TERJADINYA PERILAKUTERJADINYA PERILAKU dandanTEORI PERILAKUTEORI PERILAKU

Disampaikan oleh:Yayi Suryo Prabandari

Departemen Ilmu Perilaku Kesehatan,Lingkungan & Kedokteran Sosial

Prodi S2 IKM FK-KMK UGM@2018

TERJADINYA PERILAKUTERJADINYA PERILAKU dandanTEORI PERILAKUTEORI PERILAKU

LEARNING OBJECTIVESLEARNING OBJECTIVES

After reading this chapter, the student will be able to:• Define behavior definition• Compare the differences between a model and theory.• Describe the role of models and theories in changing health

behavior.• Identify the constructs in the social cognitive theory, the health

belief model, the integrated behavior model, the transtheoreticalmodel of behavior change, and the theory of planned behavior.

• Discuss changes over time and how these models and theoriesalign with changing health behaviors.

After reading this chapter, the student will be able to:• Define behavior definition• Compare the differences between a model and theory.• Describe the role of models and theories in changing health

behavior.• Identify the constructs in the social cognitive theory, the health

belief model, the integrated behavior model, the transtheoreticalmodel of behavior change, and the theory of planned behavior.

• Discuss changes over time and how these models and theoriesalign with changing health behaviors.

ReferencesReferences

• Stevenson, M. 2014. Health behavior change theories andmodel - Understanding the Process of Behavior Change(chapter 4) . In Snelling, A. Introduction to Health Promotion.San Fransisco, US: John Wiley & Sons

• Bartholomew,LK; Parcel, GS; Kok,G; Gottlieb,NH.2006.PLANNING HEALTH PROMOTION PROGRAMS: AnIntervention Mapping Approach. San Fransisco, US: JosseyBass

• Stevenson, M. 2014. Health behavior change theories andmodel - Understanding the Process of Behavior Change(chapter 4) . In Snelling, A. Introduction to Health Promotion.San Fransisco, US: John Wiley & Sons

• Bartholomew,LK; Parcel, GS; Kok,G; Gottlieb,NH.2006.PLANNING HEALTH PROMOTION PROGRAMS: AnIntervention Mapping Approach. San Fransisco, US: JosseyBass

Behavior Individual & InterpersonalEnvironment Theory

Behavior Individual & InterpersonalEnvironment Theory

Behavior Individual & InterpersonalEnvironment Theory

Behavior Individual & InterpersonalEnvironment Theory

PrinsipPrinsip dasardasar perilakuperilaku

S – O - R

Ada stimulus ada respon

S – O - R

Ada stimulus ada respon

PerilakuPerilaku ??????????

• Yg dapat dilihat langsung (overt):– Praktek, tindakan, keterampilan

• Yg tidak dapat dilihat secara langsung:– Persepsi, motivasi, pengetahuan,

keyakinan, sikap, nilai, dsb.

• Yg dapat dilihat langsung (overt):– Praktek, tindakan, keterampilan

• Yg tidak dapat dilihat secara langsung:– Persepsi, motivasi, pengetahuan,

keyakinan, sikap, nilai, dsb.

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DefinisiDefinisi VariabelVariabel UtamaUtama dalamdalam kajiankajian BehaviorBehavior

• Persepsi: segala hal yang diterima oleh panca indra• Pengetahuan: pemahaman intelektual dgn fakta, kebenaran, dan prinsip yg diperoleh

melalui penglihatan, p’alam’ & laporan• Keterampilan: kemampuan utk melakukan sesuatu dng baik, diperoleh dr bakat,

latihan atau praktek• Keyakinan/kepercayaan: penerimaan atau kepercayaan thdp fakta sbg kebenaran

tanpa dibuktikan• Sikap: perasaan, disposisi atau posisi (suka tidak suka, setuju vs tak setuju) thdp suatu

objek• Intensi : niat untuk melakukan suatu tindakan• Nilai: ide, hal-hal yg ideal, kebiasaan yang melibatkan respon emosional

