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RUBEN DHARMAWAN
Faculty of Medicine, Sebelas Maret University
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Journal of Health Promotion and Behavior

 1 
Decision to Choose Acupuncture Therapy for Degenerative Diseases among the Elderly at Ja’far Medika Hospital, Karanganyar -, Purwanto; Dharmawan, Ruben; Demartoto, Argyo
Journal of Health Promotion and Behavior Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Aging process results in biological, physical, and mental changes in the elderly. Degenerative diseases are common in the elderly. They can be treated by pharmacologic or non pharmacologic treatment. Acupuncture therapy potentially can be used as a complementary or alternative therapy to treat degenerative diseases in the elderly. This study aimed to investigate factors that determine the decision to choose acupuncture therapy for the degenerative diseases in the elderly at Ja’far Medika Hospital, Karanganyar, Central Java.SubjectsandMethod: This was a qualitative study with phenomenology approach. This study was conducted at Ja’far Medika Hospital, Karanganyar, Central Java, fromMarch to April 2015. Ten informants were selected for this study by purposive sampling. The data were collected by in-depth interview, observation, and document review.They were validated by source triangulation, and analyzed by Miles and Huberman method.Results: The sample consisted of 5 men and 5 women, aged 53 to 72 years old, with school attainment varying from primary school to university graduate. Job category included farmer, civil servant, and pensioner. The degenerative diseases that were treated by acupuncture therapy including post-stroke, hernia nucleous pulposus, and eyelid disorder.  Internal factors that determined the decision to choose acupuncture were motivation to recover, (religious) belief, and boredom to medical service. External factors that determined the decision to choose acupuncture included the quality of service, family support, trust in the therapist, and hospital image. According to the informants, the acupuncture therapy could help recover their health from the degenerative diseases. Most of them used acupuncture as a complementary treatment.Conclusion: Some internal and external factors determine the decision to choose acupuncture therapy for the degenerative health problem in the elderly. Acupuncture treatment is reported to help recover health in the elderly. Keywords: acupuncture, decision, degenerative disease, elderlyCorrespondence: Purwanto. Masters Program in Public Health, Sebelas Maret University. Email: Purwanto.akp@gmail.com. Mobile: 081393289784.Journal of Health Promotion and Behavior (2016), 1(2): 127-137https://doi.org/10.26911/thejhpb.2016.01.02.08 
Association between Self-Esteem, Self-Efficacy, Peers, Parental Controls and Sexual Behavior in Adolescentsat High School, Surakarta -, Winarni; Astirin, Okid Parama; Dharmawan, Ruben
Journal of Health Promotion and Behavior Vol 1, No 1 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Sexual behavior among teenagers is worrying. It is influenced of permissive attitude shift, causing violation of norms, ethics in society. One factor is the opening of information about sex freely circulating in the community. In Surakarta adolescent at high school never did kiss the lips of 10.53%, a kiss in 5.6%, 4.23% masturbation and sexual intercourse 3.09%. This study aimed to determine the association of self-esteem, self-efficacy, peers, parents, with premarital sexual behavior in adolescent high school in Surakarta.Subjects and Method: This was an observational analytic study with cross sectional design. A total sample of 113 respondents was taken by using proportional random sampling. The population was in ten high schools of 1663 subjects in Surakarta. Data analysis used linear regression.Results: There is a relationship of self-esteem with premarital sexual behavior (b1= -0.202; 95% CI= -0.39 to -0.01; p= 0.036) were significantly higher self-esteem then reduce premarital sexual behavior. There