CLINICAL TEACHING LECTURE Consciously constructed opportunities for learning (WHO)

HEALTH EDUCATION Health Literacy - This is to improve the knowledge and

develop life skills of the individual and the community.
• According to Green, Health Education is a combination
Topic Outline Week 2 of learning experiences designed to facilitate voluntary
II. Health Education Perspective adaptations of behaviour conducive to health. It
A. Historical development in health education increases the competence and confidence of clients for
B. Issues and trends in health education
self- care.
1. Health issues and the biological,
psychological, and sociological aspects of health • Nurses are the ones that educate and prepare clients
and disease for self-care.
2. Contemporary health and the promotion of • According to Bastable, there is effective teaching by
optimal health throughout the lifespan the nurse if the patient can properly execute the self-
C. Theories in health education - (e.g., Pender's Health care by themselves.
Promotion Theory, Bandura's Self-Efficacy Theory,
Health Belief Model)
EDUCATION PROCESS

HEALTH EDUCATION HISTORICAL PERSPECTIVE

Nursing Process and Education Process are more of
Nurses the same thing.
● Do not only give care to the patients for they are also
health educators. Education Process is a systemic, sequential, logical,
● Not only responsible for teaching the patients for they scientific-based, and planned course of action.
have important roles as caregivers and teachers. • Has two major interdependent operations:
● They do not only care for the sick but also promote o Teaching & Learning
health and well-being to the public.
Ex. As Clinical Instructors, (All Clinical Just like in the Nursing Process, they both have the:
Instructors are nurses) They teach and • Assessment (What can you see in the patient?)
educate us student nurses. We are the • Planning (If you see that the patient has a problem,
learners, and they are educating us. what will you do?)
● Education is not only for the patient but also for the
• You make an Implementation/Intervention
patient's family, fellow nurses, and incoming nurses.
• You execute and then you Evaluate

HEALTH EDUCATION
In Nursing Process
● Health education is defined as the set of philosophies
It focuses on planning and implementation of care based on
and methodologies that educate the general public,
the assessment and diagnosis of the physical and
healthcare practitioners, and communities about
psychosocial needs of the patient.
anything related to health.
● It draws from disciplines that include biology,
In Education Process
environmental science, ecology, psychology, physical
It focuses on planning and implementation of the teachings
science, and medical science.
based on assessment and prioritization of the client’s
● It is used to promote good health as well as prevent
learning needs, readiness to learn, and learning styles.
disease, disability, and early death.
● Health education encourages voluntary behavioural
changes and positive influences.
● It can happen at the individual, group, institutional,
community, or systemic level.
● It attempts to address attitudes, behaviours, and skills
that can improve wellness.
● The World Health Organization defined Health
Education as: "comprising of 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."
HEALTH EDUCATION
Science and profession of teaching health concepts.
● To promote, maintain, and enhance one's health, and TEACHING is like an instruction.
prevent illness, disability, and premature or unlikely • Use interchangeably with the term instruction, is a
death. deliberative intervention that involves sharing
Any combination of planned learning experiences. information and experiences.
● In Nursing, the Health models and theories include • Can either be FORMAL (structured, organized,
biological, environmental, psychological, physical, and planned) or INFORMAL (spur-of-the-moment,
medical sciences. incidental encounters, spontaneous).
Based on theories that provide the individual, the group, • Need not be a lengthy and complex but highly versatile
and the community, it is the opportunity to acquire strategy.
information and skills to make quality health decisions.

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LEARNING In the 1900's
• Observed/measured change in behaviour (KSA: • →The nurse as a teacher is not only preventing
Knowledge, Skills, Attitudes) diseases but also maintaining the health of the
• Action by which KSA are consciously or unconsciously Individual and the family.
acquired)
• Success of teaching is on how much the person learns PATIENT EDUCATION
and NOT on how much content has been taught. Major component of the care given by the nurses

