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All Journal Journal of Health Policy and Management Journal of Health Promotion and Behavior
Ratih Puspita Febrinasari
Faculty of Medicine, Universitas Sebelas Maret
Medicine & Pharmacology Public Health

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Application of Social Cognitive Theory in Promoting Tertiary Prevention Behavior among Hypertensive Patients in Tulungagung, East Java, Indonesia Anggie Rahmatul Azizah; Ratih Puspita Febrinasari; Bhisma Murti; Okid Parama Astirin; Argyo Demartoto
Journal of Health Promotion and Behavior Vol. 10 No. 4 (2025)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2025.10.04.07

Abstract

Background: Hypertension is a non-communicable disease that can affect individuals across all age groups, including the productive age population, largely due to changes in lifestyle. The implementation of tertiary prevention behaviors is essential to prevent disease complications such as coronary heart disease, stroke, kidney failure, and liver disease. This study aimed to analyze the application of Social Cognitive Theory in relation to tertiary prevention behaviors among patients with hypertension. Subjects and Method: This analytic observational study employed a cross-sectional design. The study subjects were patients with hypertension of productive age (15–64 years) in Tulungagung Regency, selected using a non-proportional random sampling technique, with a total sample of 220 participants. Data were collected using a research questionnaire that had been tested for validity and reliability. Multivariate data analysis was conducted using path analysis to examine both direct and indirect effects among variables. Results: There were direct and statistically significant effects of observational learning (b = 0.13; 95% CI = 0.01 to 0.24; p = 0.028), self-efficacy (b = 0.20; 95% CI = 0.05 to 0.35; p = 0.008), and attitude (b = 0.31; 95% CI= 0.17 to 0.45; p < 0.001) on tertiary prevention behaviors. Education was not significantly associated with tertiary prevention behaviors. Age (b = 0.17; 95% CI= 0.05 to 0.29; p = 0.005) and tertiary prevention behaviors (b= −0.38; 95% CI = −0.49 to −0.27; p < 0.001) showed direct and significant effects on blood pressure. Sex was not significantly associated with blood pressure. Social support, outcome expectations, and age had indirect effects on tertiary prevention behaviors through self-efficacy. Conclusion: There are direct effects of observational learning, attitude, and self-efficacy on tertiary prevention behaviors, as well as indirect effects of social support, outcome expectations, age, and education on tertiary prevention behaviors. In addition, age, sex, and tertiary prevention behaviors have direct effects on blood pressure.
Psychosocial Factors Affecting the Performance of Community Health Center Employees Nadia Fitriana Fariati; Setyo Sri Rahardjo; Bhisma Murti; Ratih Puspita Febrinasari; Anik Lestari
Journal of Health Policy and Management Vol. 11 No. 1 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

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

Abstract

Background: Community Health Centers (Puskesmas) serve as primary healthcare facilities whose effectiveness is strongly influenced by employee performance. Psychosocial factors such as motivation, leadership perception, delegation of authority, and social capital play an essential role in enhancing work effectiveness. However, unclear task distribution and suboptimal delegation practices remain common challenges that may weaken employee performance. This study aimed to examine psychosocial factors associated with employee performance in Puskesmas. Subjects and Method: This quantitative study employed a cross-sectional design and was conducted in 17 Community Health Centers across Surakarta, Central Java, Indonesia, from June to July 2025. A total of 224 employees were selected using proportional random sampling. Data were collected using structured questionnaires that had been tested for validity and reliability. Multivariate data analysis was performed using path analysis to assess both direct and indirect relationships among variables. Results: Employee performance was directly influenced by the delegation of authority and responsibility (b= 0.42; 95% CI = 0.32 to 0.53; p < 0.001) and motivation (b = 0.34; 95% CI = 0.23 to 0.45; p <0.001). Performance was indirectly influenced by social capital and leadership perception through motivation, as well as by motivation and leadership perception through the delegation of authority and responsibility. Length of employment, employment status, and gender showed direct but statistically non-significant effects on employee performance. Conclusion: Employee performance in community health centers can be enhanced through effective delegation of authority and responsibility, increased motivation, positive leadership perception, and strengthened social capital. In contrast, gender, employment status, and length of employment were not significant determinants of performance
Co-Authors Anggie Rahmatul Azizah Anik Lestari Argyo Demartoto Bhisma Murti Nadia Fitriana Fariati Okid Parama Astirin Setyo Sri Rahardjo