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All Journal International Journal of Public Health Science (IJPHS) Jurnal Penelitian dan Evaluasi Pendidikan Jurnal Kedokteran Brawijaya Jurnal Media Gizi Indonesia (MGI) GIZI INDONESIA AcTion: Aceh Nutrition Journal Journal of Epidemiology and Public Health Indonesian Journal of Medicine Journal of Health Policy and Management Journal of Health Promotion and Behavior Journal of Maternal and Child Health Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Journal of Nursing and Public Health (JNPH) Biocaster : Jurnal Kajian Biologi Jurnal Keperawatan Soedirman (The Soedirman Journal of Nursing) Physical Therapy Journal of Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Eti Poncorini Pamungkasari
Fakultas Kedokteran Universitas Negeri Surakarta
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Factors Associated with the Risk of Autism in Children Under Five Years of Age: A Path Analysis Evidence from Banten Astuti, Fitriyani Dwi; Salimo, Harsono; Pamungkasari, Eti Poncorini
Journal of Maternal and Child Health Vol 3, No 4 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Autism, now increasingly referred to as autism spectrum disorder (ASD) is a set of clinical phenotypes mirroring an early-onset neurodevelopmental disorder affecting social communication, imagination, and behavior. Children with ASD develop differently from other children. They also have challenges in interacting and communicating with others. These challenges can affect their development and learning. This study aimed to determine factors associated with the risk of autism in children under five.Subjects and Method: This was a case control study carried out at two special schools for children with development problem in Tangerang, Banten, from February to March 2018. A sample of 200 children aged 1-5 years was selected by fixed disease sampling, consisting of 50 children with autism and 150 normal children. The dependent variable was autism. The independent variables were family income, maternal education, maternal age, gestational stress, chemical exposure, nutritional intake, fever at pregnancy, growth and development impairment, and mumps-measles-rubella (MMR) vaccine. Data on immunization status, growth and development were taken from medical record. Data on the other variables were collected by questionnaire.The data were analyzed by path analysis.Results: The risk of autism increased with chemical exposure (b= 2.86; 95%CI= 0.77 to 4.96; p= 0.007), gestational stress (b= 2.45; 95% CI= 0.60 to 4.30; p= 0.010), growth and development impairment (b= 1.69; 95% CI= -0.24 to 3.61; p= 0.086), and maternal age ?35 years (b= 2.82; 95% CI= 0.73 to 4.92; p= 0.008). Autism decreased with good nutritional intake (b= -2.08; 95%CI= -3.88 to -0.28; p= 0.023). The risk of autism was indirectly affected by fever at pregnancy, chemical exposure, family income, and maternal education. MMR vaccine did not affect the incidence of autism (b= 1.12; 95% CI= -2.11 to 4.36; p= 0.500).Conclusion: The risk of autism increases with chemical exposure, gestational stress, growth and development impairment, maternal age ?35 years, and decreases with good nutritional intake. MMR vaccine does not affect the incidence of autism in children.Keywords: autism, chemical exposure, growth and development impairment, MMR vaccine, children under fiveCorrespondence:Fitriyani Dwi Astuti. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: fitriyani.dwi.astuti@gmail.com. Mobile: +6281316730755.Journal of Maternal and Child Health (2018), 3(4): 278-286https://doi.org/10.26911/thejmch.2018.03.04.05
The Biopsychosocial Determinants of Stunting and Wasting in Children Aged 12-48 Months Rahayu, Ria Muji; Pamungkasari, Eti Poncorini; Wekadigunawan, CSP
