In the reading on creating a Behavior-Determinant Intervention (BDI) Logic Model, the idea that people do not know what there health goals are, and so they must be told what their health goals should be, is one of the original claims that this article makes. I think that it is presumptuous to say that people are not aware of their health needs. Although, I agree that all people may not be aware of how to accomplish these goals. Most people know that they do not want to be sick, and they know that they do not want to contract sexual diseases, and these ideas are inherently health goals; however, many may not be aware of how to go about accomplishing these goals.

This article also assumes that people have behaviors that must be changed, and does not consider why these behaviors exist or how they may relate to a culture or belief system, instead the author automatically assumes that all behaviors that are deviant from what would be considered "healthy," must be changed, due to the author's view that these behaviors are indeed deviant. The author does state that there are "determinants" of behavior, which influence behavior partially, but not necessarily fully. Furthermore, instead of evaluating cultural or community values, personal values and their effects are evaluated, and found by the author to only partially determine sexual behaviors. In my experience in Senegal, the individual values of the young adults I knew where shaped almost fully if not entirely by their community, culture, and religion. Due to the predominant influence of Islam in Senegal, sexual activity and behaviors were discouraged until marriage, and this was the predominant thinking of each young adult that I spoke with. I also found that in the family planning department of the hospital where I worked, that each woman who came in to receive contraception was married. This may show that a very personal decision of when to have sex, and thereby seek contraception, is influenced by the cultural values of sex. For 95% of Senegalese people (who are Muslim) this most likely means that sexual behaviors can only occur in the context of a monogamous marriage. Therefore, the behaviors, which exist in a society, are very much determined by the environment in which they are exhibited.

Should we focus on changing behaviors at face value, just because they are considered deviant?

Are there better ways to discourage these deviant behaviors, like using cultural values as a means to change behavioral patterns?

In the context of Senegal, for example, would it be better to teach about practicing safe sex by showing evidence to the population on why this is an unhealthy behavior, or would it be more effective to go about decreasing unhealthy behaviors, by using Islam's view- that having sex before marriage or outside of a marriage is wrong- as a platform for decreasing sexually deviant and perhaps unhealthy behavior?