• Persepsi: segala hal yang diterima oleh panca indra• Pengetahuan: pemahaman intelektual dgn fakta, kebenaran, dan prinsip yg diperoleh

melalui penglihatan, p’alam’ & laporan• Keterampilan: kemampuan utk melakukan sesuatu dng baik, diperoleh dr bakat,

latihan atau praktek• Keyakinan/kepercayaan: penerimaan atau kepercayaan thdp fakta sbg kebenaran

tanpa dibuktikan• Sikap: perasaan, disposisi atau posisi (suka tidak suka, setuju vs tak setuju) thdp suatu

objek• Intensi : niat untuk melakukan suatu tindakan• Nilai: ide, hal-hal yg ideal, kebiasaan yang melibatkan respon emosional

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Beberapa aspek dalam behavior, suatu contoh…

• Pesan kesehatan itu menakutkan (persepsi)• Bersalaman dengan penderita AIDS tidak menularkan virusnya (pengetahuan)• Makan ikan dapat membuat bayi saya sakit (kepercayaan)• Kesehatan adalah aspek utama dalam hidup saya, sehingga saya selalu minum

tablet besi (nilai)• Menurut saya, sebaiknya JKN diwajibkan bagi WNI (sikap)• Saya akan berolahraga secara teratur (kecenderungan untuk

bertindak/intensi)• Saya merokok sehari 10 batang (tindakan)

• Pesan kesehatan itu menakutkan (persepsi)• Bersalaman dengan penderita AIDS tidak menularkan virusnya (pengetahuan)• Makan ikan dapat membuat bayi saya sakit (kepercayaan)• Kesehatan adalah aspek utama dalam hidup saya, sehingga saya selalu minum

tablet besi (nilai)• Menurut saya, sebaiknya JKN diwajibkan bagi WNI (sikap)• Saya akan berolahraga secara teratur (kecenderungan untuk

bertindak/intensi)• Saya merokok sehari 10 batang (tindakan)

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TheoriesTheoriesarrayed byarrayed bylevellevel

Problem and interventionlevels

Theories

Individual Learning theoriesInformation-processing theoriesHealth Belief ModelProtection Motivation TheoryTheory of Planned BehaviorGoal-related theoriesHabitual behaviorTranstheoretical ModelPrecaution Adoption Process ModelAttribution theoryRelapse Prevention TheoryPersuasion Communication ModelElaboration Likelihood ModelTheories of Self-regulation theory

Learning theoriesInformation-processing theoriesHealth Belief ModelProtection Motivation TheoryTheory of Planned BehaviorGoal-related theoriesHabitual behaviorTranstheoretical ModelPrecaution Adoption Process ModelAttribution theoryRelapse Prevention TheoryPersuasion Communication ModelElaboration Likelihood ModelTheories of Self-regulation theory

Interpersonal environment Social Cognitive theoryDiffusion of Innovations Theory

Pengetahuan

Pendidikan Kesehatan

Beberapa teori pendidikan kesehatan terjadinya perilaku:

PerilakuSikap

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Pendidikan Kesehatan

Sikap PerilakuPengetahuan

Health beliefs modelHealth beliefs model

Health Beliefs ModelHealth Beliefs Model

In order to change a behavior a person must believe he/she is:• Susceptible to illness• Occurrence of condition will have a serious impact on life• Following a particular set of health recommendations will

be beneficial• Barriers to following to recommendations can be overcome• Recommendations will have psychological benefits

In order to change a behavior a person must believe he/she is:• Susceptible to illness• Occurrence of condition will have a serious impact on life• Following a particular set of health recommendations will

be beneficial• Barriers to following to recommendations can be overcome• Recommendations will have psychological benefits

Theory of Reasoned Action (TRA) &Theory of Reasoned Action (TRA) &Theory of Planned Behavior (TPB)Theory of Planned Behavior (TPB)

