1-Hazavehei

JRHS 2008; 8(1): 1-11

Copyright © Journal of Research in Health Sciences

The Comparison of Educational Intervention Effect Using BASNEF and Classic Models on Improving Assertion Skill Level

Hazavehei SMM (PhD)a, Sharifirad GhR (PhD)a, Kargar M (MSc)b

a Department of Health Education and Promotion, Isfahan University of Medical Sciences, School of Health, Iran

b Sina Hospital, Shiraz, Iran.

*Corresponding Author: Seyyed Mohammad Mehdi Hazavehei, E-mail: Hazavehei@hlth.mui.ac.ir

Received: 7 February 2007; Accepted: 22 April 200

Abstract

Background: To compare the effectiveness of BASNEF and Classic educational models to improve the assertion skill level of high school boy students.

Methods: The 60 high school male students from Shiraz City, Fars Province Iran, were participated in this study. They were randomly divided in two groups (groups A and B). The group A attended in de­signed educational planning based on BASNEF model and group B attended in classic educational pro­gram. The both groups had participated in six session educational activity (2 hours each session) dur­ing the four weeks. The data collected using questionnaire before and after one-month intervention.

Results: The mean score of knowledge, attitude, enabling factors, social norms, and Rathus Assertion Test were not significant statistically between two groups before and after intervention. However, the mean scores of all mentioned variables in group A and only knowledge and assertion variables in group B changed significantly after intervention. In addition, the comparison of the mean scores and the means of scores difference of all variables changed significantly between two groups after in­tervention.

Discussion: Performing BASNEF educational model, in accordance with its main parts (knowledge, atti­tude, social norms, and enabling factors) is more effective than performing classic educational model to improve high school boy students assertion.

Keywords: BASNEF Model, Assertion Skills, High School, Adolescence

Introduction

Adolescence is a critical period of life that physi­cal, cognitive, emotional and social changes are happen (1). The most important changes occur in social relations aspect that the indi­viduals gradually achieves abstract thinking and revolutionizes into a social maturity, as well as in maturation and deep changes in their attitudes and life style. This mainly hap­pens during high school period ages in the adolescents. Therefore, they must be trained to practice and experience social skills for promoting social dimension of their per­son­ality. Social skills are a series and nec­essary for bases of behavior, related to each other, and relevant to situation being able to be learned and controlled by the indi­vidual (2) as the foundation of successful rela­tionships with others by learning and prac­ticing them (3). Furthermore, one of the main parts of social skills is assertion skill, i.e. acting in individual own best interests by expressing his/her thoughts and feelings di­rectly and honestly. In other word, Assertion skill is to achieve owns rights, stating ones be­liefs, and emotions directly, suitably and honestly, so that enable the individual to stand on his own appropriate feeling. Essen­tially, asser­tiveness involves standing up for own rights when someone else is about to in­fringe on them. To be assertive is to speak out openly rather than your punches. Asser­tive behavior includes no such intention to in­flict harm, but it does involve defending your right (4). Therefore, this skill leads to im­prove indi­vid­uals self-respect and self-es­teem (5), they need to learn how to practice the skill effi­ciently through a planned asser­tion skill train­ing program. It is notable that the key to achieving assertive behavior is to practice it and work toward gradual improve­ment.

Unfortunately, the high school teachers have different opinions about the importance of as­sertion skills or its influence for success. Yet, assertions skills are not perceived as criti­cal role for the students success (6) as well as purely situation-specific approach to as­sertion training and research (7). In addi­tion, the upper elementary educators place sig­nificantly less emphasis on assertion skills than on cooperation and self-control skills (8). Therefore, Assertion skill training is one of the social skills trainings, which en­able the individuals to react, and state his/her own beliefs suitably in different social situa­tion. In this study, the assertion skill is per­ceived as a healthy behavior that the students need to be educated for modifying and im­proving their assertion behavior. On the other hand, there are various models to train as­sertion skills (9). Classic model is one of them in which the focus is on training verbal and non-verbal behaviors on the basis of desensitization and use of cognitive recon­struction so that the individual knows the iden­tity of these skill, being edited and performs it practically (4, 10). Therefore, it makes the background to use assertion skill in his daily life. However, there are some edu­cational models in health education field, which can be used to get more effectiveness in assertion training. The value of health edu­cation programs depends on designing ap­propriate the educational framework pro­gram based on the use of theories and mod­els. In principle, support that is more theoreti­cal and basic health need leads to ac­complish more effectiveness of the programs (11). The Beliefs, Attitude, Subjective Norms, Enabling Factors (BASNEF) Model (Figure 1) is one of the health education mod­els (12, 13), used to train assertion in addi­tion to classic model in this study. Based on BASNEF Model main parts are the knowl­edge and attitude of the cases about assertion skill and its importance must be brought about as well as important groups of people in­terfering in forming cases assertion behav­iors participate in training them and the cases perceiving how this skill is important for their social norms. Finally, intention to con­duct assertive behaviors establishes in the cases and enabling factors, which enable them to learn and practice assertion leads to take assertive behaviors more than before. Since, adolescents are affected by different so­cial groups in taking their behaviors and us­ing factors enabling them to learn and prac­tice this skill is very significant (1), BAS­NEF Model chosen as a conceptual frame work of the educational program to achieve the aim of this study on the basis of models principles and the results compared with using Classic model to improve stu­dents assertion skills.

