OVERVIEW OF

BEHAVIOUR CHANGE
 MỤC TIÊU
- Trình bày được tầm quan trọng của các
khái niệm thay đổi hành vi đối với thực hành
nha khoa.
- Áp dụng được nội dung các thuyết thay đổi
hành vi trong việc hỗ trợ bệnh nhân thay
đổi và duy trì các hành vi nâng cao sức
khỏe.
Overview of behaviour change
- “Victim blame”
- The dental team need to understand what
factors influence these behaviours and how
they can be altered successfully.
WHO:
Health education comprises consciously
constructed opportunities for learning
involving some form of communication
designed to improve health literacy,
including improving knowledge, and
developing life skills which are conducive to
individual and community health.
WHO: the primary objectives of the health
education: To persuade people
1. To adopt and sustain healthy life practices.
2. To use judiciously and wisely health
services available to them.
3. To take their own decisions both
individually and collectively to improve their
health status and environment.
 Definitions of health behaviour
• ‘Overt behaviour patterns, actions and
habits that relate to health maintenance, to
health restoration and to health
improvement’ (Gochman 1982 ).
• ‘Any activity undertaken by people in order
to protect, promote or maintain health and
prevent disease’ (Steptoe and Wardle
1994 ).
Overview of behaviour change
- Theories of change
- Social epidemiology frameworks
- Practical reflections on theories of
behaviour change
-Implications for clincal practice and health
promotion
-Conclusion
 Theories of change
Health locus of control (HLOC)
Rotter et al . (1972)
Measures the extent to which individuals
believe that their health is influenced either
by their own behaviour or by external causes.
•Internal HLOC
•Powerful others HLOC
•Chance HLOC
 Theories of change
Health belief model (HBM)
(Becker 1974 ; Rosenstock 1966 )
- the function of beliefs in decision-making
- when individuals consider changing their behaviour
they engage in a cost/benefit analysis of the situation
+ their susceptibility to the health threat;
+ the perceived severity of that threat;
+ the perceived value of changing the behaviour in
question.
 Theories of change
The health belief model (HBM)
- before a change of behaviour takes place
there needs to be a cue or trigger to initiate
an alteration in behaviour.
The health belief model
(Becker 1974 ; Rosenstock 1966 )
 Theories of change

The Theory of Planned Behaviour (TPB) model

 Theories of change

Communication of innovation model

Theories of change

Stages of change model

Figure 9.4 Stages of change model. Reproduced from Prochaska J

and DiClemente C (1984). The Transtheoretical Approach: Crossing
Traditional Boundaries of Therapy . Krieger
Social epidemiology frameworks
Life course approach
-Bartley et al 1997, Kuh & BenShlomo 1997.
-the significant impact of adverse early life
conditions on later oral health outcomes
(Nicolau et al . 2007 )
Social epidemiology frameworks
Life course approach
Critical periods in human development most relevant to health:
1 Transition from primary to secondary school.
2 School examinations.
3 Entry to labour market.
4 Leaving parental home.
5 Establishing own residence.
6 Transition to parenthood.
7 Job insecurity, change, or loss.
8 Exit from labour market. (Bartley et al . 1997 .)
Social epidemiology frameworks
Social capital
- Social capital: features of social organization, such
as civic participation, norms of reciprocity, and trust
in others, that facilitate co-operation for mutual
benefit’ (Putnam 1993 )
- Kawachi and colleagues (1997): ‘the growing gap
between the rich and the poor affects the social
organization of communities and that the resulting
damage to the social fabric may have profound
implications for the public’s health.’
 Theories of change
Social capital
- What role do health workers have in
facilitating improved social networks, social
support, and community involvement?
Community development approaches within
health promotion clearly fit very well into this
agenda.
Practical reflections on theories
of behaviour change
- Process of change
- Motivations to change
- Barriers preventing change
- Clustering of behaviours
Barriers to achieving long-term change

- Lack of opportunity
-Lack of resources
-Lack of support
-Conflicting information on nature of change.
-Conflicting motives
Barriers to achieving long-term change

- Long-term nature of benefit.

- Belief that change is not possible
- No clearly defined goals
- Lack of knowledge on what to change
 Implications for clincal practice
and health promotion

Key implications of behaviour change

- Importance of context and environment
Individual behaviours are largely determined
by a complex array of factors beyond the
control of most individuals.
- Limitations of information alone.
- Process of change.
- Support essential
 CONCLUSION
- To be a successful clinician you will need to be
able to influence your clients and assist them
with desired changes.
- Success in helping clients to alter their
behaviours will largely depend upon your
awareness of the factors and processes
influencing behaviour change. The provision of
information alone in most cases will be
insufficient to achieve sustained changes in
behaviour to promote oral health.
 TÀI LIỆU THAM KHẢO
Blánaid Daly et al (2013), “Overview of
behaviour change”, Essential Dental Public
Health, Oxford University Press,pp.114:126.