Disampaikan oleh: Bagoes Widjanarko Gombong, 1 April 2013 Ringkasan topik Masalah apa yang ada dalam kaitan dengan kesehatan? Apakah masalah tersebut terkait dengan perilaku? Perilaku apa yang perlu diubah? Target perlu berperilaku seperti apa? Faktor penentu perilaku apa yang perlu ditampilkan dalam pesan? Apa isi pesannya (formulasi)? (formulasi, ikon) Media apa yang sesuai? (target, biaya dll) Disain media Strategi penyampaiannya bagaimana? Describing health problem Epidemiologic inquiry Mortality Morbidity Disability Discomfort Logical analysis Menjelaskan dengan teori perilaku Masyarakat (calon pengantin) tidak berpartisipasi dalam program imunisasi TT ibu hamil Dipergunakan HBM untuk menjelaskan CONCEPT DEFINITION APLICATION PERCIVED One's opinion of chances of Define population(s) at risk, SUSCEPTIBILITY getting a condition risk levels; personalize risk
PERCEIVED One's opinion of how serious a Specify consequences of
SEVERITY condition and its sequelae are the risk and the condition
PERCEIVED One's opinion of the efficacy of Define action to take; how,
BENEFIT the advised action where, when;
PERCEIVED One's opinion of the tangible Identify and reduce barriers
BARRIER and psychological costs of the through reassurance, advised action incentives, assistance
CUES TO Strategies to activate Provide how-to information,
ACTION "readiness" promote awareness, reminders. SELF EFFICACY Confidence in one's ability to Provide training, guidance take action in performing action Memfokuskan pesan Dari diagram di atas ditentukan determinan apa yang akan dipilih sebagai isi pesan Melalui kajian referensi, pendapat ahli atau riset lapangan Menentukan objective goal Pada dasarnya objective goal adalah perubahan determinan perilaku atau perubahan perilaku yang akan dicapai misal: pada akhir program, capeng di Desa X bersedia datang untuk imunisasi TT Determinan spesifik: Perceived susceptibility, perceived seriousness, perceived benefit Mengembangkan matriks tujuan perubahan KEADAAN AWAL PERUBAHAN YANG AKAN DICAPAI CAPENG TIDAK SADAR BAHAYA CAPENG MENYADARI BAHAYA TN TN CAPENG TIDAK TAHU CAPENG TAHU MANFAAT MANFAAT IMUNISASI TT IMUNISASI TT
CAPENG TIDAK TAHU JADWAL CAPENG TAHU JADWAL
IMUNISASI IMUNISASI TT
CAPENG TIDAK TAHU TEMPAT CAPENG TAHU TEMPAT
IMUNISASI PELAYANAN IMUNISASI TT Pengembangan pesan Menggunakan cara berpikir sistematik (perlu fakta, data empiris, jaminan) Menggunakan cara berpikir heuristik (ringan, “bahagia”, “heppy”, kebersamaan, riang gembira) Behaviorist theory Conditioning (pavlov) -comfort eating -makanan sebagai hadiah perilaku baik memberi impresi :makan enak, manis menimbulkan rasa nyaman, kalau sedang sedih. BT, makan aja -suasana kebersamaan yang nyaman (enaknya sambil merokok) Operant conditioning Perilaku dibentuk dari “reward and punishment” dalam sepanjang perjalanan hidup Social learning Belajar dari lingkungan sosial Melihat orang lain melakukan dan meng imitasi (bintang film sebagai ikon iklan) Remaja mencoba merokok setelah melihat “para bintang di iklan rokok terlihat hebat” Remaja putri melihat kecantikan para model dan betapa model tersebut terkenal dan banyak uang, lalu memaksakan diri untuk terlihat ramping hingga mengalami Eating disorder Telaah ekologi intervensi Pada dasarnya perubahan perilaku yang diharapkan membutuhkan perubahan lingkungan sosial dan aspek regulasi Telaah ekologi adalah rentang sasaran dari program intervensi yang akan dilakukan dalam rangka perubahan perilaku CONCEPS DEFINITION INTRA PERSONAL Individual characteristics that influence FACTORS behavior, such as knowledge, attitudes, beliefs, and personality traits
INTERPERSONAL Interpersonal processes, and primary groups
FACTORS including family, friends, peers, that provide social identity, support, and role definition
INSTITUTIONAL Rules, regulations, policies, and informal
FACTORS structures, which may constrain or promote recommended behaviors COMMUNITY Social networks and norms, or standards, FACTORS which exist as formal or informal among individuals, groups, and organizations
PUBLIC POLICY Local, state, federal policies and laws that
regulate or support healthy actions and practices for disease prevention, early detection, control, and management Dinamika perubahan Internal Pengaruh lingkungan Penguatan internal Intensi untuk berubah Mencoba berubah Mantap untuk berubah CONCEPT DEFINITION APLICATION
RECIPROCAL Behavior changes result from Involve the individual and relevant DETERMINISM interaction between person others and environment .
