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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.

Adherence to Direct Observed Treatment Short-Course Treatment in Tuberculosis: Application of the Health Belief Model Pusporini; Didik Gunawan Tamtomo; Hanung Prasetya
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.2024.09.02.06

Background: Tuberculosis (TB) is a disease that is a public health priority, because it was the leading infectious disease killer before COVID-19 which caused more than 1.4 million deaths in 2019. Non-compliance of TB patients to undergo regular treatment can be an obstacle in achieving a cure rate. and high treatment success. This study aimed to analyze the effect of the Health Belief Model application on Direct Observed Treatment Short-Course (DOTS) treatment adherence for Tuberculosis in Karanganyar Regency. Subjects and Method: Cross-sectional study was conducted in Karanganyar, Central Java, Indonesia. The study population was Tuberculosis patients undergoing Direct Observed Short-Course Treatment. A total of 200 Tuberculosis Patients undergoing DOTS was selected using purposive sampling. The dependent variable was DOTS compliance. The independent variable was construct of health belief model. Data were collected using a questionnaire and analyzed using a multiple logistic regression. Results: Perceived threat (b= 0.20; 95% CI= 0.06 to 0.35; p= 0.007), perceived benefit (b= 0.31; 95% CI= 0.14 – 0.49; p= 0.001), and self-efficacy (b= 0.24; 95% CI= 0.13 to 0.36; p< 0.001) significantly increased TB-DOTS compliance. Perceived barrier significantly decreased TB-DOTS compliance (b= -0.21; 95% CI= -0.31 to -0.11; p< 0.001). Conclusion: Perceived threat, perceived benefit, and self-efficacy significantly increase TB-DOTS compliance. Perceived barrier significantly decreases TB-DOTS compliance.

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.

Path Analysis: Implementation of Information Motivation Behavioral Skill Model on Tertiary Preventive Behavior in Type II Diabetes Melitus Aktif Cahyaning Tyas; Bhisma Murti; Didik Gunawan Tamtomo
Journal of Health Promotion and Behavior Vol. 10 No. 1 (2025)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2025.10.01.01

Background: Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia. Hyperglycemia over a long period of time increases the occurrence of complications. Complications due to type 2 DM can be prevented or delayed by implementing tertiary preventive behavior. This study aims to analyze the influence of the Information Motivation and Behavior Skill Model on tertiary preventive behavior in type 2 DM patients. Subjects and Method: This research with a cross-sectional design was conducted in Boyolali Regency, Central Java from November to December 2023. The research was conducted at 25 posbindu in Ngemplak and Nogosari Districts. The sample size was 200 adults with a diagnosis of type 2 DM who were selected using the stratified random sampling method. The dependent variable is tertiary preventive behavior. The independent variables are information, motivation, behavioral skills, age, gender, education, and employment. Data collection was carried out using questionnaire interviews. Data were analyzed using path analysis in the STATA 13 application. Results: There is a positive relationship between behavioral skills and tertiary preventive behavior (b= 0.16; 95% CI= 0.02 to 0.29; p= 0.023). There is a positive relationship between information and behavioral skills (b= 0.25; 95% CI= 0.13 to 0.38; p<0.001). There is a positive relationship between motivation and behavioral skills (b= 0.38; 95% CI= 0.15 to 0.41; p<0.001). The path analysis model has good model suitability, as indicated by the following suitability indicators: p= 0.244; RMSEA= 0.045; CFI= 0.98; TLI= 0.95; SRMR= 0.032. Conclusion: Tertiary preventive behavior in adult type 2 DM patients is directly influenced by behavioral skills. Tertiary preventive behavior is indirectly influenced by information and motivation. Tertiary preventive behavior in type 2 DM patients increases with good information, strong motivation and good behavioral skills.

Application of Information Motivation Behavior Skill on Tertiary Preventive Behavior of Type 2 Diabetes Mellitus Patients at Blora Health Center Jihan Nabilla; Didik Gunawan Tamtomo; Bhisma Murti
Journal of Health Promotion and Behavior Vol. 10 No. 1 (2025)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2025.10.01.12

Background: Diabetes mellitus (DM) is a priority disease that not only requires control efforts but is also important for prevention efforts. Complications that occur in type II DM patients can be prevented with tertiary preventive behavior. This tertiary preventive behavior can be done by applying the Information Motivation Behavior (IMB) skill model. The purpose of this study is to explore the influence of the application based on the IMB model on tertiary prevention behavior in type II DM patients. Subjects and Method: This study is cross sectional from April-May 2024. The sample used was 200 type 2 DM patients aged >18 years and selected by random sampling technique at the Blora Health Center, Central Java. The dependent variable was the tertiary preventive behavior of type 2 DM patients. The independent variables were information, motivation and behavioral skills. Data collection using questionnaires and data analysis using path analysis with Stata 13. Results: Tertiary preventive behavior of patients with type 2 diabetes mellitus was directly influenced by behavioral skills (b= 5.80; CI 95%= 4.73 to 6.87; p <0.001), information (b= 1.25; CI 95%= 0.01 to 2.50; p= 0.047) and gender (b= -1.60; CI 95%= -0.60 to -2.59; p= 0.002). Tertiary preventive behavior of type 2 DM patients through behavioral skills is indirectly influenced by information, motivation, age and education. Information is indirectly influenced by motivation and education. There was no significant effect on gender on behavioral skills. Conclusion: Tertiary preventive behavior is directly influenced by behavioral skills, information and gender. Tertiary preventive behavior is indirectly influenced by information, motivation, age, and education through behavioral skills. Tertiary preventive behavior is indirectly influenced by gender and education through information.

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