Agung Wiwiek Indrayani
Department Pharmacology and Therapy, College of Medicine, Universitas Udayana, Denpasar, 80232, Indonesia

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Integrating Health Belief Model and Theory of Planned Behavior to Explain Complementary Therapy Use in Type 2 Diabetes: A Cross-Sectional Study in Denpasar, Indonesia Ni Made Umi Kartika Dewi; Ni Luh Seri Ani; Dinar Saurmauli Lubis; Agung Wiwiek Indrayani; Pande Putu Januraga
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 9 No. 4 (2026): April 2026
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v9i4.9114

Abstract

Introduction: Complementary therapy (CT) is widely practiced among individuals with type 2 diabetes mellitus (T2DM) in Indonesia. However, the psychosocial determinants influencing CT adoption and its safe integration into biomedical care remain insufficiently understood. This study aimed to determine the prevalence and psychosocial determinants of CT use among patients with T2DM using an integrated Health Belief Model (HBM) and Theory of Planned Behavior (TPB) framework. We hypothesized that stronger psychosocial constructs specifically self-efficacy, subjective norms, and positive attitudes would be positively associated with CT use, whereas higher levels of CT-specific rational knowledge would be inversely associated with CT adoption. Methods: A cross-sectional survey of 300 adult outpatients with T2DM was conducted at four community health centers in Denpasar, Indonesia, selected through multistage cluster sampling from May to July 2025. Interviewer-administered questionnaires collected sociodemographic and clinical characteristics, CT-specific rational knowledge, and HBM/TPB constructs. Data were analyzed using chi-square and Mann–Whitney U tests for bivariate comparisons, and backward stepwise binary logistic regression to identify independent predictors of CT use. Results: CT use within the past six months was reported by 43.3% of participants. Usage was significantly associated with treatment type (?²=9.458, p=0.024) and check-up consistency (?²=5.999, p=0.014). CT users demonstrated higher scores across all HBM and TPB constructs (all p<0.001) but lower rational knowledge (p<0.001). In multivariate analysis, self-efficacy (OR=13.46, p=0.002), subjective norms (OR=9.20, p=0.005), and attitudes (OR=3.86, p=0.021) independently predicted CT use, while rational knowledge was inversely related (OR=0.395, p<0.001). Conclusion:CT use among patients with T2DM was prevalent and predominantly influenced by psychosocial rather than demographic or knowledge-related factors. Strengthening culturally tailored communication, CT-specific health literacy, and provider readiness is crucial to promote safe, integrative diabetes management.
Socio-demographic determinants and prevalence of traditional medicine product use in Bali: implications for healthcare integration Ni Made Umi Kartika Dewi; Sri Sulistyawati Anton; Dewi Puspita Apsari; Luh Seri Ani; Agung Wiwiek Indrayani; Pande Putu Januraga
JURNAL ILMU KEFARMASIAN INDONESIA Vol. 24 No. 1 (2026): JIFI
Publisher : Faculty of Pharmacy, Universitas Pancasila

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35814/jifi.v24i1.1672

Abstract

Traditional medicine products (TMPs) are integral to Balinese cultural practices. This study examined the socio-demographic determinants of TMP use through a cross-sectional survey of 440 households across all districts and cities in Bali province. A multistage cluster sampling method was applied, and data were collected using a structured questionnaire validated by expert review and tested for reliability (Cronbach’s alpha = 0.82). The results showed that 76.1% of the respondents used TMPs. The key predictors included age, gender, income, and residence. Middle-aged adults (46–55 years) had the highest odds of TMP use (OR = 5.667), followed by urban residents (OR = 4.999), individuals with no income (OR = 4.681), those earning below the provincial minimum wage (OR = 2.496), and women (OR = 1.838). These trends may be linked to cultural familiarity, financial barriers, caregiving roles, and increased product availability in urban areas. These findings underscore the need to integrate TMPs into Bali’s healthcare system through policy regulation, clinical guidelines, community education, and interprofessional training. Integration efforts must also address challenges such as regulatory oversight, product standardization, and patient safety. This study provides a foundation for developing culturally informed public health strategies to ensure the safe and effective use of TMP.