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Path Analysis on the Determinants of the Use of Integrated Health Post and the Application of Theory of Planned Behavior Fitriani, Yuni; Tamtomo, Didik; Sulaeman, Endang Sutisna
Journal of Health Promotion and Behavior Vol 1, No 4 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Integrated health post (Posyandu) is a strategy for community empowerement. It has an important role to reduce maternal mortality rate (MMR) and infant mortality rate (IMR). The intergrated health post monitors the health of infants, children, pregnant women, lactating women, and women of reproductive age. Weighing coverage of children under five was only 80.4% in Central Java, in 2014. Weighing coverage of children under five was only 78.4 % in Tegal District, in 2015, which was lower than the expected target of 80%. This study aimed to investigate the determinant of of the use of integrated health post and the application ofÃÂ Theory of Planned Behavior (TPB).Subjects and method: This was an analytic observational study with case control design. This study was conducted in Tegal District, Central Java, from 25 September to 25 October 2016. A total sample of 135 mothers with their respective children aged 6-59 months were selected for this study by fixed disease sampling. The dependent variables were intention and use of the integrated health post. The independent variables were constructs of TPB, including attitude toward behavior, subjective norm, and perceived behavior control. The data were collected by a pre-tested set of questionnaire. The data were analyzed by path analysis using IBM SPSS AMOS 22.Results: The path model showed goodness of fit with CMIN=4.24; p=0.120; GFI=0.99; NFI=0.99; CFI=0.99; and RMSEA=0.09. Intention had direct positive and statistically significant effect on the use of the integrated health post (b=0.29; p<0.001). All of the three TPB constructs, including attitude toward behavior (b=0.27; p<0.001), subjective norm (b=0.27; p=0.046), and perceived behavior control (b=0.34; p=0.007) had indirect positive and statistically significant effect on the use of the integrated health post.Conclusion: Intention has direct positive effect on the use of the integrated health post. All of the three TPB constructs, i.e. attitude toward behavior, subjective norm, and perceived behavior control has positive and indirect effect on the use of the integrated health post.Keywords: integrated health post, theory of planned behaviorCorrespondence: Yuni Fitriani. School of Health and Sciences, STIKes Bhakti Mandala Husada Slawi. Email: yfitriani85@yahoo.co.id.Journal of Health Promotion and Behavior (2016), ÃÂ 1(4): 228-237https://doi.org/10.26911/thejhpb.2016.01.04.02

Path Analysis on the Effectiveness of Exclusive Breastfeeding Advocacy Program on Breastfeeding Practice using Theory of Planned Behavior Ariwati, Valentina Dili; Tamtomo, Didik; Sulaeman, Endang Sutisna
Journal of Health Promotion and Behavior Vol. 1 No. 3 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Exclusive breastfeeding coverage was 52.30% in 2015, which was below the national target of 80%. For the past few years Klaten local government has launched the Exclusive Breastfeeding Advocacy Program with the objective to increase exclusive breastfeeding coverage. This study aimed to determine the effectiveness of Exclusive Breastfeeding Advocacy Program using Theory of Planned Behaviour framework.Subjects and Method: This was an analytic observational study with retrospective cohort design. This study was conducted from 2 August to 16 September 2016 in Klaten and Magelang, Central Java, Indonesia. A total of 200 lactating mothers of infants aged 6 to 12 months was selected for this study by multi-stage random sampling. The dependent variables were exclusive breastfeeding and intention. The independent variables were exclusive breastfeeding advocacy program, attitude, subjective norm, and perceived behavior control. The data were collected using a set of questionnaire, and analyzed by path analysis.Results: The path model showed Goodness of Fit indices as follows: