Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education

Mass Distribution of Insecticide-Treated Nets: A Qualitative Study on Sumba Island

Yona Patanduk — 2024-09-02

Background: The distribution of insecticide-treated nets (ITNs) is one of the main forms of malaria control intervention in Sumba Island. Although it has been running for more than a decade, there are still some gaps in the planning and implementation of this program. Aims: This study aims to obtain an overview of the planning and implementation of the mass distribution of ITNs running on Sumba Island, Indonesia. Methods: This study is qualitative research conducted in 2019 in all districts on Sumba Island. Data were collected by conducting in-depth interviews with 53 informants, including those in charge of the program, cross-sectors, and communities selected based on the researcher's considerations. Thematic analysis was used to produce the findings. Results: The study showed a gap between the number of ITNs and the real target, the sources of data on ITNs targets are different, and cross-sector involvement is limited to socialization activities, not maximizing the socialization and education of ITNs to the community. Conclusion: The planning and implementation of the mass distribution of ITNs on Sumba Island have not run optimally at the stages of socialization, logistics
management, and distribution to the community. Modification of socialization methods and strengthening of distribution strategies to the community is needed.

The Influence of Community and Societal Factors on the Occurrence of Wasting in Children Aged 3-5 Years

Yuni Riska Hadi — 2024-09-02

Background: Nutritional problems in toddlers remain a serious issue in several regions in Indonesia, including the working area of Songgon Health Center in Banyuwangi Regency. Aims: This study aims to analyze the influence of community and societal factors on wasting in children aged 3-5 years. Methods: The study uses a case-control approach with the entire population of toddlers in the working area of Songgon Primary Health Center as the target population. A cluster random sampling technique was used to obtain a sample of 166 individuals (83 wasting cases and 83 controls). Data were collected using a questionnaire that had passed validity and reliability testing. The collected data were analyzed through bivariate analysis using the chi-square test, and multivariate analysis using logistic regression. Results: The research results on wasting showed the following pvalues: t for family income 0.520 > α (0.05); occupation 0.263 > α (0.05 access to healthcare 0.121 > α (0.05); f immunization status 0.064 > α (0.05); education 0.436 > α (0.05); maternal knowledge 0.148 > α (0.05); family support 0.931 > α (0.05), and food security 0.430 > α (0.05), thus it can be interpreted these do not have a significant influence on wasting incidence. However, environmental sanitation significantly influences wasting incidence, as the p-value is 0.002 < α (0.05). Conclusion: The most influential factor in wasting incidence is environmental sanitation. Meanwhile, factors that have no influence are family income, mother’s occupation, healthcare access, immunization, education, knowledge, family support, and food safety.

Health Education Media to Increase Vegetable and Fruit Consumption in School-Aged Children

Widyana Lakshmi Puspita — 2024-09-02

Background: The lack of regulatory substances from fruits and vegetables is related to individual factors. Aims: The purpose of this study is to determine the effect of using educational media, lift-the-flap books, and leaflets on increasing knowledge, attitudes, parental support, and consumption of vegetables and fruit in elementary school children. Methods: This type of research was a quasi-experiment with a pre-and post-design approach to see the causal relationship between before and after counseling intervention with lift-the-flap book and leaflet media on increasing knowledge, attitudes, parental support, and consumption of vegetables and fruits in school-age children. Measuring knowledge scores, attitudes, and parental support was done using a Likert scale, and vegetable and fruit consumption using a 2x24-hour recall. Statistical analysis was conducted using the Test correlation test with a 95% confidence level (α = 5%). Results: Based on the research, it can be seen that using the lift-the-flap books and leaflet media can increase knowledge, attitudes, parental support, and consumption of vegetables and fruit compared to before using the media in elementary school children Pontianak. Conclusion: Lift-the-flap books are more effective in increasing knowledge, attitudes, parental support, and consumption of vegetables and fruits than leaflets.

