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Journal of Health Promotion and Behavior

thejhpb
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Published by Universitas Sebelas Maret

ISSN : - EISSN : 25490281 DOI : -

Core Subject : Health,

Medicine & Pharmacology Public Health

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 factors at various layers associated with health behavior and health-impacting policy and find evidence-based social and behavioral strategies to improve population health status.

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Articles 509 Documents

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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 Andriyaningtiyas, Yudi; Tamtomo, Didik Gunawan; Murti, Bhisma
Journal of Health Promotion and Behavior Vol 5, No 1 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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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

KNOWLEDGE, BARRIERS, AND MOTIVATION RELATED TO BREAST AND CERVICAL CANCER SCREENING AMONG WOMEN IN BOJONEGORO, EAST JAVA: A QUALITATIVE STUDY Umami, Afriza; Sudalhar, Sudalhar; Pratama, Tegar Wahyu Yudha; Fitri, Istiqlal; Firmansyah, Andan
Journal of Health Promotion and Behavior Vol 5, No 1 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Breast and cervical cancer remain a major cause of morbidity and mortality for women in Indonesia. Although this cancer can be detected early, women are still less active in self-detecting breast and cervical cancer, so both cancers are found at an advanced stage. This study aimed to explore how women's knowledge, barriers, and motivations are related to early detection of breast and cervical cancer.Subjects and Method: This was a qualitative study, with focus group discussions (FGDs) and interviews with key informants. Discussions and interviews were conducted in the community within Ledok Kulon village, Bojonegoro Regency, East Java, Indonesia. Participants: FGD participants involved 20 women, 10 women underwent FDG about cervical cancer and 10 other women conducted FGD about breast cancer. Three key informants interviewed with health worker and administrator that allow triangulation of responses thereby increasing the validity of the findings. Participants were aged 20 to ?60 years, with no history of symptoms or previous diagnosis of breast or cervical cancer. The women were interviewed in October-November 2019. The transcribed data were analyzed using content analysis.Results: Participants' knowledge about understanding, risk factors, signs and symptoms of breast and cervical cancer was still lacking. Participants attributed the cause of cervical cancer to the vaginal wound resulting in cervical cancer and signs of symptoms such as heartburn. Whereas for breast cancer participants were not know the signs and symptoms, they only said there was a lump in the breast. Barriers to screening were ashamed to be examined by health workers, afraid of testing procedures, feeling healthy and there were no signs of cancer. Screening motivation were experiencing signs and symptoms of cancer, family history of the disease and awareness of the disease/screening service.Conclusion: The study participants' knowledge of breast and cervical cancer was still lacking. To improve breast and cervical cancer screening, efforts must focus on reducing identified barriers and increasing motivation.Keywords: knowledge, barriers, motivation, breast and cervical cancer screeningCorrespondence: Afriza Umami. Diploma III of Medical Records, School of Health Sciences Muhammadiyah Bojonegoro, Jl. A.Yani No.14, Bojonegoro, Indonesia. Email: afrizaumami20@gmail.com. Mobile: +6282254348041.Journal of Health Promotion and Behavior (2020), 5(1): 1-10 https://doi.org/10.26911/thejhpb.2020.05.01.01

