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Endah Puji Astuti, Endah Puji
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Health belief model in pregnant women in the free nutritional meal program: a review Rosdiana; Utami, Nendhi Wahyunia; Sunarsih, Tri; Astuti, Endah Puji; Shanti, Elvika Fit Ari
MEDIA ILMU KESEHATAN Vol 14 No 2 (2025): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v14i2.1646

Abstract

Background: Stunting is still a serious problem in Indonesia, one of which is caused by malnutrition since pregnancy.Objective: To systematically identify and map the use of HBM in understanding pregnant women's compliance with nutritional intervention programs, especially free nutritious meals.Methods: This scoping review was conducted based on the Arksey and O'Malley framework and followed the PRISMA-ScR guidelines. The literature was searched through the PubMed, ScienceDirect, and Google Scholar databases in 2018–2025. The studies reviewed were original studies with a quantitative, qualitative, or mixed methods approach that used HBM in pregnant women.Results: From 12 selected studies, it was found that HBM components such as perceived benefits, barriers, and cues to action had a significant effect on the nutritional behavior of pregnant women. Driving factors include culture-based education, family support, and the use of educational media. Meanwhile, the main barriers include economic constraints, food access, and cultural norms.Conclusion: HBM effectively understands pregnant women's behavior in the free nutritious meal program. HBM-based educational interventions integrated with community approaches and digital technology are recommended to improve the program's effectiveness.
Sosialisasi dan Pelatihan Pembuatan PMBA Sebagai Upaya Pencegahan Stunting di Kalurahan Demangrejo Kulon Progo linda, yulinda; Sunarsih, Tri; Sunarsih, Kharisma; Damayanti, Rizki Wahyuning; Astuti, Endah Puji; Ari shanti, Elvika Fit
The Journal of Innovation in Community Empowerment Vol 7 No 1 (2025): Journal of Innovation in Community Empowerment (JICE)
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/jice.v7i1.1551

Abstract

Stunting merupakan salah satu masalah gizi yang masih menjadi isu, baik di dunia maupun di Indonesia. Salah satu faktor risiko stunting adalah asupan gizi yang kurang berupa rendahnya kadar protein, vitamin dan mineral yang ada dalam makanan yang dikonsumsi oleh bayi maupun balita. Oleh karena itu pemerintah membuat program untuk mengatasi stunting dengan memberikan Pemberian Makan Bayi dan Anak (PMBA) yang dikelola oleh petugas kesehatan yang bekerjasama dengan kader kesehatan. Sosialisasi dan pelatihan pembuatan PMBA ini dilaksanakan untuk meningkatkan pengetahuan dan keterampilan dalam pembuatan PMBA yang lebih bervariatif dengan memperhatikan nilai gizi untuk balita.  Pengabdian kepada msyarakat ini telah dilaksanakan di Kalurahan Demangrejo Kulon Progo pada Kelompok Wanita Tani (KWT). Jumlah peserta yang berpartisipasi pada kegiatan ini sejumlah 30 orang. Peserta berusia > 35 tahun dengan pendidikan terbanyak SMA. Evaluasi pengetahuan dilakukan dengan melakukan pretest dan posttest dengan hasil rata-rata pengetahuan tentang nutrisi balita pada saat pretest 4,27, sedangkan rata-rata pengetahuan pada saat posttest 9,29. Oleh karena itu, dengan adanya peningkatan pengetahuan tentang nutrisi balita dan pembuatan PMBA dari nilai rata-rata pretest dan posttes, selain itu keberhasilan dalam pembuatan olahan makanan dapat diaplikasikan untuk mendukung program pemberian makanan tambahan bagi balita stunting
The influence of trust and social norms on the utilization of health service access in pregnant women Sunarsih, Tri; Astuti, Endah Puji; Shanti, Elvika Fit Ari
MEDIA ILMU KESEHATAN Vol 14 No 2 (2025): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v14i2.1721