IMPORTANCE OF HEALTH EDUCATION TIMELINE

Mid 1800's to Turn of 20th Century.
● EMPOWERS people to decide for themselves on ✓ Start of Patient Education
what options to choose to enhance their quality of ✓ Formative period
life. ✓ 1st phase in the development of organized healthcare.
● EQUIPS people with knowledge and competencies
to prevent illness, maintain health or apply first aid 4 Decades of 20th Century
measures to prevent complications. ✓ 2nd phase in the development of organized healthcare.
● ENHANCES quality of life by promoting a healthy
lifestyle. After World War II (Around 1940s-1950s)
● CREATES awareness regarding the importance of ✓ 3rd phase in the development of organized healthcare.
preventive and promotive care thereby avoiding or ✓ Time of significant scientific accomplishments and a
reducing the causes involved in medical treatment profound change in the delivery system of healthcare
and hospitalization. ✓ The course content in the nursing school curriculum is
to prepare nurses to assume the role of teachers.
HISTORY OF HEALTH EDUCATION
1960's and 1970's
• The first examples of health education or roots of health ✓ Patient education began to be seen as a specific task
education began with the ancient Greeks. (of nurses).
o They realized tools like sanitary practices and ✓ The Need for Patient Education
medication were related to health outcomes ✓ President Nixon used the term Health Education.
and they created public policies and education
to encourage healthy lifestyles. 1980's and 1990's
• The concept of educating about health has been ✓ National Health Education Programs focused on
everywhere since the beginning of humans. health promotion and disease prevention.
• The history of health education dates back to the 19th
Mid 1990's
century:
✓ Pew Health Professions Commission - published a
o By the 1940s, the field began evolving as a
broad set of competencies.
distinct discipline.
✓ Marked the success of the health profession.
o Over time, health education's theory and
practice base has widened from focusing on
Around 2006
one-to-one and mass media behavioural
✓ Incidence of medical harm is reduced.
interventions to incorporating responsibility for
✓ Care is improved to reduce injuries and save lives.
policies, systems, and environments that affect
✓ Cause of healthcare is decreased.
population health.
✓ The cause of healthcare decreases because the
• At the time of the Alma Ata Declaration of Primary
individuals and the family already know how to take
Health Care (PHC) in 1978, health education was put
care of themselves.
as one of the components of PHC and it was
✓ Promoting health prevents illness or diseases.
recognized as a major tool for the attainment of health
for all.
ISSUES AND TRENDS IN HEALTH EDUCATION
• Since then, many countries in Africa have utilized
health education as a primary means of prevention of Issues are ideas, thoughts, and debates centered on
diseases and promotion of health. educational policy and practices. Trends are new, up-and-
coming, and popular educational practices.
FLORENCE NIGHTINGALE
Issues In Nursing Education
Founder of Modern Nursing • Students
• Educator on the First School of Nursing Teaches not • Teachers
only nurses but also doctors and fellow Health officials. • Education environment
• She gives the importance of proper conditions in the • Political environment
hospitals and homes to improve the health of people. • Controlling bodies
• She emphasized the importance of teaching patients • Health care problems • Health care industry
about the need for adequate nutrition, fresh air, • Environment
exercise, and personal hygiene to improve their well- • Globalization
being. • Modern technology
• Resolute advocate of the educational responsibilities of • Research
district public health nurses
• Authored Health Teachings in Towns and Villages -
advocated for school teaching of health rules as well as
health teaching in the home.