Social Marketing Promotion Strategy on Pregnant Women’s Decision to Adopt “Sayang Bunda” Application in Semarang, Indonesia Rahayu, Tiwuk Puji
Journal of Health Promotion and Behavior Vol 5, No 2 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Semarang City’s Health Office launched “SAYANG BUNDA” android-based mobile application simultaneously, aiming to help pregnant women find out and monitor their pregnancy health, thereby can improve Antenatal Care (ANC) coverage. Purwoyoso and Ngaliyan public health centers with low visit ANC coverage and not achieving the target of program. The purpose of this study was to examine the effect of sales promotion, personal selling, advertising, and publication on pregnant women’s decision to adopt “SAYANG BUNDA” android-based mobile application.Subjects and Method: This was a case-control study conducted at Purwoyoso and Ngaliyan health centers, in Semarang City, from August to November 2019. A sample of 84 pregnant women was selected for this study. The dependent variable was pregnant women’s decision. The independent variable was social marketing promotion strategy including sales promotion, personal selling, advertising, and publication. The data were collected by questionnaire and analyzed by a multiple linear regression.Results: The result of multiple-linear regression analysis showed that sales promotion (b=0.223; SE=0.406; p=0.005) and personal selling (b=0.286; SE=0.406; p=0.000) affect strongly the introduction of pregnant women’s need and contribute by 40.6%. Sales promotion(b=0.346; SE=0.330; p=0.000), personal selling(b=0.177; SE=0.330; p=0.026), advertising and publication(b=-0.253; SE=0.330; p=0.002) affect strongly and contribute by 33% to information search. Sales promotion(b=0.214; SE=0.169; p=0.035) affects most strongly and contributes by 16.9% to alternative evaluation. There is no strong effect of sales promotion(b=0.025; SE=0.069; p=0.839), advertisingand publication(b=0.216; SE=0.068; p=0.094), and personal selling(b=0.001; SE=0.069; p=0.994) and contributes by 6.9% to trying and adopting. Advertising and publication (b=1.685; SE=0.082; p=0.037)affect most strongly and contributes by 8.2% to pregnant women’s post-use assessment.Conclusion: To improve pregnant women’s decision to adopt the “SAYANG BUNDA” android-based mobile application, Semarang City’s Health Office improves and focuses social marketing strategy on promotion mix strategy including advertising, sales promotion, publication, and personal selling.Keywords: social marketing promotion strategy, pregnant women’s decision, SAYANG BUNDA applicationCorrespondence: Tiwuk Puji Rahayu. Masters Program of Health Promotion, Universitas Diponegoro. Email: tiwp01@yahoo.co.id. Mobile: 085790337111.Journal of Health Promotion and Behavior (2020), 5(2): 104-113https://doi.org/10.26911/thejhpb.2020.05.02.05

EFFECT OF CARE SUPPORT TREATMENT AND OTHER FACTORS AFFECTING THE INTENTION AND ADHERENCE TO ANTIRETROVIRAL THERAPY: PATH ANALYSIS EVIDENCE, FROM MALANG EAST JAVA Ayu Pangerti, Fitria Diyah; Pawito, Pawito; Prasetya, Hanung
Journal of Health Promotion and Behavior Vol 4, No 4 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: People living with HIV/AIDS (PLWHA) are still a health problem because of the cumulative increase in the population and there is a gap in the need for services to get antiretroviral therapy (ART). Compliance with PLHIV will consume antiretroviral drugs is a form of treatment success by being influenced by several factors encouraging to act, attitudes, intentions, perceptions of behavioral control, and care, support and treatment services (CST). The purpose of this study was to analyze the effect of CST services and other factors that influence the intention and compliance of ARV therapy, using theory of planned behavior, health belief model, and path analysis.Subjects and Method: This was a cross sectional study conducted in Malang, East Java, from September to October 2019. A sample of 200 PLWH was selected by fixed disease sampling. The dependent variable was adherence to ARV treatment. The independent variables were intention, cues to action, attitude, perceived of behavioral control (PBC), and CST service. The data were collected by questionnaire and analyzed by path analysis run on Stata 13.Results: Adherence to ARV therapy in PLWH was directly increased by strong intention (b= 3.12; 95% CI= 2.12 to 4.12; p<0.001). CST service was directly increased adherence to ARV therapy, but it was statistically non-significant (b= 0.19; 95% CI= -0.89 to 1.28; p= 0.293). Adherence to ARV therapy was indirectly affected by strong cues to action, positive attitude, and strong PBC.Conclusion: Adherence to ARV therapy in PLWH is directly increased by strong intention. CST service is directly increased adherence to ARV therapy, but it is statistically non-significant. Adherence to ARV therapy is indirectly affected by strong cues to action, positive attitude, and strong PBC.Keywords: compliance, ARV therapy, PLWH, health belief model, theory of planned behavior Correspondence: Fitria Diyah Ayu Pangerti. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Jawa Tengah, Indonesia, 57126. Email: ayupangerti13@yahoo.com. Mobile: 081332600710Journal of Health Promotion and Behavior (2019), 4(4): 298-305 https://doi.org/10.26911/thejhpb.2019.04.04.06