Abstract

Background: Maternal health is a crucial aspect of pregnancy, requiring adequate healthcare access to ensure the well-being of both mother and fetus. However, various social, cultural, and economic factors influence healthcare utilization among pregnant women.Objective: This study aims to analyze the impact of trust and social norms on healthcare access among pregnant women in Ngalang, Gedangsari, Gunungkidul.Methods: A quantitative approach was employed using multiple regression analysis, with healthcare access as the dependent variable and trust and social norms as independent variables. Data were collected from mothers with young children (0–6 years) through a structured questionnaire. Descriptive statistics and classical assumption tests were conducted to ensure data validity.Results: The results indicate that most respondents (76.3%) have high levels of trust and adherence to social norms, which significantly influence their utilization of healthcare services. The regression analysis shows a positive and significant relationship between trust, social norms, and healthcare access, with a determination coefficient (R²) of 19.4%.Conclusion: This suggests that while trust and social norms contribute to healthcare utilization, other factors also play a role. Additionally, traditional beliefs and limited health literacy may hinder healthcare access despite high trust levels.
Faktor-faktor yang berkontribusi terhadap akses pelayanan kesehatan Sunarsih, Tri; Astuti, Endah Puji; Shanti, Elvika Fit Ari
Holistik Jurnal Kesehatan Vol. 19 No. 6 (2025): Volume 19 Nomor 6
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i6.943

Abstract

Background: Equitable access to health services is a crucial factor in improving public welfare. However, obstacles remain in the distribution of health services, especially for marginalized groups and communities in remote areas. Purpose: To analyze factors contributing to access to health services. Method: Quantitative research using a multiple regression analysis approach was used to analyze the influence of government policies and regulations, as well as social support, on access to health services. Data were collected through questionnaires from mothers of toddlers in Ngalang Village, Gunungkidul, using a simple random sampling technique. Data analysis included descriptive statistics, classical assumption tests (normality, multicollinearity, heteroscedasticity, autocorrelation), and multiple regression. F-tests, t-tests, and the coefficient of determination (R²) were used to test the significance of the influence and the ability of the independent variables to explain the dependent variable. Results: Government policies and social support significantly influence access to health services, with a significance value of 0.000 and a variable contribution of 58.2%. Conclusion: A combination of effective policies and strong social support can improve public access to health services. Therefore, more adaptive policies and collaboration between the government, communities, and the private sector are needed to support a more inclusive and sustainable health system. Suggestion: The government needs to develop more adaptive policies based on community needs and optimize the health care administration system to make it more efficient and accessible. Increasing the number of medical personnel and developing health care infrastructure, especially in underdeveloped areas, must be a top priority to ensure equitable and quality health care.   Keywords: Access; Government Policy; Health Services; Social Support.   Pendahuluan: Akses terhadap pelayanan kesehatan yang merata merupakan faktor penting dalam meningkatkan kesejahteraan masyarakat. Namun, masih terdapat tantangan dalam pemerataan layanan kesehatan, terutama bagi kelompok marginal dan masyarakat di daerah terpencil. Tujuan: Untuk menganalisis faktor-faktor yang berkontribusi terhadap akses pelayanan kesehatan. Metode: Penelitian kuantitatif dengan pendekatan analisis regresi berganda untuk menganalisis pengaruh kebijakan dan regulasi pemerintah serta dukungan sosial terhadap akses pelayanan kesehatan. Data dikumpulkan melalui kuesioner dari ibu yang memiliki anak usia dini di Desa Ngalang, Gunungkidul, dengan teknik simple random sampling. Analisis data meliputi statistik deskriptif, uji asumsi klasik (normalitas, multikolinearitas, heteroskedastisitas, autokorelasi), serta regresi berganda. Uji F, uji t, dan koefisien determinasi (R²) digunakan untuk menguji signifikansi pengaruh dan kemampuan variabel independen dalam menjelaskan variabel dependen. Hasil: Kebijakan pemerintah dan dukungan sosial berpengaruh signifikan terhadap akses pelayanan kesehatan dengan nilai signifikansi 0.000 dan kontribusi variabel sebesar 58.2%. Simpulan: Kombinasi kebijakan yang efektif dan dukungan sosial yang kuat dapat meningkatkan akses masyarakat terhadap layanan kesehatan. Oleh karena itu, diperlukan kebijakan yang lebih adaptif dan kolaborasi antara pemerintah, komunitas, serta sektor swasta dalam mendukung sistem kesehatan yang lebih inklusif dan berkelanjutan. Saran: Pemerintah perlu mengembangkan kebijakan yang lebih adaptif dan berbasis kebutuhan masyarakat serta mengoptimalkan sistem administrasi layanan kesehatan agar lebih efisien dan mudah diakses. Peningkatan jumlah tenaga medis dan pengembangan infrastruktur kesehatan, terutama di daerah tertinggal, harus menjadi prioritas utama guna memastikan layanan kesehatan yang merata dan berkualitas   Kata Kunci: Akses; Dukungan Sosial; Kebijakan Pemerintah; Layanan Kesehatan.
Faktor-faktor berhubungan dengan pola asuh holistik Sunarsih, Tri; Astuti, Endah Puji; Shanti, Elvika Fit Ari
Holistik Jurnal Kesehatan Vol. 19 No. 7 (2025): Volume 19 Nomor 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i7.944

