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Determinants of Dementia Among the Elderly in Jakarta, Indonesia Miciko Umeda; Aris Widiyanto; Dedy Muhdiana; Lily Herlina; Joko Tri Atmojo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 10 No. 3 (2025)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2025.10.03.06

Background: The incidence of dementia rises sharply, and it is expected to grow worldwide in the decades ahead. This study aimed to investigate the determinants of dementia among the elderly in Jakarta, Indonesia.Subjects and Method: A cross-sectional design was employed in the Aisyah organization at Jakarta City, Indonesia. A total of 65 elderly people were selected using Stratified random sampling. The dependent variable was dementia. The independent variables were education, occupation, married status, and exercise routine. The dementia was assessed using the Mini-Mental State Examination (MMSE) questionnaire, which was translated into Bahasa. Results: The participants had an education level of high school or below (52.31%), were not married (53.85%), and were not working (55.38%). The majority reported frequent exercise (92.31%), and 44.62% were identified with dementia. Bivariate analysis showed that higher education (OR = 0.92; 95% CI= 0.26 to 3.22; p= 0.002) and being married (OR= 0.94; 95% CI= 0.34 to 2.61; p= 0.020) were significantly associated with lower dementia risk. Exercise routine showed a strong protective effect (OR = 0.17; 95% CI= 0.01 to 1.79; p= 0.043), while occupational status was not significantly associated (p= 0.074). In multivariate analysis, only exercise routine remained significantly associated with dementia (OR= 0.17; 95% CI= 0.01 to 1.78; p= 0.042), suggesting it as an independent protective factor after controlling for confounders.Conclusion: Regular physical activity was identified as a significant protective factor against dementia among the elderly. Promoting exercise may be an effective strategy for dementia prevention in this population.

Meta Analysis: Effects of Peer, Family, and School Environment on Smoking Behavior in Adolescents Anse Putra; Hanung Prasetya; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2023.08.04.08

Background: Smoking behavior is a behavior that is harmful to health, but there are still many people who do smoking activities, even someone starts smoking starting as a teenager. This study aimed to estimate the influence of peers, family, school on smoking behavior in adolescents through a meta-analysis of primary studies conducted by previous authors. Subjects and Method: This was a systematic review and meta-analysis conducted following the PRISMA diagram and the PICO format. Population: Teenagers. Intervention: Smokers' peers, smokers' family members, schools apply smoking rules. Comparison: Peers don't smoke, family members don't smoke, schools don't enforce smoking rules. Outcome: Smoking. The online databases used are Google Scholar, Science Direct, and ProQuest with the words ''Smoking peers'' AND ''Smoking parents'' AND ''Smoking policy school'' AND ''smoking'' AND behavior AND adolescents AND ''cross sectional'' AND aOR. There were 16 cross-sectional studies published in 2013-2023 that met the inclusion criteria. Analysis was performed with RevMan 5.3. Results: The meta-analysis included 16 cross-sectional studies from India, Korea, China, Hong Kong, Taiwan, South Africa, America, Chile, Denmark, Saudi Arabia and, Turkey. The total sample was 191,101. Smoking behavior increased with smoker peers (aOR= 5.04; 95% CI = 3.23 to 7.87; p< 0.001), smoker family members (aOR=2.04; 95% CI= 1.45 to 2.87; p< 0.001), and low smoking policy in school (aOR= 1.00; 95% CI= 0.65 to 1.54; p< 0.001). Conclusion: There is influence of smoking peers, smoking families, smoking policies in schools with smoking behavior in adolescents. Keywords: adolescents, peers of smokers, families of smokers, smoking policies. Correspondence: Anse Putra. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: anseputra9@gmail.com. Mobile: +6282120298227.

