Journal of Health Promotion and Behavior
e-ISSN: 2549-1172 Publisher: Masters Program in Public Health, Sebelas Maret University, Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia Editor in Chief: Dr. Argyo Demartoto, M.Si Department of Sociology, Faculty of Social and Political Science, Universitas Sebelas Maret Aim and Scope The Journal of Health Promotion and Behavior (JHPB) is a peer-reviewed, open-access international journal that publishes original research articles, systematic reviews, and meta-analyses on a quarterly basis. Since its establishment on May 21, 2015, JHPB has served as a scholarly platform for advancing knowledge and practice in health promotion, health education, and health-related behavior across diverse populations and settings. JHPB takes a multidisciplinary approach to understanding the complex interplay of psychological, social, cultural, behavioral, and policy-level factors that influence health outcomes. The journal welcomes contributions from fields such as psychology, sociology, anthropology, communication, education, nursing, public health, and allied health professions, particularly as they relate to the prevention of illness, promotion of well-being, and transformation of health behaviors. The journal aims to provide evidence-based insights and practical strategies for improving population health through behavior change, policy reform, and community-based interventions. It seeks to deepen understanding of health behaviors and their determinants at individual, community, and societal levels. JHPB encourages submissions from researchers worldwide and places a strong emphasis on supporting high-quality research from low- and middle-income countries (LMICs), especially work that addresses pressing local health issues with potential global relevance. Areas of interest include, but are not limited to: Health behavior theories and applications Health promotion and disease prevention strategies Behavioral epidemiology and lifestyle research Health education methodologies and outcomes Cultural and social influences on health behavior Community health interventions and participatory approaches Health communication and information dissemination Policy and environmental influences on public health behavior Evaluation of health programs and health systems JHPB is officially accredited by the Ministry of Research, Technology, and Higher Education, Government of Indonesia, under Decree No. 10/C/C3/DT.05.00/2025. The journal holds SINTA 2 status, effective from April 16, 2022, to July 16, 2027. Through the dissemination of rigorous and impactful research, the Journal of Health Promotion and Behavior strives to advance global health equity, foster innovation in public health practice, and support the development of effective health promotion strategies tailored to diverse populations.
Masters Program in Public Health, Sebelas Maret University
Application of the Health Belief Model to Dengue Fever Prevention Behavior and Dengue Fever Incidence in Jepara Regency, Central Java
Background: Dengue fever is an infectious disease caused by the dengue virus and transmitted through the bites of Aedes aegypti and Aedes albopictus mosquitoes. The disease continues to pose a major public health challenge, particularly in tropical and subtropical regions, including Indonesia. This study aims to examine the Health Belief Model in relation to dengue prevention behaviors and the incidence of dengue fever in Jepara District, Central Java. Subjects and Method: This was a cross-sectional study conducted in Jepara District, Central Java, in January 2025. A sample of 200 respondents was selected using the fixed disease sampling method, all of whom were residents of Jepara District. The dependent variable was dengue prevention behavior. Independent variables included perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. The data were collected using a questionnaire and analyzed using multiple linear analysis. Results: Dengue prevention behavior increased with higher perceived susceptibility (b = 0.21; 95% CI = 0.00 to 0.43; p = 0.049), perceived severity (b = 0.29; 95% CI = 0.01 to 0.57; p = 0.044), perceived benefits (b= 0.33; 95% CI= 0.03 to 0.63; p = 0.030), cues to action (b = 0.19; 95% CI = 0.01 to 0.37; p = 0.042), and self-efficacy (b= 0.33; 95% CI = 0.01 to 0.65; p = 0.045), while lower perceived barriers were associated with improved prevention behavior (b = –0.18; 95% CI = –0.36 to –0.01; p = 0.045). Conclusion: The results of this study show that higher levels of perceived susceptibility, perceived severity, perceived benefits, cues to action, and self-efficacy, as well as lower perceived barriers, enhance dengue prevention behaviors.