MULTILEVEL ANALYSIS ON FACTORS AFFECTING CARIES PREVENTIVE BEHAVIOR AMONG PRIMARY SCHOOL CHILDREN: APPLICATION OF HEALTH BELIEF MODEL Ratih, Dewi Mustika; Dewi, Yulia Lanti Retno; Murti, Bhisma
Journal of Health Promotion and Behavior Vol 4, No 4 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Dental caries (tooth decay) is a problem of children?s dental health in the world. Primary school age is a strategic group for the precaution of dental and oral diseases. There is a transition from baby teeth to permanent teeth in the early childhood. Primary school age children do not have good self-care behavior. Therefore, they need parental supervision such as maintenance of dental and oral health. The theory of Health Belief Model (HBM) is used by the community to take positive health action such as precaution of a disease. This study aimed to analyze the caries preventive behavior by using the theory of the Health Belief Model.Subjects and Method: This study used analytic observational method with cross sectional approach. This study was conducted at 25 Primary Schools, Klaten Regency, in September 2019. This study used stratified proportional random sampling and random sampling techniques of 200 primary school children at 25 primary schools in Klaten Regency as the sampling technique. The dependent variable was caries preventive behavior. The independent variables were perceived susceptiblity, perceived severity, perceived benefit, and perceived barrier. This study used questionnaires to collect the data. The data were analyzed by using multilevel analysis on Stata 13.Results: Caries preventive behavior increased with perceived susceptibility (b=0.89; 95%CI=0.85 to 1.69; p=0.030), perceived severity (b=1.59; 95%CI=2.73 to 0.44; p=0.006), perceived benefit (b=1.05; 95%CI=1.97 to 0.12; p=0.026), and perceived barrier (b=-1.54; 95%CI=-2.84 to 0.25; p=0.019). The variation of caries preventive behavior by 7% was determined by variables at the primary school level. This rate was smaller than the standard size of rule of thumb by 8-10%. Therefore, there was a contextual effect shown from the multilevel analysis, but the result was statistically low.Conclusion: There is an effect of perceived susceptibility, perceived severity, perceived benefit, and perceived barrier on caries preventive behavior in primary school children. There is a contextual effect of primary school on caries preventive behavior based on the theory of Health Belief Model, but the result was statistically low.Keywords: multilevel analysis, primary school children, theory of Health Belief Model, precaution of caries.Correspondence: Dewi Mustika Ratih, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: dewiratih1822@gmail.com. Mobile: +625640041822Journal of Health Promotion and Behavior (2019), 4(4): 258-266https://doi.org/10.26911/thejhpb.2019.04.04.02

Relationship between Demographic Factors and Body Mass Index with the Prevention of Hypertension in Adolescents Indriawati, Ratna; Syaifudin, Syaifudin
Journal of Health Promotion and Behavior Vol 5, No 2 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Hypertension or increased blood pressure is often referred as the silent killer because it usually does not show significant signs and symptoms. Thus, almost all patients do not realize if they suffer from hypertension. The Basic Health Research (Riskesdas) 2007 reported that the prevalence of hypertension in the population aged over 18 years old in Indonesia was 31.7%. Because of the increasing prevalence of hypertension in adolescence, it is necessary to take precautions. This study aimed to examine the relationship between demographic factors and body mass index with the prevention of hypertension in adolescentsSubjects and Method: This was a cross sectional study conducted at Muhammadiyah 1 Senior high school, Yogyakarta, from May 2017 to February 2018. A sample of 80 students was selected for this study. The dependent variables were prevention behavior. The independent variables were age, sex, body mass index (BMI), and residence. The data were collected by questionnaire and analyzed by Chi square.Results: 48 (60%) students had good hypertension prevention behavior. Female (OR= 3.00; p= 0.030), urban residence (OR= 2.78; p= 0.040), and normal body weight (OR= 4.30; p= 0.001) increased behavior of hypertension prevention, and they were statistically significant. Older age (OR= 1.59; p= 0.220) increased behavior of hypertension prevention, but it was statistically non-significant.Conclusion: Female, urban residence, normal body weight, and older age increase behavior of hypertension prevention.Keywords: hypertension prevention behavior, demographic factorsCorrespondence: Ratna Indriawati. Department of Physiology, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta 55183 Indonesia. Email: r_indriawatiwibowo@yahoo.comJournal of Health Promotion and Behavior (2020), 5(2): 72-78https://doi.org/10.26911/thejhpb.2020.05.02.01