Behaviorintentionmerupakanprediktorperilaku

Behaviorintentionmerupakanprediktorperilaku

Attitude towardbehavior

BehaviorSubjective

norms

Intention toperform the

behavior

Theory of Reasoned Action & Planned Behavior

Behavioral beliefs

Normativebeliefs

Evaluation ofbehavioraloutcomes

Demographicvariable

Attitudetoward targets

Externalvariables

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Behavior

Perceived control

Subjectivenorms

Intention toperform the

behavior

Control beliefs

Perceived power

Motivation tocomply

Personalitytraits

Otherindividualdifferencevariables

Social Learning TheorySocial Learning Theory

Self Efficacy

Social Learning TheoriesSocial Learning Theories

• Knowledge of health risks and benefits of various health behaviors• Perceived self-efficacy of one’s ability to control one’s own health behaviors• Outcome expectations related to the consequences of particular health

behaviors• Personal health goals established by individuals• Perceived facilitators of the desired health behaviors• Perceived impediments to the desired health behaviors (Bandura, 2004)

• Knowledge of health risks and benefits of various health behaviors• Perceived self-efficacy of one’s ability to control one’s own health behaviors• Outcome expectations related to the consequences of particular health

behaviors• Personal health goals established by individuals• Perceived facilitators of the desired health behaviors• Perceived impediments to the desired health behaviors (Bandura, 2004)

Social Learning TheorySocial Learning Theory

Central premise:• Personal knowledge and beliefs, the beliefs of important others,

and the physical and emotional environment influences what aperson conduct a change in one of these factors has implicationsfor the other factors.

• A strength of SLT if that it focuses on behavior, rather thanknowledge and attitudes

• The concepts, with their definitions and implications, provide waysof addressing the physical and social environment, mastery of skills,self-monitoring, rewards and incentives, and small steps for goalcompletion.

Central premise:• Personal knowledge and beliefs, the beliefs of important others,

and the physical and emotional environment influences what aperson conduct a change in one of these factors has implicationsfor the other factors.

• A strength of SLT if that it focuses on behavior, rather thanknowledge and attitudes

• The concepts, with their definitions and implications, provide waysof addressing the physical and social environment, mastery of skills,self-monitoring, rewards and incentives, and small steps for goalcompletion.

Knowledge and skills toperform the behavior

BehaviorIntention toperform the

behavior

An Integrated Behavioral Model

Experientialattitude

Instrumentattitude

Behavioralbeliefs

Normativebeliefs – others’

expectations

Feelings aboutbehavior

Salience of thebehavior

Attitude

Injunctive normPerceived norm

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BehaviorIntention toperform the

behavior

Normativebeliefs – others’

expectations

Efficacy beliefs

Control beliefs

Normativebeliefs – others’

behavior

Environmentalconstraints

Habits

Injunctive norm

Descriptive norm

Perceived control

Self efficacy

Personal Agency

DiskusikanDiskusikan

• Mengapa seorang penderita hipertensi yang tahukalau harus mengurangi konsumsi makananberlemak, namun tetap makan sate kambing?

• Mengapa ibu-ibu berusia setengah baya rajinmelakukan senam?

• Mengapa seorang penderita hipertensi yang tahukalau harus mengurangi konsumsi makananberlemak, namun tetap makan sate kambing?

• Mengapa ibu-ibu berusia setengah baya rajinmelakukan senam?

Diffusion Innovation Theory

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change

Central premise:

Most people do notchange behavioreasily or quickly.Some change earlierthan others.

Very useful theorywhen planning aninterventionaddressing groups ofpeople (macro levelinterventions).

Diffusion Innovation

time

change

Central premise:

Most people do notchange behavioreasily or quickly.Some change earlierthan others.

Very useful theorywhen planning aninterventionaddressing groups ofpeople (macro levelinterventions).

Stages of InnovationStages of Innovation

• Knowledge--Individual is aware of innovation and hasacquired some information about it

• Persuasion--Individual forms an attitude about theinnovation--either in favor of or against it

• Decision--Individual performs activities that lead to eitheradopting or rejecting the innovation

• Confirmation--Individual looks for reinforcement for hisdecision and may change it if he is exposed to counter-reinforcing messages

• Knowledge--Individual is aware of innovation and hasacquired some information about it

• Persuasion--Individual forms an attitude about theinnovation--either in favor of or against it

• Decision--Individual performs activities that lead to eitheradopting or rejecting the innovation

• Confirmation--Individual looks for reinforcement for hisdecision and may change it if he is exposed to counter-reinforcing messages

