Rahardjo, Setyo Sri
Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Predictors of Macro and Microvascular Complication in Type 2 Diabetes Mellitus Patients at Dr. Moewardi Hospital, Surakarta Handoko, Handoko; Rahardjo, Setyo Sri; Murti, Bhisma
Indonesian Journal of Medicine Vol 3, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Type 2 Diabetes Mellitus (Type 2 DM) is one of the major causes of morbidity and mor­tality worldwide. Morbidity and mortality due to diabetes are associated with the development of various microvascular complications (retinopathy, nephropathy, and neuropathy) and macro­vascular complications (coronary heart disease, stroke, and peripheral vascular disease). This study aimed to examine the determinants of biopsychosocial macro and microvascular complications in pa­tients with type 2 DM at Dr. Moewardi Surakarta.Subjects and Method: This was an analytic observational with a case-control design. The study was conducted at Dr. Moewardi, Surakarta, Central Java, from January to March 2018. A sample of 75 Type 2 DM cases with complication and 75 Type 2 DM cases without complication was selected for this study by fixed disease sampling. The dependent variables were macro and microvascular com­plications. The independent variables were body mass index (BMI), blood pressure, quality of life, depression, duration of disease, physical activity, diet, medication adherence, health financing, and routine blood sample. Clinical data were taken from medical record. The data of other varia­bles were collected by a set of pre-tested questionnaire. Logistic regression was employed for data ana­lysis.Results: The risk of macro and microvascular complications in type 2 DM patients increased with high BMI (OR= 22.00; 95% CI= 7.50 to 64.52, p<0.001), poor quality of life (OR= 7.06; CI 95%= 3.51 to 14.16, p<0.001), depression (OR= 3.30; 95% CI= 1.39 to 7.79, p= 0.007), longer duration of disease (OR= 9.71; 95% CI= 2.79 to 33.71, p<0.001), lack of physical activity (OR= 8.16; 95% CI= 1.23 to 53.93, p=0.029), poor diet (OR= 3.58; 95% CI= 1.39 to 9.18, p=0.008), poor medication adherence (OR= 4.54; 95% CI= 1.71 to 12.05, p=0.002), and irregular blood sample control (OR= 5.80; 95% CI= 1.97 to 14.65, p=0.001).Conclusion: The risk of macro and microvascular complications in patients with type 2 DM is de­ter­mined by BMI, quality of life, depression, duration of disease, physical activity, diet, medication adhe­rence, and blood sample control.Keywords: biopsychosocial, macrovascular, microvascular, complications, type 2 DMCorrespondence: Handoko. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, Indonesia. Email: handhira83@yahoo.co.id. Mobile: +6285225591917.Indonesian Journal of Medicine (2018), 3(1): 1-13https://doi.org/10.26911/theijmed.2018.03.01.01
Biopsychosocial Determinants of Human Papilloma Virus Immunization in Women of Reproductive Age in Surakarta, Central Java Febriani, Gabriela Advitri; Rahardjo, Setyo Sri; Murti, Bhisma
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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Background: Cervical cancer ranks second as the cause of death in women worldwide. Cervical cancer is preventable by Human Papilloma Virus (HPV) immunization. It was hypothesized that use of HPV immunization is determined by biopsychosocial factors as involved in the Health Belief Model and Social Learning Theory. This study aimed to analyze the determinants of HPV immunization use in women of reproductive age.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at Permata Harapan Clinic and Budi Sehat Laboratory Clinic, Surakarta, Central Java. The data were collected from February to March 2018. A sample of 200 women was selected by random sampling, consisting of 50 women undertaking screening and 150 women not undertaking screening. The dependent variable was HPV immunization. The independent variables were perceptions of susceptibility, seriousness, benefit, barrier, respectively, and self-efficacy, education, family income, employment status, family support, social environment, and cervical cancer screening. Data on HPV vaccine use were taken from medical record. The data were collected by questionnaire and analyzed by path analysis.Results: Use of HPV immunization was directly associated with perceived susceptibility (b= 2.01; 95% CI= 1.03 to 3.00; p<0.001), perceived seriousness (b= 