Figure 1: BASNEF Model. After Hubley J., 1988

Methods

Sixty high school male students from the Shi­raz City, Fars Province Iran, participated in this quasi-experimental study in the year 2005. The high school was organized in two shift (morning and afternoon) work staff sys­tem. The students were selected from second grade that one class from the morning shift (math­ematic major) and another from after­noon shift (experimental sciences major). These two classes randomly were divided in two groups. One group assigned in the BAS­NEF educa­tional model grogram (BASNEF group) and the other class in the classic educa­tional pro­gram (Clas­sic group). The BASNEF group trained based on the BAS­NEF model and classic group trained based on the routinely school setting educational grogram without ap­plying any particular edu­cational model or theory.

A total of 85 question items were include, among which four were demographics, 15 were about assertive definition, causes, and benefits knowledge, 13 assertion apply atti­tude, 7 social norms influence behave asser­tiveness, 16 enabling factors facilitate acting as assertive person and 30 Rathus Assertion Test for measuring level of students asser­tion skills (14) (Appendix A). The knowl­edge questions were in True and Fuels for­mat, while the attitude scale consisted of four Likert type (very agree, agree, disagree, very disagree) items. The social norm and ena­bling factors questions were in Yes and No format, while the Rathus Assertion Test consisted of six Likert type (very agree, agree, less agree, less disagree, disagree, very disagree) items.

Internal consistency of the questionnaire was calculated by using test retest (1-week after) techniques among similar the subjects. The overall reliability coefficient (correlation coef­ficient) for the questionnaire was 0.87. 

The questionnaire were applied the prior of in­tervention and recollected one month later after intervention. Also, the questionnaires completed by the cases in the both groups. The educational intervention planning (see Ap­pendix B, C and D) consisted a series of six sessions of 2 hour class room setting dur­ing the 4 weeks in every group. The educa­tional goal and objective designed based on educational BASNEF models and classic teaching session.

During educational sessions, educational meth­ods such as role playing, group discus­sion, and question and answer were used among BASNEF group. Moreover, one train­ing ses­sion arranged separately, in turn, for parents and teachers of students in BAS­NEF group as a main part of students social norms in the program according to the BAS­NEF model.

T-paired test and t-independent test used to compare, the means score in every group, be­tween the two groups, before and after inter­vention for knowledge, attitude, ena­bling fac­tores, and assertion skill. In addi­tion, McNe­mar test used to compare social norms in every group before and after intervention.

Results

There was no any significant relationship be­tween the variables such as knowledge, atti­tude, social norms, enabling factors and as­ser­tion) and demographic characteristics  such as family size, birth turn, parent's educa­tional levels and social skills training history  among the groups before and after in­tervention.

The results also demonstrated that mean scours of all BASNEF components like knowl­edge, attitude, social norms, enabling factors, and assertiveness level were not differ­ent signifi­cantly between two groups be­fore the inter­vention. Whereas, the mean scours of all the variables in BASNEF group changed signifi­cantly after the educational in­tervention, but the only scours of knowl­edge and assertion skill changed signifi­cantly in Classic group (Table 1, 2). On the other hand, t-independ­ent test showed that the mean scours of all the variables changed significantly between two groups after educa­tional intervention.

Table 1: Comparing the mean knowledge, attitude, enabling factors, and assertion skill scores before and after intervention among the groups

Studied

Groups

Before intervention

After intervention

T- Paired test result

Mean

SD

Mean

SD

knowledge

BASNEF

9.7

2.1

13.6

1.1

P<0.000

Classic

10.9

1.7

12

2.4

P<0.004

T-test result

P=0.18

P<0.000

Attitude

BASNEF

38.9

3.7

44.8

4.1

P<0.000

Classic

38.4

3.6

39.6

4

P<0.138

T-test result

P=0.579

P<0.000

Enabling factors

BASNEF

5.1

2

19.3

151

P<0.000

Classic

5.4

1.4

20.9

132

P<0.081

T-test result

P=0.5

P<0.000

Assertion Skill

BASNEF

121

18.6

151

19.3

P<0.000


Classic

121

23.1

132

20.9

P<0.006


T-test result

P=0.884

P<0.000

Table 2: Comparing of frequency and percentages of social norms before and after intervention among the groups

