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Multilevel Analysis of the Effect of School and Peer Group on Smoking Behavior in Adolescents in Banjarnegara Annisa Widya Panduwinata; Bhisma Murti; Pawito Pawito
Journal of Health Promotion and Behavior Vol. 3 No. 3 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Smoking remains a public health problem in the world, especially in Indonesia. Indonesia is the third country with the largest number of smokers, especially among teenagers. School and peers are one of the factors that influence smoking behavior in adolescents. This study aims at analyzing the influence of schools and peers on smoking behavior in adolescents.Subjects and Method: This was an analytic observational study with a cross sectional design. It was conducted in Banjarnegara, Central Java, from October to November 2018. A sample of 200 adolescents was selected by simple random sampling. The dependent variable was smoking behavior. The independent variables were intention, attitude, subjective norm, perceived behavior control, pocket money, media exposure, peer, and family intimacy. The data were collected by questionnaire and analyzed by multilevel regression.Results: Smoking behavior was positively affected by intention (b= 1.49; CI95%= 0.25 to 2.73; p= 0.019), peer group (b= 1.20; 95% CI= 0.12 to 2.28; p= 0.030), and media exposure (b= 1.97; 95% CI= 0.87 to 3.08; p<0.001). Smoking behavior was negatively affected by family intimacy (b= -1.34; 95% CI= -2.44 to -0.24; p= 0.017), attitude (b= -1.44; 95% CI= -2.43 to –0. 44; p= 0.005), subjective norm (b= -1.84; 95% CI= -2. 87 to –0.81; p< 0.001), perceived behavior (b=- 1.91; 95% CI= -3.03 to –0.79; p= 0.001). Smoking behavior was negatively affected by money pocket (b= -0.77; 95% CI= -1.85 to 0.30; p= 0.158) but it was statistically non-significant. School had contextual effect of smoking behavior in adolescents (ICC= 13.8%).Conclusion: Smoking behavior is positively affected by intention, peer group, and media exposure. Smoking behavior is negatively affected by family intimacy, attitude, subjective norm, perceived behavior. Smoking behavior is not associated with money pocket. The school has contextual effect of smoking behavior in adolescents.Keywords: smoking behavior, school, adolescents, multilevel analysisCorrespondence: Annisa Widya Panduwinata. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta, Central Java. Email: annisawidya20@gmail.com. Mobile: +6285326744630.Journal of Health Promotion and Behavior (2018), 3(3): 166-178https://doi.org/10.26911/thejhpb.2018.03.03.04

The Effects of Water Intake, Fruits and Vegetables Consumption, and Socio-Cultural on Obesity among Adolescents Nita Aprilia; Didik Tantomo; Pawito Pawito; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 3 No. 4 (2018)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: The prevalence of obesity is increasing in the world, especially in Indonesia. Obesity can cause health problems, such as hyperinsulinemia, diabetes, cardiovascular disease, hypertension, immunological disorders, certain types of cancer, etc. This study aims to analyze the influence of consumption of water, fruit and vegetables and sociocultural views on the risk of obesity in senior high school adolescents.Subjects and method: This was a cross-sectional study conducted at 25 senior high schools in Banyuwangi, East Java, from March to April 2018. Samples of 225 students were selected using random sampling technique. The dependent variable was obesity. The independent variables were consumption of water, fruit and vegetables and socio-cultural views. The data were collected using questionnaires and analyzed using multilevel logistic regression.Results: Water consumption (b = -2.67; CI 95% = -3.77 to -1.58; p = <0.001), fruit and vegetables (b = -1.16; CI 95% = -1.88 to -0.44; p = 0.002), activity physical (b = -1.12; 95% CI = -2.08 to -0.15; p = 0.023) and socio-cultural views (b = -1.89; CI 95% = -2.72 to -1.05; p = <0.001) reduce risk of obesity . Genetic factors (b = 3.12; 95% CI = 1.98 to 4.26; p = <0.001) increase the risk of obesity. Senior high school has a contextual effect on the risk of obesity with ICC = 9.89%.Conclusion: The risk of obesity decreases with adequate consumption of water, consumption of enough fruits and vegetables, enough physical activity and living in a society with a socio-cultural outlook with a good diet. The risk of obesity increases with the presence of factors. SMA has a contextual influence on the risk of obesity in adolescents.Keywords: water, fruit and vegetables, socio-cultural views, obesityCorrespondence: Nita Aprilia. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir.Sutami No. 36 A, Surakarta, Central Java. Email: nitaapriliamelia@gmail.com. Mobile: +6283847987215.Journal of Health Promotion and Behavior (2018), 3(4): 279-289https://doi.org/10.26911/thejhpb.2018.03.04.08

Application of Health Belief Model on Factors Influencing Long-Term Contraceptive Use Ayu Dhiah Pitaloka; Pawito Pawito; Hanung Prasetya
Journal of Health Promotion and Behavior Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Family planning is one of the strategies to reduce maternal mortality. Data in 2017 shows that in Indonesia, out of 37,338,265 couples of reproductive age there were 18.63% who did not do family planning. Women of reproductive age (WRA) who have not done family planning can affect reproductive health. This study aimed to analyze factors influencing long-term contraceptive method (LTCM) using health belief model theory.Subjects and Method: This was a cross sectional study conducted in Sleman, Central Java, from March to April 2019. A sample of 220 women of reproductive age was selected by quota sampling. The dependent variable was LTCM use. The independent variables were perceived severity, perceived susceptibility, perceived benefit, cues to action, self-efficacy, education, and culture. The data was collected by questionnaire and analyzed by a multiple logistic regression.Results: Perceived severity (OR= 8.02; 95% CI= 2.62 to 24.51; p<0.001), perceived susceptibility (OR= 12.16; 95% CI= 3.65 to 40.42; p<0.001), perceived benefit (OR= 6.05; 95% CI= 2.10 to 17.40; p= 0.001), cues to action (OR= 6.98; 95% CI= 2.30 to 21.18; p= 0.001), self-efficacy (OR= 3.60; 95% CI= 1.23 to 10.52; p= 0.019), education (OR= 2.50; 95% CI= 1.40 to 10.41; p= 0.029), culture (OR= 6.65; 95% CI= 2.14 to 20.62; p= 0.001) increased long-term contraceptive use.Conclusions: Perceived severity, perceived susceptibility, perceived benefit, cues to action, self-efficacy, education, culture increase long-term contraceptive use.Keywords: family planning, long-term contraceptive, health belief modelCorrespondence: Ayu Dhiah Pitaloka. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: ayudhiahp@gmail.com. Mobile: +62812266896291Journal of Health Promotion and Behavior (2019), 4(1): 55-63https://doi.org/10.26911/thejhpb.2019.04.01.06

The Effect of Community Health Center on Visual Acetic Acid Uptake in Pati, Central Java Retno Wulan; Pawito Pawito; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 4 No. 3 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Cervical cancer is included in the category of malignant tumors that arise in the cervix of women. The incidence of cervical cancer is high due to lack of awareness to make efforts to examine early detection of cervical cancer by using the visual inspection acetic acid (VIA) method. The purpose of this study was to analyze the effect of community health center on the use of VIA.Subjects dan Method: This was an analytic observational study with a cross sectional design. was The study was conducted at 29 community health centers in Pati, Central Java. A sample of 232 women was selected by simple random sampling. The dependent variable was VIA uptake. The independent variable were perceived susceptibility, perceived seriousness, cues to action, perceived threat, perceived benefit, perceived barrier, self-efficacy, economic status, and social capital. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13.Result: Community health center had a contextual effect on VIA uptake with intra-class correlation (ICC)= 16.91%. VIA uptake increased with high perceived susceptibility (b= 3.21; 95% CI= 0.22 to 6.19; p = 0.035), high perceived seriousness (b= 4.68; 95% CI= 1.06 to 8.29; p= 0.011), high perceived threat (b= 4.03; 95% CI= 0.61 to 7.45; p= 0.021), high perceived barrier (b= 2.48; 95% CI= 0.06 to 4.91; p= 0.044), high perceived benefit (b= 2.50; 95% CI= 0.10 to 4.91; p= 0.041), and high economic status (b= 11.22; 95% CI= 3.64 to 18.81; p= 0.004). VIA uptake decreased with low cues to action (b= -0.92; 95% CI= -3.08 to 1.24; p= 0.405), low self-efficacy (b= -0.32; 95% CI= -2.45 to 1.80; p= 0.765), and low social capital (b= 0.79; 95% CI= 3.64 to 18.81; p= 0.562).Conclusion: Community health center had a contextual effect on VIA uptake. VIA uptake increases with high perceived susceptibility, high perceived seriousness, high perceived threat, high perceived barrier, high perceived benefit, and high economic status. VIA uptake decreases with low cues to action, low self-efficacy, and low social capital.Keywords: Community Community health center, Acetic Acid Visual Inspection.Correspondence: Retno Wulan. Masters Program of Public Health, Universitas Sebelas Maret, JL. Ir.Sutami 36A, Surakarta, Central Jawa, Indonesia. E-mail: wuland.cimmutzz12@gmail.com. Mobile: 085740969271.Journal of Health Promotion and Behavior (2019), 4(3): 189-197https://doi.org/10.26911/thejhpb.2019.04.03.04

Factors Affecting Early Marriage among Female Adolescents: A Path Analysis Evidence from Blora, Central Java Wella Anggraini; Pawito Pawito; Eti Poncorini Pamungkasari
Journal of Health Promotion and Behavior Vol. 4 No. 4 (2019)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Early marriage is a phenomenon which has been a controversy to this day. The prevalence of early marriage in Indonesia has decreased, namely in 2013 by 24% and decreased by 1% in 2015. The purpose of this study was to analyze the factors that influence early marriage in Blora, Central Java, using a path analysis model.Subject and Method: This was a cross sectional study conducted in Blora, Central Java, from September to October 2019. A sample of 200 married women within 5 years was selected by random sampling. The dependent variable was early marriage. The independent variables were parental income, peer support, society culture, parental support, daughter's status, attitude, subjective norms, perceived control of behavior (PBC), and intention. The data were collected by questionnaire analyzed by path analysis run on Stata 13.Results: The likelihood of early marriage in adolescents increased with strong intention (b= 2.06; 95% CI= 3.00 to 1.13; p <0.001) and low family income (<Rp. 1,650,000) (b= 1.83; CI 95% = 2.68 to 0.98; p<0.001). The likelihood of early marriage was decreased with weak status of girls in families (b= -1.71; 95% CI= -2.61 to -0.80; p<0.001) and strong peer support to not do early marriage (b= -2.08; 95% CI= -2.98 to -1.19; p<0.001). Early marriage was indirectly affected by attitude through society culture, intention through family support, intention through attitude, intention through perceived behavioral control, and family support through subjective norm.Conclusions: The likelihood of early marriage in adolescents increases with strong intention and low family income. The likelihood of early marriage is decreased by weak status of girls in families and strong peer support to not do early marriage. Early marriage is indirectly affected by society culture, family support, attitude, PBC, and subjective norm.Keywords: early marriage, adolescentsCorrespondence: Wella Anggraini. Masters Program of Public Health Science, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: wellaanggraini89@gmail.com. Mobile: 081215216795Journal of Health Promotion and Behavior (2019), 4(4): 287-297https://doi.org/10.26911/thejhpb.2019.04.04.05

