Journal of Health Promotion and Behavior
Vol. 5 No. 1 (2020)

Theory of Planned Behavior and Social Cognitive Theory on the Effect of the Community Health Center Tertiary Preventive Behavior among Patients with Type 2 Diabetes Mellitus: A Multilevel Analysis

Yudi Andriyaningtiyas (Masters Program in Public Health, Universitas Sebelas Maret)
Didik Gunawan Tamtomo (Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret)
Bhisma Murti (Masters Program in Public Health, Universitas Sebelas Maret)



Article Info

Publish Date
16 Jan 2020

Abstract

Background: Type 2 diabetes mellitus (DM) accounts for 90% to 95% of all diabetes cases. Complications of type 2 diabetes increase the risk of death for suf­ferers. Complications and deaths from type 2 dia­betes can be prevented by changes in behavior. This study aimed to determine the effect of health cen­­ters and other factors on the prevention of ter­­tiary diabetes type 2, using the theory of plan­ned behavior and social cognitive theory.Subjects and Method: This was an analytic ob­ser­­vational study with cross sectional de­sign, conducted at 25 community health centers, in Bantul Re­gen­cy, Yogyakarta, Indonesia. A sample of 200 type 2 DM patients was selected by exha­ustive samp­­ling. The dependent variable was type 2 DM tertiary prevention. The indepen­dent vari­ables at level 1 are intention, attitude, sub­jective norm, perceived behavior con­trol/ self-efficacy, experience, modelling, self-re­gu­­­­lation, and out­come expectation. Community health center was an independent variable at level 2. The data were col­­lected by questionnaire and analyzed by a mul­ti­level multiple linear regression.Results: Tertiary preventive behavior in type 2 DM patients increased with strong intention (b= 1.19; 95% CI= 0.62 to 1.76; p <0.001), positive atti­tude (b= 1.19; 95% CI= 0.58 to 1.80; p <0.001), supportive subjec­­tive norm (b= 0.79; 95% CI= 0.12 to 1.45; p= 0.019), perceived be­ha­vior control (b= 1.16; 95% CI= 0.60 to 1.72; p <0.001), abundant experience (b= 0.65; 95% CI= 0.62 to 1.25; p<0.001), strong modelling (b= 1.07; 95% CI= 0.53 to 1.67; p= 0.030), strong self-regulation (b= 0.87; 95% CI= 0.34 to 1.40; p= 0.001), and positive outcome expectation (b= 0.82; 95% CI= 0.25 to 1.38; p = 0.004). Commu­nity health center had con­textual effect on the tertiary pre­ventive behavior in type 2 DM patients with ICC= 19.18%.Conclusion: Tertiary preventive behavior in type 2 DM patients increases with strong intent­ion, positive atti­tude, supportive subjec­­tive norm, perceived be­ha­vior control, abundant experience, strong modelling, strong self-regula­tion, and positive outcome expectation. Commu­nity health center has con­textual effect on the tertiary pre­ventive behavior in type 2 DM patients.Keywords: tertiary prevention behavior, type 2 diabetes, TBP, SCT, multilevel analysis.Correspondence: Yudi Andriyaningtiyas. Masters Program in Pub­lic Health, Universitas Sebelas Maret, Jl. Ir. Su­tami No. 36A, Surakarta. Email: yudi.andriya­ning­­tiyas@gmail.com. Mobile: +6281392704899Journal of Health Promotion and Behavior (2020), 05(01): 59-71https://doi.org/10.26911/thejhpb.2020.05.01.08

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Journal Info

Abbrev

thejhpb

Publisher

Subject

Medicine & Pharmacology Public Health

Description

Journal of Health Promotion and Behavior (JHPB) is an electronic, open-access, double-blind and peer-reviewed international journal, focusing on health promotion and health-related behaviors. It began its publication on May 21, 2015. The journal is published four times yearly. It seeks to understand ...