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Trends in Health Education • Pender's health promotion model defines health as
• Patients are being encouraged to play an active role in "a positive dynamic state not merely the absence
the care and information they receive. of disease."
• Supported by numerous programs. • Health promotion is directed at increasing a client's
• Goal of patient and family education is to improve level of well-being.
patient outcomes: • It describes the multi-dimensional nature of persons as
o Often through encouraging adherence they interact within the environment to pursue health.
o Especially important for those with chronic health
problems MAJOR CONCEPTS OF THE HEALTH PROMOTION
MODEL
THEORIES IN HEALTH EDUCATION
• Nola J. Pender (1941- present) is a nursing theorist 1. Health Promotion is defined as behavior motivated by
who developed the Health Promotion Model in 1982. the desire to increase well- being and actualize human
• She is also an author and a professor emeritus of health potential. It is an approach to wellness.
nursing at the University of Michigan. She started 2. On the other hand, Health Protection or Illness
studying health-promoting behaviour in the mid-1970s Prevention is described as behavior behavior-
and first published the motivated desire to actively avoid illness, detect it early,
• Health Promotion Model in 1982. Her Health Promotion or maintain functioning within illness constraints.
Model indicates preventative health measures and 3. Individual Characteristics and Experiences (prior
describes nurses' critical function in helping patients related behavior and personal factors).
prevent illness by self-care and bold alternatives, 4. Behavior-Specific Cognitions and Affect (perceived
• Pender has been named a Living Legend of the benefits of action, perceived barriers to action,
American Academy of Nursing perceived self-efficacy, activity-related affect,
interpersonal influences, and situational influences).
Nola Pender's Health Promotion Model 5. Behavioral Outcomes (commitment to a plan of
• Have you ever noticed advertisements in malls, grocery action, immediate competing demands and
stores, or schools that advocate healthy eating or preferences, and health-promoting behavior).
regular exercise?
SUBCONCEPTS OF THE HEALTH PROMOTION MODEL
• Have you gone to your local centers or hospitals
promoting physical activities and smoking cessation
programs such as "quit" activities and "brief Personal Factors
interventions?" • Personal factors are categorized as biological,
These are all examples of health promotion. psychological, and socio-cultural.
• The Health Promotion Model, developed by nursing • These factors are predictive of a given behaviour and
theorist Nola Pender, has provided healthcare a new shaped by the target behaviour’s nature being
path. considered.
• According to Nola J. Pender, Health Promotion and o Personal Biological Factors. Include variables
Disease Prevention should focus on health care. such as age, gender, body mass index, pubertal
• When health promotion and prevention fail to anticipate status, aerobic capacity, strength, agility, or
predicaments and problems, care for illness becomes balance.
the subsequent priority. o Personal Psychological Factors. Include
variables such as self-esteem, self-motivation,
WHAT IS HEALTH PROMOTION MODEL? personal competence, perceived health status,
and definition of health.
• The Health Promotion Model notes that each person
o Personal Socio-Cultural Factors. Include
has unique personal characteristics and experiences
variables such as race, ethnicity, acculturation,
that affect subsequent actions.
education, and socioeconomic status.
• The set of variables for behavioral-specific knowledge
and effect has important motivational significance.
• Perceived Benefits of Action: Anticipated positive
• These variables can be modified through nursing
outcomes that will occur from health behavior.
actions. Health-promoting behavior is the desired
• Perceived Barriers to Action: Anticipated, imagined,
behavioral outcome and is the endpoint in the Health
or real blocks and personal costs of understanding a
Promotion Model.
given behavior.
• Health-promoting behaviors should result in improved
• Perceived Self-Efficacy
health, enhanced functional ability, and better quality of
o The judgment of personal capability to organize
life at all development stages.
and execute a health-promoting behavior.
• The final behavioral demand is also influenced by the
o Perceived self-efficacy influences perceived
immediate competing demands and preferences, which
barriers to action, so higher efficacy results in
can derail intended health-promoting actions.
lowered perceptions of barriers to the behavior's
• The Health Promotion Model was designed to be a
performance.
"complementary counterpart to models of health
protection."
Situational Influences
• It develops to incorporate behaviors for improving
• Personal perceptions and cognitions of any given
health and applies across the lifespan.
situation or context can facilitate or impede behaviour.
• Its purpose is to help nurses know and understand the
• Include perceptions of options available, demand
major determinants of health behaviors as a foundation
characteristics, and aesthetic features of the
for behavioral counseling to promote well-being and
environment in which given health-promoting is
healthy lifestyles.
proposed to take place.

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• Situational influences may have direct or indirect • Commitment to a plan of action is less likely to result in
influences on health behaviour. the desired behaviour when competing demands over
which persons have little control require immediate
Immediate Competing Demands and Preferences attention.
• Competing demands are those alternative behaviors • Commitment to a plan of action is less likely to result in
over which individuals have low control because of the desired behaviour when other actions are more
environmental contingencies such as work or family attractive and preferred over the target behaviour.
care responsibilities. • Persons can modify cognitions, affect, and the
• Competing preferences are alternative behaviors over interpersonal and physical environment to create
which individuals exert relatively high control, such as incentives for healthy actions.
the choice of ice cream or apple for a snack.
THEORIES IN HEALTH EDUCATION
Health-Promoting Behavior
• A health-promoting behavior is an endpoint or action Albert Bandura (1925-2021)
outcome directed toward attaining positive health ✓ Social Learning Theory
outcomes such as optimal well- being, personal ✓ Bobo Doll Experiment
fulfillment, and productive living. ✓ Self-Efficacy

