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Multilevel Analysis of the Biopsychosocial Determinants and Contextual Peer Groups on Smoking Habit in High School Students in East Lampung, Lampung, Indonesia Sulistyani, Retno; Rahardjo, Setyo Sri; Pawito, Pawito
Journal of Health Promotion and Behavior Vol 6, No 1 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Smoking is still one of the greatest public health threats faced by citizens of the world. Data from the Central Statistics Agency in 2018 shows that smoking behavior in Lampung Province has a prevalence of 35.95%. The World Health Organization (WHO) states that smoking kills more than 8 million people per year worldwide. This study aimed to analyze the determinants of adolescent smoking behavior at the individual level and at the school level.Subjects and Method: This was a cross sectional study conducted in East Lampung Regency, Indonesia, from October to November 2020. A number of 200 male adolescents were selected by random sampling. The dependent variable was smoking behavior. The independent variables were the influence of parents, peers, media exposure, pocket money, cigarette price, intention, attitude, and contextual effect of school. The data were collected by questionnaire and analyzed using a multiple multilevel logistic regression with Stata 13.Results: The influence of family (b=2.88; 95% CI= 0.73 to 3.85; p= 0.004), peers (b= 2.85; 95% CI= 0.65 to 3.52; p= 0.004), media exposure (b= 3.04; 95% CI= 0.78 to 3.62; p= 0.002), money pocket (b= 3.22; 95% CI= 0.87 to 3.59; p= 0.001), cigarette price (b= 2.73; 95% CI= 0.54 to 3.28; p= 0.006), intention to smoke (b= 2.80; 95% CI= 0.69 to 3.95; p= 0.005), attitude toward smoking (b=3.83; 95% CI= 1.80 to 5.58; p<0.001) increased the likelihood to smoke in male adolescents. School had strong contextual effect on smoking in adolescents with ICC= 21.83%.Conclusion: The influence of family, peers, media exposure, money pocket, cigarette price, intention to smoke, attitude toward smoking increase the likelihood to smoke in male adolescents. School has strong contextual effect on smoking in adolescentsKeywords: smoking behavior, adolescents, contextual effect of schoolCorrespondence: Retno Sulistiani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: retnosulistiani91@gmail.com. Mobile: +6285867006699.Journal of Health Promotion and Behavior (2021), 06(01): 9-20https://doi.org/10.26911/thejhpb.2021.06.01.02

The Effect of Community Health Center on Visual Acetic Acid Uptake in Pati, Central Java Wulan, Retno; Pawito, Pawito; Murti, Bhisma
Journal of Health Promotion and Behavior Vol. 4 No. 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Cervical cancer is included in the category of malignant tumors that arise in the cervix of women. The incidence of cervical cancer is high due to lack of awareness to make efforts to examine early detection of cervical cancer by using the visual inspection acetic acid (VIA) method. The purpose of this study was to analyze the effect of community health center on the use of VIA.Subjects dan Method: This was an analytic observational study with a cross sectional design. was The study was conducted at 29 community health centers in Pati, Central Java. A sample of 232 women was selected by simple random sampling. The dependent variable was VIA uptake. The independent variable were perceived susceptibility, perceived seriousness, cues to action, perceived threat, perceived benefit, perceived barrier, self-efficacy, economic status, and social capital. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13.Result: Community health center had a contextual effect on VIA uptake with intra-class correlation (ICC)= 16.91%. VIA uptake increased with high perceived susceptibility (b= 3.21; 95% CI= 0.22 to 6.19; p = 0.035), high perceived seriousness (b= 4.68; 95% CI= 1.06 to 8.29; p= 0.011), high perceived threat (b= 4.03; 95% CI= 0.61 to 7.45; p= 0.021), high perceived barrier (b= 2.48; 95% CI= 0.06 to 4.91; p= 0.044), high perceived benefit (b= 2.50; 95% CI= 0.10 to 4.91; p= 0.041), and high economic status (b= 11.22; 95% CI= 3.64 to 18.81; p= 0.004). VIA uptake decreased with low cues to action (b= -0.92; 