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Path Analysis on the Effect of Biopsychosocial and Economic Factors during Gestational Period on the Risk of Stunting and Development in Children under Five, in Nganjuk, East Java Viridula, Erike Yunicha; Murti, Bhisma; 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: There is growing evidence of the connections between slow growth in height early in life and impaired health and educational and economic performance later in life. Basic Health Research (Riset Kesehatan Dasar, Riskesdas) conducted by The Minister of Health in 2010, showed that prevalence of stunting in Indonesia was 35.6% of children aged under five years old. This study aimed to examine path analysis on the effect of biopsychosocial and economic factors during gestational period on the risk of stunting and development in children under five, in Nganjuk, East Java.Subjects and Method: This was an analytic observational study with case control design. This study was conducted at Bagor Community Health Center, Nganjuk, East Java. A total sample of 150 children under five, consisting of 50 stunted children and 100 normal children, was selected for this study by fixed exposure sampling. The dependent variables were stunting and development. The independent variables were middle upper arm circumference (MUAC) and family support at pregnancy, low birthweight, maternal height, maternal schooling, and family income. The stunting was measured by anthropometry (weight for height). The child development was measured by Kuesioner Pra-Skrining Perkembangan (KPSP). Other variables were measured by a set of questionnaire. The data were analyzed by path analysis.Results: Low birth weight had direct negative effect on stunting (b=0.99; p=0.897). Maternal height (b=-2.58; p= 0.029), maternal education (b=-1.55; p=0.002), and family income (b=-1.30; p=0.002) had direct negative effects on stunting. Low birth weight (b=-0.27; p=0.253) and family income (b=-0.007; p=0.976) have negative but statistically non-significant effect on development. Maternal education had positive but statistically non-significant effect on development (b=2.16; p=0.883). MUAC (b=-4.60; p<0.001) had negative and statically significant effect on low birth weight. Family support had positive but statistically non-significant on low birth weight (b=0.52; p=0.492). Maternal height had positive and statistically significant effect on MUAC (b=3.16; p<0.001). Family income had positive but statistically non-significant effect on MUAC (b=0.83; p=0.253).Conclusion: MUAC and maternal education have indirect, negative and statistically significant effect on stunting Maternal height, maternal education, and family income, have direct, negative, and statistically significant effect on stunting.Keywords: stunting, biopsychosocial, economic, gestational periodCorrespondence : Erike Yunicha Viridula. Masters Program in Public Health, Sebelas Maret University. Email: yunichasabdana@gmail.com.Journal of Health Promotion and Behavior (2016), 1(3): 180-189https://doi.org/10.26911/thejhpb.2016.01.03.05

Health Promotion Model to Increase Maternal Visit and Exclusive Breastfeeding in the Puerperium Period in Sleman, Yogyakarta Ambarwati, Eny Retna; Khoirunnisa, Endang; -, Waryana
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 in the puerperium period is beneficial for mother and infant. Breastfeeding stimulate oxytocin release that will increase uterine contraction. It in turn fastens uterine involution process and eventually prevents prolonged post partum bleeding. Breastfed infants are healthier, have better nutritional status, and less probability of dying. Therefore, there is a need to develop a health promotion model that empowers post partum mothers to visit maternity clinic for post partum examination. This study aimed to determine factors that affect maternal visits to maternity clinic for post partum examination.Subjects and Method: This was an analytical observational study with cross-sectional design. This study was conducted in Sleman, Yogyakarta. A total sample of 125 post partum mothers was selected for this study. The dependent variable was number of visits to maternity clinic for post partum examination. The independent variables were maternal knowledge, access to information, husband support, stakeholder role, and participation in maternal health promotion class. The data were collected by a set of questionnaire, and then were analyzed by Structural Equation Model (SEM).Results: The SEM showed Goodness of Fit, with indicators as follows: Chi Square 263.01, p= 0.055, RMSEA=0.025, GFI=0.98, NFI=0.92, and CFI 1.00. Maternal knowledge (b=0.15), access to information (b=0.42), husband support (b=0.52), stakeholder role (b=0.57), participation in maternal health promotion class (b=0.04).Conclusion: Maternal knowledge, access to information, husband support, stakeholder role, participation in maternal health promotion class, are important determinant of maternal visit to maternal clinic for post partum examination.Keywords: maternal visit, maternal clinic, health promotion class, puerperium.Correspondence: Eny Retna Ambarwati. Academyof Midwifery Yogyakarta, Yogyakarta,Indonesia. Email: enyretnaambarwati@gmail.com.Journal of Health Promotion and Behavior (2016), 1(3): 138-148https://doi.org/10.26911/thejhpb.2016.01.03.01

