norm(emphasizing: advocacy, multilevel sociallevel and social norms)
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The relationship of health education to the three major
categories of health & illness determinants
Personal
Behavior&
Lifestyle
HEALTH
EDUCATIONPublic Health
&
Medical Care
Environment
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Pustaka
Glanz,Karens, Frances Marcus Lewis,
Barbara K.Rimer, editors, 1997. HEALTH
BEHAVIOR and HEALTH EDUCATION,
Theory, Research, and Practice. 2 ed.
Jossey-Bass Pulishers, San Franscisco,
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