Copyright (c) 2025 Journal of Health Promotion and Behavior
The Correlation of Knowledge and Attitudes to Passive Smoking Behavior among Public Health Students of Sriwijaya University
Background: There is no safe level of cigarette smoke, but not everyone can avoid the exposure. Public health students are expected to bring changes to healthy behaviors in the community, including getting the right to have air free from cigarette smoke through various preventive efforts. Therefore, this study aims to identify the behavior of public health students at Universitas Sriwijaya as passive smokers, and its correlation with knowledge and attitudes. Subjects and Method: This was a cross-sectional study conducted at Universitas Sriwijaya, South Sumatera, Indonesia, from February to March 2025. A sample of undergraduate students of Public Health was selected using purposive sampling. The dependent variable was smoking behavior. The independent variables were knowledge and attitude. Data were analyzed using a multiple logistic regression. Results: Passive smoking behavior among college students was influenced by knowledge (b = 0.17; 95% CI = –0.14 to 0.47; p = 0.103) and attitude (b = 0.61; 95% CI = 0.26 to 0.96; p = 0.001). While knowledge showed a positive but not statistically significant association with passive smoking behavior, attitude showed a statistically significant positive association. Conclusion: Passive smoking behavior among college students is influenced by knowledge and attitude. Knowledge and attitude have positive association with passive smoking behavior.
Application of the Information-Motivation-Behavioral Skills Model to Tertiary Preventive Behavior in Osteoarthritis
Background: Osteoarthritis (OA) is a type of degenerative disease in which chronic joint inflammation occurs that can occur in the elderly. People with osteoarthritis will feel pain and experience functional limitations. Physiotherapy helps prevent and minimize further joint damage. The success of the rehabilitation program depends on the patient's skills in doing exercises, lifestyle changes, such as maintaining weight and avoiding activities that improve the joints. This study aims to analyze the influence of the Application of the Information Motivation Behavioral Skills Model (IMB) on the tertiary preventive behavior in osteoarthritis patients. Subjects and Method: This was a cross sectional study conducted at a physiotherapy clinic in Surakarta, in January 2025. A sample of 210 osteoarthritis patients was selected using the fixed diseases sampling. The dependent variable was the tertiary preventive behavior. Independent vari­ables were information, motivation, and behavioral skill. The data were collected using question­naire and analyzed using a path analysis. Results: Tertiary preventive behaviors in OA patients increased with behavioral skills (b= 0.45; 95% CI= 0.34 to 0.55; p<0.001) and motivation (b= 0.44; 95% CI= 0.34 to 0.53; p<0.001). Behavioral skill increased with information (b= 0.47; 95% CI= 0.37 to 0.57; p<0.001) and motivation (b= 0.35; 95% CI= 0.25 to 0.46; p<0.001). The goodness of fit indices were p= 0.285; RMSEA= 0.026 (<0.050); CFI= 1.0 (≥0.90); TLI= 0.99 (≥0.90); and SRMR= 0.01 (<0.050). Conclusion: Tertiary preventive behaviors in OA patients increases with behavioral skill and motivation. Behavioral skill increases with information and motivation.
Implementation of the Health Belief Model as a Predictor of Acupuncture Therapy Adherence in Post-Stroke Patients
Background: Post-stroke symptoms include limb weakness, paralysis, loss of balance, pain and numbness, memory and cognitive disorders, and urinary and digestive problems. The recovery process in post-stroke patients takes a long time, therefore, the patient needs to adhere to acupuncture therapy for recovery. This study aims to analyze the influence of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action on acupuncture therapy adherence in post-stroke patients. Subjects and Method: This study was a cross-sectional study conducted in Yogyakarta, from November to December 2024. A total of 205 patients were selected using random sampling. The dependent variable was adherence to acupuncture therapy in post-stroke patients. Independent variables were perceived vulnerability, perceived severity, perceived benefits, perceived benefits, self-efficacy, and cues to action. The data were analyzed using path analysis. Results: Adherence to acupuncture therapy increased with increased perceived susceptibility (b= 1.19; 95% CI= -0.13 to 2.27; p=0.081), perceived severity (b= 2.16; 95% CI= 0.81 to 3.31; p= 0.001), perceived benefits (b= 1.71; 95% CI= 0.98 to 2.45; p<0.001), self-efficacy (b= 0.73; 95% CI= 0.11 to 1.36; p= 0.022) and cues to action (b= 1.77; 95% CI= 1.08 to 2.45; p<0.001). Conclusion: There is a positive relationship between perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and cues to action on adherence to acupuncture therapy in post-stroke patients. The perceived benefits and self-efficacy are a direct influence on adherence to acupuncture therapy in post-stroke patients, while the perceived susceptibility, perceived severity, and cues to action are indirect influences.
