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Health Action Process Approach (HAPA) as a Framework to Understand Compliance Issues With Health Protocols Among
Khamelia Malik1,2, Nurmiati Amir1, A A A A Kusumawardhani1
1Department of Psychiatry, Faculty of Medicine, Cipto Mangunkusumo National Referral Hospital, Universitas Indonesia, Jakarta, Indonesia.
Insights
Strong self-efficacy and planning are key to COVID-19 protocol compliance in isolation. Intent to follow health guidelines, driven by self-belief and clear planning, significantly improves adherence among isolated individuals.
Area of Science:
- Public Health
- Health Psychology
- Behavioral Science
Background:
- Understanding psychosocial factors influencing adherence to COVID-19 health protocols is crucial for effective public health interventions.
- Compliance among individuals in isolation facilities presents unique challenges that require specific investigation.
Purpose of the Study:
- To identify psychosocial determinants of compliance with COVID-19 health protocols.
- To examine the mediation mechanisms of compliance among individuals isolated in COVID-19 health facilities in Jakarta, Indonesia.
Main Methods:
- Cross-sectional study utilizing the Health Action Process Approach (HAPA) socio-cognitive model.
- Data collected via questionnaire from 1,584 participants (865 men, 719 women) in isolation facilities.
- Structural Equation Modeling (SEM) used for data analysis.
Main Results:
- Strong self-efficacy positively correlates with a stronger future intent to comply with health protocols.
- Increased intent to comply leads to more robust planning.
- Planning was identified as a significant mediator between intention and actual compliance with health protocols.
Conclusions:
- The Health Action Process Approach model effectively explains compliance with COVID-19 health protocols in isolation settings.
- Intent (influenced by risk perception, outcome expectancies, self-efficacy) and planning are vital for improving adherence.
- Findings can inform strategies to enhance COVID-19 protocol compliance in communities.
Introduction:
This study aims to identify the psychosocial determinants and examine the mediation mechanisms of the compliance with COVID-19 health protocols among people undergoing isolation in health facilities that specifically treat COVID-19 cases in Jakarta, Indonesia.
Methods:
This is a cross-sectional study which used socio-cognitive approach, known as the Health Action Process Approach (HAPA), to understand the complexity of issues related to compliance with health protocols. A total of 1,584 subjects participated in this study, including 865 men and 719 women over the age of 18 years old during the data collection period (October 19-26, 2020). The data were collected using questionnaire that was developed by a team of experts from the Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, and survivors. The data that has been collected were then analyzed using Structural Equation Modeling, a multivariate data analysis technique.
Results:
The final research model in this study fulfills the criteria for a good model fit. This study found that individuals who have strong self-efficacy regarding their ability to implement behaviors and overcome obstacles will have stronger intent to comply in the future. The study also found that stronger intent will lead to stronger planning, and planning was found mediating intention and compliance with health protocols.
Conclusion:
This research model is comprehensive and useful in understanding compliance with health protocols among people undergoing isolation in health facilities for COVID-19 (Wisma Atlet and RSCM Kiara Ultimate). Having intent (related to the risk perception, outcome expectancies, and self-efficacy) and having a plan can positively influence the behavior of people undergoing isolation, resulting in better compliance to health protocols. The understanding gained from this study can be used to improve strategies related to compliance with health protocols against COVID-19 in the communities.
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