Reinforcing factors / social influences

Reinforcing factors come into play after a behavior has begun and provide continuing rewards or incentives. They are important for persistence or repetition of the behavior. For example, social support, praise, reassurance..., etc. are very important for the persistence of the behavior. The most important reinforcing factors for a behavior to occur or avoid include: recognizedFamily, peers, teachers, employers, health providers, community leaders, decision-makers-- these and others are known as influential individuals or significant others who encourage or discourage us from performing certain health-related behaviors. Reinforcement may be either positive--- occurs when a behavior is increased because it is followed by the presentation of something desirable. For example, a health extension work recognised and certified with some good achievements will be reinforced to do more in the future. Or negative--- occurs when a behavior is increased (negatively) because it is followed by the removal of something undesirable.

For example, a mother who is planning to start family planning (FP) might be influenced by negative attitudes from her peer group and think, "Most of my friends do not use FP methods, and I may lose friends in the neighbourhood if I use the methods". She might also be influenced by her family: "My family members do not all support the idea of using FP methods, especially my husband and my mother-in-law. They would be mad at me if I use FP". She may also be aware that her community society or culture generally may not be supportive: "Everyone in our community is against FP, and it is seen as a sin in our society".

In general, we are all influenced by the various persons in the social network. Pressure from others can be a positive influence to adopt health promoting practices as well as an obstacle. In the case of a young child, it is usually the parents who have the most influence. As a child grows older, friends/peers become important, and a young person can feel a powerful pressure to conform to the peer group. For example, a young man starts smoking because his friends encouraged him to do so.