Information Motivation Behavior Determinants of Decision to Quit Smoking Danu Aprilianto; Hanung Prasetya; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.02.08

Background: Cigarette sales in Indonesia continue to increase, as does the number of people who consume cigarettes, children who smoke, and also deaths caused by smoking. This study aimed to analyze the factors that influence the decision to stop smoking in the Special Region of Yogyakarta using the information motivation behavior skills theory. Subjects and Method: This research is an analytical observational study with a cross-sectional study approach conducted in the Special Region of Yogyakarta in June-July 2023. There were 212 adults consisting of 153 active smokers and 59 former smokers. The dependent variable is the decision to stop smoking. The independent variable is Information Motivation Behavior Skill (IMB). Data was collected using a questionnaire distributed online and analyzed using a path analysis test. Results: Good information (b= 1.25; 95% CI= 0.32 to 2.17; p< 0.008) and high motivation (b= 2.23; 95% CI= 1.54 to 2.9; p< 0.001) were associated with smoking cessation skills, smoking cessation skills good (b= 1.72; 95% CI= 1.01 to 2.43; p< 0.000) is associated with the decision to stop smoking. Conclusion: Good information, high motivation, and smoking cessation skills are statistically related directly and indirectly to the decision to stop smoking.

Meta Analysis of Health Belief Model Theory on the Predictor of HPV Vaccine Uptake in Women of Reproductive Age Nurul Qomariah; Bhisma Murti; Uki Retno Budihastuti
Journal of Health Promotion and Behavior Vol. 9 No. 1 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.01.05

Background: Lack of knowledge about the use of HPV vaccine in women of productive age can result in cervical cancer. This study aims to determine the effect of the Health Belief Model application on the predictor of HPV vaccine uptake in women of reproductive age. Subjects and Method: Systematic review and meta-analyses were conducted using PRISMA guidelines and PICO model including: Population = women of reproductive age; Intervention= high perceived benefits, high perceived severity, high perceived susceptibility; Comparison= low perceived benefits, low perceived severity, low perceived susceptibility; Outcome= HPV vaccine uptake. Articles were collected from databases such as PubMed, Science Direct, and Google Scholar. The keywords used in the database search were "Health Belief Model" AND "Human Papilloma Virus" OR "HPV" AND "Women" AND "cross sectional study". A total of 7 articles met the inclusion criteria, namely full-text primary paper, cross-sectional study design, with a measure of association was the Odds Ratio (OR), the study subjects were women of reproductive age, interventions were in the form of high perceived benefits, high perceived severity, high perceived vulnerability, and the outcome was in the form of HPV vaccine use. They were subsequently assessed for meta-analysis using RevMan 5.3. Results: Meta-analysis from Indonesia, Ethiopia, the United Kingdom, Japan, Romania, Spain, and Italy showed that high perceived benefits of HPV vaccine use (aOR= 1.81; 95% CI= 1.00 to 3.26; p= 0.050), high perceived severity (aOR= 1.78; 95% CI= 0.94 to 3.40; p= 0.080), and high perceived susceptibility (aOR= 1.70; CI 95%= 0.75 to 3.83; p= 0. 200) increased the likelihood of HPV vaccine uptake. Conclusion: High perceived benefits, high perceived severity, and high perceived susceptibility have the likelihood of women of productive age to use HPV vaccine

Meta-Analysis the Effects of Hand Washing Behavior Using Soap and Latrine Availability on the Diarrhea Incidence in Children Under Five Dyah Ayu Fatmawati; Sumardiyono; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.02.03