"Feel Supported and not Alone": A Qualitative Study of Supports Needed by Pregnant Women in Preventing Anemia

Izzatul Arifah — 2024-09-02

Background: The ability of pregnant women to prevent anemia is influenced by their social environment support, such as family, husband, or health workers. However, it has not been known which sources of support are preferred and needed by pregnant women. Aims: This study aims to explore the support preferred and needed by pregnant women in preventing anemia. Methods: This study was qualitative research with a case study approach. Semi-structured interviews were conducted with 18 pregnant women at the gestational age starting from 16 weeks who had pregnancy checks at the Sangkrah, Kratonan, and Gilingan Primary Healthcare Centers, Surakarta City. Informants were obtained through a purposive sampling technique. This study used thematic data analysis. Results: Three emerging themes from this study include 1) pregnant women's perceived ability and motivation to prevent anemia; 2) the support needed to prevent anemia; and 3) information technology support for preventing anemia. Some women felt difficulties preventing anemia, especially in consuming IFA tablets and nutritious food; feeling supported and not alone was the motivation to prevent anemia. The most preferred support was from the husband, and the next was health workers. Pregnant women
welcome an application with some features to support preventing anemia. Conclusions: Support from husband and health workers is the most preferred. Pregnant women perceive the benefits of using applications that support anemia prevention. It is necessary to develop applications that integrate support from husbands and health workers to create good conditions that enable and motivate pregnant women to practice anemia prevention behavior.

Students’ Perception of Their Self-Efficacy by Being a “Hey Peer Educator” in Drug Abuse Prevention

Ira Nurmala — 2024-09-02

Background: Peer education programs provided in schools are one method to help prevent drug abuse; however, the effectiveness of these programs relies, in part, on their delivery to the population in need. Therefore, the effectiveness of the program relies on the self-efficacy of peer educators. The peer education program helps students to practice their skills as peer educators in avoiding drug abuse. Aims: This study aimed to explore the students’ self-efficacy as peer educators after being a peer educator in the peer education program. Methods: In-depth semi-structured interviews were conducted with 45 student peer educators in Middle schools located in Surabaya, Indonesia. Results: Adolescents who acted as student peers perceived and experienced an improvement in their knowledge and ability to help their peers avoid drug abuse. Conclusion: The peer education program is perceived to improve students’ self-efficacy in counseling tasks, to learn analytical skills, and to maintain positive behavior.

Household Latrine Utilization Behavioral Model as an Effort to Improve Open Defecation-Free Program

Erna Hartatik — 2024-09-02

Background: Healthy latrine-using behavior indicates healthy behavior. However, many people still practice open defecation, which can cause illness and increase death risk. Self-efficacy is a dominant predictor of health behavior change. Aims: The study aims to develop a household latrine utilization behavior model based on self-efficacy to improve an open defecation-free (ODF) program. Method: The study was a descriptive-analytic with a cross-sectional design. The sample size was 138 respondents with cluster random sampling. The study variables were endogenous (household latrine utilization), exogenous (predisposing, enabling, and reinforcing factors), and intervening variables (self-efficacy). Data were collected by questionnaire and analyzed using SEM-PLS. Result: The household latrine utilization behavior-based self-efficacy model is fit (SRMR=0.098; NFI= 0.910; Q2=0.334). Valid and reliable indicators were education (predisposing), clean water availability and latrine maintenance (enabling), and health worker and family support (reinforcing). Path analysis showed exogenous factors, directly and indirectly, influence latrine utilization behavior through self-efficacy. Predisposing and reinforcing factors had a direct and significant effect (p = 0.025; p = 0.001) while enabling factors were insignificant (p = 0.438). Enabling and reinforcing factors indirectly and significantly affected latrine utilization behavior through self-efficacy (p = 0.033; p = 0.004), while predisposing factors were insignificant (p = 0.141). Self-efficacy significantly influenced latrine-using behavior (p = 0.023). Conclusion: The household latrine utilization behavior-based self-efficacy model is a fit model with good predictive relevance in predicting household latrine use behavior. Health workers can use the model to enhance household latrine utilization behavior and improve the ODF program and public health status.