HEALTH PROMOTION MODEL • Albert Bandura was a Canadian-born American

psychologist who is perhaps most well-known for his
Major Assumptions in Health Promotion Model Bobo Doll experiment. This study investigated
• Individuals seek to regulate their own behaviour aggression and the influence of media on violent
actively. behaviours. His social learning theory posited that
• Individuals in all their biopsychosocial complexity aggressive and other behaviours are learned and
interact with the environment, progressively emulated through a process of modelling. He
transforming the environment and being transformed suggested that children learn from their environments
over time. and are prone to imitate behaviours and activities they
• Health professionals constitute a part of the observe in parents and peers.
interpersonal environment, which influences persons • Bandura's early work on social modelling segued into
throughout their life span. research on self-development, which led him to
• Self-initiated reconfiguration of person- environment theorize that people's belief in their abilities is a crucial
interactive patterns is essential to behaviour change. aspect of their success since this impacted their
thoughts, motives, and actions.
Propositions
• Prior behavior and inherited and acquired
characteristics influence beliefs, affect, and enactment
of health-promoting behavior.
• Persons commit to engaging in behaviors from which
they anticipate deriving personally valued benefits.
• Perceived barriers can constrain commitment to action,
a mediator of behavior as well as actual behavior.
• Perceived competence or self- efficacy to execute a
given behavior increases the likelihood of commitment
to action and behavior's actual performance.

• Greater perceived self-efficacy results in fewer Albert Bandura's theory of self- efficacy contends that
perceived barriers to specific health behaviour. people are inclined to succeed if they have confidence in
• Positive affect toward a behaviour result in greater their abilities. He believed that perspective was a
perceived self-efficacy, which can, in turn, result in noteworthy player in the accomplishment of goals.
increased positive affect.
• When positive emotions or affect are associated with a Bandura's Self-Efficacy
behaviour, the probability of commitment and action is • According to Bandura, self-efficacy is an individual's
increased. perception of his competencies, which plays a
• Persons are more likely to commit to and engage in significant role in his ambition and outcome
health- promoting behaviours when significant others expectations.
model the behaviour, expect the behaviour to occur, • Bandura's self-efficacy theory suggests that a
and provide assistance and support to enable the person's confidence in his abilities can determine
behaviour. his drives and decisions.
• Families, peers, and healthcare providers are important • Someone with a high level of self-efficacy tends to
sources of interpersonal influence that can increase or foster a more positive outlook and experience a lower
decrease commitment to and engagement in health- incidence of stress.
promoting behaviour. • Conversely, someone with a weak sense of self-
efficacy is less confident in potential outcomes and
• Situational influences in the external environment can is more inclined to experience stress and
increase or decrease commitment to or participation in depression.
health- promoting behaviour.
• The greater the commitments to a specific plan of
action, the more likely health- promoting behaviours will
be maintained over time.
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• Self-efficacy is a person's belief in their ability to
complete a task or achieve a goal. Self-Efficacy
✓ Belief in one's capabilities to get particular things
• It encompasses a person's confidence in themselves to done (more specific than self- confidence)
control their behaviour, exert an influence over their ✓ Associated with an internal locus of control, but
environment, and stay motivated in the pursuit of their failure is more likely to be attributed to external
goal. factors.
• People can have self-efficacy in different situations and ✓ Linked to higher self-esteem.
domains, such as school, work, relationships, and other ✓ Can be improved through mastery and emotional
wellness
important areas.

• When facing a challenge, do you feel like you can rise

up and accomplish your goal, or do you give up in
defeat?
• Are you liking the little train engine from the classic
children's book ("I think I can, I think I can!"), or do you
doubt your own abilities to rise up and overcome the
difficulties that life throws your way?
• If you tend to keep going in the face of obstacles, you
probably have a high degree of self-efficacy.