Application of Social Cognitive Theory as a Predictor of Quitting E-Cigarette Use among College Students
Background: Social Cognitive Theory was selected as the framework of this study because it can be used to explain, prevent, or reduce risky behaviors such as e-cigarette use. This study aimed to analyze and predict the behavior of quitting e-cigarettes through social cognitive theory among students. Subjects and Method: This study was conducted in October-November 2024 with a sample of 200 students. The study was a cross-sectional study with study subjects selected using the fixed disease sampling technique. The dependent variable was the behavior of quitting using e-cigarettes. And the independent variables were knowledge, self-regulation, outcome expectation, self-efficacy, and observational learning. Results: Quitting e-cigarettes was directly influenced by self-efficacy (b= 1.63; CI 95%= 0.93 to 2.33; p< 0.001) and outcome expectation (b= 0.82; CI 95%= 0.15 to 1.50; p= 0.017). Self-efficacy was directly influenced by knowledge (b= 0.94; CI 95%= 0.32 to 1.57; p= 0.003). Likewise, the outcome expectation was influenced by knowledge (b= 0.90; CI 95%= 0.28 to 1.53; p= 0.004). Knowledge was influenced by observational learning (b= 1.28; CI 95%= 0.65 to 1.92; p< 0.001). And self-regulation was influenced by the decision to quit using e-cigarettes (b=0.94; CI 95%= 0.37 to 1.51; p=0.001). Conclusion: This study concludes that constructs in Social Cognitive Theory can be used as a predictor of quitting e-cigarettes.
Application of Social Cognitive Theory as a Predictor for Health Screening Utilization among Pre-Marital Couples
Background: Circumstances in the early stages of development have a tremendous impact on a person's risk of developing diseases in adulthood. Numerous diseases can start in childhood and are generated by various traumas in early life, including improper treatment during pregnancy, maternal malnutrition, and maternal disease, one of which is diseases related to reproductive health. Premarital health screening is a series of tests that must be carried out by prospective brides and grooms before marriage, which aims to reduce the burden of inherited diseases by reducing the number of high-risk marriages. This study aimed to analyze the use of health screen­ing among pre-marital couples through the Social Cognitive Theory. Subjects and Method: A cross-sectional study was conducted in Nias, Indonesia, in October-November 2024. A sample of 200 brides and grooms was selected using fixed disease sampling. The data were collected using questionnaire and analyzed using a path analysis. Results: Outcome expectation was positively and indirectly associated with pre-marital health screening (b= 0.58; 95% CI= 0.01 to 1.15; p= 0.046). Knowledge, reinforcement, and observational learning were indirectly associated with pre-marital health screening among pre-marital couples. Conclusion: Social cognitive theory can be used to predict health screening uptake among pre-marital couples.
Relationships Between the Health Belief Model Constructs and Post-Stroke Patient Preferences in Choosing Acupuncture Therapy in Ngawi East Java
Background: Stroke is a serious medical condition that poses a significant risk of mortality and long-term disability, making it one of the leading causes of death and disability worldwide. Select­ing an appropriate therapy is crucial to enhancing the quality of life among post-stroke patients. The Health Belief Model (HBM), which emphasizes individual beliefs regarding health and illness, is thought to play a pivotal role in influencing patients' decisions when choosing therapeutic inter­ventions. This study aims to analyze the application of the Health Belief Model in the selection of acupuncture therapy among post-stroke patients. Subjects and Method: This study employed a cross-sectional design and was conducted in Ngawi Regency from October to December 2024. 200 samples of post-stroke patients were taken using the fixed disease sampling technique, consisting of 100 patients undergoing acupuncture and 100 patients undergoing physiotherapy. Dependent variables were the preference of acupuncture therapy and physiotherapy. Independent variables were perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Data was collected using questionnaires and analyzed using path analysis on STATA 17. Results: The preference for acupuncture therapy was directly influenced by self-efficacy (b=3.41; CI95%=2.59 to 4.23; p<0.001). Self-efficacy to undergo acupuncture therapy was influenced by the perceived benefits (=2.75; CI95%=1.74 to 3.75; p<0.001), perceived barrier (b=-0.94; CI95%=-1.96 to 0.80; p<0.001), and cues to action (b=3.36; CI95%=2.32 to 4.40; p<0.001). Perceived benefit was influenced by perceived severity (b=1.25; CI95%=0.62 to 1.88; p<0.001). Conclusion: Self-efficacy directly influences the preference for acupuncture therapy. Meanwhile, the perceived benefit, the perceived barrier, and cues of action indirectly affect the preference for acupuncture therapy through self-efficacy. Perceived benefit was influenced by severity perception.