CMIN=4.24, p=0.374, GFI=0.99, NFI=0.99, CFI=1.00, RMSEA=0.017. Strong intention (b=0.15; p <0.001) had direct effect on exclusive breastfeeding. Positive atittude (b = 0.27; p<0.001), positive subjective norm (b=0.26; p <0.001), strong perception of behavior control (b=0.25; p<0.001), and exclusive breastfeeding advocacy program (b=0.36; p<0.001), had positive effects on intention.Conclusion: Intention has direct effect on exclusive breastfeeding. Atittude toward exclusive breastfeeding, subjective norm, and perception of behavior control, have positive effects on intention. Exclusive breastfeeding advocacy program is effective in increasing the likelihood of providing exclusive breastfeeding.Keywords: exclusive breastfeeding advocacy program, attitude, subjective norm, perceived behavior control, intention, exclusive breastfeeding behavior.Correspondence: Valentina Dili Ariwati. Masters Program in Public Health, Sebelas Maret University.Journal of Health Promotion and Behavior (2016), 1 (3): 149-159https://doi.org/10.26911/thejhpb.2016.01.03.02

Health Belief Model: Determinants of Hypertension Prevention Behavior in Adults at Community Health Center, Sukoharjo, Central Java Setiyaningsih, Ratna; Tamtomo, Didik; Suryani, Nunuk
Journal of Health Promotion and Behavior Vol. 1 No. 3 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: According the WHO the estimated of age standarized prevalence of High blood presure in adults age 25+ years in Indonesia in 2008 was 42.7% in men and 39.2% in women. Hypertension deaths in Indonesia reached 42.226 or 3.02% of total deaths in 2014. Age-adjusted death rate was 25.26 per 100.000 of population (ranked 29 in the world). The prevalence of hypertension in Sukoharjo, Central Java, was 36.827 cases in 2015. This study aimed to examine the determinants hypertension prevention behavior using Health Belief Model.Subjects and Method: This was an analytic and observational study with cross sectional design. This study was conducted in Sukoharjo, Central Java, Indonesia, from September to October 2016. A total of 160 patients visiting Sukoharjo Community Health Center, Sukoharjo, Central Java, was selected for this study by simple random sampling. The sample consisted of 83 (51.9%) patients aged <35 years and 77 (48.1%) patients aged ≥35 years. The exogenous variables were perceived vulnerability, perceived seriousness, cues to action, perceived benefits, perceived barrier, and self efficacy. The endogenous variables were perceived threat and hypertension prevention behavior. The data were collected by questionnaire and analyzed by path analysis.Results: The path model showed goodness of fit with indices as follows: CMIN= 9.03, p=0.172, GFI= 0.99, NFI= 0.99, CFI= 1.00, and RMSEA= 0.06. Self-efficacy (b= 0.11; p<0.001; β=0.31), perceived benefit (b=0.12; p=0.005), and perceived threat (b=-0.10; p<0.001), had positive and statistically significant effect on hypertension prevention behavior. Perceived barrier (b=-0.10; p<0.001) had negative and statistically significant effect on hypertension prevention behavior. Perceived vulnerability (b=0.35; p<0.001), perceived of seriousness (b=0.48; p<0.001), and cues to action (b=0.33; p<0.001) had indirect positive effects on hypertension prevention behavior.Conclusion: Self-efficacy, perceived benefit, and perceived threat, have positive effect on hypertension prevention behavior. Perceived barrier have negative effect on hypertension prevention behavior. Perceived vulnerability, perceived of seriousness, and cues to action have indirect positive effects on hypertension prevention behavior.Keyword: hypertension, prevention behavior, health belief model.Correspondence: Ratna Setyaningsih. School of Nursing Bhakti Mulia, Sukoharjo, Central Java. Email: ratnaa_ zeitiyanie@yahoo.co.id.Journal of Health Promotion and Behavior (2016),1(3): 161-171https://doi.org/10.26911/thejhpb.2016.01.03.03

Health Belief Model for the Analysis of Factors Affecting Hypertension Preventive Behavior among Adolescents in Surakarta Puspita, Rumeyda Chitra; Tamtomo, Didik; Indarto, Dono