is a relationship of self-efficacy with premarital sexual behavior (b2= -0.168; 95% CI= -0.33 to -0.01; p= 0.041) were significantly higher self-efficacy students then reduce premarital sexual behavior. There are peer relationships with premarital sexual behavior (b3= -0.271; 95% CI= -0.51 to -0.04; p= 0.024) were significantly better peer support and will reduce premarital sexual behavior. There is a parental relationship with premarital sexual behavior (b4= -0.236; 95% CI= -0.44 to -0.03; p= 0.025), the better the more parental supervision reduce premarital sexual behavior. There is a relationship of self-esteem, self-efficacy, peers, parents with premarital sexual behavior (F = 10.053; 95% CI= 24.16 to 43.61; p <0.001; R 2 = 24.4%)Conclusion: Self-esteem, self-efficacy, peers, and parents are associated with premarital sexual behavior in adolescents of 24.4%. Seventy six point six percent is influenced by other variables outside the research model.Keywords: Self-esteem, Self Efficacy, Peers, Parents Supervision, Premarital sex behaviorCorrespondence: Winarni. School of Public Health, Sebelas Maret University, Surakarta.Journal of Health Promotion and Behavior (2016), 1(1): 46-53https://doi.org/10.26911/thejhpb.2016.01.01.07
Effects of Fruit and Vegetable Consumption, a Socio-Economic Factor of Adolescent Obesity in Surakarta City Wati, Emita Dewi Lilis Angkasa; Pamungkasari, Eti Poncorini; Dharmawan, Ruben
Journal of Health Promotion and Behavior Vol 2, No 1 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Adolescent obesity is an escalating global epidemic. It is estimated that 70% of obese teenagers aged 10 to 13 years are at risk of being obese over their life course. Obesity becomes a problem because it brings complications and it is associated with accelerated atherosclerosis, increased incidences of degenerative diseases, such as cardiovascular diseases, stroke and diabetic. The purpose of this study was to decribe the effects of fruit and vegetable consumption, a socio-economic factor of adolescent obesity.Subjects and Methods: The study was an analytical observation using case control design. The study was conducted in Surakarta city in February to March 2017, and it involved 140 subjects. Samples were collected using purposive sampling technique with fixed disease sampling. The independent variables under the study were fruit and vegetable consumption, mothers’ education, family income, and age. The dependent variable of the study was obesity. Data was collected using questionnaire, information on the fruit and vegetable consumption was gathered through a 24-hour food recall, and weight and height were measured. The data was analyzed using path analysis.Results: The statistic finding showed that obesity was affected by fruit and vegetable consumption (b=-0.01, SE <0.01, p=0.010), and age (b=-0.28, SE= 0.14, p=0.048), and the fruit and vegetable consumption was affected by the mothers’ education (b=14.118, p=0.133) and family income (b=-0.35, SE= 0.44, p=0.431).Conclusions:  Fruit and vegetable consumption and age are directly associated with adolescent obesity. Mothers’ education and family income are indirectly associated with adolescent obesity.Keywords: Adolescent, fruit and vegetable consumption, socio-economic, obesity.Correspondence: Emita Dewi Lilis Angkasa Wati. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: Taurus.emita92@gmail.com. Mobile: +6281252794863Journal of Health Promotion and Behavior (2017), 2(1): 55-64https://doi.org/10.26911/thejhpb.2017.02.01.05 
The Effect of Peer Support Group on Depression and Quality of Life among People Living with HIV/AIDS in Kediri East Java Rasyiid, Astika; Dharmawan, Ruben; Respati, Supriyadi Hari
