The currently accepted explanation of noncompliant behavior, that it is recalcitrant, inner-drive and inaccessible to interventions, is incomplete and inefficacious; further, that the associated interventions of fear arousal and legal enforcement, while critical to resolve imminent hazards, have been ineffective in producing lasting change. Overemphasis on fear arousal and legal enforcement siphons resources from education and consultation functions, leading to incomplete, enforcement-oriented evaluations, decreased inspector morale and even relapse of compliant conditions due to overuse of fear arousal. This view of noncompliance has become nearly axiomatic, preventing research on system modifications and pushing sanitarians into an enforcement mode.
Decades of behavioral science (health education) research suggest the need to look at root causes of noncompliance, rather than simply citing the behavior itself1. Examples of this research, e.g the Health Belief Model and Social Learning Theory, lead to a more comprehensive explanation of noncompliance which incorporates enforcement, education and consultation functions, based on needs of the situation. These concepts can be used both to increase compliance and gain a better understanding, both of the occurrence of noncompliant behavior and of the process required to change behaviors. Few changes are needed in the existing inspection system while the rewards will be higher morale, efficacious site evaluations and, in the long term, better lasting compliance. Expanded public health networking, especially with health educators, is essential to this change, as well as better training and education of sanitarians.
tThis sounds like a much needed discussion. Look forward to understanding more at the next conference!
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