• Self-efficacy is important because it plays a role in how

a person feels about themselves and whether or not
they successfully achieve their goals in life.
SELF-EFFICACY THEORY OF MOTIVATION
• The concept of self-efficacy is central to Albert
Bandura's social cognitive theory, which emphasizes
• Bandura's theory of self-efficacy is closely related to the
the role of observational learning, social experience,
concept of motivation in that a person's beliefs are
and reciprocal determinism in personality development.
fundamental to his aspirations.
• Self-efficacy, therefore, becomes an explanation of a
• According to Bandura, self-efficacy is part of the self-
person's trajectory in many areas: professionally,
system comprised of a person's attitudes, abilities, and
relationally, academically, and otherwise.
cognitive skills.
• Self-efficacy translates to greater intrinsic motivation,
• This system plays a major role in how we perceive and
more goal-oriented behaviours, elevated confidence,
respond to different situations.
and persistence in completing tasks.
• Self-efficacy is an essential part of this self-system.
• The self-efficacy theory of motivation sustains certain
optimism about future success.
THE ROLE OF SELF-EFFICACY

Four Factors/Types of Self-Efficacy

• Virtually all people can identify goals they want to
• Bandura recognized four factors/types in construction
accomplish, things they would like to change, and
of self-efficacy.
things they would like to achieve.
o They included mastery of prior experiences,
• However, most people also realize that putting these
imitation of successful models, encouragement
plans into action is not quite so simple.
from others, and physiological traits.
• Bandura and others have found that an individual's self- o These are the sources of information on which
efficacy plays a major role in how goals, tasks, and people rely when forming self-efficacy
challenges are approached. judgments.
• Having high self-efficacy is a good thing. People with a
strong sense of self-efficacy: FOUR TYPES OF SELF-EFFICACY
o Develop a deeper interest in the activities in
which they participate!
Mastery Experiences – Past positive experiences
o Form a stronger sense of commitment to their
contribute to a greater sense of self-efficacy so that
interests and activities.
performing well in school or at work can serve to fortify a
o Recover quickly from setbacks and
sense of self-efficacy.
disappointments.
o "The most effective way of developing a strong sense
o View challenging problems as tasks to be
of efficacy is through mastery experiences," Bandura
mastered.
explained.
• Poor self-efficacy, on the other hand, can have a
o Performing a task successfully strengthens our sense
number of detrimental effects. People with a weak
of self-efficacy.
sense of self-efficacy:
o However, failing to adequately deal with a task or
o Avoid challenging tasks.
challenge can undermine and weaken self-efficacy.
o Believe that difficult tasks and situations are
beyond their capabilities.
Social Modelling - When a person is exposed to others
o Focus on personal failings and negative
who typify success, they are inclined to model that
outcomes Quickly lose confidence in personal
behaviour, thereby drawing positive influence from the
abilities.
accomplishment of others.
o Witnessing other people successfully completing a task
is another important source of self-efficacy.
o According to Bandura, "Seeing people similar to
oneself succeed by sustained effort raises observers'