Journal of Health Promotion and Behavior Vol 1, No 1 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: People living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome or HIV/AIDs encounter such problems as society stigma and depression that can affect their quality of life in the term of physical, mental, and social health. Social support should be improved from individual, family, Peer Support Group (PSG), and government. PSG serves to help PLWHA feel not lonely, to give opportunity of seeing others, of sharing information about newest treatment and local support service, to reduce isolation, to improve social support, and to reduce stigma in order to achieve better quality of life and to reduce depression. The objective of research was to analyze the effect of KDS on depression and quality of life among PLWHA in Friendship Plus Peer Support Group in Kediri City.Subjects and Method: This study was an analytical observational study with cross sectional design. This was conducted at Friendship Plus Peer Support Group in Kediri, Indonesia in May to July 2016. The sample consisted of 60 subjects taken using simple random sampling. Technique of collecting data used was questionnaire, while analysis was carried out using Pearson’s Product Moment correlational and multiple linear regression tests.Results: The result of research showed that there was a statistically significant effect of Peer Support Group on the reduced depression in PLWHA (b= -0.60; 95% CI= -0.82 to 0.38; p<0.001). Depression was affected by family income of 88.8% (b= -8.68; 95% CI= 0.01; p=0.021) and education (b= -7.86; 95% CI= -14.05 to 1.67; p=0.014). There was a statistically significant effect of Peer Support Group on the improved quality of life among PLWHA (b=0.32; 95% CI= 0.09 to 0.53; p=0.005). Quality of life was affected by family income of 92.3% (b= 1.36; 95% CI= 0.01; p<0.001) and education (b=20.84; 95% CI=  14.75 to 26.93; p<0.001). Conclusion: This research concluded that there was an effect of peer support group on the reduced depression among PLWHA and there was an effect of peer support group the improved quality of life among PLWHA.Keywords: peer support group, depression, quality of life, PLWHACorrespondence: Astika Rasyiid. Diploma III Midwifery of Tulungagung University, East Java.Journal of Health Promotion and Behavior (2016), 1(1): 32-40https://doi.org/10.26911/thejhpb.2016.01.01.05
Biopshychosocial and Economic Determinants of Personal Hygiene in the Prevention of Diarrheal Diseases in Sragen District, Central Java Siswandwika, Hervindita Dinda; Murti, Bhisma; Dharmawan, Ruben
Journal of Health Promotion and Behavior Vol 2, No 1 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Poor environmental sanitation and personal hygiene have been shown to be associated with increased risk of diarrheal disease. Poor personal hygiene that is associated with an increased risk of diarrheal disease may be explained by the constructs  of Health Belief Model, such as perceived susceptibility and perceived seriousness. This study aimed to examine biopshychosocial and economic determinants of personal hygiene in the prevention of diarrheal diseases.Subjects and Method: This was an analytic observational study with case control design. This study was conducted at Mondokan, Gesi, and Sambungmacan Health Centers, Sragen District, Central java, from January to March, 2017. A sample of 150 subjects, consisting of  50 cases of diarrheal disease during the past month and 100 subjects without diarrheal disease, was selected in this study by purposive sampling. The dependent variable was prevention behavior of diarrheal disease. The independent variable included perceived susceptibility, seriousness, threat, benefit, barrier, cues to action, and self-efficacy. The data was collected using a pre-tested questionnaire, and analyzed by path analysis model.  