Background: Diarrheal disease is a major problem in developing countries, including Indonesia. Apart from being a cause of death, diarrhea is also a major cause of malnutrition and can cause extraordinary events. This study aimed to analyze and estimate the effect of washing hands with soap and availability of latrines on the incidence of diarrhea in toddlers, with a meta-analysis based on previous primary studies. Subjects and Method: The meta-analysis was carried out using the PICO format including: (1) Population: Children under five; (2) Intervention: Mother washing hands with soap and having latrines available; (3) Comparison: Mothers who don't wash their hands with soap and don't have latrines available; and (4) Outcome: Incidence of diarrhea. Article searches were performed using several databases such as PubMed, Google Scholar, ScienceDirect, BioMed Central, and PLOS ONE. The keywords used are “Hand Washing OR Hand Hygiene AND “Latrine OR Latrine Availability” AND “Infection” AND “Diarrhea Childhood” AND “Children”. The inclusion criteria for the included articles were full text articles with a cross-sectional design, published years from 2013 to 2022. This study was conducted according to PRISMA guidelines (Preferred Reporting Item for Systematic Reviews and Meta-Analysis). Data were analyzed using the Review Manager 5.3 application. Results: A total of 14 cross-sectional studies were included in this meta-analysis study which contained a total of 12,851 children under five who were at risk of diarrhea. This research article comes from Ethiopia which is on the African continent. The results of this meta-analysis show that mothers who wash their hands with soap can reduce the incidence of diarrhea in toddlers by 0.31 times compared to mothers who do not wash their hands with soap (aOR= 0.31; 95% CI= 0.17 to 0.57; p= 0.001), and the availability of latrines can reduce the incidence of diarrhea in toddlers by 0.38 times compared to the unavailability of latrines (aOR= 0.38; 95% CI= 0.15 to 0.96; p= 0.040). Conclusion: The behavior of washing hands with soap and the availability of latrines can reduce the incidence of diarrhea in toddlers.

Meta-Analysis: Effectiveness of Health Education Based on Health Belief Model in Type 2 Diabetes Mellitus Patients Atika Afniratri; Didik Gunawan Tamtomo; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.02.04

Background: The effectiveness of health education based on the Health Belief Model in diabetes mellitus patients can improve diabetes mellitus prevention behavior. This study aimed to determine the effect of the application of the Health Belief Model on health education in patients with diabetes mellitus. Subjects and Method: A systematic review and meta-analysis was performed using the PRISMA guidelines and the PICO model including Population= Type 2 diabetes patients; Intervention = Education based on the Health Belief Model; Comparison= Not using an educational method based on the Health Belief Model; Outcome= Perceived vulnerability, Perceived compliance, Perceived benefits, Perceived obstacles. Articles are collected from PubMed, Science Direct, and Google Schoolar. The keywords used “Health Belief Model” AND “DM” OR “Diabetes Mellitus” AND “Type-2”. A total of 8 articles met the inclusion criteria, namely primary full text paper, randomized controlled trial study design, based on the Health Belief Model, and outcomes in the form of perceptions of vulnerability, perceived compliance, perceived benefits, perceived obstacles for the meta-analysis were then assessed using RevMan 5.3. Results: Meta-analyses from Iran, India and Turkey showed that diabetes patients who were given education had an average perceived susceptibility score 1.37 units higher than those without education (SMD= 1.37; 95% CI= 0.74 to 2.01; p= 0.050). Diabetes patients who received education or education had an average severity perception score of 0.86 units higher than those without education (SMD= 0.86; 95% CI= 0.23 to 1.48; p= 0.007). Diabetes patients who received education on average had a perceived benefit score of 1.02 units higher than those who did not receive education (SMD= 1.02; 95% CI= 0.54 to 1.50; p < 0.001). Conclusion: Education based on the health belief model is effective for increasing perceptions of vulnerability, perceptions of adherence, and perceptions of benefits in diabetes patients with type 2 diabetes mellitus.

Meta-Analysis: Factors Related with Premarital Sexual Behavior in Adolescents Aktif Cahyaning Tyas; Hallisa'tu Zahro; Putri Fortuna Salsabila; Aem Ismail; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 9 No. 3 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.03.03