Journal of Health Promotion and Behavior Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Hypertension is an important public health issue in developed and developing countries. The incidence of hypertension continues to rise to a serious level. Raising awareness of the seriousness of hypertension among peer groups may be an important factor for preventive health behavior. This study aimed to examine the used of health belief model for the analysis of factors affecting hypertension preventive behavior among adolescents.Subjects and Method: This study was an observational analytic study with cross sectional design. It was conducted at 5 Vocational High Schools (SMK) in Surakarta from April to May, 2017. A sample of 200 class X and XI SMK students aged 15-17 years was selected for this study by stratified random sampling. The dependent variable was hypertension ÃÂ preventive behavior. The independent variables were perceived susceptibility, perceived seriousness, perceived benefit, perceived barriers, cues to action, and self efficacy, with perceived threat as a mediating variable. The data were collected by a set of pre-tested questionnaire. Path analysis was employed for data analysis using SPSS AMOS 22.Results: Perceived threat (b=0.24, SE=0.07, p=0.002), perceived benefit (b=0.24, SE=0.10, p=0.021), self efficacy (b=0.40, SE=0.23, p=0.084), and cues to action (b=0.45, SE=0.15, p=0.003) showed direct positive effects on hypertension preventive behavior. Perceived barrier (b=-0.26, SE=0.10, p=0.015) showed direct negative effect on hypertension preventive behavior. Perceived susceptibility (b= 0.27, SE= 0.09, p=0.005), perceived seriousness (b=0.29, SE=0.09, p<0.001), and cues to actionÃÂ (b=0.34, SE=0.13, p=0.008) showed indirect positive effects on hypertension preventive behavior.Conclusion: Hypertension preventive behavior is positively and directly affected by perceived threat, perceived benefit, self, and cues to action. The preventive behavior is negatively and directly affected by perceived barrier. Perceived susceptibility, perceived seriousness, and cues to action indirectly and positively affect on hypertension preventive behavior.Keywords: health belief model, hypertension, preventive behavior, adolescentsCorrespondence: Rumeyda Chitra Puspita. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: rumeydacp@gmail.com. Mobile: +6287736044472.Journal of Health Promotion and Behavior (2017), 2(2): 183-196https://doi.org/10.26911/thejhpb.2017.02.02.08

Effect of Sexual Knowledge and Attitude, Exposure to Electronic Media Pornography, Peer Group, and Family Intimacy, on Sexual Behaviors among Adolescents in Surakarta Wardhani, Yeni; Tamtomo, Didik; Demartoto, Argyo
Journal of Health Promotion and Behavior Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Globalization has tremendous impact on adolescent behaviors, including sexual behavior. Sexual behaviors that exceed socially accepted norms may result in undesireable impact adolescent health. Many factors can affect the sexual behavior of adolescents, both from within and from outside the adolescent self. This study aimed to investigate the effect of sexual knowledge and attitude, exposure to electronic media pornography, peer group, and family intimacy, on sexual ÃÂ behaviors among adolescents.Subjects and Method: This was an analytic observational study using cross-sectional design. The study was conducted at SMA Negeri Kota Surakarta, Central Java, from March to April 2017. A sample of 100 students were selected for this study by multi-stage sampling. The dependent variable was sexual behaviour. The independent variables were sexual knowledge, attitude toward sex, exposure to electronic pornography, peer group, and family intimacy. The data were collected by a set of pre-tested questionnaire. Path analysis was employed for data analysis.Results: Adolescent sexual behavior was affected by sexual knowledge (b=0.16; SE=0.05; p=0.006), attitude toward sex (b=0.18; SE=0.06; p= 0.005), exposure to electronic pornography (b=-0.13; SE=0.05; p=0.026), peer group (b=0.06; SE=0.03; p= 0.042), and family intimacy (b=0.07; SE=0.03; p=0.038). Sexual knowledge was affected by exposure to electronic pornography (b=-0.20; SE=0.09; p=0.037), and peer group (b=0.14; SE=0.05; p=0.005). Attitude toward sex was affected by exposure to electronic pornography (b=-0.21; SE=0.08; p=0.013), sexual knowledge (b=0.14; SE=0.08; p=0.110), and group (b=0.12; SE=0.05; p=0.009).