The Influence of Health Promotion Interventions Counseling and Peer Education Groups on Clean and Healthy Living Behaviors of Students in Islamic Boarding Schools

Puspita Sari — 2024-09-02

Background: The concept of healthy students is related to clean and healthy living behavior (PHBS) in the Islamic boarding school environment, which combines clean and healthy living behavior (PHBS) in educational institutions and the home environment. Aims: To determine the effect of counseling and peer education groups on the clean and healthy living behavior of students at the Irsyadul Ibad Islamic boarding school. Method: This research is an experimental study using a factorial design with two variables, counseling and peer education. The research sample was 84 students divided into 4 different groups, namely the combination group (counseling and peer education), the counseling group, the peer education group, and the control group. Each group lives in a different dormitory. The health promotion intervention was carried out for 15 days with 10 meetings to discuss clean and healthy living behavior. The statistical tests used were paired t-test and Wilcoxon to determine the differences in values before and after treatment. Kruskall Wallis and Mann Whitney were used to determine the differences in the scores of each group. Results: There are significant differences in knowledge and
attitude values before and after treatment, namely: combination group (counseling and peer education), Knowledge p= 0.003, attitude p= 0.009, Knowledge counseling group p= 0.001, attitude p= 0.030 peer group education knowledge p= 0.000, attitude p= 0.001 and control group knowledge p= 0.067, attitude p= 0.053. There are differences in knowledge and attitudes in each group, namely the combination group (counseling and peer education), with the control group, knowledge p = 0.000, attitude = 0.000, counseling group with the control group, knowledge p = 0.000, attitude p = 0.000 peer education group with the control group knowledge p=0.000 attitude p= 0.000. Combination group
(counseling and peer education), with knowledge counseling group p=0.063 attitude p= 0.134 combination group (counseling and peer education), with peer education knowledge p=0.079, attitude p=0.095. Counseling group with peer education group knowledge p= 0.332, attitude p=0.424. Conclusion: Combination groups (counseling and peer education), counseling groups, and peer education groups influence clean and healthy living behavior among students at the Irsyadul Ibad Islamic Boarding School.

Using the Theory of Planned Behavior to Explore Factors Associated with the Behavior of Consuming Blood Booster Tablets Among Adolescent Girls in Bantul Regency

Retno Heru Setyorini — 2024-09-02

Background: Providing iron and folic acid through the ingestion of blood booster tablets is an intervention to lower the prevalence of anemia in adolescents. However, just a small percentage of adolescent girls have consumed blood booster tablets as prescribed. Aims: To identify the factors related to the behavior of consuming blood booster tablets among adolescent girls in Bantul Regency based on the Theory of Planned Behavior. Methods: The cross-sectional study was conducted in Bantul Regency, a Special Region of Yogyakarta Province, between March and May 2023. A total of 381 adolescent girls aged 16-18 years participated in filling out questionnaires to collect data. The questionnaire includes socio-demographics, knowledge about blood booster tablets and anemia,
attitudes, subjective norms, intentions, and behaviors of consuming blood booster tablets. Path Analysis was used to analyze the data with statistical significance (p) at 0.05. Result: As a result, intention directly influences the behavior of consuming blood booster tablets (p=˂0.001). Subjective norms have a direct influence on the behavior of consuming blood booster tablets (p=0.023) and have an indirect influence through attitudes (p˂0.001) and intentions (p˂0.001). Attitude has an indirect influence on the behavior of consuming blood booster tablets through intention (˂0.001), then the level of knowledge has an indirect influence on intention (p=0.037) and attitude (p=0.032). Conclusion: Adolescent girls will have good consumption behavior of blood booster tablets if they have a positive attitude, a high level of knowledge, subjective norms, and high intentions. These findings can be used to design health promotion models useful for increasing the consumption behavior of blood booster tablets. Further research is needed to find the right educational model to increase knowledge, attitudes, subjective norms, and intentions to consume blood booster tablets.

Mitigating Stunting in Semarang City, Indonesia: A Comprehensive Approach to Better Health and Well-Being

Krisseptiana — 2024-09-02

Background: Among the 29 districts and 6 cities in Central Java, Semarang City stands out as the urban area with the most substantial reduction in stunting prevalence over a year (2021-2022), from 21,3% to 10.4%, while numerous regions continue to grapple with challenges in lowering rates of stunting. Aims: This study aims to investigate Semarang City's comprehensive strategy for mitigating stunting. Methods: This study used a qualitative case study approach. Utilizing focus group discussions (FGD) and document analysis, representatives from 16 diverse sectors, including health, education, religion,
social services, food security, and more, engaged in discussions to synchronize activities and policies to achieve the common goal of stunting reduction. Simultaneously, a comprehensive document analysis was conducted, reviewing relevant documents, reports, and policies across 16 districts in Semarang City. Data analysis employed Miles et al.'s interactive model, involving data condensation, display, and conclusion drawing/verification. Results: The success of stunting reduction in Semarang City is highlighted by relevant regulations, an updated and accurate statistical database, intensive cross-sector coordination, and a synchronized effort across diverse sectors. Furthermore, the city's prudent financial planning is evident through sufficient and on-target budget allocations dedicated to stunting reduction programs. Conclusion: The research the importance of ongoing commitment, adaptability, and collaborative efforts to achieve the ambitious goal of zero stunting by 2024 in Semarang City, suggesting future studies focus on program effectiveness and long-term sustainability.

