The Development of Training Model Based on Theory of Planned Behavior and Willingness to Behave Higienic Practices for The Food Handler at Foodcourt Baseball in Unesa Surabaya

Training is not always change the personal behavior. According to the theory of planned behavior, the behavior intention is influence by three factors including the attitude, the subjective norms and the perceived behavior control (PBC). Willingness is the independent concept of the presumption behavior and influenced by intention as well. The aim of this study was to develop training model based on the theory of planned behavior and and willingness to higienic behavior for the food handler at foodcourt Baseball in Unesa Surabaya and implementation analysis of the development of training model. The development of the training model is using preliminary investigation phase, design phase and implementation. Partial Least Square (PLS) was performed. The effectiveness of training model was analyzed by using t test with two paired samples (paired t test). The result of food handlers hygienic behavioral analisys showed: PBC had contributed the most to the intentions through the willingness to behave hygienic practices, compared to the contribution of the attitude, subjective norm and PBC directly against the intention. These results could be used to develop a model of training for food handlers at the venue. The training was significantly effective (paired t test, p <0,05) in increasing the knowledge, practicing the hygienic behavior, attitude, subjective norm, PBC, intention and willingness of hygienic behavior of food handlers. The practicality of evaluation model was obtained by instructor assessment activities in very good result (88,42), 96% of trainees could participate well, and 89% of trainees responded well to the training. This training model was effectively proven to be used in increasing the intention of hygienic behavior of food handlers. Keywords— Hygienic Behavior; The willingness to behave hygienic practices; Theory of Planned Behavior; Food handlers


I. INTRODUCTION
Food handlers who do not or have not gained knowledge has the potential to contaminate food hygiene in food production en masse. The key to preventing food-borne illness is the education and training of food handlers [5]. Knowledge of the intention underlying the formation of hygienic behavior, according to the previous study that knowledge or cognitive domain is important for individuals to take action or behavior [9].
Theory of Planned Behavior (TPB) provides a precise description of the antecedents of hygienic behavior which indicates that the intention or desire of the individual to behave hygienic practices is a combination of three psychological antecedents, namely attitude, subjective norm and PBC. Involvement in behaviors that are directly affected individual intentions. This hygienic behavior also depends on the capacity to generate willingness to expose their knowledge.
Willingness in hygienic behavior is a statement of food handlers willingness to to behave hygienic practices. The willingness is a concept that is independent of the alleged conduct (behavior expectation) who feel the possibility of individuals actually perform a behavior [7,8]. Therefore, the aim of the study was to analyzed hygienic behavior formation based on Theory of Planned Behavior and willingness to behave hygienic practices for the food handlers at Foodcourt Baseball in Unesa Surabaya and implementation analysis of the development of training model.
The main solutions to prevent food diseases are education and training for food handlers [5]. However , food handlers in foodcourt Baseball of Unesa had higiene behavior a less well in presenting food to consumers , although some of them had followed food hygiene training. In addition, the food handlers had different background (like education , social economic and cultural ). Based on this fact shows that the training must be designed in accordance with their condition or characteristic of the food handler. The food hygiene training must be planned well by doing analysis of training need to obtain a comprehensive illustration about material, duration for each material, and appropriate learning strategy.

II. RESEARCH METHODOLOGY
This quantitative descriptive study was conducted among 36 food handlers who served at Foodcourt Baseball in Unesa Surabaya. Moreover, the researchers of this study did the research procedure that was a preliminary investigation phase, design phase and implementation. A questionnaire was used to retrieve the data associated with the determinant factor the intention and the willingness to behave hygienic practices, the observation sheet to assess the hygienic practices and tests used to measure the knowledge of hygienic practices of food handlers. The observation of hygienic practices included the use of aprons, making food tool, and hand washing. The data retrieval of knowledge, intention, attitude, subjective norm, PBC and the willingness to behave hygienic practices done prior to training. Data collection and analysis: Partial Least Square (PLS) test was used to determine the relationship of knowledge, perception of attitudes, subjective norms, PBC, the intention and the willingness to behave hygienic practices. Descriptive analysis was used to examine the practicality of training model, meanwhile,in order to determine the effectiveness of the model, it was used paired t-test.

