Gender, Diet, and Metabolic Syndrome in Adolescents in Malang, East Java

BACKGROUND: Metabolic syndrome is a set of sympton causing degenerative disease. Metabolic syndrome is assesed based on individual body mass index, waist circumference, blood presure, triglyceride level, high density lipoprotein level, and fasting blood sugar level. People with overweight and obesity had an increased risk of metabolic syndrome. This study aimed to examine the relationship between gender, diet, and metabolic syndrome, in adolescents. SUBJECT AND METHODS: This was a cross sectional study conducted in Malang, East Java. A sample of 227 adolescents was selected from several high school in Malang. The dependent variable was metabolic syndrome. The independent variables were gender and diet, which included energy, carbohydrate, protein, and fat intake. The data were analyzed using linear regression. RESULT: There were positive and statistically significant relationships between metabolic syndrome and energy intake (b=0.01; 95%CI=0.009 to 0.02; p=0.026); carbohydrates intake (b=0.02, 95%CI=0.01 to 0.04; p=0.012); protein intake (b=0.07; 95%CI=0.03 to 0.09; p=0.010); fat intake (b=0.06; 95%CI=0.04 to 0.12; p=0.002), gender (b=1.81; 95%CI=0.08 to 3.52; p=0.039). CONCLUSION: Diet and gender are risk factors for metabolic syndrome. Keywords: metabolic syndrome, gender, die

Penggantian Bungkil Kedelai dengan Ampas Susu Kedelai dalam Pakan: Pengaruhnya pada Kinerja Pertumbuhan dan Kualitas Daging Ayam Broiler

Enam puluh ekor ayam broiler jantan digunakan untuk mengetahui pengaruh penggantian tepung bungkil kedelai (SBM) dengan ampas susu kedelai (SMW) dengan menggunakan kinerja pertumbuhan, rasio efisiensi protein-energi, serta kualitas fisik daging sebagai respon kriteria yang diamati. Ayam mendapatkan pakan kontrol (SMW-0), atau pakan kontrol dengan penggantian ampas susu kedelai sebanyak 5% (SMW-1), 10% (SMW-2), dan 15% (SMW-3). Setiap perlakuan diberikan replikasi 3 kali, masing-masing dengan 5 ekor ayam per replikasi. Data yang diperoleh selanjutnya dianalisis statistik menggunakan Oneway ANOVA, yang dilanjutkan dengan Duncan’s new Multiple Range Test. Hasil penelitian menunjukkan bahwa penggantian SBM dengan SMW tidak mempengaruhi konsumsi protein dan energi, konsumsi pakan, maupun rasio efisiensi energi. Akan tetapi, penggantian 10% SMW meningkatkan (P<0,05) rasio efisiensi protein, pertambahan bobot badan, dan bobot potong ayam, sehingga nilai konversi pakan turun (P<0,05). Nilai pH daging, daya ikat air, susut masak, maupun keempukan daging tidak terpengaruh oleh penggantian 5-15% SMW

The Effectiveness of Diabetes Self-Management Education Program in Improving Self-Care among Patients with Type 2 Diabetes Mellitus

Background: Diabetes self-management education (DSME) is a critical element of care for all people with diabetes and those at risk for developing the disease. It is necessary in order to prevent or delay the complications of diabetes and has elements related to lifestyle changes that are also essential for individuals with pre diabetes as part of efforts to prevent the disease. This study aimed to examine the effectiveness of diabetes self management education program in improving self-care among patients with type 2 diabetes mellitus. Subjects and Method: A randomized controlled trial study was carried out in 7 puskesmas (community health centers) in Tarakan, North Kalimantan, from March 28 to May 20, 2018. A sample of 126 diabetes patients was selected for this study by simple random sampling, comprising 63 patients as intervention group and 63 patients as control group. The dependent variable was diabetes self-management behavior. The independent variables were diabetes self-management education program (DSME). The data were collected by questionnaire. The difference between two groups was analyzed by t-test. Results: Self-management behavior in the DSME group (median= 26; SD= 6.62) was better than the control group (median= 21; SD= 4.55) with p<0.001. Conclusion: Diabetes self-management education program is effective to improve self-management behaviour among patients with type 2 diabetes mellitus. Keywords: diabetes self-management education, self-management behavior, type 2 diabetes mellitus patien

Knowledge, Attitude, Sexual Behavior, Family Support, and Their Associations with HIV/AIDS Status in Housewives