Effect of Social Capital on Smoking and Alcohol Consumption Behavior in Adults
Background: Clinical epidemiological studies show that smoking and alcohol are often used together as social activities. Smoking and alcohol consumption are related to the risk of developing non-communicable diseases. According to data from the Indonesian Health Survey (SKI), (2023) the percentage of smokers in Surakarta City is 23.6% and the percentage of alcohol consumption is 1.4%. This study aims to analyze the influence of social capital on smoking behavior and alcohol consumption in adults. Subjects and Method: The research design used is a cross-sectional study. The population in this study is adults aged 19-59 years in the city of Surakarta. Sampling in the study was carried out by the snowball sampling method, then as many as 200 adults domiciled in the city of Surakarta were obtained. The method used in collecting data for this study is a questionnaire. The analysis used in this study is the Structural Equation Model (SEM) to analyze the influence of social capital elements on smoking behavior and alcohol consumption in adults. The dependent variables are smoking habits and alcohol consumption. The independent variable is social capital including 3 elements, namely structural elements, cognitive elements and relational elements. Results: Social capital had a negative effect on smoking behavior (b= -0.80; 95% CI= -0.88 to -0.71; p= 0.001), and social capital has a negative effect on alcohol consumption (b= -0.71; 95% CI= -0.80 to -0.63; p= 0.001). Conclusion: The results of this study show that social capital constructs include structural elements, cognitive elements and relational elements that are high have a lower likelihood of smoking behavior and alcohol consumption in adults.
Meta-Analysis: The Effect of HBM-Based Health Education on Improving Oral Health in Students
Background: Oral health problems are an important concern in health development, one of which is caused by the vulnerability of school-age children from oral and dental health disorders. School age is an important age in the growth and physical development of children. One of them is the habit of maintaining oral and dental health. This study aims to analyze and estimate the influence of HBM-based health education on oral and dental health in students. Subject and Method: The meta-analysis was performed according to the flow of the PRISMA diagram and the PICO model. The search for articles in this study is through databases that include PubMed, Google Scholar, Science Direct and Scopus. With keywords including: "Oral health" AND "Health Belief Model" AND "Students". Full paper article with RCT study, the subject of the study is the student, the measure of the relationship used is SMD, the outcome of the research is knowledge and perception of the severity of obesity prevention. Analysis was done with Revman 5.3 Results: There were 6 articles with randomized control trial designs from Iran and Hong Kong with 829 research samples. A meta-analysis of 6 randomized control trial studies concluded that students who received HBM-based education had a 1.04-fold higher perceived benefit for improving oral health compared to students who did not receive education, and the effect was statistically significant (SMD= 1.04; CI 95%= 0.28 to 1.79; p= 0.007). A meta-analysis of 5 rando­mized control trial studies concluded that students who received HBM-based education had a higher perception of severity to improve oral health 1.73 times compared to students who did not receive education, and the effect was statistically significant (SMD= 1.73; CI 95%= 0.49 to 2.98; p=0.006). Conclusion: HBM-based education has benefit to improve oral health.
Application of Social Cognitive Theory to Promote Healthy Behavior Among the Elderly at Integrated Health Post for Elderly
Background: The results of a survey by the Central Statistics Agency in 2021 reported that as many as 42.22% of the elderly population in Indonesia experience health problems. One of the factors that determines healthy behavior in the elderly is implementing healthy behavior. This study aims to examine the application of social cognitive theory as a determinant of healthy behavior of the elderly in Sukoharjo Regency, Central Java. Subjects and Method: This was a cross-sectional study carried out at integrated health post (posyandu) in Grogol, Sukoharjo Regency, Central Java, in June-July 2024. A sample of 200 elderly was selected purposively. Five villages were randomly selected. From each village, 6 primary strata Posyandu, 6 intermediate strata Posyandu, 6 purnama strata Posyandu, and 7 independent Posyandu were chosen. Then, from each selected Posyandu, 8 elderly individuals were randomly selected. The dependent variable is healthy behavior in the elderly. The independent variables are a number of constructs in social cognitive theory, namely observational learning, outcome expectation, outcome expectancy, reinforcement, and self-efficacy. Data were analyzed by multiple linear regression. Results: Healthy behaviors increased with observational learning (b= 0.17; 95% CI= 0.12 to 0.43; p= 0.001), outcome expectation (b=0.24; 95% CI= 0.02 to 0.473; p= 0.036), outcome expectancy (b= 0.36; 95% CI= 0.05 to 0.68; p= 0.025), reinforcement (b= 0.36; 95% CI= 0.10 to 0.84; p= 0.013), and self efficacy (b= 0.55; 95% CI= 0.19 to 0.91; p= 0.003). Conclusion: Healthy behavior in the elderly is positively associated with observational learning, outcome expectation, outcome expectancy, reinforcement, and self efficacy.