Abstract

Background: Holistic parenting is a comprehensive parenting approach, encompassing a child's physical, emotional, social, and spiritual aspects. In Indonesia, the success of this parenting style is still influenced by access to information, social norms, and environmental support. Purpose: To analyze the influence of health information and education, social norms, and social support on holistic parenting among mothers of young children. Method: A quantitative approach with multiple regression analysis was used. The sample consisted of 337 mothers in Ngalang Village, Gedangsari, Gunungkidul, selected using simple random sampling, and data were collected using a questionnaire. Data analysis included descriptive statistics, classical assumption tests (normality, multicollinearity, heteroscedasticity, autocorrelation), and multiple regression. The F test, t test, and coefficient of determination (R²) were used to measure the simultaneous and partial effects between variables on holistic parenting. Results: The three independent variables simultaneously had a significant effect on holistic parenting, with a significance value of 0.000 and a contribution of 45.3%. Social support was the most dominant factor influencing holistic parenting. Conclusion: These findings indicate that promoting optimal holistic parenting requires strengthening health education, establishing supportive social norms, and establishing a strong social support system. Practical implications include the need for integrated and sustainable community-based interventions to support healthy and holistic parenting. Suggestion: Conduct further research with a broader population and a more qualitative approach to further explore the factors influencing parenting and develop sustainable policies to support the sustainability of holistic parenting, particularly for socially and economically vulnerable groups.   Keywords: Health Education; Holistic Parenting; Mother-Child; Social Norms; Social Support.   Pendahuluan: Pola asuh holistik merupakan pendekatan pengasuhan yang menyeluruh, mencakup aspek fisik, emosional, sosial, dan spiritual anak. Di Indonesia, keberhasilan pola asuh ini masih dipengaruhi oleh akses informasi, norma sosial, dan dukungan lingkungan. Tujuan: Untuk menganalisis pengaruh informasi dan edukasi kesehatan, norma sosial, dan dukungan sosial terhadap pola asuh holistik ibu yang memiliki anak usia dini. Metode: Menggunakan pendekatan kuantitatif dengan analisis regresi berganda. Sampel terdiri dari 337 ibu di Desa Ngalang, Gedangsari, Gunungkidul, yang dipilih secara simple random sampling dan data dikumpulkan menggunakan kuesioner. Analisis data mencakup statistik deskriptif, uji asumsi klasik (normalitas, multikolinearitas, heteroskedastisitas, autokorelasi), serta regresi berganda. Uji F, uji t, dan koefisien determinasi (R²) digunakan untuk mengukur pengaruh simultan dan parsial antar variabel terhadap pola asuh holistik. Hasil: Ketiga variabel independen tersebut secara simultan berpengaruh signifikan terhadap pola asuh holistik dengan nilai signifikansi 0.000 dan kontribusi sebesar 45.3%. Dukungan sosial merupakan faktor yang paling dominan memengaruhi pola asuh holistik. Simpulan: Untuk mendorong pola asuh holistik yang optimal, diperlukan penguatan edukasi kesehatan, pembentukan norma sosial yang mendukung, serta sistem dukungan sosial yang kuat. Implikasi praktisnya adalah perlunya intervensi berbasis komunitas yang terintegrasi dan berkelanjutan untuk mendukung pengasuhan anak yang sehat dan holistik. Saran: Melakukan penelitian lanjutan dengan cakupan populasi yang lebih luas serta pendekatan yang lebih kualitatif agar dapat menggali lebih dalam faktor-faktor yang berperan dalam pola asuh dan pengembangan kebijakan yang berkelanjutan untuk mendukung keberlangsungan pola asuh holistik, khususnya bagi kelompok yang rentan secara sosial dan ekonomi.   Kata Kunci: Dukungan Sosial; Edukasi Kesehatan; Ibu-Anak; Norma Sosial; Pola Asuh Holistik.
Pembuatan Sabun Biji Alpukat Sebagai Solusi Ramah Lingkungan Dan Pemberdayaan Ekonomi Masyarakat Di Kalurahan Sumberwungu, Gunung Kidul, Yogyakarta Larasati, Dwi; Rahayu, Budi; Viyani, Ari Okta; Sunarsih, Tri; Sarmin, Sarmin; Airin, Claude Mona; Soffan, Alan; Astuti, Endah Puji; Shanti, Elvika Fit Ari
Sehati Abdimas Vol 7 No 1 (2024): Prosiding Sehati Abdimas 2024
Publisher : PPPM POLTESA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47767/sehati_abdimas.v7i1.918