Journal of Maternal and Child Health Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Stunting and wasting are a growth disorder in children under five years of age caused by malnutrition. Stunting is generally caused by recurrent acute malnutrition, whereas wasting occurs due to short-term malnutrition. If untreated properly, stunting and wasting may cause low intelligence in adult life. This study aimed to analyze the biopsychosocial determinants of stunting and wasting in children aged 12-48 months.Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted at Mulya Asri, Panaragan, and Da­ya­mur­ni community health centers, from January to February 2018. A sample of 150 children under-five was selected for this study by fixed disease sampling. The dependent variables were stunting and wasting. The independent variables were birthweight, maternal knowledge, maternal education, maternal nutritional status (mid-upper arm circumference/ MUAC), exclusive breastfeeding, upper respiratory tract infection, diarrhea, lack of clean water, poor sanitation. The data were collected by questionnaire and maternal and child health monitoring book. The data were analyzed by a logistic regression.Results: The risk of stunting increased with poor maternal knowledge (OR= 5.29; 95% CI= 1.30 to 21.54; p=0.002), low maternal education (OR=10.25; 95%CI= 2.26 to 46.79; p=0.003), poor maternal nutritional status (OR= 8.87; 95% CI= 2.14 to 36.74; p=0.003), low birthweight rendah (OR= 9.86; 95% CI= 2.60 to 37.47; p=0.001), infants receiveing no exclusive breastfeeding (OR= 5.70; 95% CI= 1.59 to 20.46; p=0.008). The risk of wasting increased with poor knowledge (OR= 10.95; 95% CI= 2.14 to 56.91; p= 0.004), low family income (OR= 7.04; 95% CI= 5.51 to 32.78; p=0.013), low birthweight (OR= 14.71; 95% CI= 2.74 to 79.06; p=0.002), URTI history (OR= 4.87; 95% CI= 1.23 to 19.38; p=0.024), diarrhea (OR= 6.09; 95% CI= 1.42 to 26.20; p=0.015), a lack of clean water (OR= 9.78; 95% CI= 2.26 to 42.36; p=0.002), and poor sanitation (OR= 7.67; 95% CI= 1.85 to 31.75; p=0.004).Conclusion: Stunting and wasting are affected by birthweight, URTI history, diarrhea, maternal nutritional status, maternal knowledge, maternal education, family income, lack of clean water, and poor sanitation.Keywords: stunting, wasting, biopsychosocial, determinantsCorrespondence: Ria Muji R, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: riamujirahayu@gmail.com. Mobile: +6285878731600Journal of Maternal and Child Health (2018), 3(2): 105-118https://doi.org/10.26911/thejmch.2018.03.02.03
Determinants of Stunting and Child Development in Jombang District Rahmawati, Vivin Eka; Pamungkasari, Eti Poncorini; Murti, Bhisma
Journal of Maternal and Child Health Vol 3, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Stunting is a very short body state in children that goes beyond the 2 SD deficit below the child population height. Worldwide stunting affects about 162 million children under five. Indonesia is included in 17 countries that have three nutritional problems in children under five: stunting, wasting, and overweight. This study aimed to investigate the determinants of stunting and child development in children under five.Subjects and Method: This was a retrospective cohort study conducted at Mayangan and Jarak Kulon Community Health Centers, Jombang, East Java, in Januari 2018. A total sample of 58 children were selected for this study by fixed exposure sampling. The dependent variables were stunting and child development. The independent variables were birth-length, maternal age, maternal height, maternal education, and family income. The data were collected by questionnaire. Data on birth length was taken from maternal and child record at community health center. The data were analyzed by path analysis model.Results: The likelihood of good child development increased with maternal education (b= 1.08; 95% CI= 0.41 to 1.75; p= 0.001) and decreased with stunting (b= -0.78; 95% CI= -1.46 to -0.10; p=0.025). The risk of stunting decreased with birth-length (b= -0.90; 95% CI= -1.60 to -0.21; p=0.011) and maternal height (b=-0.92; 95% CI= -1.69 to -0.16; p=0.018). The risk of stunting increased with maternal age <20 y.0. or ≥35 y.o. at pregnancy (b= 0.73; 95% CI= -0.03 to 1.46; p=0.051). The likelihood of maternal age <20 y.0. or ≥35 y.o. at pregnancy decreased with higher education (b=-0.75; 95% CI= -1.44 to -0.06; p=0.033). Birth-length  increased with maternal height (b= 1.07; 95% CI= 0.28 to 1.86; p= 0.008) and higher family income (b=0.93; 95% CI = 0.29 to 1.57; p=0.004). Birth-length decreased with maternal age <20 y.0. or ≥35 y.o. at pregnancy (b=-0.74; 95% CI= -1.48 to -0.01; p=0.047).Conclusion: The likelihood of good child development increases with maternal education and decreases with stunting. The risk of stunting decreases with birth-length and maternal height, and increases with maternal age <20 y.0. or ≥35 y.o. at pregnancy.Keywords: child development, stunting, birth-length, maternal age at pregnancy, maternal education, and family incomeCorrespondence: Vivin Eka Rahmawati. Masters Program in Public Health, Univesitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: vivineka74@gmail.com.Journal of Maternal and Child Health (2018), 3(1): 68-80https://doi.org/10.26911/thejmch.2018.03.01.07
Biopsychosocial Factors Associated with Postpartum Haemorrhage in Surakarta, Central Java Dewi, Rizqa Kartika; Budihastuti, Uki Retno; Pamungkasari, Eti Poncorini
Journal of Maternal and Child Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Postpartum haemorrhage is the primary cause of maternal mortality worldwide. However, studies in Indonesia examining factors associated with postpartum haemorrhage are sparse. The purpose of this study was to examine factors associated with postpartum haemorrhage.Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted at Dr. Moewardi hospital, Surakarta, Central Java, from May 2017 to May 2018. A total sample of 200 postpartum mothers was selected by fixed disease sampling. The dependent variable was postpartum haemorrhage. The independent variables were age, parity, birth space, anaemia, antenatal care, obstetrics history, education, and self-efficacy. The data were collected by questionnaire and analyzed by path analysis on Stata 13.Results:Postpartum haemorrhagewas positively and diretlyassociated with poor obstetric history(b=0.87; 95%CI=-0.03 to 1.79; p=0.059), older age (b=1.86; 95%CI=0.81 to 2.92; p= 0.001), multiparity(b= 1.62; 95%CI=0.08 to 3.15; p=0.038), anemia (b=1.74; 95%CI= 0.83 to 2.66; p<0.001), and narrow birth space (b=-2.51; 95%CI=-3.56 to -1.47; p<0.001). Postpartum haemorrhage was indirectly associated with antenatal care, education, and self-efficacy.Conclusion: Postpartum haemorrhageis positively associated with poor obstetric history, older age, multiparity, anemia, and narrow birth space. Postpartum haemorrhage is indirectly associated with antenatal care, education, and self-efficacyKeywords: postpartum haemorrhage, determinant, path analysisCorrespondence:Rizqa Kartika Dewi. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: rizqakartika@gmail.com.Journal of Maternal and Child Health (2018), 3(3): 207-215https://doi.org/10.26911/thejmch.2018.03.03.05
A Path Analysis on the Factors Associated with Birth Preparedness: Evidence from Wonogiri, Central Java Ummah, Hafari Fajria Nuril; Pamungkasari, Eti Poncorini; Adriani, Rita Benya
Journal of Maternal and Child Health Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Birth preparedness and complication readiness is a strategy that encourages pregnant women, their families, and communities to effectively plan for births and deal with emergencies, if they occur. It is a key component of globally accepted safe motherhood programs. This study aimed to determine factors associated with birth preparedness in Wonogiri, Central Java.Subjects and Method: This was a cross-sectional study carried out in Wonogiri, Central Java, from April to May 2018. A sample of 200 pregnant women was selected by cluster sampling. The dependent variable was birth preparedness. The independent variables were gestational age, parity, maternal education, maternal knowledge on birth sign, husband support, and health personnel role. The data were collected by questionnaire and analyzed by path analysis, run on Stata 13.Results: Birth preparedness was positively affected by good maternal knowledge on birth sign (b=2.97; 95% CI=0.10 to 5.84; p=0.043), husband support (b=5.06; 95% CI=2.62 to 7.51; p<0.001), and health personnel role (b=5.53; 95% CI=2.95 to 8.11; p<0.001). Birth preparedness was indirectly affected by gestational age, maternal education, and parity.Conclusion: Birth preparedness is positively affected by good maternal knowledge on birth sign, husband support, and health personnel role. Birth preparedness is indirectly affected by gestational age, maternal education, and parity.Keywords: birth preparedness, gestational age, education, knowledge, husband support, health personnel roleCorrespondence:Hafari Fajria Nuril Ummah. Masters Program on Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36A, Surakarta 57126, Central Java. Email: mbakfari93@gmail.com. Mobile:+6285712211401.Journal of Maternal and Child Health (2019), 4(1): 17-24https://doi.org/10.26911/thejmch.2019.04.01.03
Prevalence and Path Analysis on the Effects of Diarrhea and Life Course Determinants on Stunting in Children Under Two Years of Age in Kupang, East Nusa Tenggara Ilma, Nabilah Nurul; Salimo, Harsono; Pamungkasari, Eti Poncorini
Journal of Maternal and Child Health Vol 4, No 4 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: The interaction between infections and malnutrition has been recognized as a vicious cycle. Repeated diarrhoeal illnesses as well as other common childhood infections progressively altered the normal growth trajectories of children. This study aimed to analyze the effects of diarrhea and lifelong determinants on the incidence of stunting in children under two years in Kupang.Subjects and Method: This was a case-control study conducted in 25 integrated health posts in Alak and Oebobo Subdistricts, in Kupang, East Nusa Tenggara, from November December 2018. A sample of 200 children under two years was selected by multi-stage random sampling. The dependent variable was stunting. The independent variables were diarrhea, birth length, parental income, maternal education, exclusive breastfeeding, maternal height, maternal mid-upper arm circumference (MUAC), complementary feeding, maternal hygiene practice, and sanitation. The data were collected by questionnaire and analyzed by path analysis.Results: Stunting prevalence in Kupang was 30.5%. The risk of stunting was directly decreased by appropriate complementary feeding (b= -1.97; 95% CI= -3.55 to -0.39; p= 0.014), good hygiene practice (b= -4.38; 95% CI= - 6.63 to -2.12; p<0.001), good sanitation (b= -2.32; 95% CI= -4.00 to -0.64; p= 0.007), and birth length ≥48 cm (b= -2.22; 95% CI= -3.74 to -0.69; p= 0.004). The risk of stunting was directly increased by diarrhea (b= 2.55; 95% CI= 1.01 to 4.09; p= 0.001). It was indirectly affected by parental income, maternal education, exclusive breastfeeding, maternal height, and maternal MUAC at pregnancy.Conclusion: The risk of stunting is directly decreased by appropriate complementary feeding, good hygiene practice, good sanitation, and birth length ≥48 cm. The risk of stunting is directly increased by diarrhea. It is indirectly affected by parental income, maternal education, exclusive breastfeeding, maternal height, and maternal MUAC at pregnancy.Keywords: stunting, determinants, prevalence, diarrheaCorrespondence: Nabilah Nurul Ilma. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nabilahnurul86@gmail.com. Mobile: +6287838555468.Journal of Maternal and Child Health, 2019, 4(4): 230-241https://doi.org/10.26911/thejmch.2019.04.04.02
Factors Associated with Decision to Use a Long-Term Intra Uterine Device: A Path Analysis Evidence Deviasti, Rindra; Pamungkasari, Eti Poncorini; Murti, Bhisma
