What Factors Influence The Changing Health-Related Behavior?
Living in 2020 must be tough for everyone. It is the year when everyone around us seems so fragile. Many people lose their jobs. Every business has to struggle with the loss of revenue.
Even after going through that circumstance, I hardly believe that people in my country, Indonesia, still ignore the preventive action of COVID-19. What’s more shocking is that so many people are still debating whether this virus is such a “fictional creature” or not. It makes me wonder about the reason behind those thoughts above. Thus, now I would like to share my insight about Health Behavior Model (HBM) approach that might explain these problems. (Disclaimer: I’m still not an expert in this field and opinions expressed are solely my own)
HBM was developed to understand the failure of people to conduct any prevention deed toward disease or screening tests for early detection of disease[1]. It has been used for decades to study the behaviors that require modification of patient’s actions to mitigate a threat to health. Health behaviors are influenced by a person’s desire to avoid illness or to get well, and the belief that a specific health action will prevent or cure the disease[1,2].
Below I will give you an explanation about the factors whether an individual decides to engage with health-related behavior and why most Indonesian did not modify their health behavior as soon as the first COVID-19 cases are confirmed.
- Perceived Susceptibility → This refers to someone’s judgment on his or her vulnerability to this disease.
“How susceptible do you think you are to COVID-19?”
Jakarta Post April 3, 2020, reported that Minister Luhut claimed that Indonesia’s climate could beat Coronavirus. He added that the virus would be weaker in high-temperature locations, and that could be Indonesia’s advantage compared to other countries [4].
As a result, I guess most Indonesian probably assumed that they were not prone to COVID-19 in the earlier case of COVID-19 identified. And here is the fact now: Indonesia has 64,924 active and 320,564 confirmed cases (data from worldometers on 10/9/2020).
2. Perceived Severity → This refers to the perception of the severity of the disease (pain, death, disability, etc.) and its effect on lifestyle (working ability, social relationship)
“How terrible would it be if you got infected by Coronavirus?”
In case of the seriousness of contracting COVID-19, The Health Minister, Terawan, stated that COVID-19 was a self-limiting disease and more like the flu. Moreover, the patient who got higher immune would recover immediately.
From that statement, I know that He did not want to make a fuss in the first place, but the fact that people might underestimate this disease would jeopardize others with a low immune system[5].
3. Perceived Benefits → the effectiveness of particular actions to reduce the illness (the positive and negative effects of adopting new practice)
“Are there any benefits to stay at home?”
Since the first Large-scale social restriction (PSBB) in April 2020 was implemented, most white-collar workers were allowed to work at home.
Working from home has given the workers more time to spend with family and do hobbies they haven’t had before.
4. Perceived Barriers → the comparison of benefit and perceived cost of an action (cost/benefit analysis)
“How difficult do you think it would be to only stay at home for two weeks?”
On September 28, the Jakarta government reimposed large-scale social restriction (PSBB) for two weeks. Anies, the governor, instructed us to stay at home to flatten the curve.
It was such a dilemma because blue-collar workers couldn’t fulfill their daily needs if they only stayed at home. Hence, they see no benefit to stay at home [6].
5. Self-efficacy → level of a person’s confidence in performing successful health behavior
“How likely is that you can implement physical distancing?”
Based on the survey from The Indonesian Public Opinion Research and Discussion Group in late April, Greater Jakartan’s awareness of physical distancing measures to flatten the COVID-19 infection curve was still low [7].
I understand that it would be difficult to change our behavior right away in the earlier cases of COVID-19, but now as we all can see this more clearly, we should strictly carry out the precautions.
6. Cues to action → the internal (e.g. physical symptoms) and external (e.g. mass media, reminders, advice) factors which trigger the decision-making process to take beneficial action
There were more and more invalid information on different mass media about what we should do if our body showed early symptoms of COVID-19 and what actions we should take to prevent the spread of this viral infection in the first reported case of COVID-19. The right and accessible information are certainly important during this situation.
In my opinion, most Indonesian presumably had an optimistic bias or known as unrealistic optimism in the early cases of COVID-19 (I think I need to validate this through a study or survey). Optimistic bias can be defined as people’s tendency when they perceived they are less likely to experience worse outcomes than those of other people in similar circumstances.
Eventually, I hope I can see more people aware of COVID-19 prevention acts, such as washing hands, physical distancing, wearing a mask in public, and limiting social gatherings. Also, there is a need to recheck the validity of any information related to COVID-19 to the doctor, pharmacist, or experts, before sharing it massively. Let’s fight this together!
References:
2. https://www.med.uottawa.ca/courses/epi6181/images/Health_Belief_Model_review.pdf
3. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/health-belief-model
4. https://www.sciencedirect.com/science/article/abs/pii/S155174112030293X
9. https://academic.csuohio.edu/jdemarco/StewartArticle/pdfFiles/HBMOptimisim.pdf
10. Rosenstock IM. Historical origins of the Health Belief Model. Health Educ Monogr 1974; 2:328–335.
11. Janz NK, Champion VL, Strecher VJ. The Health Belief Model. In: Glanz K, Rimer BK, Lewis FM, editors. Health behavior and health education: theory, research, and practice. San Francisco: Jossey-Bass, 2002: 45–66.