Application of Social Cognitive Theory: Tertiary Prevention Behavior in Patients with Type 2 Diabetes Mellitus in Ponorogo Hospital, East Java, Indonesia Nur Aida Yuliana; Pawito Pawito; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Diabetes Mellitus (DM) is a non-communicable disease that becomes a serious threat to global health. This disease is a serious chronic disease because it cannot be cured. An increasing number of cases of non-communicable diseases that are associated with risk factors are in line with lifestyle changes that increasingly modern. This study aimed to analyze the effect of the variables in Social Cognitive Theory on tertiary prevention behavior in patients with type 2 Diabetes Mellitus.Subjects and Method: This was a cross-sectional study design. This study was conducted on patients with type 2 DM in the hospital in Ponorogo Regency, East Java, from January to February 2020. There were 200 patients with type 2 DM as the sample of the study. The sample was taken by random sampling. The dependent variable was Tertiary prevention behavior of type 2 DM. The independent variables were observational learning, role model, vicarious experience, imitation, attitude, outcome expectations, knowledge, reinforcement, self-efficacy, and self-management. The data were collected through a set of questionnaires. The data were analyzed based on Path Analysis using stata 13 application.Results: Tertiary prevention behavior of type 2 DM was directly increased by strong imitation (b= 1.40; 95% CI= 0.51 to 2.28; p= 0.002), good knowledge (b= 1.36; 95% CI= 0.48 to 2.25; p= 0.002), positive attitude (b= 1.32; 95% CI= 0.44 to 2.19; p= 0.003), strong self-efficacy (b= 1.07; 95% CI= 0.18 to 1.96; p= 0.018), and good self-management (b= 2.26; 95% CI= 1.31 to 3.22; p <0.001). Tertiary prevention behavior of type 2 DM was indirectly affected by observational learning, role model, vicarious experience, outcome expectation, and reinforcement.Conclusion: Tertiary prevention behavior of type 2 DM is directly increased by strong imitation, good knowledge, positive attitude, strong self-efficacy, and good self-management. Tertiary prevention behavior of type 2 DM is indirectly affected by observational learning, role model, vicarious experience, outcome expectation, and reinforcement.Keywords: social cognitive theory, type 2 Diabetes Mellitus.Correspondence: Nur Aida Yuliana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: Aidayuliana17@gmail.com.Mobile: +628-5790767582.Journal of Health Promotion and Behavior (2020), 5(1): 157-168https://doi.org/10.26911/thejhpb.2020.05.03.02

Contextual Effect of the Integrated Health Post (Posbindu) and Biopsychosocial Determinants of Tertiary Preventive Behavior in Patients with Hypertension Very Retnowati; Pawito Pawito; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Tertiary prevention of hypertension is a preventive effort to make patients with hypertension do not have disabilities and further complications. It also improves the quality of life and makes life longer. The biopsychosocial aspect affects individuals in learning, doing, and maintaining certain behaviors based on social cognitive theory. This study aimed to analyze the biopsychosocial determinants of tertiary preventive behavior among patients with hypertension.Subjects and Method: This study was an analytical observational study with a cross-sectional design. The study was conducted at 25 Integrated Health Posts (Posbindu) in Sragen, Central Java. A sample of 200 hypertensive patients was selected by stratified random sampling. The dependent variable was the tertiary preventive behavior of hypertension. The independent variables were observational learning, role model, imitation, vicarious learning, reinforcement, self-efficacy, self-regulation, outcome expectation, and attitude. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression.Results: Hypertension preventive behavior increased with observational learning (b= 2.85; 95% CI= 0.17 to 5.53; p= 0.037), role model (b= 2.73; 95% CI =0.73 to 4.73; p=0.007), imitation (b= 3.46 ; 95% CI= 0.73 to 6.19; p= 0.013), vicarious learning (b= 2.54; 95% CI =0.16 to 4.93; p= 0.036), reinforcement (b= 3.89; 95% CI= 0.96 to 6.82; p= 0.009), self-efficacy (b= 3.04; 95% CI= 0.41 to 5.67; p= 0.024), self-regulation (b= 2.28; 95% CI= 0.02 to 4.54; p= 0.048), outcome expectation (b= 3.56; 95% CI= 0.75 to 6.38; p= 0.013), and a positive attitude (b= 2.86; 95% CI= 0.26 to 5.47; p= 0.031). Posbindu had a contextual effect on tertiary preventive behavior of hypertension with an Intra Class Correlation (ICC) value of 63.05%.Conclusion: Tertiary preventive behavior of hypertension increases with high observational learning, strong role model, strong imitation, high vicarious learning, strong reinforcement, high self-efficacy, high self-regulation, positive outcome expectation, and positive attitude. Posbindu has a contextual effect on tertiary preventive behavior of hypertension.Keywords: tertiary prevention, hypertension, social cognitive theory, multilevel analysisCorrespondence: Very Retnowati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: veryretnowati@gmail.com. Mobile: +6281548592491.Journal of Health Promotion and Behavior (2020), 05(03): 174-186https://doi.org/10.26911/thejhpb.2020.05.03.04