Biopsychosocial Determinants of Dental and Oral Health Behavior in Elementary School Children in Ponorogo, Indonesia: Application of Health Belief Model Kusumawardhani, Fahma Widya
Journal of Health Promotion and Behavior Vol 5, No 2 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Based on Basic Health Research in 2018, the proper brushing teeth behavior in children in Indonesia was 2.8%. The Elementary School period is an important stage for developing the behavior of maintaining dental and oral health in children (students). This study aimed to analyze the bio psychosocial determinants of the behavior of maintaining dental and oral health in elementary school children in Ponorogo by implementing the theory of Health Belief Model.Subjects and Method: This was a cross-sectional study conducted in Ponorogo, East Java, Indonesia, from January to February 2020. A sample of 200 students from 25 elementary schools was selected by simple random sampling. The dependent variable was dental and oral health behavior. The independent variables were knowledge, teacher’s role, attitude, perceived susceptibility, perceived seriousness, perceived benefit, perceived barrier, cues to action, self-efficacy, and school. The data were collected by questionnaire. The data were analyzed by a multilevel multiple logistic regression run on Stata 13.Results: Dental and oral health behavior in elementary school students increased with good knowledge (OR= 8.73; 95% CI= 2.18 to 34.95; p= 0.002), strong teacher’s role (OR= 3.99; 95% CI= 1.17 to 13.65; p= 0.027), positive attitude (OR= 6.45; 95% CI= 1.73 to 24.04; p= 0.005), strong perceived susceptibility (OR= 7.81; 95% CI= 2.12 to 28.78; p= 0.011), high perceived seriousness (OR= 6.62; 95% CI= 1.93 to 22.69; p= 0.003), weak perceived barrier (OR= 0.18; 95% CI= 0.05 to 0.72; p = 0.015), big perceived benefit (OR= 7.78; 95% CI= 1.80 to 33.56; p= 0.006), strong cues to action (OR= 3.95; 95% CI= 1.12 to 13.91; p= 0.032), and strong self-efficacy (OR= 4.99; 95% CI= 1.38 to 18.05; p=0.014 ). Elementary schools had contextual effect on the dental and oral health behavior with ICC= 14.14%.Conclusion: The behavior of maintaining dental and oral health in elementary school students is affected by good knowledge, strong teacher’s role, high perceived susceptibility, high perceived seriousness, weak perceived barrier, big perceived benefit, high cues to action, and strong self-efficacy. The school has a contextual effect on the behaviour of maintaining dental and oral health in students.Keywords: the behaviour of maintaining dental health, health belief model.Journal of Health Promotion and Behavior (2020), 5(2): 135-146https://doi.org/10.26911/thejhpb.2020.05.02.08

Determinants of Pregnant Women Participation on Triple Elimination of HIV, Syphilis, and Hepatitis B, in Semarang Fatimah, Mei
Journal of Health Promotion and Behavior Vol 5, No 2 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: HIV, Syphilis, and Hepatitis B infections are very susceptible to transmission from mother to child during pregnancy, childbirth, and breastfeeding. In 2014, the World Health Organisation (WHO) established a list of validation criteria to facilitate efforts of elimination of mother-to-child transmission (EMTCT) of HIV and syphilis. This study aimed to analyze determinants of pregnant women participation in the triple elimination uptake.Subjects and Method: This was a cross sectional study conducted at 25 Public health centers, in Semarang District, Central Java, from December 2019 to February 2020. A sample of 200 pregnant women was selected by random sampling. The dependent variable was triple elimination. The independent variables were intention, access to information, knowledge, outcome expectation, modeling, distance, self-efficacy, and husband support. Community health center was variable in level 2. The data were collected by questionnaire and analyzed by a multiple logistic multilevel analysis.Results: Triple elimination participation in pregnant women increased with good access to information (b= 1.76; 95% CI= 16.72 to 102.18; p<0.001), good knowledge (b= 2.09; 95% CI= 10.91 to 56.14; p<0.001), positive outcome expectation (b= 2.03; 95% CI= 12.93 to 71.91; p<0.001), strong modeling (b= 2.03; 95% CI= 2.83 to 1.64, p< 0.001), strong intention (b= 2.43; 95% CI= 8.49 to 46.22; p <0.001), strong self-efficacy (b= 2.48; 95% CI= 12.64 to 72.37; p<0.001), and strong husband support (b= 1.97; 95% CI= 12.2 to 65.24; p <0.001). Triple elimination participation in pregnant women decreased with further distance to health center (b= -2.20; 95% CI= 0.41 to 1.38; p= 0.032). Public health center had contextual effect on the participation of triple elimination in pregnant women with ICC= 40.64%.Conclusion: Triple elimination participation in pregnant women increases with good access to information, good knowledge, positive outcome expectation, strong modeling, strong intention, strong self-efficacy, and strong husband support. It decreases with further distance to health center. Public health center has contextual effect on the participation of triple elimination in pregnant womenKeywords: triple elimination, HIV, Syphilis, Hepatitis B, multilevel analysisJournal of Health Promotion and Behavior (2020), 5(2): 124-134https://doi.org/10.26911/thejhpb.2020.05.02.07