Application of Health Belief Model of Tertiary Prevention Behavior in Elderly People with Hypertension: A Multilevel Analysis
Background: The health of the elderly is influenced by various risk factors and changes from within themselves and their environment. These various conditions can affect health problems, functional status, level of independence and quality of life of the elderly. Deterioration of health in the elderly can manifest in a variety of diseases, including hypertension. Efforts to control the incidence of hypertension can be done through the provision of health education about hyper­ten­sion, which aims to raise awareness of hypertensives about the concept of hypertension, compli­cations, and how to overcome. This study aims to examine the application of the Health Belief Model (HBM) as a predictor by taking into account the contextual effects of the Elderly Integrated Healthcare Posts in Kepanjen, Malang, East Java, Indonesia. Subjects and Method: This study was an observational analytical study with a cross-sectional approach using a multilevel analysis model. The population in this study was all elderly people with hypertension at the Elderly Integrated Healthcare Posts in the working area of Kepanjen Commu­nity Health Center, Malang, East Java, Indonesia. The sample in this study was 200 elderly with hypertension at the Elderly Integrated Healthcare Posts in the Kepanjen Community Health Center Working Area, Malang, East Java, Indonesia. The study used the Stratified Sampling technique at the healthcare level (Elderly Integrated Healthcare Posts), and Stratified Random Sampling in the selection of the elderly. Results: Tertiary prevention behavior among elderly with hypertension increased with high self-efficacy (b= 0.57; CI 95%= 0.39 to 0.73; p<0.001), cues to action (b= 0.27; CI 95%= 0.35 to 1.71; p<0.001), female gender (b= 0.76; CI 95%= 0.10 to 0.42; p<0.001), age 70-90 years (b= 0.37; CI 95%= -0.01 to 0.75; p= 0.060). Integrated health posts for elderly on the tertiary prevention beha­vior of hypertension. The Integrated Healthcare Posts had contextual effect on tertiary prevention behavior (ICC=29.87%; p<0.001). Conclusion: Tertiary prevention behavior of hypertension in the elderly increases with high self-efficacy, cues to action, female gender, age 70-90 years.
Meta-Analysis: The Effect of HBM-Based Health Education on Obesity Prevention among Students
Background: Students engage in various health-risk behaviors such as lack of physical activity and unhealthy diet. Obesity is a worldwide health problem with increased prevalence every year, both in developed and developing countries. This study aims to analyze and estimate the influence of HBM-based health education on obesity prevention in students. Subject and Method: Meta-analysis was conducted according to the PRISMA flow diagram and PICO model. The search for articles in this study was through databases including PubMed, Google Scholar, Science Direct and Scopus. With keywords including: "Obesity" AND "Health Belief Model" OR "Health Belief" AND "Students". Full paper articles with RCT studies, research subjects were students, the relationship measure used was SMD, the outcome of the study was knowledge and perceived severity of obesity prevention. The analysis was conducted with RevMan 5.3 program. Results: There are 12 articles with randomized control trial designs originating from Iran, Iraq, India, Thailand, Australia with 2,261 research samples. Meta-analysis of 8 randomized control trial studies concluded that students who received HBM-based health education had knowledge in preventing obesity by 1.65 times higher than those without HBM education (SMD= 1.65; 95% CI= 0.60 to 2.70; p= 0.002). Meta-analysis of 6 randomized control trial studies concluded that students who received HBM-based health education had a perceived severity in preventing obesity by 1.85 times higher than those without HBM education (SMD= 1.08; 95% CI = 0.52 to 1.64; p= 0.002). Conclusion: HBM-based health education has a significant effect on increasing knowledge and perceived severity of obesity prevention in students.