Diffusion of InnovationsDiffusion of Innovations

Innovations that are successful must meet certain criteria:• Compatible with existing value systems and lifestyles• Flexible• Appear more advantageous than previous practices• Reversible• Low risk• Perceived as having greater benefits than costs

Innovations that are successful must meet certain criteria:• Compatible with existing value systems and lifestyles• Flexible• Appear more advantageous than previous practices• Reversible• Low risk• Perceived as having greater benefits than costs

Bagaimana mengubah perilaku?Bagaimana mengubah perilaku?Bagaimana mengubah perilaku?Bagaimana mengubah perilaku?

Preparation or readinessWillingnessAbility to change

PerubahanPerubahan perilakuperilaku membutuhkanmembutuhkan

Preparation or readinessWillingnessAbility to change

• Prekontemplasi (belum mau berubah/sadar, ingin)• Kontemplasi (sudah sadar/ingin/berpikir tapi belum

beraksi)• Persiapan (langkah awal utk bertindak)• Tindakan• Pemeliharaan

TahapanTahapan PerubahanPerubahan ((ProchascaProchasca, 1994), 1994)

• Prekontemplasi (belum mau berubah/sadar, ingin)• Kontemplasi (sudah sadar/ingin/berpikir tapi belum

beraksi)• Persiapan (langkah awal utk bertindak)• Tindakan• Pemeliharaan

StagesStages ofof ChangesChanges and Particularly Relevantand Particularly RelevantIntervention ApproachIntervention Approach(Simon(Simon--Morton, Greene & Gottlieb, 1995)Morton, Greene & Gottlieb, 1995)

Stages of changeStages of change

ProcessesProcessesofofChangeChange

Processes of ChangeProcesses of Change

Comparison ofthe Theories

Theories and common construct:Theories and common construct:Eight variables as key determinants of behaviorEight variables as key determinants of behavior

1. The person has formed a strong positive intention (or made a commitment) to perform the behavior2. No environmental constraints make it impossible for the behavior to occur3. The person has the skills necessary to perform the behavior4. The person believers that the advantages of performing the behavior outweigh) the disadvantages

(attitude)5. The person perceives more social (normative) pressure to perform the behavior than not to do so6. The person perceives that performing the behavior is more consistent than inconsistent with his or

her own self-image (personal norms, personal standards)7. The person’s emotional reaction to performing the behavior is more positive than negative8. The person perceives that he or she has the capability to perform the behavior under a number of

different circumstances (perceived self-efficacy, perceived behavioral control)

1. The person has formed a strong positive intention (or made a commitment) to perform the behavior2. No environmental constraints make it impossible for the behavior to occur3. The person has the skills necessary to perform the behavior4. The person believers that the advantages of performing the behavior outweigh) the disadvantages

(attitude)5. The person perceives more social (normative) pressure to perform the behavior than not to do so6. The person perceives that performing the behavior is more consistent than inconsistent with his or

her own self-image (personal norms, personal standards)7. The person’s emotional reaction to performing the behavior is more positive than negative8. The person perceives that he or she has the capability to perform the behavior under a number of

different circumstances (perceived self-efficacy, perceived behavioral control)

33 halhal ygyg pentingpenting utkutk membentukmembentuk perilakuperilaku

• Niat positif yang kuat• Keterampilan utama utk melakukan perilaku tersebut &• Tidak ada hambatan untuk melakukan perilaku

tersebut

• Niat positif yang kuat• Keterampilan utama utk melakukan perilaku tersebut &• Tidak ada hambatan untuk melakukan perilaku

tersebut

55 factor yangfactor yang mempengaruhimempengaruhikekuatankekuatan dandan araharah niatniat

• Sikap,• Tekanan sosial,• Citra diri,• Reaksi emosi, dan• Efikasi diri

• Sikap,• Tekanan sosial,• Citra diri,• Reaksi emosi, dan• Efikasi diri

SUMARRY

Rangkuman beberapa teori perilaku untukmenjelaskan terjadinya perilaku

Terima kasih atasperhatiannya dansemoga sukses

Terima kasih atasperhatiannya dansemoga sukses