Abstract

Avocado seeds, often regarded as waste, have significant potential as an alternative raw material for producing environmentally friendly products, such as natural soap. These seeds contain beneficial active compounds, including antioxidants, unsaturated fatty acids, and vitamin E, which contribute to skin health. This community service program aims to train the residents of Sumberwungu Village, Gunung Kidul, Yogyakarta, in making soap using avocado seeds as the primary ingredient through the cold process method. The program’s objectives are not only to reduce waste but also to enhance the community's skills in producing high-quality soap that can be marketed as a local product with economic value. It is hoped that through this training, participants will be able to utilize avocado seeds to create soap with skin benefits, opening new economic opportunities for small businesses. The results of the community service activities indicated that the participants welcomed the initiative enthusiastically and actively engaged in the training process. Evaluations revealed a significant improvement in participants’ pretest and posttest scores, demonstrating a better understanding of the soap-making process and its applications. Furthermore, participants were directly involved in soap production using an effective cold saponification technique. This avocado seed soap shows promising market potential. Overall, the program not only offers economic benefits but also raises public awareness of the importance of waste management and environmental sustainability.
Proximate Analysis: Content of Red Dragon Fruit Peel Astuti, Endah Puji; Susanti, Dwi; Suwarno, Suwarno
Disease Prevention and Public Health Journal Vol. 19 No. 2 (2025): Disease Prevention and Public Health Journal
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/dpphj.v19i2.12512

Abstract

Background: The dragon fruits have the beneficial, including antioxidants, anti-inflammatory, antimicrobial, properties, blood sugar regulation, and can be used as an ingredient in cosmetics. The purpose of the study was to identify the active compunds contains in Dragon fruits peels using proximate analysis approach. Method: In this study, The proximate analysis was used to measure the contents of water, materials, protein, fat, carbohydrate, crude fiber, energy, Fe, vitamin C and E content, and beta carotene content in the laboratory process. Results: The proximate test results showed that the moisture content of dragon fruit peel flour was 6.3732% - 6.5158%, ash content was 4.8069% - 4.6173%, protein content was 9.2396% - 9.4276%, fat content was 0.4807% - 0.3646%, carbohydrate content was 28.5208% - 28.4530%, crude fiber content was 50, 5788% - 50.6217%, energy content 238.5314 cal/100g - 238.4489 cal/100g, mineral content 2.8993 mg/100g - 2.8747 mg/100g, vitamin C content 16.9835 mg/100g - 25.4752 mg/100g, beta carotene content 5.4672 μg/100g - 4.7922 μg/100g. Conclusion: Research shows that dragon fruit peelc contains various nutrients and bioactive compounds that are beneficial for health Background: The dragon fruits have the beneficial, including antioxidants, anti-inflammatory, antimicrobial, properties, blood sugar regulation, and can be used as an ingredient in cosmetics. The purpose of the study was to identify the active compunds contains in Dragon fruits peels using proximate analysis approach. Method: In this study, The proximate analysis was used to measure the contents of water, materials, protein, fat, carbohydrate, crude fiber, energy, Fe, vitamin C and E content, and beta carotene content in the laboratory process. Results: The proximate test results showed that the moisture content of dragon fruit peel flour was 6.3732% - 6.5158%, ash content was 4.8069% - 4.6173%, protein content was 9.2396% - 9.4276%, fat content was 0.4807% - 0.3646%, carbohydrate content was 28.5208% - 28.4530%, crude fiber content was 50, 5788% - 50.6217%, energy content 238.5314 cal/100g - 238.4489 cal/100g, mineral content 2.8993 mg/100g - 2.8747 mg/100g, vitamin C content 16.9835 mg/100g - 25.4752 mg/100g, beta carotene content 5.4672 μg/100g - 4.7922 μg/100g. Conclusion: Research shows that dragon fruit peelc contains various nutrients and bioactive compounds that are beneficial for health
Pendidikan pranikah sebagai upaya pencegahan risiko reproduksi dan pendewasaan usia nikah: A scoping review Yulinda, Dwi; Anggawijayanto, Erydani; Ekawati, Ekawati; Sunarsih, Tri; Astuti, Endah Puji; Shanti, Elvika Fit Ari
Holistik Jurnal Kesehatan Vol. 19 No. 8 (2025): Volume 19 Nomor 8
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i8.1035