A. Preliminary Investigation
Analyzing the hygienic behavior of food handler based on the theory of planned behavior (TPB) and the willingness. Test results between variables and acceptance hypothesis showed the results: Knowledge had positive correlation with attitude, the subjective norms and Perceived Behavioral Control (PBC) (t PLS 9.159 ,5.947, 2.701) respectively; attitude, subjective norm and PBC had positive correlation with the intention (t PLS 2.258; 2.110; 2.244) respectively. Further, subjective norm and PBC had positive correlation with the willingness to behave hygienic practices (t PLS 4.908, 11.476). At the end, higher score of the willingness to behave hygienic practices and the intention leaded to become high hygienic practices behavior (t PLS 4.051; 4.431). It could be concluded, that: 1) The higher knowledge, then it became also the higher attitude, subjective norm and PBC; 2) The higher attitude, subjective norm and PBC, then it became also higher the intention; 3) The higher subjective norm and PBC, then it became also the higher the willingness to behave hygienic practices; and 4) The higher the willingness to behave hygienic practices and the intention, then it became also increasing hygienic practices. PBC had contributed the most to the intentions on the willingness to behave hygienic practices, compared with the contribution of attitude, subjective norm and PBC directly against the intention. This would be used as the basis for the development of models of the formation of the intention to behave hygiene practicess among food handlers. Hygienic practice and analyzing training need in Focus Group Discussion (FGD) on the food handler and minimum standard capability.
According to the observation of hygienic practice that was done by the food handlers at the food court Baseball in Unesa showed that most of the hygienic practice was quite good (64%). In the other hand, things that had value and low frequency ( less ) were particularly in the habit of wearing apron, using specific tool for taking food or the food handlers did not touch directly the fast food with their hand, and the habit of washing their hand well (51,07%). The aspect in observing the hygienic practice was determined based on the terms of hygienic behavior in Permenkes No. 1096/MENKES/PER/VI/2011. The result of FGD toward the food handlers was the time in implementation the training that was expected in holiday or ordinary day, but in the time when they were not busy. The place for the training was near with the place where they worked and it was provided handbooks which were not in many descriptions, but in explanations or in showing the examples with the pictures. Moreover, the duration in giving the material was not very long time. Besides, the training also focused more in discussion session and development activity or mentoring periodically in effective weekdays for several meetings for each outlet. The result of the correlation analysis based on the theory of TPB and the willingness concluded that PBC gave the biggest contribution toward the implementation of the desire in having hygienic behavior through the willingness.

B. Design
According to the result in realization phase, it can be formulated the training model for the food handlers at the food court Baseball in Unesa as follows: 1. Training Program Name The program in improving knowledge, attitude, and skill for these food handlers was "Food Hygiene Training for The Food Handler in Foodcourt Baseball in Unesa Surabaya." 2. Purpose of the Training The purpose of the program was to improve the food handlers' desire in doing hygienic behavior. Hence, it was expected that the food handlers had knowledge, attitude, and skill or practiced hygienic behavior such as doing food service well that the food handlers gave more attention the personal hygiene and prevented cross-contamination toward the food that they sold, particularly while washing hands, used specific tool for taking each kind of food, and wore work dress or clean apron while working.

Target Training and Participant
The participants for the training were the food handlers at the foodcourt Baseball in Unesa.

Place and Time for the Training
The training (giving material) was done in joglo at the food court Baseball in Unesa that was placed next to the place where the food handlers sold their food. The activity of giving the material was done among on Monday until Friday and the practice activity was done once for four meetings.

Training Syllabus
The material that would be given during the training of food hygiene was general food hygiene because not all food handlers ever obtained the training. The material was organized briefly and solidly in order to make effective duration and the practice activity could be done effectively.