Background: Premarital sexual behavior is a sexual activity carried out before marriage. Premarital sexual behavior is a health priority in adolescents because it causes unwanted pregnancies, abortions, STIs, HIV/AIDS and even death. Parents, peers, community environment, economic and cultural conditions influence premarital sexual behavior. This study aims to analyze the effect of peers, smoking behavior, alcohol consumption, exposure to pornography and rural areas on premarital sexual behavior in adolescents. Subjects and Method: This was a systematic review and meta-analysis of study articles. Data obtained from databases including Google Schoolar, Pubmed and Science Direct. Article search was carried out by considering eligibility criteria with the PICO model. Population: adolescents. Intervention: high peer pressure, smoking behavior, alcohol consumption, exposure to pornography, and rural areas. Comparation: low peer pressure, non-smoking, no alcohol consumption, no exposure to pornography, and urban areas. Outcome: premarital sexual behavior. The articles were collected with keywords including "Peer Pressure" AND "Smoking" AND "Alcohol Compsumtion" AND "Pornography Exposure" AND "Rural" OR "Premarital Sexual Behavior" AND "Cross Sectional Study". Study articles were collected with PRISMA flow diagrams and analyzed using Review Manager 5.3 application. Results: The results of the meta-analysis indicated that adolescents were influenced by premarital sexual behavior in the presence of high peer pressure (aOR= 3.57; CI95%= 1.38 to 9.26; p<0.001), smoking behavior (aOR= 1.17; CI95%= 0.63 to 2.16; p<0.001), alcohol consumption (aOR=2.11; CI95%=1.34 to 3.33; p<0.001), and exposure to pornography (aOR= 2.43; CI95%= 1.44 to 4.09; p<0.001). Conclusion: Adolescent premarital sexual behavior increases with high peer pressure, smoking, alcohol consumption, and exposure to pornography.

Multilevel Analysis of Information Motivation Behavioral Skill Models and Its Effect on Tertiary Preventive Behavior in Elderly with Type II Diabetes Mellitus Alimah Ulfah Khairiyyah; Bhisma Murti; Didik Gunawan Tamtomo
Journal of Health Promotion and Behavior Vol. 9 No. 3 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.03.04

Background: Diabetes Mellitus (DM) is an important health condition for the elderly population, about a quarter of people over the age of 65 suffer from diabetes. Complications of type 2 diabetes increase the risk of death for sufferers. Complications and death from type 2 diabetes can be prevented by implementing tertiary preventive behavior. This study aimed to determine the influence of Integrated services post and other factors on tertiary preventive behavior for type 2 diabetes, using information motivation behavioral skill models theory. Subjects and Method: A cross-sectional study was conducted at 25 Integrated services post in Sukoharjo Regency, Central Java from October to November 2023. A total of 200 elderly patients with type II DM were selected by the stratified random sampling. The dependent variable is tertiary preventive behavior. The independent variables used are information, motivation, behavioral skills, age and gender. Data collection was carried out by interviews and questionnaires. Data analysis uses multilevel multiple linear regression analysis. Results: Tertiary preventive behavior is positively related to motivation (b= 0.31; 95% CI= 0.01 to 0.61; p= 0.037), behavioral skills (b= 0.74; 95% CI= 0.43 to 1.05; p= 0.001). Tertiary preventive behavior was positively related to information but was not statistically significant (b= 0.01; 95% CI= -0.30 to 0.32; p= 0.945). Tertiary preventive behavior was negatively related to age but was not statistically significant (b= -0.04; 95% CI= -0.11 to 0.01; p= 0.168) and gender (b= -0.07; 95% CI= -0.98 to 0.83; p= 0.878). Integrated services post has a contextual influence on tertiary preventive behavior in elderly patients with type-II DM (ICC= 35.99%). Conclusion: Tertiary preventive behavior in elderly patients with type 2 DM increases with good information, strong motivation and good behavioral skills. Integrated services post has a contextual effect on tertiary preventive behavior in type 2 DM patients.