95% CI= -3.08 to 1.24; p= 0.405), low self-efficacy (b= -0.32; 95% CI= -2.45 to 1.80; p= 0.765), and low social capital (b= 0.79; 95% CI= 3.64 to 18.81; p= 0.562).Conclusion: Community health center had a contextual effect on VIA uptake. VIA uptake increases with high perceived susceptibility, high perceived seriousness, high perceived threat, high perceived barrier, high perceived benefit, and high economic status. VIA uptake decreases with low cues to action, low self-efficacy, and low social capital.Keywords: Community Community health center, Acetic Acid Visual Inspection.Correspondence: Retno Wulan. Masters Program of Public Health, Universitas Sebelas Maret, JL. Ir.Sutami 36A, Surakarta, Central Jawa, Indonesia. E-mail: wuland.cimmutzz12@gmail.com. Mobile: 085740969271.Journal of Health Promotion and Behavior (2019), 4(3): 189-197https://doi.org/10.26911/thejhpb.2019.04.03.04

Do Primary Schools Have Contextual Influence on Health Behavior? A Multilevel Evidence from Nganjuk, East Java Indriani, Frida; Pawito, Pawito; Pamungkasari, Eti Poncorini
Journal of Health Promotion and Behavior Vol. 4 No. 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Health problems among primary school age children caused by poor personal hygiene can be prevented by good clean and healthy life behavior. Clean and healthy life behavior is affected by perceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, cues to action, and self-efficacy. This study aimed to analyze the contextual effect of primary school on clean and healthy life behavior in primary school age children in Nganjuk, East Java.Subjects and Method: This was cross sectional study conducted at 25 primary schools in Nganjuk, East Java, from August to December 2019. There were 200 primary school age children aged 6-12 years involved as the sample of this study. The study used stratified random sampling. The dependent variable was clean and healthy life behavior. The independent variables were perceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, cues to action, and self-efficacy. This study used questionnaires to collect the data. This study used multilevel multiple logistic regression with Stata 13 to analyze the data.Results: Clean and healthy life behavior in the primary school age children increased with high perceived susceptibility (b=1.06; 95%CI=0.31 to 1.80; p=0.005), high perceived seriousness (b= 0.92; 95%CI=0.16 to 1.68; p=0.018 ), strong perceived benefit (b=0.76; 95%CI=0.05 to 1.47; p= 0.036), strong cues to action (b=0.97; 95%CI=0.26 to 1.68; p=0.007), and strong self-efficacy (b= 1.16; 95%CI=0.43 to 1.89; p=0.002). Clean and healthy life behavior in the primary school age children decreased with strong perceived barrier, but the result was statistically non-significant (b= -0.27; 95%CI=-1.02 to 0.33; p=0.484). Primary school had a contextual effect on clean and healthy life behavior (ICC 17.33%).Conclusion: Clean and healthy life behavior in primary school age children is affected by perceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, cues to action, and self-efficacy. Primary school has a contextual effect on clean and healthy life behavior.Keywords: clean and healthy life behavior, Health Belief Model, contextual of primary schoolCorrespondence:Frida Indriani, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir.Sutami 36A, Surakarta, Central Java, Indonesia. Email: nersfrida15@gmail.com. Mobile: 082226327646Journal of Health Promotion and Behavior (2019), 4(3): 235-245https://doi.org/10.26911/thejhpb.2019.04.03.08

Application of Social Cognitive Theory: Tertiary Prevention Behavior in Patients with Type 2 Diabetes Mellitus in Ponorogo Hospital, East Java, Indonesia Yuliana, Nur Aida; Pawito, Pawito; Murti, Bhisma