Path Analysis on the Association Between Predisposing, Enabling, and Reinforcing Factors, and House Sanitation in Bengkulu, Sumatera Nasir, Shinta; Murti, Bhisma; 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: Poor sanitation is one of the primary causes of communicable diseases in the world. According to UNICEF (2012) 116 million people in Indonesia in 2010 were lacking in standard sanitation. In Bengkulu province, only 33.18% household in 2014 and 39.22% in 2015 had access to good sanitation. This coverage was lower than that of the national level at 62.14%. This study aimed investigating the association between predisposing, enabling, and reinforcing factors, and house sanitation in Bengkulu, Sumatera.Subjects and Method: This was an analytic and observational study with cross sectional design. This study was conducted in Teluk Segara District, Bengkulu, Sumatera from November to December 2016. A total of 120 households were selected by fixed exposure sampling for this study. The dependent variable was household sanitation. The independent variables were family education, family income, health education, social capital, and health behavior. The data were collected by a set of questionnaire and analyzed by path analysis.Results: Family education (b= 1.08; SE= 0.48; p= 0.024) and health education (b= 0.19; SE= 0.07; p= 0.007) had positive and statistically significant effect on household sanitation. Health education had positive and statistically significant effect on healthy behavior (b= 0.09; SE= 0.04; p= 0.018). Social capital had positive and marginally significant effect on healthy behavior (b= 0.05; SE= 0.03; p= 0.099). Family income (b= 0.14; SE = 0.45; p= 0.756) and family education (b= 0.15; SE= 0.25; p= 0.566) did not show significant effect on household sanitation.Conclusion: Family education and health education had positive and statistically significant effect on household sanitation. Health education had positive and statistically significant effect on healthy behavior. Social capital had positive and marginally significant effect on healthy behavior. Family income and family education did not show significant effect on household sanitation.Keywords: path analysis, predisposing, enabling, reinforcing factors, household sanitationCorrespondence: Shinta Nasir. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: shinta_nasir26@yahoo.co.id.Journal of Health Promotion and Behavior (2016), 1(3): 190-200https://doi.org/10.26911/thejhpb.2016.01.03.06