Application of Information Motivation Behavior Skill Model on Maternal Parenting Behavior on Child Growth in Sleman, Yogyakarta, Indonesia
Background: Toddler growth disorders in Indonesia reach 59% of the highest ranking in the ASEAN continent, including: physical growth disorders, motor development, language and behavior. Suboptimal child growth can be avoided if mothers are able to support toddler growth by providing the right parenting pattern. Proper parenting can optimize child growth and develop­ment. This maternal behavior can be done by applying the Information Motivation Behavior (IMB) skill model. The purpose of this study aims to explore the application of the IMB model-based applica­tion to maternal parenting behavior on child growth in Sleman Regency. Subjects and Method: This was a cross-sectional study was conducted at 25 integrated health posts (Posyandu) in Sleman Regency, Yogyakarta, in April-May 2024. A sample of 200 mothers who have toddlers aged 24-60 months was selected using the stratified random sampling. The dependent variable was child growth. The independent variables were information, motivation, skills, and maternal parenting behavior. Data collection was using questionnaires and data analysis was using path analysis with Stata 13. Results: Maternal parenting behavior increased with good behavioral skills (OR = 1.28; 95% CI 0.60 to 1.97; p <0.001), good information (OR = 1.20; 95% CI 0.52 to 1.88; p <0.001), and strong motivation (OR= 0.98; 95% CI= 0.31 to 1.66; p= 0.004). Toddler growth is positively influenced by maternal parenting behavior (OR= 1.29; 95% CI= 0.46 to 2.13; p= 0.002) and family income (OR = 3.15; 95% CI = 1.92 to 4.38; p <0.001). Conclusion: Maternal parenting behavior increases with good behavioral skills, good information and strong motivation. Toddler growth is positively influenced by maternal parenting behavior and family income.
The Influence of Parental Sexual Education on the Prevention of Sexual Violence in Children: A Systematic Review
Background: Child sexual abuse is a serious form of violence and a major global public health concern. A 2018 survey by the Ministry of Women’s Empowerment and Child Protection reported that 1 in 17 boys and 3 in 5 girls in Indonesia had experienced sexual violence at least once in their lives. This study aims to analyze the influence of parental sexual education on the prevention of sexual violence in children. Subjects and Method: This systematic review was conducted using the PRISMA-ScR checklist. Database searches were performed in PubMed, Scopus, Wiley Online Library, and ScienceDirect for articles published between 2019 and 2022, with all sources accessible free of charge. The search terms used included: sex education to parents about sexual against children, “sex education” AND “parents” OR “sexual abuse” AND “children” OR “sex education” OR “parents” OR “sexual abuse” OR “children.” Selected articles were then critically appraised using the Joanna Briggs Institute (JBI) checklist. Results: From the initial search across the four databases (PubMed, Scopus, Wiley Online Library, and ScienceDirect), a total of 976 articles were identified. After removing three duplicate articles and screening the full texts, 10 articles met the inclusion criteria and were included in this systematic review. Conclusion: This study identified two main themes showing that parental sexual education plays an important role in helping children understand how to protect themselves and recognize different forms and consequences of sexual violence. The results emphasize that clear guidance and regular education from parents are essential to support children in preventing sexual violence.
The Role of Social Support in Improving Treatment Compliance in Tuberculosis Patients: A Meta-Analysis
Background: Tuberculosis is a disease that requires attention in global health issues. Tuber­culosis is a disease with a high mortality rate. Although a cure for tuberculosis has been discovered, the treatment process remains challenging, particularly the length of treatment. Tuberculosis pati­ents often fail to complete their treatment due to the lengthy duration. Support from loved ones and a supportive environment is crucial for tuberculosis patients during their treatment. With this support, tuberculosis patients will have a support system that can assist them in their treatment. This study aims to estimate the effect of social support on treatment compliance in tuberculosis patients. Subjects and Method: This study used a systematic review and meta-analysis using PICO. Population: tuberculosis patients. Intervention: social support. Comparison: no social support. Outcome: treatment adherence. The articles used in this study came from 2 databases, namely Google Scholar and Science Direct. The keywords of the article are "tuberculosis" AND ("social support" OR "support system") AND ("adherence" OR "compliance") AND "cross sectional" AND "multivariate". This study uses articles published in 2019 to 2025 with full paper articles, cross-sectional study designs, and the magnitude of the Adjusted Odds Ratio relationship. Articles were analyzed using the Review Manager 5.3 application. Results: Eleven cross-sectional studies showed that social support can increase tuberculosis treatment adherence by 1.44 times compared to tuberculosis patients who do not receive social support, and this result is statistically significant (aOR = 1.44; 95% CI = 1.03 to 2.01; p = 0.03). The forest plot also shows high heterogeneity of effect estimates between primary studies I2 = 84%. The calculation of the average effect estimate was carried out using the random effect model approach. Conclusion: Good social support can help improve treatment adherence in patients with tuberculosis.