Journal of Health Promotion and Behavior Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Diabetes Mellitus (DM) is a non-communicable disease that becomes a serious threat to global health. This disease is a serious chronic disease because it cannot be cured. An increasing number of cases of non-communicable diseases that are associated with risk factors are in line with lifestyle changes that increasingly modern. This study aimed to analyze the effect of the variables in Social Cognitive Theory on tertiary prevention behavior in patients with type 2 Diabetes Mellitus.Subjects and Method: This was a cross-sectional study design. This study was conducted on patients with type 2 DM in the hospital in Ponorogo Regency, East Java, from January to February 2020. There were 200 patients with type 2 DM as the sample of the study. The sample was taken by random sampling. The dependent variable was Tertiary prevention behavior of type 2 DM. The independent variables were observational learning, role model, vicarious experience, imitation, attitude, outcome expectations, knowledge, reinforcement, self-efficacy, and self-management. The data were collected through a set of questionnaires. The data were analyzed based on Path Analysis using stata 13 application.Results: Tertiary prevention behavior of type 2 DM was directly increased by strong imitation (b= 1.40; 95% CI= 0.51 to 2.28; p= 0.002), good knowledge (b= 1.36; 95% CI= 0.48 to 2.25; p= 0.002), positive attitude (b= 1.32; 95% CI= 0.44 to 2.19; p= 0.003), strong self-efficacy (b= 1.07; 95% CI= 0.18 to 1.96; p= 0.018), and good self-management (b= 2.26; 95% CI= 1.31 to 3.22; p <0.001). Tertiary prevention behavior of type 2 DM was indirectly affected by observational learning, role model, vicarious experience, outcome expectation, and reinforcement.Conclusion: Tertiary prevention behavior of type 2 DM is directly increased by strong imitation, good knowledge, positive attitude, strong self-efficacy, and good self-management. Tertiary prevention behavior of type 2 DM is indirectly affected by observational learning, role model, vicarious experience, outcome expectation, and reinforcement.Keywords: social cognitive theory, type 2 Diabetes Mellitus.Correspondence: Nur Aida Yuliana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: Aidayuliana17@gmail.com.Mobile: +628-5790767582.Journal of Health Promotion and Behavior (2020), 5(1): 157-168https://doi.org/10.26911/thejhpb.2020.05.03.02

Factors Affecting Exclusive Breastfeeding Practice using Social Cognitive Theory Constructs: A Multilevel Evidence from Madiun, East Java Syahputri, Rezyana Budi; Pawito, Pawito; Murti, Bhisma
Journal of Health Promotion and Behavior Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Exclusive breastfeeding for infants up to 6 months of age is the most effective way to ensure the health and the viability of the child. Exclusive breastfeeding coverage still does not meet the target due to various factors. This study aimed to determine the effectiveness level of health promotion of exclusive breastfeeding program in the integrated health service in Madiun, East Java.Subjects and Method: This was an a cross-sectional study conducted in Madiun, East Java, from February to May 2020. A sample of 200 lactating mother who had infants aged 6 to 24 months was selected randomly. The dependent variable was exclusive breastfeeding practice. The independent variables were health promotion program, observational learning, role model, vicarious learning, imitation, attitude, outcome expectation, self regulation, self-efficacy, reinforcement, and integrated health post contextual. The data were collected using questionnaire and analyzed by a multilevel multiple logistic regression run on Stata 13.Results: Exclusive breastfeeding practice increased with adequate health promotion program (OR= 3.08; 95% CI= 1.06 to 8.94; p= 0.038), high observational learning (OR= 3.86; 95% CI= 1.31 to 11.39; p= 0.014), strong role model (OR= 4.01; 95% CI= 1.12 to 14.29; p= 0.033), vicarious learning (OR= 4.46; 95% CI= 1.34 to 14.82; p= 0.015), strong imitation (OR= 2.74; 95% CI= 1.02 to 7.35; p= 0.045), positive attitude (OR= 3.51; 95% CI= 1.04 to 11.88; p= 0.043), positive outcome expectation (OR= 4.04; 95% CI= 1.32 to 12.38; p= 0.014), strong self-regulation (OR= 2.36; 95% CI= 0.93 to 5.99; p= 0.068), strong self-efficacy (OR= 5.35; 95% CI= 1.81 to 15.77; p= 0.002), and strong reinforcement (OR= 3.90; 95% CI= 1.21 to 12.57; p= 0.022). There was a contextual effect of integrated health post on exclusive breastfeeding practice with intraclass correlation (ICC)= 10.97%.Conclusion: Exclusive breastfeeding practice is affected by health promotion program, observational learning, role model, vicarious learning, imitation, attitude, outcome expectation, self regulation, self-efficacy, and reinforcement. Integrated health post has a contextual effect on exclusive breastfeeding practice.Keywords: exclusive breastfeeding, health promotion, social cognitive theory.Correspondence: Rezyana Budi Syahputri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: rezyanabs@gmail.com. Mobile: +6282325750134.Journal of Health Promotion and Behavior (2020), 05(03): 169-173https://doi.org/10.26911/thejhpb.2020.05.03.03