1.52; 95% CI 95%= -0.08 to 3.13; p=0.063), self efficacy (b= 1.55; 95% CI= 0.05 to 3.05; p=0.043), and perceived barrier (b= -2.25; 95% CI= -3.22 to -1.28; p<0.001). It was indirectly associated with perceived benefit, education, family income, employment status, family support, social environment, and cervical cancer screening.Conclusion: Use of HPV immunization is directly associated with perceived susceptibility, perceived seriousness, self-efficacy, and perceived barrier. It is indirectly associated with perceived benefit, education, family income, employment status, family support, social environment, and cervical cancer screening. Keywords: Human Papilloma Virus, immunization, women of reproductive age, health belief model, social learning theoryCorrespondence:Gabriela Advitri Febriani. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: gabrielaadvitri8@gmail.com. Mobile: +6285743809055.Journal of Health Promotion and Behavior (2018), 3(1): 66-77https://doi.org/10.26911/thejhpb.2018.03.01.07
Path Analysis on the Factors Affecting the Use of Personal Protection Equipment among Airport Construction Workers in Yogyakarta Dewi, Ristamaya Danar; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Health Promotion and Behavior Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Occupational accidents in the construction sector are still a major problem in every infrastructure development in Indonesia. The lack of supervision in the use of personal protective equipment (PPE) is one reason for the high number of occupational accidents. This study aimed to determine the factors that influence the implementation of the use of PPE.Subjects and Method: A cross sectional study was conducted at Yogyakarta International Airport, Kulon Progo, Yogyakarta, Indonesia, in March 2019. A sample of 200 active field workers was selected by proportional random sampling. The dependent variable was the use of PPE. The independent variables were age, education, working experience, knowledge, perception of vulnerability, perceived benefit, perceived severity, and cues to action. The data were collected by questionnaire and analyzed by path analysis.Results: The use of PPE was directly and positively affected by high knowledge (b= 2.14; 95% CI= 1.17 to 3.10; p<0.001), high perceived susceptibility (b= 1.94; 95% CI= 0.95 to 2.93; p< 0.001), high perceived severity (b= 1.33; 95% CI= 0.42 to 2.24; p= 0.004), high perceived benefit (b= 1.79; 95% CI= 0.85 to 2.73; p<0.001), and high cues to action (b= 1.64; 95% CI= 0.67 to 2.61; p= 0.001). The use of PPE was indirectly affected by age, work experience, and education.Conclusion: The use of PPE is directly and positively affected by knowledge, perceived suscep¬tibility, perceived severity, perceived benefit, and cues to action. The use of personal protective equip¬ment is indirectly affected by age, work experience, and education.  Keywords: personal protective equipment, construction workers, path analysis Correspondence: Ristamaya Danar Dewi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: ristamayadd@gmail.com. Mobile: 082-131666953. Journal of Health Promotion and Behavior (2019), 4(1): 12-21https://doi.org/10.26911/thejhpb.2019.04.01.02
Linear Regression Analysis on the Determinants of Hypertension Prevention Behavior Nurjannah, Nurjannah; Rahardjo, Setyo Sri; Sanusi, Rossi
Journal of Health Promotion and Behavior Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Hypertension is a risk factor for cardiovascular events and the highest contributor to death in the world, including Indonesia. 90.08% of health centers in DI Yogyakarta have im­ple­me­nted integrated non-communicable disease (NCD) control. However, the incidence of NCD including hypertension is still the highest disease seen from the top 10 diseases in Yogyakarta. This study aimed to examine the determinants of hypertension preventive behavior.Subjects and Method: This was a cross sectional study conducted in Bantul, Yogyakarta, from Feb­ruary to March 2019. A total of 200 study subjects was selected by simple random sampling. The dependent variable was hypertension preventive behavior. The independent variables were self­-efficacy, knowledge, family support, gender, age, and health personnel support. The data were collec­ted by questionnaire and analyzed by a multilevel linear regression.Results: Self-efficacy (b= 0.09; 95% CI= 0.03 to 0.15; p= 