Factors Affecting Exclusive Breastfeeding Practice using Social Cognitive Theory Constructs: A Multilevel Evidence from Madiun, East Java Rezyana Budi Syahputri; Pawito Pawito; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Exclusive breastfeeding for infants up to 6 months of age is the most effective way to ensure the health and the viability of the child. Exclusive breastfeeding coverage still does not meet the target due to various factors. This study aimed to determine the effectiveness level of health promotion of exclusive breastfeeding program in the integrated health service in Madiun, East Java.Subjects and Method: This was an a cross-sectional study conducted in Madiun, East Java, from February to May 2020. A sample of 200 lactating mother who had infants aged 6 to 24 months was selected randomly. The dependent variable was exclusive breastfeeding practice. The independent variables were health promotion program, observational learning, role model, vicarious learning, imitation, attitude, outcome expectation, self regulation, self-efficacy, reinforcement, and integrated health post contextual. The data were collected using questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13.Results: Exclusive breastfeeding practice increased with adequate health promotion program (OR= 3.08; 95% CI= 1.06 to 8.94; p= 0.038), high observational learning (OR= 3.86; 95% CI= 1.31 to 11.39; p= 0.014), strong role model (OR= 4.01; 95% CI= 1.12 to 14.29; p= 0.033), vicarious learning (OR= 4.46; 95% CI= 1.34 to 14.82; p= 0.015), strong imitation (OR= 2.74; 95% CI= 1.02 to 7.35; p= 0.045), positive attitude (OR= 3.51; 95% CI= 1.04 to 11.88; p= 0.043), positive outcome expectation (OR= 4.04; 95% CI= 1.32 to 12.38; p= 0.014), strong self-regulation (OR= 2.36; 95% CI= 0.93 to 5.99; p= 0.068), strong self-efficacy (OR= 5.35; 95% CI= 1.81 to 15.77; p= 0.002), and strong reinforcement (OR= 3.90; 95% CI= 1.21 to 12.57; p= 0.022). There was a contextual effect of integrated health post on exclusive breastfeeding practice with intraclass correlation (ICC)= 10.97%.Conclusion: Exclusive breastfeeding practice is affected by health promotion program, observational learning, role model, vicarious learning, imitation, attitude, outcome expectation, self regulation, self-efficacy, and reinforcement. Integrated health post has a contextual effect on exclusive breastfeeding practice.Keywords: exclusive breastfeeding, health promotion, social cognitive theory.Correspondence: Rezyana Budi Syahputri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: rezyanabs@gmail.com. Mobile: +6282325750134.Journal of Health Promotion and Behavior (2020), 05(03): 169-173https://doi.org/10.26911/thejhpb.2020.05.03.03

Multilevel Analysis of the Biopsychosocial Determinants and Contextual Peer Groups on Smoking Habit in High School Students in East Lampung, Lampung, Indonesia Retno Sulistyani; Setyo Sri Rahardjo; Pawito Pawito
Journal of Health Promotion and Behavior Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Smoking is still one of the greatest public health threats faced by citizens of the world. Data from the Central Statistics Agency in 2018 shows that smoking behavior in Lampung Province has a prevalence of 35.95%. The World Health Organization (WHO) states that smoking kills more than 8 million people per year worldwide. This study aimed to analyze the determinants of adolescent smoking behavior at the individual level and at the school level.Subjects and Method: This was a cross sectional study conducted in East Lampung Regency, Indonesia, from October to November 