Hanifatul Afifah, Afif Kurniawan, Iswati Iswati, Siti Hardiyanti

Factors Affecting Decision Making in Health Service Selection Using the Theory of Planned Behavior Approach

Introduction

Factors affecting decision making in health service selection using the theory of planned behavior approach. Pahami faktor (sikap, norma, kontrol) yang memengaruhi pilihan fasilitas kesehatan masyarakat di daerah terpencil menggunakan Teori Perilaku Terencana. Penting untuk promosi kesehatan efektif.

Abstract

Pemanfaatan fasilitas pelayanan kesehatan masih menjadi tantangan di daerah dengan keterbatasan akses sejumlah wilayah yang secara geografis kurang terjangkau. Salah satu pendekatan teoritis yang dapat menjelaskan perilaku masyarakat dalam memilih fasyankes adalah Theory of Planned Behavior (TPB), dapat digunakan sebagai kerangka konseptual untuk menganalisis perilaku masyarakat dalam memilih fasilitas pelayanan kesehatan. Metode Penelitian ini menggunakan pendekatan kuantitatif dengan desain cross-sectional. Responden merupakan anggota masyarakat yang memenuhi kriteria inklusi terkait pengalaman dalam mengakses layanan kesehatan. Data dianalisis dengan regresi logistik untuk mengevaluasi pengaruh variabel-variabel independen terhadap kecenderungan pemilihan fasilitas kesehatan formal. Sampel sebanyak 96 responden dipilih menggunakan teknik purposive sampling. Data dikumpulkan melalui kuesioner yang telah diuji validitas dengan nilai r tabel 0,514 dan reliabilitasnya Attitude Toward The Behavior menunjukkan nilai sebesar 0,883, variabel Subjective Norm menunjukkan nilai sebesar 0,866, variabel Perceived Behavior Control menujukkan nilai sebesar 0,775. Analisis data menggunakan regresi logistik biner. Hasil uji regresi logistik biner penelitian menunjukkan bahwa attitude toward behavior (0,000). subjective norms (0,000), dan perceived behavioral control (0,000) berhubungan yang signifikan terhadap intention dengan sikap positif, dukungan sosial yang tinggi dan persepsi bahwa mengakses layanan kesehatan adalah hal yang mudah dan terjangkau. Kesimpulan attitude toward behavior, subjective norms, dan perceived behavioral control secara signifikan memengaruhi niat masyarakat untuk menggunakan fasyankes. Hal ini menegaskan bahwa pendekatan berbasis psikososial perlu dijadikan dasar dalam intervensi promosi kesehatan, khususnya di wilayah pedesaan

Review

The paper, "Factors Affecting Decision Making in Health Service Selection Using the Theory of Planned Behavior Approach," addresses a critical challenge in public health: the underutilization of health facilities, particularly in geographically disadvantaged areas. The authors appropriately leverage the Theory of Planned Behavior (TPB) as a robust conceptual framework to investigate the factors influencing individuals' intentions to choose health services. This theoretical grounding provides a strong foundation for understanding complex health behaviors and is highly relevant to developing targeted interventions in settings with limited access. Methodologically, the study employed a quantitative cross-sectional design, utilizing logistic regression to analyze the relationship between TPB constructs and the intention to use formal health facilities. The abstract notes a sample size of 96 respondents, selected via purposive sampling, and provides encouraging details regarding the validity and reliability of the questionnaire instruments. The findings clearly indicate a significant relationship between attitude toward behavior, subjective norms, and perceived behavioral control with the intention to utilize health services, consistently demonstrating strong statistical significance (p=0.000 for all constructs). While these results reaffirm the utility of TPB, the relatively modest sample size might warrant caution regarding the generalizability of the findings, especially if the target population in "geographically less accessible regions" is substantially larger and diverse. The study's conclusion, emphasizing the significant influence of attitude, subjective norms, and perceived behavioral control on health service utilization intention, strongly supports the integration of psychosocial approaches into health promotion strategies. This is a vital contribution, particularly for designing effective interventions in rural and underserved areas, as explicitly suggested by the authors. By highlighting the actionable components of TPB, the research provides valuable insights for policymakers and health practitioners seeking to improve health service uptake. Future research could expand upon these findings by employing larger, more diverse samples from specifically targeted "less accessible" regions and perhaps exploring qualitative methods to gain deeper insights into the lived experiences and nuanced perceptions underlying these TPB constructs.

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