Schedule
The researchers of this study had arranged the schedule of the activity in training that involved material explanation meeting and practice meeting.
PBC gave the biggest contribution toward the implementation of the desire in having hygienic behavior directly through the willingness. This thing emphasizes the importance of creating an intervention that aims to improve the PBC and willingness to predict the desire [15]. Based on these results, in order to conduct hygiene among food handlers, the better the intention should be improved by doing activities that were relevant to improve the PBC, attitude, subjective norm, and the willingness to behave hygienic practices among food handlers. Although the PBC and the willingness to behave hygienic practices contributed the most to the formation of the intentions and hygienic practices, but the role of attitude and subjective norm were still needed.
The recommended activities that could be described as follows: Activities designed to improve PBC was owned by doing the following activities: (1) meeting to practice together (in addition to meeting the delivery of food hygiene materials); (2) Discussing and asking for food handlers and identifying issues that hinder the performance of hygienic behavior in their daily work and generated a plan to address this; (3) Advising or reminding each other to cultivate among members of the group during the discussion or during the observation period between group members; and (4) Controling the behavior of physical exercise in a way demonstrating of hygienic practices skills during joint practice or out of hours meetings independently. Interventions to improve the willingness to behave hygienic practices among food handlers was to: (1) Establishing a working group during practice activities; (2) Providing motivation by providing assistance in the form of 2 pieces of hygiene tool apron to any food handlers; (3) Providing input or revision of the performance of duties or less correct practices. The willingness to behave hygienic practices could be improved by establishing confidence (self-confidence). Interventions to improve the attitude of food handlers in hygienic practices are: (1) Watching movie ofdisease incidence that was caused by food seller of street food; and (2) Discussing on the causes, loss and prevention of losses. The interventions improved subjective norms were: (1) conducting the practice in groups; (2) observation of cross between members of the group; and (3) providing feedback or reminding between members of the group or other group members. These findings suggested that developing behavioral intention to adopt hygienic food handlers depended on expectations of others that were significant, including family, fellow food handlers, consumers, and managers of foodcourt.
Many activities that were done aimed to improve the control of behavior that was owned or PBC were by doing practice meeting. The practice meeting was done in 4 times after theoretical meeting. Based on the food handlers' want while doing FGD, the duration for practice meeting was not very long (70 minutes) and it was done when they worked because they did many activities. The practice meeting was done in work time in order to make their behavior in working could be seen clearly and improved at that time. In order to make the effective time, each food handler had been given task to observe hygienic behavior that was done. The hygienic behavior that was observed involved the personal hygiene and environment sanitation. The observation could train them to evaluate and do many things that were appropriate with the procedure of food hygiene and sanitation, not limited at the habit and the way to wash hands, the way to take food, and wearing apron. After that, each food handler would report the observation result and it would be continued with the explanation about the obstruction of daily hygienic behavior. Then, we would arrange a plan to solve it.
The way to solve the error that was done was by practicing together. The inferior activity that was usually done would be practiced together step by step with the guide from the instructor and they would obtain a brief explanation for the material. It was aimed to give them an understanding and the food handlers could be motivated in perceiving the difficulty or easiness in doing hygienic behavior. The more knowledge or resources that they had, the fewer obstacles that could be anticipated, hence, the greater control behavior that could be perceived. Learning activity about prior knowledge was included experiences, social interaction, and construction in sense making [13]. The method of this training that used material, observation, and practice for several meetings referenced to Roger's study [22] which stated that learning was more effective if it was based on own experience or based on the experience from the material that was learnt. The concept could be practiced directly or could be seen directly in order to make it easier to be learnt. Besides, the process of attitude change needed long time. However, if the participation was supported, this slow process tended to endure in long time for all permanent intents and purposes [20]. The correcting of direct practice in control was done in order to make the attitude and hygienic behavior of food handlers could be formed. According to Thierauf in an article stated that the people maintained about 25% from what they heart, 45% from what they saw, and 70% from what they saw, heart [21].
The willingness could be improved by forming selfconfidence. In training, by forming work group in doing practice (second until fifth meeting) was an effort to form self-confidence or improve the food handlers' willingness in doing hygienic practice. Morgan and Hunt argued that willingness in doing an action was an implicit thing in a belief [14]. If an individual had self-confidence, there would be willingness. In contrast, if an individual had no selfconfidence, there would not be willingness. Moreover, selfconfidence was a belief to form a comprehension and the participants' feeling of their ability in some aspects such as self-awareness, positive thought, optimist, objective, responsible person, and the ability to solve problem.
Besides to improve the willingness by forming work group, the other motivations that could be give toward the food handlers are giving apron as a help, giving enthusiasm to work or learn, giving compliment, improving the appreciation and social interaction for the food handlers each other and for the food handlers with the supervisor and manager of food court or forming comfortable and conducive environment for the food handlers, business owner, supervisor, and manager of food court. Furthermore, the function in giving motivation was to give enthusiasm in learning and working, hence, the goal of it could be achieved by emphasizing the exact behavior. This approach was done by giving more attention to the culture in area of food court because social culture as the background factor in achieving the goal of this training. The social culture had the impact for the people's ability to have initiative because human had human nature "to affect and be affected" each other. Concerning the culture, the food handlers tended to follow the values or people's opinion in the social environment [10].
Giving the knowledge through the film was not only to give interesting impression, but also to change the food handlers' behavior by giving information, educating, and affecting the food handlers to be able to do hygienic behavior. This film gave information for the food handlers about the incident that was happened, the food handlers' behavior, and all things that were accomplished by the actors of the film. This film was also as education because by watching the film, the film maker or the instructor or the organizers of the training could accomplish their message or knowledge and the food handlers could obtain the information and the knowledge. This film also functioned to affect the food handlers' thought and to change their attitude and behavior to be able to do hygienic practice on their daily work. Afterwards, the participants were invited to discuss the film such as the cause effect, the prevention, the positive and negative impact. During the discussion, the participants could give their arguments and response or give answer. Whether, the instruction had a job to manage the discussion in order to make all participants could have the opportunity in giving arguments. Moreover, learning through this case, the participants' belief would improve to do hygienic practice on their daily work. Hence, the attitude could be believed to have direct impact to have a desire to do hygienic practice.