ÃÂ Conclusion: Sexual behavior of adolescents is directly affected by their sexual knowledge, attitude toward sex, exposure to electronic pornography, peer group, and family intimacy.Keywords: sexual behavior, exposure to electronic pornography, PRECEDE PROCEED model, path analysisCorrespondence:ÃÂ Yeni Wardhani. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: ynwardhani@gmail.com. Mobile: +6285244390776.Journal of Health Promotion and Behavior (2017), 2(2): 138-147https://doi.org/10.26911/thejhpb.2017.02.02.04

Factors Associated with Healthy Preventive Behavior among the Elderly in Lamongan, East Java Jannah, Nurul; Tamtomo, Didik; Soemanto, RB
Journal of Health Promotion and Behavior Vol 3, No 4 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Health promotion behaviors in the elderly have potential effects in promoting health and quality of life and reducing the cost of health care services. Changes in the lifestyle of the people affected by cardiovascular diseases have more potential shares in reducing vascular problems than medicinal treatments of hypertension and high cholesterol. By convincing more people to maintain and obtain healthy lifestyles, there will be considerable reduction in emergence and disabilities due to cardiac problems. This study aimed to determine factors associated with health preventive behavior among the elderly in Lamongan, East Java.Subjects and Method: This was a cross sectional study conducted in Lamongan, East Java, from November to December 2018. A sample of 200 elderly was selected by stratified random sampling. The dependent variable was health behavior. The independent variables were education, attitude, peer support, family support, cadre support, perceived behavioral control, subjective norm, and intention. The data were collected by questionnaire and analyzed by a multiple linear regression.Results: Health behavior in elderly was influenced by education (b = 0.76; 95% CI = 0.27 to 1.24; p = 0.002), intention (b= 0.08; 95% CI = 0.01 to 0.16; p = 0.033), attitude (b = 0.20; 95% CI = 0.07 to 0.33; p= 0.002), perceived behavioral control (b= 0.18; 95% CI= 0.06 to 0.30; p= 0.002), family support (b = 0.19 ; 95% CI = 0.08 to 0.30; p = 0.001), cadre support (b = 0.13; 95% CI = 0.04 to 0.23; p = 0.005), peer support (b = 0.07; 95% CI = - 0.01 to 0.15; p = 0.060), and subjective norm (b = 0.10; 95% CI = - 0.01 to 0.22; p = 0.064).Conclusion: Health behavior in elderly is influenced by education, intention, attitude, perceived behavioral control, family support, cadre support, peer support, and subjective norm.Keywords: health behavior, elderly, linear regressionCorrespondence: Nurul Jannah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: njannah.31@gmail.com. Mobile: +6282230300405.Journal of Health Promotion and Behavior, 2018, 3(4): 223-229https://doi.org/10.26911/thejhpb.2018.03.04.01

Theory of Planned Behavior Implementation on the Factors Affecting Self-Care Management in Type 2 Diabetes Mellitus Patients Damayanti, Ana; Tamtomo, Didik; Indarto, Dono
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: Diabetes mellitus (DM) is one of the largest global health emergencies in the 21st century. Diabetes self-management education (DSME) is a continuous process of knowledge transfer in order to improve skill and ability of diabetic patient to perform self-care management, which reduces blood glucose level and prevent diabetic complications. The success of DSME is determined by behavior changes of diabetic patients, which can be assessed using behavior theories including Theory of Planned Behavior (TPB). This study aimed to analyze the factors affecting self-care management in patients with type 2 DM using TPB.Subjects and Method: A randomized controlled trial study was carried out in 7 community health centers in Tarakan City, North Kalimantan, from March to May, 2018. A sample of 126 type 2 DM patients was selected by