The Analysis of Factors Influencing Stunting Prevention Behavior in Pregnant Women
Background: Stunting is a serious health issue in Indonesia, impacting children's growth and development due to chronic malnutrition, recurrent infections, and harmful environmental factors. This study aimed to examine factors influencing stunting prevention behavior in pregnant women Subjects and Method: A quantitative study with a path analysis approach. It was conducted in Probolinggo Regency using cluster random samping, based on inclusion criteria. The sample size consisted of 220 respondents spread across four community health centers (Puskesmas). The research variables include independent varaibles: exposure to cigarette smoke, socio-economic status, and social support; intervening variables: acces to healthcare services and health status; and dependent variable: stunting prevention behavior. The research instrument useda questionnaire based on the theoryof factors influencing stunting prevention in pregnant women, Data analysis was performed using path analysis with Amos software. Results: Social support on stunting prevention behavior through health status of pregnant women (Z-value = 1.23; p-value = 0.022). Social support on stunting prevention behavior in pregnant women through access to healthcare services (Z-value = -3.92; p-value = 0.00). Cigarette smoke exposure on stunting prevention behavior through health status of pregnant women (Z-value = 10.53; p-value = 0.00). Socio-economic status on stunting prevention behavior through health status of pregnant women (Z-value = 2.19; p-value = 0.03). Conclusion: Health promotion targeting the improvement of socio-economic status and social support, as well as preventing tobacco smoke exposure, plays a significant role in influencing stunting prevention behavior among pregnant women. Health status and access to healthcare services act as mediators that link social support, tobacco smoke exposure, and socio-economic status to stunting prevention behavior. By implementing community-based health promotion strategies, we can prevent stunting in a more holistic and sustainable manner.
The Influence of Cegah Anemia Remaja (Care) Educational Video on Knowledge and Perceptions of Anemia Prevention in Female Adolescents
Background: In adolescents aged 15-20 years, anemia is a disease that is susceptible, especially in young women. Early prevention efforts use educational videos motion graphics It has not been widely studied as to how much influence it has on knowledge and perceptions regarding the prevention of anemia in adolescents. This study aims to determine the effect of the Prevent Adolescent Anemia (CARE) educational video on knowledge and perceptions of preventing anemia in adolescents. Subjects and Method: A quantitative study was conducted on 68 teenage girls who were susceptible to anemia. This research used a quasi-experimental design that was held in February 2024 at Abi-Ummi Boyolali Islamic Boarding School. The dependent variable were adolescent knowledge and perception. The independent variable was Cegah Anemia Remaja (CARE) educa­tional video. The difference in values between the two groups was analyzed using the Wilcoxon matched-pairs signed-ranks test. The influence of the CARE educational video on adolescents' knowledge and perceptions of anemia was examined using multinomial logistic regression. Results: The prevalence of knowledge of preventing anemia in adolescents is 58.8% sufficient and the majority's perception of preventing anemia in adolescents is good, at 94.1%. The effect of CARE educational videos on knowledge is significant (OR= 5.40; p <0.001) and on perception is also significant (OR= 5.48; p= 0.013). Conclusion: Health education through the Cegah Anemia Remaja (CARE) Educational Video has an effect on increasing knowledge and perception of anemia prevention in female adolescents.