The Best Practices for Designing Built Environments to Promote Healthy Food Access and Dietary Behaviors in Low-Income and Underserved Communities

Muhamad Ratodi — 2024-09-02

Background: The built environment can influence health outcomes, including access to good dietary options. Aims: The current study intends to thoroughly evaluate the literature on best practices for building environments that promote healthy food access and nutritional behaviors in low-income and underserved communities in Indonesia. Method: To discover relevant studies on this topic, a thorough literature review was done using databases from PubMed, Web of Science, and Scopus extracting. Result: The final analysis included 32 studies after removing duplicates and applying inclusion and
exclusion criteria. Extracting and assessing data from the chosen research and thematic synthesis was applied. The data was extracted and processed into a detailed narrative that provided an overview of the best practices. Conclusion: According to the findings of the literature study, built environment design can have a considerable impact on healthy food availability and eating patterns in Indonesian communities. It might be possible to develop effective interventions that enhance health outcomes for all Indonesians by addressing these gaps in the evidence.

Socio-Cultural Study of Nutrition in Families of Stunted Toddlers in Coastal Communities in Jember Regency

Iken Nafikadini — 2024-09-02

Background: Cultures, traditions, or habits that exist in society, such as dietary restrictions and wrong eating patterns, can lead to increased nutritional problems, especially in toddlers, which ultimately impacts their growth and development. Low-income family parenting patterns in feeding and primary health care for toddlers can also increase the incidence of stunting in toddlers. This could be the cause of the stunting rate in the Jember Regency, especially in coastal areas. Dietary problems, including stunting, in coastal areas should be less likely to occur because the availability of high-protein animal foods such as fish is quite high, but Curahnongko Village is included in the stunting locus area in Jember Regency. Aims: This research aims to describe the socio-cultural nutrition and parenting styles of toddlers in Curahnongko Village. Methods: The study used qualitative and research methods with a case study approach. Results: The socio-culture during pregnancy in the coastal communities of Jember Regency regarding TTD consumption, routine check-ups, taboos during pregnancy, and visits to midwives are quite good. Socio-culturally during the breastfeeding period, it can be concluded that all
informants carried out Early Breastfeeding Initiation (IMD). Socio-culturally during the feeding period for toddlers, all informants do not give food other than breast milk to babies when they are born. Conclusion: The socio-cultural aspect that appears to influence the occurrence of stunting is during the feeding period for toddlers, namely the frequency of children's snack consumption outside the home.

Self-Esteem among Men Who Have Sex with Men Living with HIV: A Qualitative Study

Linlin Lindayani — 2024-09-02

Background: HIV transmission in males, particularly in Indonesia, is increasing due to increased sexual activity among Men who have Sex with Men (MSM) groups. This is largely due to diminished self-esteem and reluctance to disclose their status, influenced by factors like power, virtue, relevance, and competence. Aims: The study investigates the self-esteem of MSM living with HIV and explores the factors that may influence their self-esteem. Methods: This study employs a descriptive qualitative study. The study used interviews and content analysis techniques to gather data on HIV individuals at the Public Health Center, specifically focusing on MSM. Results: The interview data revealed six themes: individualism, body image dissatisfaction, lack of motivation, lack of peer support, aspiration to be useful, and self-esteem needs. Conclusion: The study reveals that self-esteem in HIV-positive men is influenced by coping strategies, body image dissatisfaction, motivation, and peer support. It suggests helping others and enhancing library resources, regular investigations, and a specialized counseling program to improve self-esteem.