0.003, knowledge (b= 0.25; 95% CI= 0.08 to 0.43; p= 0.004), family support (b= 0.64; 95% CI= 0.34 to 0.93; p <0.001), and health per­son­nel support (b= 0.26; 95% CI= 0.08 to 0.44; p= 0.008) increased hypertension preventive be­ha­vior. Gender (b= 0.65; 95% CI= -0.79 to 2.10; p= 0.372) and age (b= 0.01; 95% CI= -0.03 to 0.03; p= 0.911) were associated with hypertension preventive behavior but it was statistically non-significant.Conclusion: Self-efficacy, knowledge, family support, and health personnel support increase hy­per­­­tension preventive behavior. Gender and age were associated with hypertension preventive be­ha­­vi­or but it was statistically non-significant.Keywords: hypertension preventive behavior, self-efficacy, health personnel support                                              Correspondence: Nurjannah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nurjannah9420­@gmail.com. Mobile: +628­5­293622882.Journal of Health Promotion and Behavior (2019), 4(1): 22-31https://doi.org/10.26911/thejhpb.2019.04.01.03
Meta-Analysis on the Effect of Zinc on Reducing Diarrhea Episode in Toddlers Widayati, Purwika; Rahardjo, Setyo Sri; Widyaningsih, Vitri
Indonesian Journal of Medicine Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Diarrhea is a major cause of mortality and morbidity in toddlers in the world. A number of studies have shown that zinc supplements can reduce the severity and duration of diarrhea in toddlers. This study aimed to examine the effectiveness of zinc on reducing diarrhea episode in toddlers.Subjects and Method: This was a meta-analysis conducted using PRISMA systematic guideline. Articles published between year 2000 and 2019 were selected from PubMed, Science Direct, and Springer Link databases. Six articles met the Randomized Controlled Trial (RCT) criteria. These studies were conducted in developing countries. A sample of 692 children divided into two groups of 348 zinc and 344 placebo. The data were analyzed by Review Manager (RevMan) 5.3 program. The results were assessed for Mean difference (MD) and the analysis was carried out for heterogeneity.Results: There was a high heterogeneity between experiments (I2 = 91%; p <0.001) so that Random Effects Model (REM) was used. Zinc administration reduced the duration of diarrhea 0.89 days faster than placebo, and it was statistically significant (MD= -0.89; 95% CI= -1.52 to -0.26; p= 0.006).Conclusion: Zinc supplementation is more effective than placebo in reducing the duration of diarrhea in children.Keywords: effectiveness, zinc, diarrhea, toddlers, meta analysisCorrespondence: Purwika Widayati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: purwika15@gmail.com. Mobile: 081231153131.Indonesian Journal of Medicine (2019), 4(2): 183-191https://doi.org/10.26911/theijmed.2019.04.02.12
Factors Associated with Pneumonia in Children Under Five after Earthquake: A Path Analysis Evidence from West Nusa Tenggara, Indonesia Ningsih, Nur Isniani; Salimo, Harsono; Rahardjo, Setyo Sri
Journal of Epidemiology and Public Health Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Pneumonia is an infectious disease which is the main killer among children under five. This study aims to analyze socio-economic and environmental determinants of the incidence of pneumonia in children under five after the earthquake.Subjects and Method: This study used observational analytic using case control. The total sample of 237 children under five aged 12-59 months old and the sampling technique was fixed disease sampling. The independent variables in this study were birth weight, exclusive breastfeeding, nutritional status, immunization status, maternal education, family income, healthy behavior, physical quality of the house, exposure to cooking fuel smoke, smoking activities of family members and active village influences. Collecting the variables was through questionnaires and analyzed by using path analysis.Results: Birth weight  (b=-1.92; 95%CI=-3.34 to -0.49; p=0.008), exclusive breastfeeding (b=-1.41; 95%CI=-2.43 to -0.37; p=0.007), nutritional status(b=-2.98; 95%CI=-4.10 to -1.86; p<0.001), immunization status (b=-1.45; 95%CI=-2.51 to -0.40; p=0.007), maternal education (b=-1.46; 95%CI= -2.63to -0.28; p=0.014), family income (b=-1.86; 95%CI=-3.32 to-0.41; p=0.012), healthy behavior (b=-1.24; 95%CI=-2.28 to -0.21; p=0.018), physical quality of the house (b=-1.16; 