C. Implementation
The field trial was conducted in order to obtain data about practicality and effectiveness of training model. The practicality model consisted of instructor's syntax achievement, trainees' activity, and trainees' responds. The effectiveness of training model included knowledge, attitude, subjective norm, PBC, intention, willingness, and hygienic behavior before and after the training.
Observation of syntax achievement was done by 2 observers who observed the process of training done by instructor in the 1 st meeting (material provision), and 2 nd , 3 rd , 4 th , and 5 th meetings (practice). In the 1 st meeting, there were three syntax; opening activity, main activity, and closing activity. Overall syntax achievement in the 1 st meeting was excellent with the score of 4,11. In the development and practice meeting (2 nd , 3 rd , 4 th , and 5 th meeting) obtained the average score of practice which was 3,995 and the average value from the 1 st meeting to the 5 th meeting was 4,05 that meant excellent. Trainees' activities were observed by an observer in the time of material explanation (1 st meeting) in meeting hall. The most activities which were done by trainees were listening or paying attention to instructor's explanation (67,19%), but there were also trainees who done activities which were not related to the training such as making a joke, eating, drinking, daydreaming, and so on.
The trainees were satisfied with the training (89%). Most of trainees were satisfied because the book that was given to them was easy to understand although there were also other reasons. Trainees' expectation of the training was the training that could be done periodically and books which were given used a simple language that could be understood easily.
Effectiveness of the training could be shown on difference of knowledge test result, attitude, subjective norm, PBC, intention, willingness, and hygienic practices of trainees before and after the training. The average of the result of knowledge, attitude, subjective norm, PBC, willingness, intention, and hygienic practices before and after the training could be seen in the Table 1.  The research found a result that the food handlers in Baseball Foodcourt, in Unesa Surabaya who had obtained the training of food hygiene obtained knowledge of food safety. Some researchers such as Howes et a.l,; Powell, Attwell and Massey showed that the training was able to increase knowledge of food safety, but it did not always cause a positive change toward food handlers [11,18]. It was supported by Robert who stated that this change was not always meant into the behavioral improvement [21].
A knowledge of healthy food, included hygienic behavior, was explained in the training by using lecture method, watching a movie, discussion, and asking-answering question. In order to make easier for the participants of the training in learning material, the handout was arranged based on its need by making variations of many pictures rather than some sentences. Moreover, it was aimed to give a stimulus that could influence the system of cognition toward food handlers as the participant of training. The stimulus would influence the cognition system of either short-term memory or long-term memory, hence, it would make them easier in learning.
There were many ways in giving the material such as case (movie), lecture, discussion, asking-answering questions, and direct practice about hygienic behavior in some meetings. It was aimed to increase thebest level of knowledge and skill. The material was explained by using learning method of problem solving, practice, and mentoring. It was aimed in order to make the participants easier in understanding maximally the information. Besides, it was supported by Prawiradilaga who stated that the understanding of information by reading was in 10%, listening was in 20%, listening and seeing was in 50%, speaking was in 70%, and speaking and implementing were in 90% [19]. In this training, the participants were encouraged more to discuss, re-explain, and do direct practice well, hence, these were hoped that the participants would understand the material at least in 90%.
Attitude was a positive and negative belief for showing a certain behavior. The result of t test with two paired samplestoward the consequence showed that there wasa significant difference between before and after training or the training gave an influence toward food handlers'behavior and also the evaluation.
During the process of training, there was an activity for increase an attitude by watching a movie about food supplying, which was less safe, and some diseases which were caused by food. The movie described food serving which was not qualified with a procedure of hygienic food, hence, it would cause a disease toward the consumer. There were some influences related to it such as the consumer's health and safety,the financial harm for the sellerdue to the abolishment of their selling license, hence, they couldn't earn some money, and they lost their reputation. In addition, the discussion activity finally evoked positive attitude for the importance of doing hygienic practice in daily.It was supported by Kalua who stated that positive knowledge would influence an attitude forming and the understanding of the fact of health [12]. The forming of positive attitude directed to the positive behavior, in contrast, the less good knowledge directed to misunderstanding and the development of negative attitude. The forming of attitude could occur because personal experience, the influence of other people, cultural factor, and emotional factor [4].