Background: Approximately 36.7 million people in the world were infected by HIV and 2.1 million new cases occured in 2015. A total of 191,073 HIV cases were reported in Indonesia in 2016, including 77,940 AIDS cases, and 13,247 deaths. Housewives ranked highest among HIV/AIDS patients in Indonesia. This study aimed to investigate knowledge, attitude, sexual behavior, family support, and their associations with HIV status in housewives using PRECEDE PROCEED model.Subjects and Method: This was an analytic observational study with cross-sectional design. The study was conducted at Toroh community health center, Grobogan, Central Java, in July, 2017. A total sample of 129 housewives were selected for this study using exhaustive sampling technique. The dependent variable was HIV status. The independent variables were knowledge, attitude, sexual behavior, and family support. The data was measured by a set of questionnaire and analyzed using path analysis.Results: HIV status was directly and positively associated with risky sexual behavior (b= 4.48; 95% CI= 2.30 to 6.65; p<0.001). Risky sexual behavior was associated with attitude (b= -1.27; 95% CI = -0.03 to -2.51; p<0.045) and family support (b= -1.86; 95% CI= -0.69 to -3.03; p<0.002). Attitude was associated with knowledge (b= 2.06; 95% CI = 0.86 to 3.25; p<0.001).Conclusion: HIV status is directly and positively associated with risky sexual behavior. HIV status is indirectly associated with attitude, knowledge, and family support.Keywords: HIV, AIDS, risky sexual behavior, housewives, PRECEDE PROCEED modelCorrespondence: Budi Laksana. Diploma III Program in Midwifery Muhammadiyah, Madiun, East Java. Email: [email protected]. Mobile: +6285655612000.Journal of Epidemiology and Public Health (2017), 2(2): 154-163https://doi.org/10.26911/jepublichealth.2017.02.02.0

Path Analysis on the Effects of Bio-psychosocial Factors and Calorie Intake in Blood Glucose Control in Patients with Type 2 Diabetes Mellitus

Background: Diabetes mellitus (DM) is a serious chronic disease with its tendency to deteriorate. The DM cases worldwide in 2015 was 415 million people and it is estimated to increase as many as 642 million cases in 2040. Indonesia ranked 7 in the world with 10 million cases of DM in 2015, about 90% of which were Type 2 Diabetes Mellitus. This study aimed to determine the effect of biopsychosocial factors and calorie intake on the blood glucose control in patients with Type 2 DM.Subjects and Method: This was an analytic and observational study with case control design. This study was carried out at Internal Medicine Polyclinic, Department of Endocrinology, Dr. Moewardi Hospital, Surakarta, Central Java, from October to November 2016. A total sample of 135 cases of Type 2 DM were selected for this study by fixed disease sampling. As many as 106 of these study subjects at HbA1c ≥6.5% and 29 cases of Type 2 DM had HbA1c <6.5%. The dependent variable was HbA1c level. The independent variables were educational level, family income, psychological stress, calorie intake, and Body Mass Index (BMI). The data were collected by a set of questionnaire. HbA1c was measured by High Performance Liquid Chromatography (HPLC), which was recorded in the medical record. Calorie intake was measured by 24 hour food recall. Psychological stress was measured by International Physical Activity Questionnaire (IPAQ). The data was analyzed by path analysis on STATA 13.Results: Psychological stress (b=0.99, 95%CI=0.07 to 1.92, p=0.034), calorie intake (b= 1.84, 95%CI= -0.24 to 3.92, p=0.083), and BMI (b= 1.15, 95%CI= 0.22 to 2.08, p=0.016), had positive and statistically significant effect on HbA1c. Calorie intake increased BMI (b= 2.35, 95%CI=0.31 to 4.39, p=0.024), education decreased calorie intake (b=-2.26, 95%CI= -3.38 to -1.14, p<0.001), and family income increased calorie intake (b= 1.23, 95%CI= 0.26 to 2.21, p= 0.013).Conclusion: Calorie intake, BMI, psychologi stress, and family income are associated with increase in HbA1c level. Education decreases HbA1c level via decreased calorie intake. Type 2 DM patients need to pay attention to these biopsychosocial factors and calorie intake in order to control blood sugar.Keywords: biopsychosocial factors, calorie intake, HbA1cCorrespondence: Isfaizah. Ngudi WaluyoUniversity, Ungaran, Central Java. Email: [email protected]. Mobile: +6281228570003.Indonesian Journal of Medicine (2016), 1(2): 90-99https://doi.org/10.26911/theijmed.2016.01.02.0

Health Belief Model for the Analysis of Factors Affecting Hypertension Preventive Behavior Among Adolescents in Surakarta