The Tradition of “Basunat” (Genital Circumcision) in Female Children and Its Implication on Reproductive Health
Background: The tradition of basunat or circumsised on baby girls is still carried out by the Banjaresse in South Kalimantan as part of a cultural heritage that is believed to be related to purity, family honor, and a smooth delivery process. Although it has no medical basis and is prohibited by law, this practice is still preserved on the basis of social, cultural, and religious values that develop in the community. This study aims to examine the form of basunat implementation on baby girls in the Banjar community and evaluate its impact on reproductive health. Subjects and Method: This was a qualitative study with a descriptive-exploratory approach. The study was conducted in Tapin, Barito Kuala, Banjarmasin, and Banjar Districts of South Kalimantan, Indonesia. The informants were village shamans, midwives, indigenous people, and women who had been circumcised. Data were collected through documentation and in-depth interviews, then analyzed using data reduction techniques, narrative presentation, and drawing conclusions. Results: The study showed that the practice of circumcision is still commonly carried out symbo­lically and physically, generally by village shamans with traditional tools that are not sterile. The community still believes that circumcision can smooth the delivery process and is a cultural or religious obligation. However, this practice has the potential to have negative impacts on women's physical and psychological health Conclusion: Policy interventions that prioritize local culture-based education and the involve­ment of religious and community leaders are needed. This approach can help change public perception and support the sustainable elimination of this tradition.
Promoting Menstrual Health Through Nutritional Education and Peer-Based Interventions in Adolescent Girls: A Scoping Review
Background: Menstruation, a normal part of puberty, is frequently misinterpreted because of societal stigma and limited access to proper education. Educational settings and peer-based programs are key in enhancing both menstrual and nutritional health, which are vital to supporting the overall well-being of adolescent girls. This Study aims to explore the factors influencing the promotion of menstrual health through nutrition education and peer-based interventions for adolescent girls using a scoping review methodology. Subject and Method: This scoping review was conducted using data obtained from PubMed Central, Science Direct and Google Scholar. The target population includes adolescent girl related to their menstrual health, nutritional education and peer-based intervention. A search was conducted using the keywords “Menstrual health" AND "nutritional education" AND "peer-based inter­ventions" AND ("adolescent girls" OR "teen girls" OR "adolescent health") AND ("menstruation" OR "menstrual hygiene" OR "menstrual health promotion") AND ("nutrition" OR "diet" OR "healthy eating") AND ("peer support" OR "peer education" OR "peer-led programs"), yielding 4.245 articles, which were then filtered down to 7 relevant articles after applying a 10-year time frame. Results: Several factors influence the promotion of menstrual health through nutrition education and peer-based interventions for adolescent girls. These include social support from peers, skills-based education, family involvement (especially mothers), sufficient nutrition literacy, psychosocial factors such as self-confidence and self-control, the role of schools as a health education platform, and the theoretical models used in the program, such as the Theory of Planned Behavior. Conclusion: Peer-led and skills-based education improves health outcomes for adolescent girls. Combining peer support, family involvement, and active learning enhances program success. Schools and communities should adopt these models to address adolescent health issues effectively.
Parental Communication as a Protective Factor Against Adolescent Risky Sexual Behavior: A Meta-Analysis
Background: Adolescence is a significant developmental stage marked by notable physical, psychological, and social changes. Adolescent reproductive health surveys show that a number of teenagers report engaging in premarital sexual intercourse without fully understanding its social and health consequences. Given this phenomenon, it is crucial to understand the factors that can protect them from risky sexual behaviors, particularly starting from the family. This study aimed to estimate the impact of family communication on risky sexual behavior in adolescents. Subjects and Method: This research is a meta-analysis and systematic review using the PRISMA diagram with PICO frame work (P= adolescent; I = parental communication; C= no parental communication; O= risky sexual behavior). Primary studies were searched through several indexing databases, including PubMed, Google Scholar, and ScienceDirect. Keywords used to facilitate the search for articles include: “parental participation,” or “parental communication,” or “family interaction,” or “sexual risk” or “sexual risk behavior” AND “adults” or “adolescents.” The inclusion criteria for this study are articles published using a cross-sectional study design up to 2024. The statistical analysis used in this study was conducted using the RevMan 5.4 meta-analysis program with both fixed effect and random effect approaches to present the data in the form of forest plots and funnel plots. Results: A total 9 Articles were included in the meta-analysis. The results of the study show that adolescents with low family participation in sexual education, or in the absence of parental communication, are 1.46 times more likely to engage in risky sexual behavior compared to adolescents who receive sexual education or have parental communication, and this result is statistically significant (aOR= 1.46; CI 95%= 1.43 to 1.49; p<0.001). Conclusion: adolescents with low family participation in sexual education, or in the absence of parental communication are more likely to engage in risky sexual behavior compared to adolescents who receive sexual education or have parental communication.