BEHAVIORAL Knowledge and skills to Provide information and training
CAPABILITY influence behavior . about action
EXPECTATION Beliefs about likely results of Incorporate information about likely
action results of action in advice.
SELF EFFICACY Confidence in ability to take Use persuasion and
action encouragement; approach behavior change in small steps.
OBSERVATIONAL Beliefs based on observing Point out others' experience,
LEARNING others physical changes; identify role models
REINFORCEMENT Responses to a person's Provide incentives, rewards, praise
behavior that increase or decrease Media Sesuai isi pesan Sesuai dengan objective goal Sesuai karaketeristik sasaran Sesuai dengan cakupan yang diharapkan Sesuai dengan kemampuan petugas Sesuai dengan pendanaan Jenis media Grafis Audibel Visual Audiovisual Model Media berdasarkan cara penyampaian Statis (poster, foto, pameran, lembar balik, model) Pancar luas (radio, program TV, internet) Poster Relatif murah Menarik Relatif mudah Mudah diganti -Berpotensi salah persepsi pada target Lembar balik Mampu memberi info ringkas dengan cara praktis Media yang cocok untuk kebutuhan dalam ruangan atau luar ruangan Bahan dan pembuatan murah Mudah dibawa kemana-mana Membantu mengingatkan pesan dasar bagi fasilitator/pengguna media Disain flipchart Ukuran standar 60- 90 cm , atau sesuaikan dengan jumlah peserta Gunakan ilustasi foto/kartun yang sederhaan dan dikenal khalayak Penulisan Judul yang menonjol , gunakan huruf besar dan sederhana Pesan jelas dan ringkas , istilah disederhanakan Gunakan warna mencolok dan tebal. Program Consult with intended participants and impleenters Create program scope, sequence, theme and materials list Develop design document and protocols Review available materials Develop program materials Pretest program material Adoption and Implementation Plan Identify adopters and users Specify adoption, implementation, and sustainability performance objectives Specify determinants and create matrices Select methods and strategies Design interventions to affect program use Diffusion innovation Concept application
innovator . Track them down and become their “first followers”
support and publicity for their ideas.
Early Reward their egos e.g. with media coverage.
adopter
Early simplify application forms and instructions.
majority Provide strong customer service and support.
Late Focus on promoting social norms rather than just
majority product benefits
laggard Give them high levels of personal control over when,
where, how and whether they do the new behaviour. CONCEPT DEFINITION APLICATION
RELATIVE The degree to which an innovation Point out unique
ADVANTAGE is seen as better than the idea, benefits: monetary value practice, program, or product it convenience, time replaces saving, prestige, etc.
COMPATIBILITY How consistent the innovation is Tailor innovation for the
with values, habits, experience, and intended audience's needs of potential adopters . values, norms, or situation COMPLEXITY How difficult the innovation is to Create program/ to be understand and/or use uncomplicated, easy to use and understand
TRIALIBILITY Extent to which the innovation can Provide opportunities to
be experimented with before a try on a limited basis commitment to adopt is required
OBSERVABILITY Extent to which the innovation Assure visibility of
provides tangible or visible results results: feedback or publicity. Evaluation Plan Describe the program Describe program outcome and effect questions Write questions based on matrix Write process questions Develop indicator and measures Specify evaluation design