Teori Perilaku Kesehatan
Teori Perilaku Kesehatan
in Educational Diagnosis
evaluation are
by guiding
the
implementation
and
evaluation
of
those Precede programs. While Precede works backward from the desired end
result, attained through the diagnostic process, to the beginning point (the point(s)
that preceded the end result) of the assessment process, Proceed works forward to
(external)
Physical environment. Examples: where a person lives and crowding
conditions (external)
Health services. Examples: Access to quality health care and having or not
Enabling
factors are
those
internal
and
external
available.
Accessibility of services. Services do no good if they have
waiting lists that run into years, or arent physically accessible to
teachers,
employers,
health
or
human
service
the quality of life, i.e., health, and socio-cultural support factors of the
population or community.
actual
in
a continuous
cycle.
The cyclical mature of this model encourages more systematic and comprehensive
planning of public health programs so that the programs match what the
community identifies as its needs with the result that programs are participated in
with goals and objectives more often reached. This model encourages recognition
of differing goals, priorities and values in different communities of populations.
As a result the real-world applications of the Precede-Proceed model have been
myriad and varied. The model has been used to plan, design, implement, and/or
evaluate programs for such diverse health and quality-of-life issues as breast,
cervical, and prostate cancer screening; breast self-examination; cancer education;
heart health; maternal and child health; injury prevention; weight control;
increasing physical activity; tobacco control; alcohol and drug abuse; school-
based nutrition; health education policy; and curriculum development and training
for health care professionals(Green LW and Shawna LM, 2002).
References:
Lawrence W.
Green
and
Shawna
L.
Mercer.
"Precede-Proceed
.
2
The HBM was spelled out in terms of four constructs representing the perceived
threat and net benefits: perceived susceptibility, perceived severity, perceived
benefits, and perceived barriers. These concepts were proposed as accounting for
people's "readiness to act." An added concept, cues to action, would activate that
readiness and stimulate overt behavior. A recent addition to the HBM is the
concept of self-efficacy, or one's confidence in the ability to successfully perform
an action. This concept was added by Rosenstock and others in 1988 to help the
HBM better fit the challenges of changing habitual unhealthy behaviors, such as
being sedentary, smoking, or overeating. Table from Theory at a Glance: A Guide
for Health Promotion Practice" (1997)
Concept
Definition
Application
One's
opinion
heighten
perceived
Perceived
Severity
One's
belief
in
the
Perceived
Benefits
when;
clarify
the
Perceived
Barriers
tangible
psychological costs of
the advised action
Cues to Action
Self-Efficacy
Strategies
to
activate Provide
"readiness"
Confidence
assistance.
how-to
information,
in
c. Conceptual Model
performing action.
Prochaska,
DiClemente,
&
Norcross,
1992)
is
an
that
can
be
applied
to
variety
of
behaviors,
policy-making
settings,
etc.)hence,
the
name
Precontemplation.
People in the Precontemplation stage do not intend to take action in the
foreseeable future, usually measured as the next six months. Being uninformed or
under informed about the consequences of ones behavior may cause a person to
be in the Precontemplation stage. Multiple unsuccessful attempts at change can
lead to demoralization about the ability to change. Both the uninformed and under
Contemplation.
Contemplation is the stage in which people intend to change in the next six
months. They are more aware of the pros of changing, but are also acutely aware
of the cons. In a meta-analysis across 48 health risk behaviors, the pros and cons
of changing were equal. This weighting between the costs and benefits of
changing can produce profound ambivalence that can cause people to remain in
this stage for long periods of time. This phenomenon is often characterized as
chronic contemplation or behavioral procrastination. Individuals in the
Contemplation stage are not ready for traditional action-oriented programs that
expect participants to act immediately (Prochaska JO et al, 1994).
Preparation.
Preparation is the stage in which people intend to take action in the
immediate future, usually measured as the next month. Typically, they have
already taken some significant action in the past year. These individuals have a
plan of action, such as joining a health education class, consulting a counselor,
talking to their physician, buying a self-help book, or relying on a self-change
approach. These are the people who should be recruited for action-oriented
programs (Prochaska JO et al, 1994).
Action.
Action is the stage in which people have made specific overt modifications
in their lifestyles within the past six months. Because action is observable, the
overall process of behavior change often has been equated with action. But in the
TTM, Action is only one of six stages. Typically, not all modifications of behavior
Maintenance.
Maintenance is the stage in which people have made specific overt
modifications in their lifestyles and are working to prevent relapse; however, they
do not apply change processes as frequently as do people in Action. While in the
Maintenance stage, people are less tempted to relapse and grow increasingly more
confident that they can continue their changes. Based on self-efficacy data,
researchers have estimated that Maintenance lasts from six months to about five
years (Prochaska JO et al, 1994).
References:
Prochaska, JO; DiClemente, CC. Stages of change in the
modification
of
problem
behaviors.
Prog
Behav
Modif
1992;28:183218.
Prochaska, J.O., Butterworth, S., Redding, C.A., Burden, V., Perrin,
N., Lea, Michael, Flaherty, Robb M., and Prochaska, J.M. (2008).
Initial efficacy of MI, TTM tailoring, and HRIs in multiple
behaviors for employee health promotion. Preventive Medicine,
46, 226-231.
Prochaska, JO; Norcross, JC; DiClemente, CC. Changing for good:
the revolutionary program that explains the six stages of change
and teaches you how to free yourself from bad habits. New York:
W. Morrow; 1994
4. Theory of Planned Behavior/ Reasoned Action
norm, and the greater the perceived control the stronger should the
persons intention to perform the behavior in question.
c. Conceptual Model
as
guide
for
action."
Attention:
In order to learn, you need to be paying. Anything that distracts
your attention is going to have a negative effect on observational
learning. If the model interesting or there is a novel aspect to the
situation, you are far more likely to dedicate your full attention to
learning.
Retention:
The ability to store information is also an important part of the
learning process. Retention can be affected by a number of factors,
but the ability to pull up information later and act on it is vital to
observational learning.
Reproduction:
Once you have paid attention to the model and retained the
information, it is time to actually perform the behavior you
observed. Further practice of the learned behavior leads to
improvement and skill advancement.
Motivation:
Finally, in order for observational learning to be successful, you
have to be motivated to imitate the behavior that has been modeled.
and play an important role in motivation. While experiencing these
motivators can be highly effective, so can observing other
experience some type of reinforcement or punishment. For
example, if you see another student rewarded with extra credit for
being to class on time, you might start to show up a few minutes
early each day.
e. Final Thoughts
In addition to influencing other psychologists, Bandura's social learning
theory has had important implication in the field of eduction. Today, both
teachers and parents recognize the importance of modeling appropriate
The
This
included
all
forms
of
language