Journal of Maternal and Child Health Vol 3, No 4 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Intra uterine device (IUD) is a highly effective contraceptive method with a 98-99 percent success rate over five years of IUD use. However, its share of modern method mix is pitifully small, at less than 5%, in 63 countries and only 5%9% in a further 32 countries. Moreover, IUD's share is declining in many countries. The reasons for this are not well understood, particularly in Mojokerto, East Java, Indonesia, apart from growing popularity of injectables. This study aimed to examine factors associated with decision to use a long-term intra uterine device using a path analysis model.Subjects and Method: A case control study was conducted at Puskesmas (community health center) Gondang, Mojokerto, East Java, from April to May 2018. A sample of 225 women was selected for this study by fixed disease sampling, comprising 75 IUD users and 150 non-IUD users. The dependent variable was IUD use. The independent variables were age, education, knowledge, attitude, self-efficacy, cultural belief, husband support, and peer support. Data on IUD use were taken from puskesmas Gondang. The data were collected by questionnaire and analyzed by path analysis.Results: IUD use was directly and positively associated with positive attitude (b= 0.79; 95% CI= 0.19 to 1.40; p= 0.010) and low anxiety (b= 0.76; 95% CI= 0.16 to 1.37; p= 0.014). IUD use was indirectly associated with cultural belief, self efficacy, education, knowledge, husband support, and peer support.Conclusion: IUD use is directly associated with positive attitude and low anxiety, and is indirectly associated with cultural belief, self efficacy, education, knowledge, husband support, and peer support.Keywords: intra-uterine devise use, biopsychosocial factor, cultural belief, anxietyCorrespondence:Rindra Deviasti. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta 57126, Central Java. Email: widodarigunung@gmail.com. Mobile: +6281331301065.Journal of Maternal and Child Health (2018), 3(4): 269-277https://doi.org/10.26911/thejmch.2018.03.04.04
Multilevel Analysis on the Contextual Effect of Posyandu on Exclusive Breastfeeding in Sleman, Yogyakarta Lestari, Esti; Pamungkasari, Eti Poncorini; Dewi, Yulia Lanti Retno
Journal of Maternal and Child Health Vol 4, No 4 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: There is a piece of increasing evidence that exclusive breastfeeding (EBF) up to six-month of age has important consequences on health and nutritional outcomes of children. However, studies on the contextual effect of integrated health post (posyandu) on EBF are scarce. The purpose of this study was to examine the contextual effect of posyandu on exclusive breastfeeding using multilevel analysis.Subjects and Method: A cross-sectional study was conducted in Sleman, Yogyakarta, from November to December 2018. A sample of 200 lactating mothers was selected by simple random sampling. The dependent variable was exclusive breastfeeding. The independent variables were knowledge, education, age, parity, birth spacing, employment, and family support. The data were collected by a multilevel logistic regression.Results: Exclusive breastfeeding increased with good knowledge (b= 2.66; 95% CI= 0.85 to 4.47; p= 0.004), high education (b= 2.10; 95% CI= 0.29 to 3.91; p= 0.023), maternal age 20-35 years (b= 3.35; 95% CI= 1.46 to 5.24; p<0.001), multiparous (b= 2.90; 95% CI= 0.41 to 3.39; p= 0.012), birth spacing ≥2 years (b= 2.91; 95% CI= 0.92 to 4.89; p= 0.004), unemployed mother (b= 4.53; 95% CI= 2.39 to 6.67; p<0.001), strong family support (b= 2.88; 95% CI= 1.04 to 4.72; p= 0.002). Integrated health post had substantial contextual effect on exclusive breastfeeding with ICC= 29.2%.Conclusion: Exclusive breastfeeding increases with high knowledge, high education, maternal age 20-35 years, multiparous, birth spacing, unemployed mother, strong family support. Integrated health post has the substantial contextual effect on exclusive breastfeeding.Keywords: exclusive breastfeeding, integrated health post, multilevel analysisCorrespondence: Esti Lestari. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: estylestary727@gmail.com. Mobile: 082363242993.Journal of Maternal and Child Health, 2019, 4(4): 250-259https://doi.org/10.26911/thejmch.2019.04.04.04
The Association between Knowledge, Family Support, and Blood Sugar Level in Type 2 Diabetes Mellitus Patients Herawati, Ratna; Pamungkasari, Eti Poncorini; Sugiarto, Sugiarto