Background: Hypertension is an important public health issue in developed and developing countries. The incidence of hypertension continues to rise to a serious level. Raising awareness of the seriousness of hypertension among peer groups may be an important factor for preventive health behavior. This study aimed to examine the used of health belief model for the analysis of factors affecting hypertension preventive behavior among adolescents.Subjects and Method: This study was an observational analytic study with cross sectional design. It was conducted at 5 Vocational High Schools (SMK) in Surakarta from April to May, 2017. A sample of 200 class X and XI SMK students aged 15-17 years was selected for this study by stratified random sampling. The dependent variable was hypertension preventive behavior. The independent variables were perceived susceptibility, perceived seriousness, perceived benefit, perceived barriers, cues to action, and self efficacy, with perceived threat as a mediating variable. The data were collected by a set of pre-tested questionnaire. Path analysis was employed for data analysis using SPSS AMOS 22.Results: Perceived threat (b=0.24, SE=0.07, p=0.002), perceived benefit (b=0.24, SE=0.10, p=0.021), self efficacy (b=0.40, SE=0.23, p=0.084), and cues to action (b=0.45, SE=0.15, p=0.003) showed direct positive effects on hypertension preventive behavior. Perceived barrier (b=-0.26, SE=0.10, p=0.015) showed direct negative effect on hypertension preventive behavior. Perceived susceptibility (b= 0.27, SE= 0.09, p=0.005), perceived seriousness (b=0.29, SE=0.09, p<0.001), and cues to action (b=0.34, SE=0.13, p=0.008) showed indirect positive effects on hypertension preventive behavior.Conclusion: Hypertension preventive behavior is positively and directly affected by perceived threat, perceived benefit, self, and cues to action. The preventive behavior is negatively and directly affected by perceived barrier. Perceived susceptibility, perceived seriousness, and cues to action indirectly and positively affect on hypertension preventive behavior.Keywords: health belief model, hypertension, preventive behavior, adolescentsCorrespondence: Rumeyda Chitra Puspita. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: [email protected]. Mobile: +6287736044472.Journal of Health Promotion and Behavior (2017), 2(2): 183-196https://doi.org/10.26911/thejhpb.2017.02.02.0

Community Participation in Sanitation Kampung Program, Surakarta

Background: Indonesia ranks third in the world in the number of people with limited access to sanitation. Surakarta municipality government in collaboration with local drinking water supplier (PDAM) operate Indonesian Urban Water, Sanitation and Hygiene (IUWASH) to overcome sanitation problems in the form of Sanitation Kampung Program in Semanggi Village, Surakarta. This study aimed to review community participation in Sanitation Kampung Program, Semanggi Village.Subjects and Method: This was a qualitative study conducted at RW 23, Semanggi Village, Pasar Kliwon subdistrict, Surakarta, Central Java. Informants were selected purposively for this study comprising 12 community members as key informants, 2 community leaders, head of Sanitation Kampung Program, and 1 environmental health expert as supporting informants, The data were collected by in-depth interview, focus group discussion, and document review. Data credibility was checked by triangulation. The data were analyzed by content analysis. Results: At the beginning of Sanitation Kampung Program planning there were some pros and cons from the community. Some of the community accepted the program but some others refused it due to negative perception that Sanitation Kampung Program would cause bad smell and pollute well water. In order to overcome community refusal toward Sanitation Kampung Program, IUWASH, Surakarta municipality government, and community leaders, carried out socialization, community approach, and study tour to other places. In the end, the community accepted Sanitation Kampung Program. Community members participated the program by providing support for water and sanitation facility development. Community members made use of the water and sanitation facility for daily activities. They also maintained the water and sanitation facility.Conclusion: By developing good and trustable collaboration, community participate in Sanitation Kampung Program from planning, developing, using, and maintenance of the water and sanitation facility.Keywords: water, sanitation, community, participation, programCorrespondence: Anak Agung Alit Kirti Estuti Narendra Putri. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285643231616.Journal of Health Promotion and Behavior (2017), 2(3): 257-271https://doi.org/10.26911/thejhpb.2017.02.03.0

Maternal Employment Status, Ethnicity, Food Intake, and Their Effects on Teenage Obesity, in Surakarta

Background: Obesity is one of the main causesof premature death in adulthood. The prevalence of teenage obesity in Indonesia hasbeen increasing from 1.4% in 2007 to 7.3%. It is hypothesized that the risk of obesity is influenced by lifestyle and socio-economic status. This study aimed to determine the effect of maternal job status, ethnicity, and food intake, on the risk of obesity in teenagers.Subjects and Method: This was an analytical observational using case-control design. This study was conducted in Surakarta, in September – November 2016. A total of 120 teenagers were selected for the study, consisting of 41obese teenagers aged 16-18 years old and 79 normal weight teenagers, using fixed disease sampling. The dependent variable was obesity. The independent variables were maternal employment status, ethnicity, carbohydrate intake, fat intake, and energy intake. The data were collected using a set of questionnaires. Food intake was measured by 24 hour food recall. The data were analyzed using path analysis model.Results: Energy intake had positive, significant, and direct effect on the risk of teenage obesity (b = 6.75; 95%CI = 4.36 to 9.14; p = <0.001). Working mother indirectly had positive and significant effect on teenage obesity, via fat intake (b=0.77; 95% CI = 0.03 to 1.52; p=0.040). Fat intake indirectly had positive and significant effect on teenage obesity, via energy intake (b=4.16; 95%CI=1.95 to 6.38; p=0.001). Likewise, carbohydrateintake had positive and significant effect on teenage obesity, via energy intake(b = 3.31; 95% CI= 1.73 to 4.88; p = 0.001). Ethnicity (Chinese versus Javanese) did not have significant effect on teenage obesity (b =-1.14; 95% CI =-3.56 to 1.28; p = 0.355).Conclusion: Energy intake has direct effect on the risk of teenage obesity. Fat intake, carbohydrate intake, and maternal employment status, have indirect effect on the risk of teenage obesity.Keywords: maternal employment status, ethnicity,food intake, obesity, teenager.Correspondence: Rahmah Purwaningsih Febri Susanti. Master Program in Public Health Sebelas Maret University. Email: [email protected] of Epidemiology and Public Health (2016), 1(2): 75-85https://doi.org/10.26911/jepublichealth.2016.01.02.0