Application of Health Belief Model on Breast Self-Examination: A Meta-Analysis Maranata, Maranata; Pamungkasari, Eti Poncorini; Adriani, Rita Benya
Journal of Health Promotion and Behavior Vol 5, No 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Breast cancer is a type of cancer and the leading cause of cancer death in women. BSE is an early detection method for breast cancer. Health Belief Model is a model of health behavior that can predict women's interest in practicing BSE. This study aims to estimate the Health Belief Model's effect in the practice of BSE by meta-analysis.Subjects and Method: Meta-analysis was performed by searching for articles from the PubMed database, Springer Link, Elsevier, and Google Scholar. The keywords used were "health belief model," OR "health belief" OR "belief" AND "breast self-examination," OR "breast cancer screening." This study's inclusion criteria were full-text articles published in 2011-2020, a cross-sectional study design. Article analysis using RevMan 5.3 software.Results: There were 12 articles in total. The results showed that perceived benefits were strong (aOR= 1.02; 95% CI= 0.94-1.11; p= 0.590; I2= 73%), perceived barriers were weak (aOR = 1; 95% CI= 0.95-1.05; p= 0.920; I2= 87%).Conclusion: Perceived benefits and perceived barriers are not statistically significant in predicting BSE practice in women.Keywords: health belief model, perceived benefits, perceived barriers, BSECorrespondence: Maranata. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: maranataima@gmail.com. Mobile: 085867548771Journal of Health Promotion and Behavior (2020), 05(03): 221-231https://doi.org/10.26911/thejhpb.2020.05.03.08.

Determinants of Premarital Sex Behavior: Application of Theory of Planned Behavior and Social Cognitive Theory Qomariah, Nur Laili; Pamungkasari, Eti Poncorini; Budihastuti, Uki Retno
Journal of Health Promotion and Behavior Vol 5, No 4 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Health problems in adolescents are among the most important problems in the human life cycle, especially reproductive and sexual problems. Actively conducted premarital sex behavior poses a risk to teenage pregnancy and transmission of sexually transmitted diseases. This study aims to analyze the theory of planned behavior and social cognitive theory on the determinants of premarital sex behavior in adolescents.Subjects and Method: This was a cross-sectional study design. The study was conducted at 25 high schools/vocational high schools in Gresik, East Java, from September to October 2020. A sampling of 200 adolescents used stratified random sampling and simple random sampling. The dependent variable was premarital sex behavior. The independent variables were the intention, attitude, subjective norms, peer support, family intimacy, and self-efficacy. The data were collected by using a questionnaire. Data were analyzed using multiple logistic regression with Stata 13.Results: Premarital sexual behavior increased with strong intention (b= 1.06; 95% CI= 0.15 to 1.98; p= 0.015), positive attitude (b= 1.22; 95% CI= 0.38 to 2.13; p= 0.009), subjective norms supportive (b= 1.09; 95% CI= 0.14 to 2.04; p= 0.024), and strong peer support (b= 1.37; 95% CI= 0.44 to 2.30; p= 0.004). Premarital sexual behavior decreased with strong family intimacy (b= -1.32; 95% CI= -2.23 to -0.40; p= 0.005) and strong self-efficacy for abstinence (b= -1.03; 95% CI= -2.23 to -1.93; p= 0.025). There was an effect at the school level on premarital sex behavior with ICC 24.6%.Conclusion: Premarital sexual behavior increases with strong intentions, positive attitudes, supportive subjective norms, and strong peer support. Premarital sexual behavior decreases with strong family intimacy and strong abstinence self-efficacy. There is an effect at the school level on premarital sexual behavior.Keywords: premarital sex behavior, theory of planned behavior, social cognitive theory, adolescents.Correspondence: Nur Laili Qomariah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126. Email: lailiqomar@gmail.com. Mobile: +6281234190160.Journal of Health Promotion and Behavior (2020), 05(04): 272-283https://doi.org/10.26911/thejhpb.2020.05.04.05.

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