Indonesian Journal of Medicine Vol 3, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia. The incidence of DM has increased due to lack of knowledge about DM and changes in lifestyle. The purpose of this study was to analyze the relationship of knowledge about DM, family support, and blood sugar levels in type 2 DM patients in Jebres health center, Surakarta.Subjects and Method: A cross sectional study was conducted at Sibela and Ngoresan Surakarta health center. The study subjects were 100 DM patients selected by purposive sampling. Socio-economic data, knowledge and family support were measured by questionnaires. Blood sugar levels were measured using a spectrophotometer. The data were analyzed using a multiple logistic regression.Results: A total of 66 DM patients had a high level of knowledge, 58 patients received strong family support, and 76 people had normal blood sugar levels. High knowledge about DM (OR= 0.87; p= 0.001) and strong family support (OR= 0.99; p= 0.017) lowered blood sugar levels in DM patients.Conclusions: High knowledge about DM and strong family support reduce blood sugar levels in DM patients.Keywords: knowledge about DM, family support, blood sugar level, type 2 diabetes mellitusCorrespondence:Ratna Herawati. Masters Program in Family Medicine, Universitas Sebelas Maret. Jl. Ir Sutami 36A, Surakarta 57126, Central Java. Email: ratna_herawati_dokter@yahoo.co.id.Indonesian Journal of Medicine (2018), 3(1): 49-55https://doi.org/10.26911/theijmed.2018.03.01.07
Effectiveness of Health Promotion by Indonesian Breastfeeding Association in Increasing Exclusive Breastfeeding Coverage in Surabaya City, East Java Handajani, Diani Octaviyanti; Pamungkasari, Eti Poncorini; Budihastuti, Uki Retno
Journal of Health Promotion and Behavior Vol 3, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Breastfeeding is essential for health, development, and child survival by preventing child illness. However, exclusive breastfeeding has not reached the desired target. Health promotion by Indonesian Breastfeeding Association (AIMI) participation is one way to increase exclusive breastfeeding coverage. There are several causative factors that influence exclusive breastfeeding, which can be explained by the PRECEDE-PROCEED model. This study aimed to determine the effectiveness of health promotion through the Association of Indonesian Breastfeeding Mothers (AIMI) in increasing coverage of exclusive breastfeeding in Surabaya, East Java.Subjects and Method: This was an analytic observational study with a cohort retrospective design. The study was conducted at AIMI Surabaya branch office and 6 community health centers in Surabaya, East Java, from December 2017 and January 2018. A total sample of 120 lactating mothers was selected for this study by simple random sampling. The dependent variable was breastfeeding. The independent variables were AIMI participation, maternal knowledge, maternal education, maternal attitude, family support, and peer support. The data were collected by questionnaire and analyzed by path analysis.Results: Exclusive breastfeeding increased with AIMI participation (b= 1.02; 95% CI= -0.19 to 2.24; p=0.101), better maternal knowledge (b= 1.48; 95% CI= 0.15 to 2.79; p=0.029), positive maternal attitude (b= 2.22; 95% CI= 1.03 to 3.38; p<0.001), and stronger family support (b= 2.69; 95% CI= 1.25 to 4.11; p<0.001). Maternal attitude increased with AIMI participation (b= 0.69; 95% CI= -0.18 to 1.57; p=0.116), better maternal knowledge (b= 1.56; 95% CI= 0.72 to 2.39; p<0.001), and higher maternal education (b= 0.71; 95% CI= -0.11 to 1.52; p=0.089). AIMI participation increased with higher education (b= 1.07; 95% CI= 0.26 to 1.87; p=0.009). Family support increased with stronger peer support (b= 2.24; 95% CI= 0.73 to 3.75; p=0.004).Conclusion: Exclusive breastfeeding increases with AIMI participation, better maternal knowledge, positive maternal attitude, and stronger family support.Keywords: exclusive breastfeeding, PRECEDE-PROCEED model, Indonesian Breastfeeding Association (AIMI)Correspondence: Diani Octaviyanti Handajani. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: diani.octaviyanti@gmail.com. Mobile: +628563328666Journal of Health Promotion and Behavior (2018), 3(1): 1-15https://doi.org/10.26911/thejhpb.2018.03.01.01 