Subjective norm was an individual perception which related to an important of most of people's opinion that could give an influence to themselves. It meant that an individual would do or would not do the certain behavior. A person who wasconsidered as an important person to him or herself would become a guide to direct his or her behavior [6]. In this research, training method was conducted four times by involving peerfood handlers or the participantof the training, supervisor, and manager of food court and Health Department in Surabaya who was as the instructor of the training. Through this activity, each participant must observe one of their friends in one small group. This interaction would cause emotional relation for caring, having tolerance, helping others, appreciating, and reminding others.
Caring would evoke a motivation from them for doing hygienic attitude. During the training activity, many interactions happened between food handlers and others, food handlers in a group and other group, food handlers and their instructor, food handlers and their consumer or food handlers and outside environment of the food court. People who were standing around food handlers, they were believed in giving an influence to food handlers them selves. According to Peter and Olson, subjective norm was formed based on normative belief which related to what other people wanted them to do and a motivation for fulfilling of others' hope [17].
A certain control that was owned showed an ease and a difficulty for someone in doing her or his action which was considered as a reflection of past experience. The result of t test with 2-pairedsamples for all valuation (control ability and self-efficacy) showed that there was a significant difference between pre-and post-test that had been done or the training gave an influence toward food handlers, especially a control attitude that had been owned. In doing training activity, the participants obtained different experience, knowledge, and skill. Training method included lecture, discussion/asking-answering questions, watching a movie, and also direct practice. Furthermore, a direct practice was bigger than giving material. The practice was done in four times, although it was not in long time, but it had been enough to give an influence toward PBC. Besidespractice, there were two aprons for each person to give a motivation and belief toward food handlers that doing hygienic attitude was not expensive and it was a simple activity.
Willingness was an independent concept that came from behavior expectation in which an individual was really doing a behavior [7,8]. The result of t test with two paired samples showed that there was a very significant difference between pre-and post-test that was done based on willingness to behave in hygienic way or the training gave an influence toward willingness of hygienic behavior to food handlers. For encouraging the willingness of food handlers in doing hygienic practice, food handlers were asked to do an observation and to evaluate an activity which had been done, then it was practiced in a right way through the training. An observation was done in crossed way by other food handlers every week toward other partners' job in a group. The practice was done by all food handlers and it was done repeatedly to simplify in doing practice. For minimizing an obstacle in doing practice, then, every food handlerwas given equipment such as two aprons for each.
Intention was disposition of behavior, if there was an exact time and opportunity, it would be created in a form of behavior [1]. By having stronger intention to show a behavior, it would have more the possibility of doing the behavior. Hence, the main factor of a behavior that was shown by the individual in TPB theory was intention [2]. An intention or food handlers'intention to behave hygienic way was determined by attitude factor, socio-demography (such as gender and job experience), and contextual factor such as an experience in joining hygienic training of food sanitation, having support from the environment and society. Based on the response from the participants of training, 89% of them stated that they enjoyed the training and they hoped that this training would be done periodically.
This training was conducted in five time meetings. First meeting gave the materials; second until fifth meeting was used for development activity and practice. There were three syntaxes in syntax achievement of the training in first meeting which were the initial activity, main activity, and closing. An assessment of an achievement in initial activity was good. Main activity in the first meeting had been done in a good way. Main activity was watching a movie about disease that was caused by food which was sold in Singapore food court. Duration of the movie was 20 minutes, which served a cause of diseases and an impact of it. The participants of the training felt interested about this movie because they were not only watching, but also they were learning. According to Thierauf that people tended to maintain surround them approximately in 25% of what they had listened, 45% of what they had seen, and 70% of what they had seen, listened and implemented [21]. Moreover, all this time, they never obtained learning through watching a movie. Afterwards, they discussed.