Results: There were positive, and statistically significant effects of perceived seriousness (b= 0.26; SE=0.06; p= <0.001), threat (b= 0.29; SE=0.06; p= <0.001), benefit (b= 0.21; SE= 0.06; p= <0.001), barrier (b= -0.12; SE= 0.08; p= 0.032), cues to action (b= 0.17; SE= 0.07; p= 0.003), and self-efficacy (b= 0.28; SE= 0.14; p= <0.001) on prevention behavior of diarrheal disease. There were positive, indirect, and statistically significant effect of perceived susceptibility (b= 0.55; SE= 0.06; p= <0.001), seriousness (b= 0.34; SE= 0.06; p= <0.001), and benefit (b= 0.12; SE= 0.07; p= 0.025) on prevention behavior of diarrheal disease, via perceived threat.Conclusion: Perceived seriousness, threat, benefit, barrier, cues to action, and self-efficacy, are direct determinants of prevention behavior of diarrheal disease. Perceived susceptibility, seriousness, and benefit, are indirect determinants of prevention behavior of diarrheal disease.Keyword: Biopshychosocial and economy, personal hygiene, Health Belief ModelCorrespondence: Hervindita Dinda Siswandwika. Masters Program in Public Health, Sebelas Maret University. Email: vindy_7@yahoo.com. Mobile: +6282136242777.Journal of Health Promotion and Behavior (2017), 2(1): 1-14https://doi.org/10.26911/thejhpb.2017.02.01.01
Path Analysis and Theory of Planned Behavior on Using PAP SMEAR as Early Detection of Cervical Cancer in Sewon I Community Health Center, Bantul, Yogyakarta, Indonesia Anggraeni, Fatimah Dewi; Murti, Bhisma; Dharmawan, Ruben
Journal of Health Promotion and Behavior Vol 1, No 1 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Cervical cancer patients per hour has increased by 2.5 people. Women died because of cervical cancer are 1.1 per hours.  Indonesia is the second country after Tiongkok with the largest number incidence of cancer. Pap smear is one of the screening programs to reduce the numbers of cervical cancer genesis. Moreover in Indonesia, the rates of screening Pap smear less than 5%. This study aimed to investigate path analyze of using pap smear with as early detection of cervical cancer by planned theory of behavior in women in Sewon 1 Public Health Center, Bantul.Subjects and Method: This was an observational analytic study with the direction cross sectional design. A total sample of 96 women with comprised 32 cases and 64 control with fixed-disease sampling method. Data analysis used path analysis.Results: The results show there is influence between intentions and screening Pap smear (p=<0.000), perceived behavioral control with Pap smear test (p=0.010). An indirectly interaction with the screening Pap smear through intention on attitudes (p=<0.001), subjective norms (p=0.036), and control behavior perceptions (p=0.034).Conclusion: from this study there are interactions directly and indirectly the uses of screening Pap smear based on planned of behavior theory.Keywords: Planned of behavior theory, screening pap smearCorrespondence:Fatimah Dewi Anggraeni. School of Public Health, Graduate Program, Sebelas Maret University, Surakarta.Journal of Health Promotion and Behavior (2016), 1(1): 1-8https://doi.org/10.26911/thejhpb.2016.01.01.01 
Health Belief Model on the Predictors of Healthy Sex Behavior among Commercial Female Sex Workers in Surakarta, Central Java Syarifah, Syarifah; Demartoto, Argyo; Dharmawan, Ruben
Journal of Health Promotion and Behavior Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Sexually transmitted infections (STIs) are diseases that are now a global issue because they are the entrance to HIV transmission. Female sex workers (WPS) have a high risk of contracting and transmitting STIs and HIV / AIDS due to unsafe sex behavior. The purpose of this study was to analyze the relationship of safe sex behavior for the prevention of sexually transmitted infections in female sex workers in Surakarta.Subjects and Method: A cross-sectional study was conducetd in Surakarta, Central Java, from December 2017 to January 2018. A sample of 105 female sex workers was selected by fixed disease sample. The dependent variable was safe sex behavior. The independent variables were perceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, perceive threat, cues to action, and self-efficacy. The data were collected by questionnaire and analyzed by a multiple logistic regression.Results: Safe sex behavior among female sex worker increased with strong perceived benefit (b= 0.18; 95% CI= 0.74 to 0.28; p= 0.001) and strong self-efficacy (b=0.51; 95% CI=0.25 to 0.76; p<0.001). Safe sex behavior decreased with strong perceived barrier (b= 0.15; 95% CI= -0.27 to -0.03; p=0.012). Terdapat hubungan antara persepsi manfaat, efikasi diri dan persepsi hambatan dengan perilaku seks yang aman (F= 10.351; 95% CI= 6.70 to 17.00; p<0.001; R2=23.5%).Conclusion: Safe sex behavior among female sex workers increases with strong perceived benefit and strong self-efficacy. Safe sex behavior decreases with strong perceived barrier.Keywords: sex behaviour, safe sex, sexually transmitted infections, female sex workersCorrespondence:Syarifah. Masters Program in Public Health, Universitas Sebelas MaretJournal of Health Promotion and Behavior (2018), 3(2): 116-125https://doi.org/10.26911/thejhpb.2018.03.02.05
