Didik Gunawan Tamtomo
Faculty of Medicine, Universitas Sebelas Maret, Indonesia

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The Application of Social Cognitive Theory on Tertiary Preventive Behavior in Elderly with Type 2 Diabetes Mellitus: A Multilevel Analysis Amanda Widyarahma; 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.2025.10.01.08

Abstract

Background: Diabetes Mellitus is a chronic disease whose prevalence increases, especially in old age. About a quarter of people over the age of 65 suffer from diabetes. DM can cause serious compli­cations up to death. The importance of tertiary preventive behavior to prevent compli­cations. This study aimed to analyze the influence of the Social Cognitive Theory construct and the contextual influence of posyandu on the tertiary preventive behavior of elderly people with type 2 diabetes mellitus. Subjects and Method: A cross-sectional study was conducted at 25 integrated health posts (posyandu) in Magetan, East Java, Indonesia, from April to May 2024. 200 elderly with type 2 DM were selected by stratified random sampling. The dependent variable was tertiary preventive behavior. The independent variables were self-regulation, knowledge, expectations, self-efficacy, reinforcement, and observational learning. Data collection was carried out by interviews and questionnaires. The data were analyzed using a multiple multilevel linear regression. Results: Tertiary preventive behavior was higher in self-regulation (b= 0.24; 95% CI= 0.01 to 0.46; p= 0.038), know­ledge (b= 0.70; 95% CI= 0.23 to 1.17; p= 0.003), expectations (b= 0.53; 95% CI= 0.35 to 0.71; p <0.001), self-efficacy (b= 0.39; 95% CI= 0.11 to 0.67; p= 0.006), reinforcement (b= 1.26; 95% CI= 0.90 to 1.62; p<0.001), and observational learning (b= 0.30; 95% CI= 0.01 to 0.59; p= 0.036). There were no significant relationships of age and gender on tertiary preventive behavior. There was a contextual effect of elderly posyandu on tertiary preventive behavior (ICC= 6.39%). Conclusion: Tertiary preventive behavior is higher in self-regulation, know­ledge, expectations, self-efficacy, reinforcement, and observational learning. There are no significant relationships of age and gender on tertiary preventive behavior. There is a contextual effect of elderly posyandu on tertiary preventive behavior.