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 beliefs that they too possess the capabilities to master o If he or she lacks access to fiber-rich foods, like
comparable activities to succeed." fruits and vegetables, because of cost or local
availability, he or she will not be able to take
Verbal Persuasion – Individuals are encouraged to excel action.
when others express confidence in their ability to succeed
by voicing positive affirmations. Six Health Belief Model Concepts
o Bandura also asserted that people could be persuaded
to believe that they have the skills and capabilities to 1. Perceived Susceptibility
succeed. • Perceived susceptibility refers to a person's belief about
o Consider a time when someone said something their chances of getting a certain condition.
positive and encouraging that helped you achieve a • For a person to take action, they must believe they are
goal. at risk for disease, illness or negative health outcomes.
o Getting verbal encouragement from others helps • When people believe they are at risk for a disease, they
people overcome self-doubt and instead focus on will be more likely to do something to prevent it from
giving their best effort to the task at hand. happening.
• The opposite is also true: when people believe they are
Physiological States - People can interpret their not at risk or are at low risk, they tend to have
physiological signals in ways that reduce self- efficacy, behaviours that are less healthy.
Increased adrenaline when public speaking. for example,
will arouse a fear of failure rather than stimulate energetic Perceived susceptibility alone is often not enough to
enthusiasm. cause behaviour change. For example, older adults are
o Our own responses and emotional reactions to among those most at risk for foodborne illness, often with
situations also play an important role in self- efficacy. serious ill health effects. Older adults may know they are at
o Moods, emotional states, physical reactions, and stress risk for foodborne illness but may continue to use unsafe
levels can all impact how a person feels about their food-handling practices.
personal abilities in a particular situation.
o A person who becomes extremely nervous before 2. Perceived Severity
speaking in public may develop a weak sense of self- • Perceived severity refers to a person's belief about the
efficacy in these situations. seriousness or severity of a disease.
o However, Bandura also notes "it is not the sheer • Severity can be based on medical consequences, like
intensity of emotional and physical reactions that is death or disability, or personal beliefs about how the
important but rather how they are perceived and condition or disease would affect their life.
interpreted." • For example. despite public health recommendations,
some people do not get the flu vaccine. They probably
THEORIES IN HEALTH EDUCATION know they can get the flu but may believe that getting
the flu will not be serious. However, getting the flu can
Health Belief Model be very serious for some groups, like older adults and
• The Health Belief Model states that people's beliefs people with asthma,
influence their health-related actions or behaviours • Perceived Severity might also be heightened among
• According to the Health Belief Model, readiness to take those self-employed because missing a week of work
action is based on the following beliefs or conditions: means reduced income.
✓ I am susceptible to this health risk or problem. • When perceived susceptibility and severity are
✓ The threat to my health is serious, heightened, people are more likely to take action.
✓ I perceive that the benefits of the recommended
action outweigh the barriers or costs. 3. Perceived Benefits
✓ I am confident I can carry out the action • Perceived benefits refer to a person’s opinion of the
successfully. value or usefulness of a new behaviour in lowering the
✓ Cues to action are present to remind me to take risk of disease.
action. • To make a change, people must believe that the
change will have a positive result.
• For example, people with diabetes take medication
believing it will work to control blood sugar. People quit
smoking because they believe it will improve their
health. When people get a colonoscopy, they do so
believing it will effectively screen for colon cancer.
• The belief that action will lead to beneficial results
makes a person more likely to take action. Sometimes
the benefits of changing behaviour are not strong
enough to cause a change, even when a person
believes they are susceptible.
• The perceived benefits may be outweighed by
• Individuals will likely take action when experiencing a perceived barriers.
personal threat or risk, but only if the benefits of taking
action outweigh the barriers, whether real or perceived. 4. Perceived Barriers
• Being able to take action is also crucial. • Perceived barriers are the most significant factor in
o For example, one at risk for colon cancer may determining behaviour change.
believe dietary change to increase fiber • Perceived barriers are a person’s view of the obstacles
consumption is needed. that stand in the way of behaviour change. Barriers can
be tangible or intangible.

6
• Tangible Barriers can be a lack of financial resources,
lack of transportation, childcare needs, etc.
• Intangible Barriers may be psychological, like fear of
pain, embarrassment, or inconvenience.
• For a new behaviour to be adopted, a person needs to
believe the benefits of the new behaviour outweigh the
consequences of continuing the old behaviour. If
barriers are stronger than benefits, change will not
occur. Sometimes people need help to find ways to
overcome barriers.

5. Cues to Action
• Cues to action are events, people, or things that trigger
people to change behaviour.
• Advice from others, the illness of a family member or
social media can provide cues.
• Restaurants that provide nutrition information on their
menus offer a cue to consider calorie content in food
choices.
• Posters in public restrooms offer hand washing cues.
• Highway signs to “buckle up” provide cues to action.
• Calendar reminders and mobile device alarms can also
trigger action.
• Cues can also be internal, such as chest pain,
discomfort, or fatigue.

6. Self-efficacy
• Self-efficacy is a person’s confidence and belief in
ability to take action or perform a given behaviour.
• People generally do not try to adopt new behaviours
unless they believe they can do them.
• A person who thinks altering their behaviour is
worthwhile (perceived benefit) but is unsure of their
ability to make a change is unlikely to attempt lifestyle
changes.
• In other words, even if a person believes adopting
healthier behaviour will have significant benefits, they
are unlikely to change current behaviours if they doubt
that the barriers to change can be overcome.
• Self-efficacy can be increased with encouragement,
training, and other support.

Health Belief Model Concepts

An individual’s assessment of their
• Perceived
chances of getting a disease or
Susceptibility
condition
• Perceived An individual’s judgment of the
Severity severity of the disease
An individual’s conclusion as to
• Perceived
whether the new behaviour is better
Benefits
than what they are already doing
An individual’s opinion as to what will
• Perceived
stop them from adopting the new
Barriers
behaviour
• Cues to Factors that trigger behaviour
Action change

Personal belief in the ability to do

• Self-efficacy
something