THE ABCs OF BEHAVIOR

EpidPeril-Teori ABC-07

The A B C
(Antecedents -Behavior -Consequences)

EpidPeril-Teori ABC-07

Health communication
The modification of human behavior and environmental factors related to that behavior which directly or indirectly promote health, prevent illness or protect individuals from harm (Graef, 1993: Elder, Geller, Hovell & Mayer)

EpidPeril-Teori ABC-07

CURRENT THEORIES & MODELS OF HEALTH BEHAVIOR predominate in the field of HP & H.COMM are (Graef, 1993):
1. 2. 3. 4. 5. 6. 7. 8. HBM COMMUNICATION/ PERSUASION MODEL THEORY OF REASON ACTION TRANSTHEORETICAL MODEL PRECEDE / PROCEED MODEL DIFFUSIONS of INNOVATION MODEL SOCIAL LEARNING THEORY APPLIED BEHAVIOR ANALYSIS
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HEALTH BELIEF MODEL

(Graef, 1993: Rosenstock, 1974,1977)

B= f (K.A) Ones perception of vulnerability to an illness & efficacy of treatment influence ones decisions about health behavior HBM (Becker, 1974,1979), behavior is determined by whether individuals:
1. Perceived susceptible 2. Perceived severity 3. Convinced that treatment or prevention activities are effective 4. Inexpensive, safe 5. Receive a prompt to take health action
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KEY CONCEPTS AND DEFINITIONS OF HBM (Dignan,1992)

Perceived susceptibility: ones opinion of chances of getting a condition Perceived severity: ones opinion of how serious a condition and its sequelae are Perceived barriers: ones opinion of tangible & psychological costs of advised action

Perceived benefits: ones opinion of the efficacy of the advised action to reduce risk or seriousness of impact. Cues to action: Strategies to activate ones readiness Self-efficacy: Ones confidence in ones ability to take action

EpidPeril-Teori ABC-07

KEY CONCEPTS AND DEFINITIONS OF HBM (Glanz,1997)

Concepts Definition Application

EpidPeril-Teori ABC-07

KEY CONCEPTS AND DEFINITIONS OF HBM (Glanz,1997)

Concepts Definition Application

EpidPeril-Teori ABC-07

HEALTH BELIEF MODEL

(Graef, 1993: Rosenstock, 1974,1977)

WEAKNESSES:
1. Health belief compete with others beliefs & attitudes, that may influence health behavior. 2. Social psychological research shown that beliefs formation may actually follow rather than precede behavior change. 3. The actual mental processes relative to health beliefs component is difficult to measure
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COMMUNICATION/ PERSUASION MODEL (Graef, 1993)

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THEORY OF REASON ACTION (Graef, 1993)

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TRANSTHEORETICAL MODEL (Graef, 1993)

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PRECEDE / PROCEED MODEL (Graef, 1993)

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SOCIAL LEARNING THEORY (Graef, 1993)

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APPLIED BEHAVIOR ANALYSIS

1993)

(Graef,

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ANTECEDENTS

(Graef, 1993)

Kejadian lingkungan yang menentukan tahap atau penggerak / pemicu perilaku (misal : bayi menangis merupakan tanda bagi ibu sudah waktunya menyusui) Anteseden merupakan sinyal waktu yang dapat dipercaya untuk meningkatkan timbulnya perilaku yang tepat waktu dan tempat Anteseden alami (natural antecedent) : misal, kejadian diare atau demam ibu atau petugas kesehatan berperilaku tertentu, baik tepat / tidak tepat. Anteseden terencana (Planned antecedents), misal : ingatkan ibu jadwal imunisasi anaknya, pemasangan poster jadwal imunisasi, radio spot, kentongan, genderang dll.
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CONSEQUENCES

(Graef, 1993)

Kejadian alami yang mengikuti perilaku dapat menguatkan / melemahkan / menghentikan (Holland & Skinner, 1961)

Orang cenderung mengulang perilaku jika berdampak positif, menjauhi perilaku jika berdampak negatif.

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CONSEQUENCES

(Graef, 1993)

Positive reinforcement kejadian

menyenangkan yang sesuai yang mengikuti perilaku. Tipe ini menguatkan kebiasaan / kesenangan perilaku terjadi lagi (Baer, Wolf & Risley, 1968, Miller, 1980).
Petugas PromKes mengutamakan positive reinforcements.
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CONSEQUENCES
Positive reinforcement

(Graef, 1993)

misal : - kesehatan anak meningkat sesudah pengobatan, - pekerja kesehatan memuji orang tua yang anaknya tumbuh sehat, - peserta pelatihan terima penghargaan / sertifikat bila kuasai ketrampilan selama pelatihan.
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CONSEQUENCES

(Graef, 1993)

Negative reinforcement kejadian

(persepsi dari sebuah kejadian) yang tak menyenangkan, hal-hal yang tak disetujui tapi menguatkan perilaku, jika seseorang cenderung mengulang kebiasaan yang menghentikan kejadian tak menyenangkan.
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CONSEQUENCES
Negative reinforcement

(Graef, 1993)

Kadang harus coba beberapa perilaku untuk stop kejadian tak menyenangkan (Rimm & Masters, 1979, Karoly & Harris, 1986). misal : - hukuman untuk menekan perilaku ttt (Sandler, 1986). - selalu pakai kondom untuk hindari IMS dll, mskp tak enak & ada sangsi sosial. - untuk hentikan tangisan bayi, ibu akan ganti pampers, menenangkan bayi, dan menyusuinya.
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CONSEQUENCES

(Graef, 1993)

1. Konsekuensi yang terjadi segera sesudah terjadinya perilaku lebih potensial mempengaruhi perubahan perilaku. 2. Semakin salient, relevan, penting dan berarti bagi seseorang, semakin potensial. 3. Semakin kongkrit semakin potensial dp yang abstrak. 4. Sekali suatu perilaku dipelajari dengan betul, melalui pelatihan yang secara periodik diobservasi dan mendapat masukan, maka konsekuensi yang menyenangkan. tak selalu diperlukan
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BEHAVIOR

(Graef, 1993)

Mengikuti antecedens dan tergantung consequens, oleh karena itu perhatikan target perilaku yang diinginkan perlu untuk strategi komunikasi
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THE A B C Chain (Graef, 1993)

Hubungan antara antecendens-behaviorconsequence
Radio spot Kunju ngan klinik

Sertifikat

Sertifikat

Kunjungan ulang

Compliment oleh petugas kesehatan

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Daftar pustaka
1. DIGNAN, Mark B, Patricia A.Carr, 1992. PROGRAM PLANNING FOR HEALTH EDUCATION AND PROMOTION, 2nd ed.Lea & Febiger, USA. GLANZ, KAREN, FRANCES MARCUS LEWIS, BARBARA K.RIMER editors,1997. HEALTH BEHAVIOR & HEALTH EDUCATION. Theory, Research, and Practice, 2nd ed. Jossey-Bass Publishers, San franscisco Graeff,Judith A, John P. Elder, and Elizabeth Mills Booth, 1993. COMMUNICATION FOR HEALTH AND BEHAVIOR CHANGE. A Developing Country Perspective. A Publication of the healthcom Project, Academy for Educational Development. Funded by U.S.Agency for International Development
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2.

3.