Abstract

Background: Early marriage remains a global challenge that negatively impacts reproductive health and the quality of human resources. In Indonesia, the high rate of child marriage is an obstacle to achieving superior, healthy, and competitive human resources. Purpose: To examine premarital education as an effort to prevent reproductive risks and to promote maturity at marriageable age. Method: A systematic literature review using the Population, Concept, Context (PCC) framework was conducted. The literature was searched through databases such as PubMed and Google Scholar for articles relevant to premarital education and reproductive health from 2018–2025. Results: Of the eight studies analyzed, premarital education was proven effective in increasing brides' knowledge about reproductive health, nutrition, and marriage readiness. Interventions included classes at religious affairs offices, school education, community seminars, and participatory models such as FOCUS–PDCA. Key barriers included cultural resistance, limited facilitators, and lack of contextual materials. Conversely, policy support, collaborative approaches, and interactive educational methods were important supporting factors. Conclusion: Premarital education has significant potential to reduce early marriage rates and improve the reproductive readiness of young couples. Adaptive implementation, based on local culture, and integrated with behavior change communication strategies, is essential for long-term effectiveness. Suggestion: Premarital education can be developed in a more adaptive and contextual manner by integrating participatory approaches, based on local culture, and easily accessible digital media. The program needs to be strengthened with behavior change communication strategies so that increased knowledge leads to changes in attitudes and actions.   Keywords: Early Marriage; Premarital Education; Reproductive Health.   Pendahuluan: Perkawinan usia dini masih menjadi tantangan global yang berdampak negatif terhadap kesehatan reproduksi dan kualitas sumber daya manusia. Di Indonesia, tingginya angka pernikahan anak menjadi salah satu hambatan dalam mencapai pembangunan SDM unggul, sehat, dan berdaya saing. Tujuan: Untuk mengkaji pendidikan pranikah sebagai upaya pencegahan risiko reproduksi dan pendewasaan usia nikah. Metode: Penelitian literatur sistematis dengan pendekatan scoping review, menggunakan kerangka kerja PCC (Population, Concept, Context). Literatur dicari melalui database seperti PubMed dan Google Scholar untuk artikel tahun 2018–2025 yang relevan dengan pendidikan pranikah dan kesehatan reproduksi. Hasil: Dari 8 studi yang dianalisis, pendidikan pranikah terbukti efektif meningkatkan pengetahuan calon pengantin tentang kesehatan reproduksi, gizi, dan kesiapan pernikahan. Intervensi dilakukan dalam bentuk kelas KUA, edukasi sekolah, seminar komunitas, hingga model partisipatif seperti FOCUS–PDCA. Hambatan utama mencakup resistensi budaya, keterbatasan fasilitator, dan materi kurang kontekstual. Sebaliknya, dukungan kebijakan, pendekatan kolaboratif, dan metode edukatif interaktif menjadi faktor pendukung penting. Simpulan: Pendidikan pranikah berpotensi besar dalam menurunkan angka pernikahan usia dini dan meningkatkan kesiapan reproduksi pasangan muda. Implementasi yang adaptif, berbasis budaya lokal, dan terintegrasi dengan strategi komunikasi perubahan perilaku sangat dibutuhkan untuk efektivitas jangka panjang. Saran: Pendidikan pranikah dapat dikembangkan secara lebih adaptif dan kontekstual dengan mengintegrasikan pendekatan partisipatif, berbasis budaya lokal, dan media digital yang mudah diakses. Program perlu diperkuat dengan strategi komunikasi perubahan perilaku agar peningkatan pengetahuan berlanjut pada perubahan sikap dan tindakan.   Kata Kunci: Kesehatan Reproduksi; Pendidikan Pranikah; Pernikahan Dini.
Health Belief Model of Pregnant Women in Samarinda’s Free Nutritious Meal Program: The Role of Predisposing, Reinforcing, and Enabling Factors in Self-Efficacy Sunarsih, Tri; Rosdiana, Rosdiana; Utami, Nendhi Wahyunia; Astuti, Endah Puji; Shanti, Elvika Fit Ari
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 8 No. 12: DESEMBER 2025 - Media Publikasi Promosi Kesehatan Indonesia (MPPKI)
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v8i12.8659