Meta Analysis: Application of Health Belief Model on Tertiary Preventive Behavior in Type 2 Diabetes Mellitus Patients Afifah Nur Haliza; Bhisma Murti; Didik Gunawan Tamtomo
Journal of Health Promotion and Behavior Vol. 9 No. 3 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.03.01

Background: Tertiary prevention of DM is taking action on DM sufferers who experience complications to prevent further disability by providing health education to DM sufferers about the importance of drug compliance, diet and exercise. The study aimed to analyze the effectiveness of the Health Belief Model application in improving tertiary preventive behavior in type 2 diabetes mellitus patients. Subjects and Method: This study is a systematic review and meta-analysis study using PICO. P: Patients with Diabetes Mellitus type 2; I: High perceived severity, high perceived benefit, high self-efficacy; C: Low perceived severity, low perceived benefit, low self-efficacy; O: Tertiary preventive behavior. Data collection was obtained from data bases, namely PubMed, Google Scholar, Elsevier and Springer Link. The inclusion criteria used were full-text articles with a cross-sectional design, published from 2013 to 2023, in English, the final results of the study were reported using the Adjusted Odd Ratio. The keywords used are “Health Belief Model” OR “HBM” AND “diabetes” AND “preventive behavior” OR “type 2” Health Belief Model” AND “type 2 diabetes mellitus” AND “Cross Sectional Study”. Articles were analyzed using Review Manager 5.3. Results: Meta-analysis showed the significant results. The study from Ethiopia, Nepal, and China concluded that high perceived severity had a 2.60 times higher influence than low perceived severity on tertiary preventive behavior (aOR= 2.60; 95% CI= 1.06 to 6.37; p= 0.040). Meta-analysis from Ethiopia, Malaysia, China, and Taiwan concluded that high perceived benefits had an influence of 1.76 times higher than low perceived benefits. (aOR= 1.76; 95% CI= 1.09 to 2.82; p= 0.020). The meta-analysis was obtained from Ethiopia, Sudan, India, and China it showed that high self-efficacy has an effect of 2.69 times higher than low self-efficacy (aOR= 2.69; 95% CI= 1.48 to 4.89; p= 0.001). Conclusion: Perceived severity, perceived benefits and self-efficacy increase tertiary preventive behavior in diabetes mellitus.

Multilevel Analysis of the Implementation of the Health Belief Model on Antenatal Visit at Integrated Health Posts in Kapuas Hulu, West Kalimantan, Indonesia Titis Cipta Purwanti; Argyo Demartoto; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 9 No. 3 (2024)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2024.09.03.05

Background: Antenatal care (ANC) is carried out to prevent causes of morbidity (illness or complications) and mortality (death) in pregnant women and children. This study aimed to determine the relationship between the application of the health belief model and the behavior of utilizing/visiting antenatal services. Subjects and Method: The research was conducted with a cross-sectional study design. The approach taken was to use an analytical observational model with a sample size of 213 pregnant women. This research was conducted at the Kapuas Hulu District Health Center. This research was conducted in November-December. A sample of 213 pregnant women was selected using stratified random sampling. The dependent variable in this study is ANC visits. Meanwhile, the independent variables in this study were perceived vulnerability, perceived severity, perceived benefits, self-efficacy, and gestational age. Data collection was carried out using a questionnaire and data was analyzed using a multilevel multiple linear regression analysis model. Results: ANC visits increased with high perceived susceptibility (b= 0.13; 95% CI= 0.06 to 0.20; p < 0.001), high perceived severity (b= 0.17; 95% CI= 0.12 to 0.21; p < 0.001), high perceived benefit ( b=0.13; 95% CI= 0.09 to 0.18; p <0.001), high self-efficacy (b= 0.11; 95% CI= 0.03 to 0.18; p=0.005), and high gestational age (b= 0.15; 95% CI = 0.10 to 0.20; p < 0.001). Conclusion: Several constructs in the Health Belief Models which include perceived vulnerability, perceived severity, perceived benefits and perceived self-efficacy can be used as predictors of antenatal visits for pregnant women at Integrated service post, Kapuas Hulu Regency, West Kalimantan Province. Resulting in an ICC of 14.9%, which means there is a contextual influence of Integrated service post on antenatal visits of pregnant women.

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