Contextual Effect of the Integrated Health Post (Posbindu) and Biopsychosocial Determinants of Tertiary Preventive Behavior in Patients with Hypertension Retnowati, Very; Pawito, Pawito; Murti, Bhisma
Journal of Health Promotion and Behavior Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Tertiary prevention of hypertension is a preventive effort to make patients with hypertension do not have disabilities and further complications. It also improves the quality of life and makes life longer. The biopsychosocial aspect affects individuals in learning, doing, and maintaining certain behaviors based on social cognitive theory. This study aimed to analyze the biopsychosocial determinants of tertiary preventive behavior among patients with hypertension.Subjects and Method: This study was an analytical observational study with a cross-sectional design. The study was conducted at 25 Integrated Health Posts (Posbindu) in Sragen, Central Java. A sample of 200 hypertensive patients was selected by stratified random sampling. The dependent variable was the tertiary preventive behavior of hypertension. The independent variables were observational learning, role model, imitation, vicarious learning, reinforcement, self-efficacy, self-regulation, outcome expectation, and attitude. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression.Results: Hypertension preventive behavior increased with observational learning (b= 2.85; 95% CI= 0.17 to 5.53; p= 0.037), role model (b= 2.73; 95% CI =0.73 to 4.73; p=0.007), imitation (b= 3.46 ; 95% CI= 0.73 to 6.19; p= 0.013), vicarious learning (b= 2.54; 95% CI =0.16 to 4.93; p= 0.036), reinforcement (b= 3.89; 95% CI= 0.96 to 6.82; p= 0.009), self-efficacy (b= 3.04; 95% CI= 0.41 to 5.67; p= 0.024), self-regulation (b= 2.28; 95% CI= 0.02 to 4.54; p= 0.048), outcome expectation (b= 3.56; 95% CI= 0.75 to 6.38; p= 0.013), and a positive attitude (b= 2.86; 95% CI= 0.26 to 5.47; p= 0.031). Posbindu had a contextual effect on tertiary preventive behavior of hypertension with an Intra Class Correlation (ICC) value of 63.05%.Conclusion: Tertiary preventive behavior of hypertension increases with high observational learning, strong role model, strong imitation, high vicarious learning, strong reinforcement, high self-efficacy, high self-regulation, positive outcome expectation, and positive attitude. Posbindu has a contextual effect on tertiary preventive behavior of hypertension.Keywords: tertiary prevention, hypertension, social cognitive theory, multilevel analysisCorrespondence: Very Retnowati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: veryretnowati@gmail.com. Mobile: +6281548592491.Journal of Health Promotion and Behavior (2020), 05(03): 174-186https://doi.org/10.26911/thejhpb.2020.05.03.04

Multilevel Analysis of the Biopsychosocial Determinants and Contextual Peer Groups on Smoking Habit in High School Students in East Lampung, Lampung, Indonesia Sulistyani, Retno; Rahardjo, Setyo Sri; Pawito, Pawito
Journal of Health Promotion and Behavior Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Smoking is still one of the greatest public health threats faced by citizens of the world. Data from the Central Statistics Agency in 2018 shows that smoking behavior in Lampung Province has a prevalence of 35.95%. The World Health Organization (WHO) states that smoking kills more than 8 million people per year worldwide. This study aimed to analyze the determinants of adolescent smoking behavior at the individual level and at the school level.Subjects and Method: This was a cross sectional study conducted in East Lampung Regency, Indonesia, from