simple random sampling. The dependent variable was self-care management. The independent variables were intention, attitude, subjective norm, self-efficacy, and education level. The data was collected by questionnaire and analyzed by path analysis.Results: Self-care management was positively and directly affected by education ?senior high school (b= 7.10; SE= 3.22; p= 0.028) and strong intention (b= 2.40; SE= 0.75; p= 0.001). Self-care management was indirectly affected by self-efficacy, attitude, and subjective norm trough intention.Conclusion: Self-care management in type 2 DM is directly affected by education and strong intention. These findings support the TPB implementation in self-care management.Keywords: self- care management, type 2 DM, Theory of Planned BehaviorCorrespondence:Ana Damayanti. Faculty of Health Science, Universitas Borneo Tarakan, Jl. Amal Lama 1, Tarakan 77115, North Kalimantan. Email: damayanti.titha@gmail.com. Mobile: +6281347727774.Journal Health Promotion and Behavior (2018), 3(2): 139-145https://doi.org/10.26911/thejhpb.2018.03.02.08

Path Analysis on the Effectiveness of Chronic Disease Prevention Program using Health Belief Model Aprilia, Nafi?ah; Tamtomo, Didik; Sulaeman, Endang Sutisna
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: Chronic disease prevention program is a proactive health service system on chronic diseases which can affect hypertension control. This study aimed to determine the effect of the chronic disease prevention program and the construction of the Health Belief Model (HBM) on the prevention of elderly hypertension with path analysis method.Subjects dan Method: This study used observational analytical study with retrospective cohort study approach. This study was conducted in four community health centers in Ngawi Regency, East Java, in April-May 2019. The total sample of 200 elderly aged 60-74 years was divided into2 groups, such as group which participated in chronic disease prevention program(case) and the group which did not participate in chronic disease prevention program(control) based on fixed exposure sampling. The dependent variable of this study was hypertension control. The independent variables in this study were participants in a chronic disease prevention program, perceived vulnerability, perceived seriousness, perceived benefits, perceived barriers, cues to action, and self-efficacy. Variable data collection used questionnaires and analyzed using path analysis.Results: Hypertension control was directly and positively affected by chronic disease prevention program(b= 2.85; 95%CI= 0.48 to 5.22; p= 0.018), perceived vulnerability (b= 1.35; 95%CI= 0.16 hingga 2.53; p= 0.025), perceived seriousness (b= 0.83; 95%CI= 0.04 to 1.62; p= 0.039), and self-efficacy (b= 0.99; 95%CI= 0.14 to 1.85; p= 0.023). Hypertension control was indirectly affected by perceived benefits, perceived barriers, and cues to action.Conclusion: Hypertension control in the elderly is directly and positively affected by participation in chronic disease prevention program, perceived vulnerability, perceived seriousness, and self-efficacy. Hypertension control is indirectly affected by perceived benefits, perceived barriers, and cues to action.Keywords: Hypertension, chronic disease, prevention, Health Belief Model, path analysisCorrespondence: Nafi?ah Aprilia. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: nafiahlia@gmail.com. Mobile: 082230766393Journal of Health Promotion and Behavior (2019), 4(2): 85-97https://doi.org/10.26911/thejhpb.2019.04.02.01

Path Analysis: Application of Health Belief Model on the Determinants of Clean and Healthy Behavior among Elderly with Hypertension Imtichan, Septian Najib; Tamtomo, Didik; Sulaeman, Endang Sutisna