Co-Authors -, Kartika . Zulfan ?Arub, Lathifah Abd. Rasyid Syamsuri Achmad Arman Subijanto, Achmad Arman Addini, Ragil Aidil Fitriasari Adelita, Sela Putri Adi Prayitno Adita, Kingkin Afriyanti, Neta Agus Kristiyanto Agus, Yuliana Agus, Yuliana Aini, Zahratul Aisy, Jihan Rohadatul Aisyiyah, Farida Nur Akmala, Jatu Kartika Amalia, Ade Ambar Mudigdo Anak Agung Gede Sugianthara Anggraini, Wella Anik Lestari Annisaa, Salwa Argyo Demartoto, Argyo Ari Natalia Probandari Ari Probandari Arifin Arifin Arwiyantasari, Wida Rahma Astari, Rahmi Windhy Astuti, Fitriyani Dwi Aviandari, Tifa Aziza, Triana Ulfa Nur Azizah, Fikri Dian Dinu Azzahro, Asri Wahyu ‘Arub, Lathifah Bakrie, Saekhol Bambang Purwanto Baroroh Barir Bhisma Murti Brian Wasita Budhiastuti, Uki Retno Budiastuti, Veronika Ika Bulan Kakanita Hermasari Christanto, Antonius Cynara, Ailsa Clarissa Dania, Samara Rahma Deviasti, Rindra Dewi, Arddha Maha Pawitra Dwi Puspita Dewi, Dian Puspita Dewi, Rizka Amalia Dewi, Rizqa Kartika Dian Handayani Diana Nur Afifah, Diana Nur Diani Octaviyanti Handajani Dilma’aarij, Dilma’aarij Dwiantini, Feby Endang Lestari Endang Sutisna Sulaeman Erynda, Revina Fiandany Fajriyani, Fanny Kartika Fardhiasih Dwi Astuti Fatikhu Yatuni Asmara Fitria Wulandari Fitriani, Sufia Flora, Viola Holly Gaurinindi, Melinda Febianca Handariati, Atik Handayani, Anggun Fitri Handriani, Winei Haniah, Alfi Zamilul Hanifa, Ainun Hanifah, Ainun Hanifah, Nita Layli Hanifah, Siti Nur Hapsari, Dini Hardilla, Dinda Septiani Hariyadi, Agustin Mahardika Harsono Salimo Harumi, Linda Hernanda R, Annisa Istighfari Hidayah, Siti Shafridha Ida Nurwati Ilma, Nabilah Nurul Indriani, Frida Indriasih, Merlita Indriasih, Merlita Indriastuti, Latty Jannah, Putri Isriyatil Khairunnisa, Lia Khoirunnisa, Luthfiana Nadhiifa Kumalaningrum, Melda Kurnianingsih, Mayasari Kurrniati, Era Kusumawati, Ima Larasati, Meirina Dwi Lestari, Esti Lestari, Esti Loekito, Cindy Lestyani Luthfiana, Lia Ulfah Luthfianasari, Luthfianasari Luturmas, Antina Manggandhi, Yuyun Maranata, Maranata Marliana, Wiwit Maryana, Dyan Maryani ., Maryani Maryani Maryani Maung, Yuzana Mawardi, Fitriana Mayaningrum, Yulita Endah Mayarestya, Nita Putriasti Muchsin Doewes Muhammad Rifqi Azhary Mulya Tarmidi, Mulya Mutiara, Bunga Nabilah Nurul Ilma Nawangwulan, Diyah Novia Zuriatun Solehah Novika, Revi Gama Hatta Novitasari, Isnaini Novitasari, Ratih Nuralita, Ayunda Yonik Nurhayati, Happy Nurindahsari, Yespy Anna Wahyu Nurkholifa, Ferda Fibi Tyas Nursani, Anggia Rahmah Oktaviyani, Feny Paramasari Dirgahayu Pawito Pawito Prabowo, Puspita Mayangsari Prasetya, Hanung Primaningtyas, Widana Purnama, Hanif Wildan Putri, Anggi Resina Putri, Azilla Edsa Putri, Diani Fadmi Putri, Dominika Risnanda Alfinsia Qomariah, Nur Laili Rahardjo, Setyo Sri Rahayu, Ria Muji Rahmah Rahmah Ramli, Muhammad Rizaldi Ravi Masitah RB. Soemanto Rini, Arum Kusuma Rismawati, Normalia Levi Risna Widowati Risya Cilmiaty, Risya Rita Adriani Benya Adriani Rohaniyati, Retno Dwi Rosyidah Alfitri RUBEN DHARMAWAN Safitri, Diyanti Sakinah Sakinah Sari, Prafista Wulan Sari, Putri Yunita Selviana, Tasya Ardia Septianawati, Linda Wahyu Setiamika, Made Setiowati, Tri Ayu Setiyarini, Dwi Wahyu Setyo Sri Raharjo Sinta, Prabawati Soetrisno Soetrisno Suci Arsita Sari SUGIARTO - Sugiarto S suminah ., suminah Suminah Suminah, Suminah Suprapti Suprapti Supriyadi Hari Respati Susanti, Nadya Sutiman Sutiman, Sutiman Syetiawinanda, Amriansyah Titah Pujangkara, Ajeng Ayu Tri Nur Kristina Tunurrohmin, Zela Uki Retno Budihastuti Ulhaq, Muhammad Zia Ummah, Hafari Fajria Nuril Usmaningrum, Desif Upix Utomo, Asrori Ibnu Vitri Widyaningsih VIVIN EKA RAHMAWATI Wati, Emita Dewi Lilis Angkasa Wayanshakty, Janur Putri Wekadigunawan, CSP Widiyaningrum, Alfiati Nanda Widiyawati, Rina Widyandana Widyandana Widyawardani, Tri Nyantosani Widyawati Widyawati Wulandari, Umianita Risca Yanuari, Ridha Rossela Yudhani, Ratih Dewi yulia lanti retno dewi Yusup Subagio Zakiyah, Nisaus Zauma, Luthfia Zuhaira, Ulul Azmi