Theoretical framework

Health Belief Model

According to Dr. of Public Health, Washburn (n.d.), The Health Belief Model (HBM) asserts that
"people’s beliefs influence their health-related actions or behaviors". It is a theory in public health and
psychology wherein it explains how individuals make decisions related to their health and well-being.
The model proposes that when people think they are susceptible to a particular health threat or risk,
will view the threat as serious, then perceives that taking a certain action will lower their risk, and see
few obstacles to taking that action, they are more inclined to adopt health-improving habits. This has
been widely used to understand and predict behaviors related to preventive health measures, such as
vaccination, screening, and other health interventions.

The Health Belief Model is composed of six (6) concepts. Perceived Susceptibility. The
individual's belief or assessment about their risk of developing a particular health condition or disease.
When the individual believes that he/she is susceptibility or vulnerability to a certain health problem or
risk, they will be more cautious and will do something to prevent from acquiring the disease. Perceived
Severity, refers to the person's judgement about the seriousness and potential consequences of the
health condition/disease. When the disease is perceived as serious or severe, the person is more
motivated to take action against the disease. Perceived Benefits. It is the individual's opinion as to the
effectiveness of a specific action or behavior to reduce the risk or impact of the health condition. The
more that the individual believes that this certain action has beneficial results, more likely it will be
practiced. Perceived Barriers is the perceived obstacles or challenges of the individual that may hinder
them from taking the recommended action. It can be tangible physical barriers or needs such as
economic resources. On the other hand, it can be intangible barriers which revolves in psychological
factors like fear, anxiety, etc. Then, Cues to Action which is the external or internal triggers that prompt
individuals to take action, such as health information, advice from a healthcare provider, or personal
experiences. In short, it is the factors that may trigger to take action or change certain behaviour. Lastly,
component of the HBM theory is Self-efficacy. Refers to an individual's belief or confidence in one's
capacity to execute behaviors or complete a task necessary to produce specific performance
attainments (Bandura, 1977).

Social Cognitive Theory

Social cognitive theory, developed by Albert Bandura, is a comprehensive theoretical framework

that emphasizes the importance of observational learning, imitation, and modeling in the development
of behavior. It posits that individuals learn not only through their own experiences but also by observing
the actions and outcomes of others, particularly within a social context.

This theory highlights several key concepts:

1. Observational Learning: Individuals acquire new behaviors and knowledge by observing

others and the consequences of their actions. Through this process, people can learn without directly
experiencing a particular situation themselves.
 2. Modeling: This involves the replication of behaviors displayed by others. People may imitate
the actions of role models or influential figures, which can shape their own attitudes, beliefs, and
behaviors.

3. Reciprocal Determinism: Bandura proposed that behavior, personal factors (such as cognitive
abilities, beliefs, and attitudes), and environmental influences all interact dynamically to shape an
individual's actions and experiences. This concept underscores the interplay between an individual and
their environment.

4. Self-efficacy: This is a central component of social cognitive theory, referring to an individual's

belief in their own ability to successfully execute a specific task or behavior. High self-efficacy can lead to
increased motivation, perseverance, and resilience, while low self-efficacy can result in a lack of
initiative and a diminished sense of accomplishment.

5. Behavioral Reinforcement: Bandura's theory acknowledges the role of reinforcement in

learning and behavior change. Positive reinforcement, negative reinforcement, and punishment can
influence an individual's likelihood of repeating or avoiding specific behaviors.

Furthermore, the Social Cognitive Theory emphasizes the role of observational learning and
social factors in shaping health behavior. It posits that individuals learn from observing others and their
surroundings, and their health behaviors are influenced by these observations, along with personal
factors such as self-efficacy and outcome expectations.

The Theory of Planned Behavior (TPB)

The Theory of Planned Behavior (TPB), developed by Icek Ajzen in 1991, provides a
comprehensive framework for understanding and predicting human behavior. TPB posits that human
behavior is influenced by three primary constructs: attitude toward the behavior, subjective norm, and
perceived behavioral control, which collectively shape behavioral intention. In this theoretical
framework, we explore the core principles of TPB and its implications for understanding and predicting
various human behaviors.

1. Attitude toward the Behavior (AB):

- Attitude can be influenced by cognitive, affective, and behavioral components. Cognitive components
involve beliefs and evaluations, affective components deal with emotions related to the behavior, and
behavioral components pertain to past actions or intentions.

- Attitude can change over time based on new information or experiences, affecting an individual's
behavioral intention.

2. Subjective Norm (SN):

- The subjective norm is influenced not only by the opinions of significant others but also by the
motivation to conform to those opinions.
- The strength of the subjective norm depends on the importance and proximity of the referent others in
an individual's social network.

3. Perceived Behavioral Control (PBC):

- PBC can be influenced by self-efficacy, which is an individual's belief in their ability to perform the
behavior successfully. High self-efficacy can enhance perceived control.

- PBC can be enhanced through the provision of resources, training, or the removal of obstacles, making
the behavior more achievable.

4. Behavioral Intention (BI):

- Behavioral intention is a crucial link between the cognitive processes (AB, SN, PBC) and actual behavior.
It serves as a motivational force that drives individuals to act on their intentions.

- The strength of BI can vary, and it doesn't always guarantee that the behavior will be performed, but it
significantly increases the likelihood of it happening.

5. Application of TPB:

- TPB can be effectively applied to design behavior change interventions in fields like public health. For
instance, designing campaigns that aim to increase the intention to quit smoking by addressing AB, SN,
and PBC factors.

- In marketing, TPB can be used to understand consumer preferences and create strategies that align
with consumers' attitudes and perceived control over their purchasing decisions.

6. Critique and Future Directions:

- One critique is that TPB may not fully account for impulsive or habitual behaviors, which may not
involve a conscious evaluation of attitudes, subjective norms, or perceived control.

- To enhance predictive power, future research can explore the integration of TPB with other
psychological theories, such as the Theory of Reasoned Action (TRA) or the Health Belief Model (HBM).

- Researchers can also focus on refining the measurement of TPB constructs to make them more
context-specific and culturally sensitive, improving the accuracy of predictions in various populations
and situations.

In conclusion, the Theory of Planned Behavior provides a valuable framework for understanding
and predicting human behavior by considering the interplay of attitude, subjective norm, and perceived
behavioral control. By examining these constructs and their influence on behavioral intention, TPB has
proven to be a versatile tool in various fields. This theoretical framework serves as a foundation for
research and practical applications aimed at promoting or modifying behaviors in diverse contexts.