Closing activity had been done in a very good way. In the last meeting, an instructor and the participants of the training concluded the materials which had been explained. In addition, they were also given an instruction of practice activity that would be done for next meeting. Regarding to this practice, the participants would be divided into four small groups based on their location of their stand. Each group wouldbe represented by 8-9 food handlers. By using skill observation sheet or hygienic practice, every participant must do hygienic practice observation of other food handlers' partner. This activity aimed to make the participants to do and to know the practice that had been done was appropriate or not with the help of others' observation. An observation was conducted in uncertain time and the result was noted in a sheet that had been prepared. The result of an observation would be reported or presented in next meeting. Poorly hygienic practice skill would be evaluated and practiced directly in the workplace. In giving a motivation, each food handlers was given two aprons which were written the identity of their food court by using different color.
In development and practice meeting (second, third, fourth, and fifth meeting), the average of value in practice activity was 3.955 and the average of value for first until fifth meeting was 4.05 or in a good category. The development and practice activity was conducted in food court in a workday in order to see directly the hygienic practice that had been done. In the last activity, besides they concluded the training activity, an instructor would give a reward toward participants who had good work. Furthermore, it was emphasized in order to make the participants to do hygienic practice in daily in their workplace.
Not all of the participants had a concentration to hear instructor's explanation. The most interesting activity was watching a movie because there was a story and live picture which were followed by a plot of story. Besides, most of the participants were reading the handout while they were listening to the materials which were explained. This was done because it was assumed that they were interested with the handout and they tried to look for further explanation of the materials that was explained by the instructor. Based on the characteristic of an adult, there were only few people who had an activity or writing activity that was needed, few numbers of them were tired, and finally they were sleepy or talking with their close friend. Most of participants became pleasant because a book that was given to them was easy to learn. The participants expected that the training should be done periodically and a book that was given contained perceivable language. This kind of training was rare to be done. It was proven that the 77.8% of participants had never followed such kind of the training activity of hygienic sanitation food. By using different method of training (watching a movie, discussion/asking-answering questions, lecture, and direct practice), the participants felt pleasant and hoped that this training could be done periodically.
The combination of learning method and training such as lecture, discussion/asking-answering question, watching a movie, and direct practice could give new experience for an adult [3].

IV. CONCLUSIONS
PBC had contributed the most intentions through the willingness to behave hygienic practices, compared to the contribution of attitude, subjective norm and PBC directly against the intention. The training model that was developed was the training in five meetings that consisted of one meeting for giving material and four meetings for practice.
They were doing training in a significant and effective way toward the increase of knowledge, hygienic practice, attitude, subjective norm, PBC, intention, and the willingness of food handlers. The evaluation of the practicality model was obtained the assessment result of instructor activity in very good which was 88.4% and 96% of the participants could join the training activity in a good way and 89% of the participants gave positive response toward the training activity.

ACKNOWLEDGMENT
We would like to thank to the respondents who participated in this study, the management of Baseball foodcourt in Unesa Surabaya who gave the permission for the study in that place, and all parties who helped in data collection of this study.

STATEMENT OF ETHICAL APPROVAL
Ethical approval received from Ethical Review Board of Public Health Faculty at Universitas Airlangga. There were three steps to collect inform consent sheet. Firstly, researchers invited food handlers in those areas, explained about this study, and asked a help to make a meeting schedule. Secondly, researcher invited food handlers in a meeting and explained about this study. Thirdly, inform consent sheets were collected by researcher from the respondents.