Abstract

Introduction: Stunting remains a national health priority in Indonesia due to its long-term impact on human capital. One flagship government intervention under the National Strategy for Stunting Reduction 2018–2024 is the provision of free nutritious meals for pregnant women to improve maternal nutritional status and prevent stunting. However, adherence to this program varies widely, and previous studies have rarely examined psychosocial determinants based on behavioural health theories. Objective: This study aimed to analyse factors within the Health Belief Model (HBM), including perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy, alongside predisposing, reinforcing, and enabling factors that influence the self-efficacy of pregnant women participating in the free nutritious meal program in Samarinda City. Methods: A quantitative cross-sectional design was applied to 203 pregnant women enrolled in the free nutritious meal program between March and August 2024. Participants were selected purposively to ensure representation of diverse educational backgrounds, parity, and gestational ages according to predefined inclusion criteria. Data were collected using a structured questionnaire based on HBM dimensions, perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy, that had been validated and tested for reliability. Partial Least Squares–Structural Equation Modeling (PLS-SEM) was employed due to its suitability for analyzing complex latent constructs and small-to-moderate sample sizes, enabling simultaneous estimation of measurement and structural models. Results: Predisposing factors showed a strong effect on the HBM construct (? = 0.556). Reinforcing factors exerted a greater influence on self-efficacy (? = 0.228) compared with enabling factors (? = 0.142). The HBM construct itself contributed positively to the enhancement of self-efficacy (? = 0.244). The model demonstrated an SRMR of 0.074 (< 0.08), indicating acceptable model fit. Conclusion: Predisposing factors (knowledge, attitudes, and motivation) form the foundation of maternal health perceptions, while social support (reinforcing factors) plays a more dominant role than enabling factors in improving pregnant women’s self-efficacy. This first comprehensive application of the HBM to a free nutritious meal program in Samarinda provides new empirical evidence to guide the design of theory-based maternal nutrition interventions and supports Indonesia’s national stunting reduction efforts. Theoretically, the findings extend the HBM by demonstrating how contextual predisposing and reinforcing factors interact to strengthen self-efficacy within community-based nutrition programs. Practically, policymakers should integrate behavioral counseling and family involvement components into the free meal program to enhance motivation and sustained adherence among pregnant women. Future research should use longitudinal designs to assess long-term program effects and explore contextual factors influencing self-efficacy.
Co-Authors ., Ekawati A.S., Elvika Fit Abidah, Alief Nur Insyiroh Agus Subagio Alfatinnisa, Zalfa Andriyan, Mohammad Wahyu Anggawijayanto, Erydani Ari Shanti, Elvika Fit Astuti A., Tyasning Yuni Budi Rahayu, Budi Claude Mona Airin Dhian Endahwuri, Dhian Dwi Larasati, Dwi Dwi Susanti Ekawati Ekawati Elvika Fit Ari Shanti, Elvika Fit Ari Fara Adhiba, Fara Jaya, La Ode Irman Kharisma linda, yulinda Muhammad Erwan Syah Muhammad Habibi Nizaruddin Nizaruddin Purnamaningsih, Nur’Aini Rahangmetan, Maria Alda Rahmawati, Dechoni Rizki Wahyuning Damayanti Rosdiana Rosdiana Rosdiana Rukmi, Dwi Kartika Sahnti, Elvika Fit Ari Saputra, Muhammad Ragil Sarmin Sarmin Soffan, Alan Sri Isdadiyanto Sunarno Sunarno Sunarsih Sunarsih, Kharisma Suwarno Suwarno Suwarno Tri Sunarsih Tri Sunarsih Tri, Elvika Fit Ari Shanti Utami, Nendhi Wahyunia Viyani, Ari Okta Yulinda, Dwi