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

Effect of Knowledge, Peer Group, Family, Cigarette Price, Stipend, Access to Cigarette, and Attitude, on Smoking Behavior Soesyasmoro, R. Asto; Demartoto, Argyo; Adriani, Rita Benya
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: Passive smokers inhale 75% of ambient smoke and 50% of exhaled smoke. A cigarette contains 4.000 poisonous chemical agents, at least 69 of which are carcinogenic. Therefore ambient tobacco smoke is detrimental to health. The purpose of this study was to analyze the effect of knowledge, peer group, family, cigarette price, stipend, access to cigarette, and attitude, on smoking behavior.Subjects and Method: This was an analytic and observational study with cross sectional design. This study was conducted at School of Health Polytechnics, Surakarta, Central Java. A total of 105 male students was selected for this study. The dependent variable smoking status. The independent variables knowledge, peer group, family, cigarette price, stipend, access to cigarette, and attitude. The data were collected by a set of questionnaire, and were analyze by logistic regression model. Results: High smoking peer group (OR= 3.21; 95% CI=1.18- 8.72; p= 0.022), high stipend (OR= 3.66; 95% CI= 1.28-10.49; p= 0.016), convenient access to cigarette (OR= 3.02; 95% CI= 1.04 to 8.73; p= 0.042) increased the likelihood of smoking. High knowledge about tobacco smoking (OR= 0.35; 95% CI=0.13-0.95; p = 0.039) and non-smoking family (OR= 0.16; 95% CI=0.03 to 0.70; p= 0.015) decreased the likelihood of smoking. High price of cigarette (OR= 0.86; 95% CI= 0.23 to 3.19; p= 0.819) and possitive attitude (OR= 0.88; 95% CI= 0.33 to 2.36; p= 0.795) did not show statistically significant effect on smoking.Conclusion: Smoking peer group, stipend, access to cigarette increase the probability of smoking. Knowledge about tobacco smoking and non-smoking family decrease the probability of smoking.Keywords: knowledge, peer group, family, cigarette price, stipend, access to cigarette, attitude, smoking behaviorCorrespondence: R. Asto Soesyasmoro.School of Health Polytechnics, Surakarta. Email: asto_monti@yahoo.co.id.Journal of Health Promotion and Behavior (2016), 1(3): 201-210https://doi.org/10.26911/thejhpb.2016.01.03.07

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

Analysis of the Effect of Maternal Perception on Completeness of Child Immunization Status with Health Belief Model Puri, Yessica Eka; Murti, Bhisma; Dermatoto, Argyo
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: Child immunization coverage was low in several health centers in Surakarta, Central Java. Some of the health centers did not achieve GAIN Universal Child Immunization (UCI) target in 2014. For example, Penumping Health Center (HBV <7 days= 86.9%, BCG= 87.8%, Campak= 87.5%, DTP-HBV-HIB= 86.7%, Polio= 87.5%) and Banyuanyar Health Center (Campak= 89.6%). This study aimed to determine the effect of maternal perception on completeness of child immunization status using Health Belief Model (HBM).Subjects and Method: This was an analytic observational study with case control design. It was conducted at Penumping and Banyuanyar Health Centers, Surakarta, Central java. A total sample of 120 mothers and their respective children aged <9 years was selected for this study by fixed disease sampling. This sample consisted of children with complete immunization and the other children with incomplete immunization (ratio= 1:4). The dependent variable was completeness of immunization status. The independent variables were maternal perception on various HBM constructs, including perceived susceptibility, seriousness, threat, benefit, and barrier. The data were collected by a set of questionnaire, and analyzed by path analysis.Results: Perceived susceptibility had indirect and positive effect on completeness of immunization status via perceived threat, although it was not statistically significant (b= 0.63; 95% CI= -0.13 to 1.39; p= 0.104). Perceived seriousness had indirect positive and statistically significant effect on completeness of immunization status via perceived threat (b= 1.10; 95% CI =0.71 to 3.04; p=0.005). Perceived threat (b= 1.88; 95% CI= 0.34 to 1.86; p= 0.002), and perceived benefit (b= 1.83; 95% CI = 0.69 to 2.96; p= 0.002), showed direct positive and statistically significant effect on completeness of immunization status. Perceived barrier had direct and negative effect on completeness of immunization status (b= -0.96; 95% CI= -1.97 to 0.05; p= 0.063). Conclusion: Maternal perception on child susceptibility, disease seriousness, disease threat, benefit and barrier of immunization, have effects on the completeness of immunization status.Keywords: immunization status, completeness, health belief modelCorrespondence: Yessica Eka Puri. Masters Program in Public Health, Sebelas Maret University, Surakarta. Mobile: 087856408766.Journal of Health Promotion and Behavior (2016), 1(3): 211-222https://doi.org/10.26911/thejhpb.2016.01.03.08