Maternal Factors as Determinants of Stunting in Children under the Age of Five: Scoping Review

Anna Uswatun Qoyimah — 2024-09-02

Background: Chronic malnutrition during a child's early years leads to stunting, a condition that can harm both their mental and physical development. Studies have indicated a correlation between parenting styles and stunted growth in children that the nutritional knowledge and practices of mothers significantly affect the dietary habits of toddlers. The perspectives and cultural convictions of mothers are significant but have received limited attention as factors that influence the nutritional well-being of children and adolescents. Aims: This review examined maternal factors as determinants of stunting in children under five. Methods: Three databases were used to search for literature, namely PubMed, Scopus, and Google Scholar. The key to the search is as follows: “maternal” or “mothers” and “factor” and “stunting” or “stunted” or “growth disorder” and “toddler” or “children under five.” The material displayed in search engines is selected based on inclusion and exclusion criteria. Result: This review was done on nine articles that were screened and analyzed out of 1,450 articles. The articles come from Nepal, India, Indonesia, Ghana, Congo, Uganda, Lebanon, and the Central African Republic. The type of research articles was cross-sectional and case-control. Conclusion: This review has provided an overview of maternal factors contributing to the prevalence of stunting. These factors include maternal employment, the educational status of mothers, maternal body mass index, the diversity of the mother-child diet, maternal exposure to mass media, and maternal age.

Identification of Symbols in Indonesian Traditional Fairy Tales as a Health Promotion for the Prevention of Non-Communicable Diseases Diabetes Mellitus and Hypertension

Chelomitha Malindra Purnamayanti — 2024-09-02

Background: Non-communicable diseases are one of the groups of diseases with the highest causes of death in the world. This was shown by data from WHO that in 2023, around 74 percent of the causes of death in the world are non-communicable diseases that kill 41 million people per year. This is due to the lack of public understanding of the influence of risk factors for non-communicable diseases on the incidence of non-communicable diseases and complications that can be caused by non-communicable
diseases. Therefore, the use of traditional Indonesian fairy tale symbols in health promotion media to prevent non-communicable diseases can be used as an alternative solution to overcoming this challenge. Aims: This study aims to identify, examine, and synthesize symbols in traditional Indonesian fairy tales that have the potential to they can be developed to improve health messages to prevent noncommunicable diseases, especially diabetes mellitus and hypertension. Method: The method used in this study was a Literature Review with a narrative review study design. The steps taken are to gather all the fairy tales with inclusion criteria are fairy tales that have symbols about non-communicable diseases and exclusion criteria are incomplete fairy tales, and then do the screening, identifying symbols, analyzing symbols, and selecting potential symbols. Results: Of the 21 relevant titles of Indonesian traditional fairy tales and legends, 85 symbols were identified. From the analysis of the meaning of each symbol, 16 symbols were found that have the potential to be used as promotions for
the prevention of non-communicable diseases, diabetes mellitus, and hypertension, with 10 different symbol categories spread across 7 provinces in Indonesia. Conclusion: There are many symbols from traditional Indonesian fairy tales that have the potential to they can be used to increase the effectiveness of delivering health messages as an effort to promote the prevention of non-communicable diseases diabetes mellitus and hypertension. These symbols can be made into health messages nationally and can be flexibly used to create health messages in each region.

A Scoping Review: Unveiling the Benefits of ACF on Tuberculosis Control

Saroh — 2024-09-02

Background: Tuberculosis (TB) ranks among the top ten infectious diseases and causes of death worldwide. The implementation of active case-finding TV is crucial in achieving the objectives of the World Health Organization’s End TB strategy. Aims: This review aims to determine the role of active case finding in TB control in a community with high-burden TB. Methods: This review used databases Pubmed, Research Gate, Ebscohost, Science Direct, and Scopus. The search for articles used the main keywords community, active case finding, AND tuberculosis. The articles were selected in English, with a five-year time interval between 2019 to 2023. The type of article subject area included medicine, health, health care, environmental science, and social science. The documents were from journals and articles. The text availability was free full text. Results: This review was done on 3.561 articles that were screened and analyzed out of 6 articles. The articles were originated from Cambodia, China, India, and Africa. This scoping review describes the effect of ACF in the community on TB control (cohorts and cross-sectional) in high-burden TB. Results from 5 articles including 6 studies indicated that ACF in the community was significantly associated with TB control. One of the studies revealed that studies in which ACF reported a non-significant association. Conclusion: This review summarized that ACF provides greater benefits than the PCF strategy, especially in high-risk populations and those with limited access to healthcare facilities. It promotes prompt diagnosis and treatment improves treatment outcomes, minimizes health complications, and reduces the social and economic impact of TB.