Effects of Chronic Disease Control Club on Physical Activity, Anxiety, and Blood Sugar Level: A Path Analysis Evidence Putra, Fajar Alam; Indarto, Dono; Dharmawan, Ruben
Journal of Health Promotion and Behavior Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Diabetes mellitus (DM) is a serious chronic disease with a tendency to worsen. The number of DM cases worldwide in 2015 was 415 million people and is expected to increase by 642 million cases in 2040. Indonesia ranks 7th in the world with 10 million DM cases in 2015, around 90% of which are Diabetes Mellitus Type 2. This study aimed to determine the effects of chronic disease control club on physical activity, anxiety, and blood sugar level.Subjects and Method: This was a cross sectional study conducted at Sukoharjo health center, Sukoharjo, Central Java, from August to September 2018. A sample of 245 type 2 DM patients was selected for this study. The independent variables were physical activity, anxiety, chronic disease control club, and complications. Data were collected using HARS, physical activity, complication and club activitiesquestionnaires. Data were analyzed by using path analysis.Results: Anxiety directly increased with com­plication (b= 12.55; 95% CI= 111.98 to 13.90; p<0.001). Anxiety directly de­cre­ased with chronic disease control club (b= -3.29; 95% CI= -4.72 to -1.85; p<0.001). Fasting blood sugar directly incre­ased with anxiety (b= 2.78; 95% CI= 1.32 to 4.24; p<0.001) and complication (b= 33.14; 95% CI= 8.40 to 57.87; p= 0.009). Fasting blood sugar directly decre­ased with physical activity (b= -15.12; 95% CI= -19.89 to -10.35; p<0.001) and chro­nic disease control club (b= -30.14; 95% CI= -48.80 to -11.48; p= 0.002).Conclusion: Anxiety directly increases with com­plication. Anxiety directly de­cre­ases with chronic disease control club. Fasting blood sugar directly incre­ases with anxiety and compli­cation. Fasting blood sugar directly decre­ases with physical activity and chro­nic disease control club.Keywords: blood sugar level, physical activity, anxiety, chronic disease control clubCorrespondence: Fajar Alam Putra. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: bolodewe88@gmail.comJournal of Health Promotion and Behavior (2019), 4(3): 137-144https://doi.org/10.26911/thejhpb.2019.04.02.06
Co-Authors -, Muryanti . Soetrisno . Suhanantyo A.A. Ketut Agung Cahyawan W Adi Prayitno Afiono Agung Prasetyo Anggraeni, Fatimah Dewi Argyo Demartoto, Argyo Arinto Hadi, Arinto Aris Sudiyanto Asri Sukawati Putri Atika Puspita Hapsari Atma Sanggani Tunikasari Aviria Ermamilia Bhisma Murti Darukutni, Darukutni Dono Indarto Dyah Kusumawati Dyah Mustikaningtyas Dewanti Endang Sutisna Sulaeman Eti Poncorini Pamungkasari Fajar Alam Putra, Fajar Alam Febrika Devi Nanda Hastuti, Nunik Maya Hervindita Dinda Siswandwika, Hervindita Dinda I Gusti Bagus Wiksuana Icha Dithyana Ike Nurrochmawati Irene Yunita Prihandini JB. Suparyatmo Suparyatmo, JB. Suparyatmo Kharisma Setya Harnani Krisna Rendi Awalludin Kumoro Setya, Adhi Mardiatmi Susilohati Mashuri, Yusuf Ari Mira Rizki Ramadhan, Mira Rizki Murkati, Murkati Narzah, Norma Arista Ningrum, Dhian Nurayni Sulistyo Okid Parama Astirin Pawito -, Pawito Pradana, Riska Chandra Purwanto - Rahardjo, Setyo Sri Rahmah, Anindita Hasniati Rasyiid, Astika Sofi Ariani Sofiyani, Maya Sri Haryati Sugiarto S Supriyadi Hari Respati Syarifah Syarifah, Syarifah Tamaulina Br Sembiring Umi Nadhiroh Wati, Emita Dewi Lilis Angkasa winarni - yoseph Indrayanto