Health Belief Model for the Analysis of Factors Affecting Hypertension Preventive Behavior among Adolescents in Surakarta

Background: Hypertension is an important public health issue in developed and developing countries. The incidence of hypertension continues to rise to a serious level. Raising awareness of the seriousness of hypertension among peer groups may be an important factor for preventive health behavior. This study aimed to examine the used of health belief model for the analysis of factors affecting hypertension preventive behavior among adolescents. Subjects and Method: This study was an observational analytic study with cross sectional design. It was conducted at 5 Vocational High Schools (SMK) in Surakarta from April to May, 2017. A sample of 200 class X and XI SMK students aged 15-17 years was selected for this study by stratified random sampling. The dependent variable was hypertension preventive behavior. The independent variables were perceived susceptibility, perceived seriousness, perceived benefit, perceived barriers, cues to action, and self efficacy, with perceived threat as a mediating variable. The data were collected by a set of pre-tested questionnaire. Path analysis was employed for data analysis using SPSS AMOS 22. Results: Perceived threat (b= 0.24, SE= 0.07, p= 0.002), perceived benefit (b= 0.24, SE= 0.10, p= 0.021), self efficacy (b= 0.40, SE= 0.23, p= 0.084), and cues to action (b= 0.45, SE= 0.15, p= 0.003) showed direct positive effects on hypertension preventive behavior. Perceived barrier (b= -0.26, SE= 0.10, p= 0.015) showed direct negative effect on hypertension preventive behavior. Perceived susceptibility (b= 0.27, SE= 0.09, p= 0.005), perceived seriousness (b= 0.29, SE= 0.09, p<0.001), and cues to action (b= 0.34, SE= 0.13, p= 0.008) showed indirect positive effects on hypertension preventive behavior. Conclusion: Hypertension preventive behavior is positively and directly affected by perceived threat, perceived benefit, self, and cues to action. The preventive behavior is negatively and directly affected by perceived barrier. Perceived susceptibility, perceived seriousness, and cues to action indirectly and positively affect on hypertension preventive behavior. Keywords: health belief model, hypertension, preventive behavior, adolescent

The Role of Non-Governmental Organization in Sanitation Village Program in Semanggi Village, Surakarta

Background: Sanitation Village Program is one of notable community-based water supply and sanitation development models in Indonesia. A Non-Governmental Organization (NGO) namely Community Self-Reliant Group had been established in Semanggi Village Surakarta, to manage Sanitation Village Program. This study aimed to examine the role of non-governmental organization in sanitation village program in Semanggi Village, Surakarta. Subjects and Method: This was an analytical qualitative study with phenomenology approach. The study was carried out in Semanggi Village, Surakarta, Central Java, in June 2017. The informants were selected consisting of 12 community members and 3 community leaders. The data were collected by in-depth interview and focus group discussion. The data were analyze using content analysis. Results: A Community Self-Reliant Group had been established in Semanggi Village, Surakarta, to manage Sanitation Village Program. This group had the responsibility to manage maintenance of water and sanitation facilities, including checking septic communal tanks, checking water facilities and latrines at resident houses, as well as repairing damaged water and sanitation facilities. In addition, the Community Self-Reliant Group had a financial management responsibility role, including financial accounting of sanitation maintenance costs. The group also acted as communication intermediary between community member, community leaders, and external agents such as Public Agency of Water Supply, to solve water and sanitation-related problems. Conclusion: Community Self-Reliant Group has an important role in managing various maintenance activities of water and sanitation facilities, including checking septic communal tanks, checking water facilities and latrines at resident houses, as well as repairing damaged water and sanitation facilities. Community Self-Reliant Group can serve as a role model of community empowerment in achieving populations health. Keywords: community self-reliant group, sanitation village program, environmental healt