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: Lifestyle or behavioral factors critically determine high blood pressure in individuals. Elderly with hypertension in Indonesia aged 55-64 years by 45.9%, 65-74 years by 57.6%, and > 75 years by 63.8%. This study aimed to examine factors affecting healthy behavior in elderly with hypertension using the health belief model.Subjects and Method: This was a cross-sectional study conducted in Ngawi, East Java, from June to July 2019. A sample of 200 elderly was selected by multistage random sampling. The dependent variable was clean and healthy behavior. The independent variables were perceived susceptibility, perceived severity, perceived benefit, cues to action, self-efficacy, knowledge, attitude, and access to health service. The data were collected by questionnaire and analyzed by path analysis.Results: Clean and healthy behavior was positively and directly affected by self-efficacy (b= 1.51; 95% CI= 0.29 to 2.74; p= 0.015), attitude (b= 2.37; 95% CI = 1.17 to 3.56; p<0.001) , cues for action (b = 2.48; 95% CI= 1.11 to 3.86; p <0.001), perceived susceptibility (b= 2.07; 95% CI= 0.89 to 3.26; p= 0.001), perceived severity (b= 1.76; 95% CI= 0.54 to 2.99; p= 0.005), perceived benefit (b= 1.47; 95% CI= 0.36 to 2.57; p = 0.009), and access to health services (b= 2.26; 95% CI= 1.00 to 3.53; p<0.001). Clean and healthy behavior was indirectly affected by knowledge.Conclusion: The clean and healthy lifestyle behavior of the elderly is directly affected by the perceived vulnerability, perceived severity, perceived benefits, cues to act, self-efficacy, attitudes, and access to health services. Clean and healthy behavior is affected by knowledge.Keywords: clean and healthy behavior, elderly, health belief model, path analysisCorrespondence:Septian Najib Imtichan. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 54176, Central Java. Email: septianimtichan@gmail.com.Mobile: +6285229799672Journal of Health Promotion and Behavior (2019), 4(2): 110-120https://doi.org/10.26911/thejhpb.2019.04.02.03

Path Analysis on the Effectiveness of Exclusive Breastfeeding Advocacy Program on Breastfeeding Practice using Theory of Planned Behavior Ariwati, Valentina Dili; Tamtomo, Didik; Sulaeman, Endang Sutisna
Journal of Health Promotion and Behavior Vol. 1 No. 3 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Exclusive breastfeeding coverage was 52.30% in 2015, which was below the national target of 80%. For the past few years Klaten local government has launched the Exclusive Breastfeeding Advocacy Program with the objective to increase exclusive breastfeeding coverage. This study aimed to determine the effectiveness of Exclusive Breastfeeding Advocacy Program using Theory of Planned Behaviour framework.Subjects and Method: This was an analytic observational study with retrospective cohort design. This study was conducted from 2 August to 16 September 2016 in Klaten and Magelang, Central Java, Indonesia. A total of 200 lactating mothers of infants aged 6 to 12 months was selected for this study by multi-stage random sampling. The dependent variables were exclusive breastfeeding and intention. The independent variables were exclusive breastfeeding advocacy program, attitude, subjective norm, and perceived behavior control. The data were collected using a set of questionnaire, and analyzed by path analysis.Results: The path model showed Goodness of Fit indices as follows: CMIN=4.24, p=0.374, GFI=0.99, NFI=0.99, CFI=1.00, RMSEA=0.017. Strong intention (b=0.15; p <0.001) had direct effect on exclusive breastfeeding. Positive atittude (b = 0.27; p<0.001), positive subjective norm (b=0.26; p <0.001), strong perception of behavior control (b=0.25; p<0.001), and exclusive breastfeeding advocacy program (b=0.36; p<0.001), had positive effects on intention.Conclusion: Intention has direct effect on exclusive breastfeeding. Atittude toward exclusive breastfeeding, subjective norm, and perception of behavior control, have positive effects on intention. Exclusive breastfeeding advocacy program is effective in increasing the likelihood of providing exclusive breastfeeding.Keywords: exclusive breastfeeding advocacy program, attitude, subjective norm, perceived behavior control, intention, exclusive breastfeeding behavior.Correspondence: Valentina Dili Ariwati. Masters Program in Public Health, Sebelas Maret University.Journal of Health Promotion and Behavior (2016), 1 (3): 149-159https://doi.org/10.26911/thejhpb.2016.01.03.02

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