2020. A number of 200 male adolescents were selected by random sampling. The dependent variable was smoking behavior. The independent variables were the influence of parents, peers, media exposure, pocket money, cigarette price, intention, attitude, and contextual effect of school. The data were collected by questionnaire and analyzed using a multiple multilevel logistic regression with Stata 13.Results: The influence of family (b=2.88; 95% CI= 0.73 to 3.85; p= 0.004), peers (b= 2.85; 95% CI= 0.65 to 3.52; p= 0.004), media exposure (b= 3.04; 95% CI= 0.78 to 3.62; p= 0.002), money pocket (b= 3.22; 95% CI= 0.87 to 3.59; p= 0.001), cigarette price (b= 2.73; 95% CI= 0.54 to 3.28; p= 0.006), intention to smoke (b= 2.80; 95% CI= 0.69 to 3.95; p= 0.005), attitude toward smoking (b=3.83; 95% CI= 1.80 to 5.58; p<0.001) increased the likelihood to smoke in male adolescents. School had strong contextual effect on smoking in adolescents with ICC= 21.83%.Conclusion: The influence of family, peers, media exposure, money pocket, cigarette price, intention to smoke, attitude toward smoking increase the likelihood to smoke in male adolescents. School has strong contextual effect on smoking in adolescentsKeywords: smoking behavior, adolescents, contextual effect of schoolCorrespondence: Retno Sulistiani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: retnosulistiani91@gmail.com. Mobile: +6285867006699.Journal of Health Promotion and Behavior (2021), 06(01): 9-20https://doi.org/10.26911/thejhpb.2021.06.01.02

Multilevel Analysis: Contextual Effects of School and Psychosocial Determinants on Healthy Sexual Behavior of High School Adolescents in Banyuwangi, East Java, Indonesia Lia Ulfah Luthfiana; Pawito Pawito; Eti Poncorini Pamungkasari
Journal of Health Promotion and Behavior Vol. 6 No. 3 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Background: Along with the development of the era, teenagers began to be faced with various problems and the biggest problems faced by teenagers were sexual problems. Sexual behavior in adolescents who are carried out actively poses a risk of teenage pregnancy and transmission of sexually transmitted diseases. This study aims to analyze the influence related to school context and psychosocial determinants on healthy sexual behavior of adolescents at the age of 15-19 years in Banyuwangi Regency.Subjects and Method: This study used a cross sectional research design. The study was conducted in 25 high schools/vocational high schools in Banyuwangi Regency, East Java in August to September 2020. Sampling of 225 adolescents was carried out using stratified random sampling and simple random sampling. The dependent variable is healthy sexual behavior. The independent variables include knowledge, self-efficacy, parental support, sources of information/technology, perception of seriousness. Data were collected using a questionnaire. Data were analyzed using multiple logistic regression with Stata 13.Results: Adolescents will have healthy sexual behavior with high knowledge about healthy sexual behavior (b= 0.23; 95% CI= 0.05 to 0.41; p= 0.014), have strong self-efficacy (b= 0.14; 95% CI= 0.01 to 0.27; p= 0.035), had good parental support (b= 0.21; 95% CI= 0.09 to 0.34; p = 0.001), had high exposure to information sources (b= 0.36; 95% CI= 0.15 to 0.56; p = 0.001 ), and had a high perception of seriousness for weak sexual behavior (b= 0.82; 95% CI= 0.45 to 1.19; p <0.001). There is an effect of school level on healthy sexual behavior with an ICC of 16.4%.Conclusion: Healthy sexual behavior in adolescents can increase with high knowledge, strong self-efficacy, having exposure to high sources of information, and having a high perception of seriousness. There is an effect of school level on healthy sexual behavior.Keywords: healthy sexual behavior, school contextual, psychosocial determinants, adolescentsCorrespondence: Lia Ulfah Luthfiana. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, 57126. Email: luthfianalia7@gmail.com. Mobile: +6285236800700.Journal of Health Promotion and Behavior (2021), 06(03): 188-200DOI: https://doi.org/10.26911/thejhpb.2021.06.03.03

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