95%CI= -2.20 to -0.11; p=0.030), and active standby village strata (b=-1.25; 95%CI=-2.49 to -0.12; p=0.048) can reduce the incidence of pneumonia in children under five. Smoking activities of family members (b=1.38; 95%CI=0.02 to 2.73; p=0.045) and exposure to cooking fuel smoke (b=1.46; 95% CI= 0.34 to 2.51; p=0.010) can increase the incidence of pneumonia in children under five.Conclusion: The decrease in the incidence of pneumonia was influenced directly by healthy behavior, immunization status, nutritional status, physical quality of the house, exclusive breast­feeding, birth weight, and active standby village strata. Family smoking activities and smoke exposure to cooking fuel can increase the incidence of pneumonia in children under five.Keywords: Pneumonia, socioeconomic, village strata, path analysisCorrespondence: Nur Isniani Ningsih. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: isniani2193@gmail.com. Mobile: 081997998692.Journal of Epidemiology and Public Health (2019), 4(3): 234-246 https://doi.org/10.26911/jepublichealth.2019.04.03.11
Multilevel Analysis on the Contextual Effect of Village on the Incidence of Hemorrhagic Dengue Fever in Grobogan, Central Java Sari, Ambar; Rahardjo, Setyo Sri; Sulaeman, Endang Sutisna
Journal of Epidemiology and Public Health Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Dengue hemorrhagic fever (DHF) is a disease caused by the dengue virus through the bite of the Aedes aegypti mosquito. DHF is an endemic disease in more than 100 countries. There were 728 cases of DHF and 8 cases of death in Grobogan, Central Java, in 2017. The purpose of this study was to examine the contextual effect of the village on the incidence of DHF.Subjects and Method: This was a case-control study conducted in Grobogan, Central Java, from November to December 2018. A sample of 200 study subjects was selected by fixed disease sampling. The dependent variable was DHF. The independent variables were the presence of water shelter, ponds, farmland, mosquito larvae, hanging clothes, house density, eradication of mosquito nest, education, and employment. The data were collected by questionnaire and observation. The data were analyzed by a multilevel logistic regression.Results: Existence of water shelter (b= 4.53; 95% CI= 1.29 to 7.76; p= 0.006), ponds (b= 2.71; 95% CI= 0.26 to 5.17; p= 0.030), farm land (b = 3.40; 95% CI = 0.52 to 6.28; p= 0.021), mosquito larvae (b= 3.45; 95% CI= 0.61 to 6.29; p= 0.017), hanging clothes (b= 2.39; 95% CI= 0.23 to 4.56; p= 0.030), and house density (b= 5.55; 95% CI= 1.59 to 9.51; p= 0.006), increased the risk of DHF.  Education ≥senior high school (b= -4.79; 95% CI= -8.44 to -1.13; p= 0.010), employed (b= - 5.36; 95% CI= -9.22 to -1.49; p= 0.006), and exposed to DHF mosquito nest eradication program (b= -4.31; 95% CI= -7.64 to -0.97; p= 0.011) decreased the risk of DHF. Village environment had strong contextual effect on DHF with ICC= 51.33%.Conclusion: Existence of water shelter, ponds, farmland, mosquito larvae, hanging clothes, and house density, increase the risk of DHF.  Education ≥senior high school, employed and exposed to DHF mosquito nest eradication program decrease the risk of DHF. Village environment has a strong contextual effect on DHF.Keywords: dengue hemorrhagic fever, environmental factors, eradication of mosquito nests, village strata, multilevel analysisCorrespondence: Ambar Sari. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ambarsari69.as@gmail.com. Mobile: +625647847180; 08562623045Journal of Epidemiology and Public Health (2019), 4(3): 156-170https://doi.org/10.26911/jepublichealth.2019.04.03.02
The Contextual Effect of Village on Health Preventive Behavior for Dengue Hemorrhagic Fever in Pati, Central Java Fatimah, Nurul; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Dengue is a mosquito-borne infection that has emerged to become a major public health issue and can result in death. Various efforts have been made as an attempt to empower the community in dengue preventive behavior, but has not yet reached the optimal result. This study aimed to examine the effect of the village on the health preventive behavior for dengue hemorrhagic fever in Pati, Central Java.Subjects and Method: This was a case-control study conducted in Pati, Central Java, in November 2018. A sample of 225 household heads was selected by simple random sampling. The dependent