Groups

Interfering  Norms in learning and practicing

Before intervention

After intervention

McNemar test results

n

%

n

%

BSNEF group

Family members

12

40

28

93.3

P<0.001

Friends and classmates

10

33.3

24

80

P<0.001

High school officials

(Teachers etc)

8

26.6

14

46.6

P=0.045

Classic group

Family members

13

43.3

17

56.6

P=0.140


Friends & classmates

11

36.6

15

50

P=0.150


High school officials

(Teachers etc)

9

30

11

36.7

P=0.290

Discussion

Since there was no any significant relation­ship between demographic characteristics and BASNEF components before and after in­tervention between both groups, it is indi­cated that the variables do not have any in­ter­ference in promoting assertion of the stu­dents. Significant changes in knowledge of both groups after intervention indicated that educational sessions were affected to im­prove the students' assertion knowledge. At the same time, the results implied that pro­moting knowl­edge was significantly highly in BASNEF group, which is shown more quali­fication of BASNEF model to in­crease knowl­edge rather than classic group. In other words, using social norms pressure and enabling factors may in­terfere for improv­ing knowledge in BASNEF group rather than Classic group. This con­sisted with other studies by using BASNEF model improved the effectiveness of this model to promote knowledge. (15, 16)

The attitude of behavioral intention for asser­tion taking behaviors of students in BAS­NEF group promoted significantly after intervention, whereas in Group Classic did not consequently. The promotion of the BAS­NEF group attitude might be related to use students subjective norms and enabling factors interference in the intervention pro­gram. In other words, did not considering sub­jective norms and enabling factors in train­ing program of classic group may lead un­changed students attitude significantly af­ter intervention. This evidence consisted with other study that the enabling factors af­fect the attitude changes (15). As expected, the enabling factors, which are one of the main components of the BASNEF educa­tional model in training BASNEF group cases, were significant statistically improved after intervention in contrast with classic group cases. These factors provide informa­tion, skill-training, counseling opportunity or any other aspect, which let individuals be­havioral intention lead to take assertive behav­ior action. In contrast, the factors were not interfered in classic group education dur­ing this study and subsequently it did not ex­pect to change significantly may explain that why the changes did not occur among this group. Use of interpersonal skills as a kind of enabling factor got significantly after inter­vention and promoted the cases action in some study conducted by using BASNEF model (16). Also, use of enabling factors have improved mothers preventive behaviors two times more than control group as well as lead to improve preventive behavior subse­quently (17). All these studies demonstrated that enabling factors have a unique role in changing behavioral intention into taking aimed behavior based on BASNEF model planning and implementing educational pro­gram.

Social norms or subjective norms had the im­portant role to affect BASNRF group cases assertion behavior.  The social norms di­vided into three agents in the study (fam­ily, friends and classmates, and school offi­cials like teachers). These groups of agents have critical role on facilitating students to take assertive behaviors (2). Whereas, there was no significant differences in classic group students' social norms before and after intervention related to taking assertive behav­iors. Since, classic group cases trained by Classic Model, therefore, it is not ex­pected to find any significant change in so­cial norms interference among this group. Some studies determined social norms in their studied before intervention in order to rec­ognizing the influence target group's subjec­tive norm for designing educational ac­tion and training the subjects without evalu­ating the level of effectiveness after inter­vention or their interference to take the aimed behaviors was not measured after inter­vention. (15-17). In this study, the subjec­tive norms interference measured after the intervention in other to determine the pro­gram intervention and applying the role of the subjective norm on the students behav­ior.

Assertion skill level improvement was the main goal of this study, so that two different models used to do so. As the results showed, despite both models were significantly effec­tive to promote assertion level of the stu­dents in both groups; but the promotion was highly significant among BASNEF group rather than classic group after the interven­tion (18). This difference may be related to per­formed models. While classic model aims to increase knowledge and attitude of the cases and practices assertive behavior during educational sessions, BASNEF model in­tends to improve knowledge and attitude and makes opportunity to participate social norms during training course. When the be­havioral intention created, the enabling fac­tors let the cases to take the assertive behav­iors more effective (19). Since enabling fac­tors affect attitude editing because of previ­ous studies (15, 17), when they are not used in Classic group, attitude editing was not indi­cated efficiently.

In this mater, the studies showed that the clas­sic assertion education was effective for improving university students' assertion (20-22) as well as high school students (23). How­ever, there has been no any study per­formed by BASNEF model to improve asser­tion skill yet.

In conclusion, this study supporting using edu­cational program based on BASNEF model (knowledge, attitude, social norms, ena­bling factors) to improve high school stu­dents assertion behavioral skills rather than us­ing classic model (knowledge, attitude).

Acknowledgements

The authors would like to express their grati­tude to all students for participation as well as Research Committee of Isfahan Univer­sity of Medical Sciences for providing the founding for the study. 

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