October to November 2020. A number of 200 male adolescents were selected by random sampling. The dependent variable was smoking behavior. The independent variables were the influence of parents, peers, media exposure, pocket money, cigarette price, intention, attitude, and contextual effect of school. The data were collected by questionnaire and analyzed using a multiple multilevel logistic regression with Stata 13.Results: The influence of family (b=2.88; 95% CI= 0.73 to 3.85; p= 0.004), peers (b= 2.85; 95% CI= 0.65 to 3.52; p= 0.004), media exposure (b= 3.04; 95% CI= 0.78 to 3.62; p= 0.002), money pocket (b= 3.22; 95% CI= 0.87 to 3.59; p= 0.001), cigarette price (b= 2.73; 95% CI= 0.54 to 3.28; p= 0.006), intention to smoke (b= 2.80; 95% CI= 0.69 to 3.95; p= 0.005), attitude toward smoking (b=3.83; 95% CI= 1.80 to 5.58; p<0.001) increased the likelihood to smoke in male adolescents. School had strong contextual effect on smoking in adolescents with ICC= 21.83%.Conclusion: The influence of family, peers, media exposure, money pocket, cigarette price, intention to smoke, attitude toward smoking increase the likelihood to smoke in male adolescents. School has strong contextual effect on smoking in adolescentsKeywords: smoking behavior, adolescents, contextual effect of schoolCorrespondence: Retno Sulistiani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: retnosulistiani91@gmail.com. Mobile: +6285867006699.Journal of Health Promotion and Behavior (2021), 06(01): 9-20https://doi.org/10.26911/thejhpb.2021.06.01.02

Multilevel Analysis: Contextual Effects of School and Psychosocial Determinants on Healthy Sexual Behavior of High School Adolescents in Banyuwangi, East Java, Indonesia Luthfiana, Lia Ulfah; Pawito, Pawito; Pamungkasari, Eti Poncorini
Journal of Health Promotion and Behavior Vol. 6 No. 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Along with the development of the era, teenagers began to be faced with various problems and the biggest problems faced by teenagers were sexual problems. Sexual behavior in adolescents who are carried out actively poses a risk of teenage pregnancy and transmission of sexually transmitted diseases. This study aims to analyze the influence related to school context and psychosocial determinants on healthy sexual behavior of adolescents at the age of 15-19 years in Banyuwangi Regency.Subjects and Method: This study used a cross sectional research design. The study was conducted in 25 high schools/vocational high schools in Banyuwangi Regency, East Java in August to September 2020. Sampling of 225 adolescents was carried out using stratified random sampling and simple random sampling. The dependent variable is healthy sexual behavior. The independent variables include knowledge, self-efficacy, parental support, sources of information/technology, perception of seriousness. Data were collected using a questionnaire. Data were analyzed using multiple logistic regression with Stata 13.Results: Adolescents will have healthy sexual behavior with high knowledge about healthy sexual behavior (b= 0.23; 95% CI= 0.05 to 0.41; p= 0.014), have strong self-efficacy (b= 0.14; 95% CI= 0.01 to 0.27; p= 0.035), had good parental support (b= 0.21; 95% CI= 0.09 to 0.34; p = 0.001), had high exposure to information sources (b= 0.36; 95% CI= 0.15 to 0.56; p = 0.001 ), and had a high perception of seriousness for weak sexual behavior (b= 0.82; 95% CI= 0.45 to 1.19; p <0.001). There is an effect of school level on healthy sexual behavior with an ICC of 16.4%.Conclusion: Healthy sexual behavior in adolescents can increase with high knowledge, strong self-efficacy, having exposure to high sources of information, and having a high perception of seriousness. There is an effect of school level on healthy sexual behavior.Keywords: healthy sexual behavior, school contextual, psychosocial determinants, adolescentsCorrespondence: Lia Ulfah Luthfiana. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, 57126. Email: luthfianalia7@gmail.com. Mobile: +6285236800700.Journal of Health Promotion and Behavior (2021), 06(03): 188-200DOI: https://doi.org/10.26911/thejhpb.2021.06.03.03

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