Theory of Planned Behavior on the Determinants of Participation in the Long-Term Contraceptive Method Among Women of Reproductive Age, in Nganjuk, East Java -, Joeliatin; Murti, Bhisma; 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: Unintended pregnancies remain a substantial global public health issue despite considerable advances in contraceptive technologies. The global trend shows that the use of permanent contraception to prevent unintended pregnancy is high. Although the trend also shows a rise in the use of long-acting reversible methods, these are still underutilized despite having contraceptive as well as non-contraceptive benefits. This study aimed to examine the determinants of participation in long-term contraceptive method among women of reproductive age in Nganjuk, East Java, using Theory of Planned Behavior.Subjects and Method: This was an analytic observational study, using case control design. This study was conducted in Bagor, Nganjuk, East Java. A total of 100 women of reproductive age was selected for this study by fixed disease sampling. The independent variables were constructs in the Theory of Planned Behavior, i.e. attitude, subjective norm, and perceived behavior control. The dependent variables were intention and participation in long-term contraceptive use. The data were collected by a set of questionnaire, and analyzed by path analysis.Results: Intention had direct and positive effect on participation in long-term contraceptive use (b=2.07; CI 95% 0.78-3.36; p=0.002). Attitude (b=1.40; CI 95% 0.41-2.40 p=0.006), subjective norm (b=1.64; CI 95% 0.76-2.53; p<0.001), and perceived behavior control (b=1.22; CI 95% 0.32-2.12; p=0.008) had indirect positive effect on participation in long-term contraceptive use through intention. Conclusion: There are direct and indirect effect of Theory of Planned Behavior constructs on participation long-term contraceptive use among women of reproductive age.Keywords: Theory of Planned Behavior, long-term contraceptive method, women of reproductive ageCorrespondence: Joeliatin. School of Midwifery, AKBID Wiyata Mitra Husada, Kertosono, Nganjuk, East Java. Email: yulisuyitno77@gmail.com.Journal of Health Promotion and Behavior (2016), 1(3): 171-179https://doi.org/10.26911/thejhpb.2016.01.03.04

Health Promotion Model to Increase Maternal Visit and Exclusive Breastfeeding in the Puerperium Period in Sleman, Yogyakarta Ambarwati, Eny Retna; Khoirunnisa, Endang; -, Waryana
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 in the puerperium period is beneficial for mother and infant. Breastfeeding stimulate oxytocin release that will increase uterine contraction. It in turn fastens uterine involution process and eventually prevents prolonged post partum bleeding. Breastfed infants are healthier, have better nutritional status, and less probability of dying. Therefore, there is a need to develop a health promotion model that empowers post partum mothers to visit maternity clinic for post partum examination. This study aimed to determine factors that affect maternal visits to maternity clinic for post partum examination.Subjects and Method: This was an analytical observational study with cross-sectional design. This study was conducted in Sleman, Yogyakarta. A total sample of 125 post partum mothers was selected for this study. The dependent variable was number of visits to maternity clinic for post partum examination. The independent variables were maternal knowledge, access to information, husband support, stakeholder role, and participation in maternal health promotion class. The data were collected by a set of questionnaire, and then were analyzed by Structural Equation Model (SEM).Results: The SEM showed Goodness of Fit, with indicators as follows: Chi Square 263.01, p= 0.055, RMSEA=0.025, GFI=0.98, NFI=0.92, and CFI 1.00. Maternal knowledge (b=0.15), access to information (b=0.42), husband support (b=0.52), stakeholder role (b=0.57), participation in maternal health promotion class (b=0.04).Conclusion: Maternal knowledge, access to information, husband support, stakeholder role, participation in maternal health promotion class, are important determinant of maternal visit to maternal clinic for post partum examination.Keywords: maternal visit, maternal clinic, health promotion class, puerperium.Correspondence: Eny Retna Ambarwati. Academyof Midwifery Yogyakarta, Yogyakarta,Indonesia. Email: enyretnaambarwati@gmail.com.Journal of Health Promotion and Behavior (2016), 1(3): 138-148https://doi.org/10.26911/thejhpb.2016.01.03.01

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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