variable was DHF preventive behavior. The independent variables were education, access to information, knowledge, attitude, self-efficacy, community health behavior, social capital, and villages. Data on DHF status was measured by medical record. The other data were collected by questionnaire. The data were analyzed by multilevel multiple logistic regression.Results: DHF preventive behavior improved with high education (b= 0.86; 95% CI= 0.04 to 1.70; p= 0.040), good knowledge (b= 0.86; 95% CI= 0.06 to 1.67; p= 0.036), strong self efficacy (b= 0.87; 95 % CI= 0.06 to 1.68; p= 0.036), good access to information (b= 1.98; 95% CI= 1.06 to 2.87; p <0.001), positive attitude (b= 1.40; 95% CI= 0.55 to 2.25; p= 0.001), good community behavior in DHF prevention (b= 0.86; 95% CI= 0.02 to 1.70; p= 0.045), and strong social capital (b= 1.07; 95% CI= 0.26 to 1.89; p= 0.010). Village had strong contextual effect on DHF prevention behavior with ICC= 20.30%.Conclusion: DHF preventive behavior improves with high education, good knowledge, strong self-efficacy, good access to information, positive attitude, good community behavior in DHF prevention, and strong social capital. The village has a strong contextual effect on DHF prevention behavior.Keywords: dengue hemorrhagic fever, preventive behavior, village, multilevel analysisCorrespondence: Nurul Fatimah. Masters Program in Public Health.Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nurul.fatimah00049@gmail.com. Mobile: +6281329501844.Journal of Epidemiology and Public Health (2019), 4(3): 198-204https://doi.org/10.26911/jepublichealth.2019.04.03.07
Biological and Social Economic Determinants of Adherence and Cure of Tuberculosis Treatment: Path Analysis Evidence from Yogyakarta Fitriani, Tri Godha; Rahardjo, Setyo Sri; Prasetya, Hanung
Journal of Epidemiology and Public Health Vol 4, No 4 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Tuberculosis (TB) was an infectious disease which was still a health problem world­wide, including in Indonesia, which only had a population of around 261 million. The purpose of this study was to analyze biological and social economic determinants of adherence and cure of TB treatment.Subjects and Method: This was an analytic observational study with a case control design. The study was conducted in Bantul, Yogyakarta, from April to May 2019. A sample of 225 TB patients was selected by random sampling. The dependent variable was adherence and cure of TB treat­ment. The independent variables were age, gender, education, family income, nutritional status, healthy behavior, complication, family support, drug taking supervisor, drug taking adherence, environment, and smoking. The data were collected by questionnaire and analyzed by path analysis.Results: Adherence and cure of TB treat­ment was directly increased with good nutritional status (b= 076; 95% CI= 0.03 to 1.49; p= 0.042), drug taking adherence (b= 3.67; 95% CI= 1.47 to 5.92; p= 0.001), drug taking supervisor (b= 3.64; 95% CI= 1.26 to 6.02; p= 0.003), strong family support (b= 2.03; 95% CI= -3.85 to -0.21; p= 0.029), and healthy physical environment (b= 4.05; 95% CI= - 0.09 to 8.20; p= 0.056). Adherence and cure of TB treat­ment was directly decreased with age ≥65 years old (b= -0.54; 95% CI= - 1.85 to 0.75; p= 0.411), female gender (b= -0.05; 95% CI= - 0.86 to 0.76; p= 0.900), unhealthy behavior (b= -3.20; 95% CI= - 5.02 to -1.36; p= 0.001), smoking (b= -1.50; 95% CI= - 2.56 to -0.43; p= 0.006), complication (b= -1.41; 95% CI= - 2.60 to -0.23; p= 0.019). It was indirectly affected by nutritional status, education, family income, and healthy environment.Conclusion: Adherence and cure of TB treat­ment is directly increased with good nutritional status, drug taking adherence, drug taking supervisor, strong family support, and healthy physical environment. Adherence and cure of TB treat­ment is directly decreased with age ≥65 years old, female gender, unhealthy behavior, smoking, complication. It is indirectly affected by nutritional status, education, family income, and healthy environment.Keywords: tuberculosis treat­ment, drug taking adherence, path analysisCorrespondence: Tri Godha Fitriani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: trigodha@gmail.com. Mobile: +6287738200610.Journal of Epidemiology and Public Health (2019), 4(4): 270-282 https://doi.org/10.26911/jepublichealth.2019.04.04.02