Tantut Susanto

Immaturity in puberty and negative attitudes toward reproductive health among Indonesian adolescents.

Abstract Background: Complex factors influence adolescents’ attitudes. Secondary sexual development and emotional changes are markers of puberty and affect attitudes toward reproductive health (RH). This is especially evident in the society and culture of Indonesia. This study examined the presence of immaturity at puberty and factors associated with negative attitudes toward RH among Indonesian adolescents. Methods: We conducted a cross-sectional study with 1040 students (aged 11–16 years) selected using multistage random cluster sampling. Data were collected using a self-administered questionnaire that included the illustrative questionnaire for interview surveys with young people and the pubertal development scale (PDS), modified in accordance with the Indonesian context. Data analysis used descriptive and comparative statistics and logistic regression analyses. Results: Immature pubertal development was higher in boys [22.7%, 95% confidence interval (CI): 14.7%–30.7%] than girls (18.4%, 95% CI: 11%–25.7%). However, negative attitudes were higher in girls (40.6%, 95% CI: 34.3%–46.8%) than boys (37.1%, 95% CI: 29.9%–44.7%). Factors associated with negative attitudes toward RH in both boys and girls were age, RH communication with parents, and pubertal development. Smoking was an additional factor in boys, whereas living in an urban area was an additional factor in girls. High knowledge about RH was associated with less negative attitudes toward RH in both boys and girls. Conclusion: Immaturity and factors that influence negative attitudes toward RH should be explored during puberty. Improving knowledge about RH may help to prevent negative attitudes toward RH, especially for girls in urban areas and boys with smoking habits.

Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent

OBJECTIVES Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents. METHODS A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses. RESULTS The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior. CONCLUSIONS Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.

Development and Testing of the Family Structure and Family Functions Scale for Parents Providing Adolescent Reproductive Health Based on the Friedman Family Assessment Model

Background and Purpose: To describe the development and testing of a psychometric of Family Structure and Functions (FSF) that measures parents’ ability to provide adolescent reproductive health (ARH). Methods: A cross-sectional study of Indonesian parents (n = 525). Multifactors FSF-ARH were examined using construct validity (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]) and content validity (Content Validity Index [CVI]). Internal consistency was explored using Cronbach’s α coefficient. Results: EFA revealed nine factors with 26 items accounting for 61.64% of explained variance and CFA validity testing fit for the construct validity of FSF-ARH. The CVI indicated adequate content validity (0.80–0.10) and acceptable internal consistency (0.70). Conclusions: FSF-ARH contains valid, reliable, and robust measures although some subscales performed moderate reliability, establishing the purpose for further research.

FAMILY FRIENDLY FOR IMPROVEMENT OF USING EXCLUSIVE BREAST WITH INTEGRATION FAMILY CENTER NURSING MODEL AND TRANSCULTURAL NURSING MODEL AT JEMBER DISTRICT, EAST JAVA PROVIENCE

Introduction. The phenomenon of lactation in nursing mothers breastfed exclusively fulfillment requires comprehensive treatment in the community related to the population at risk in the group of breast feeding mothers in the community. The purpose of this study was to improve the ability of nursing mothers, families, and communities in family friendly activities through the integration of family center model of cross-cultural nursing and nursing to meet the sustainability of exclusive breastfeeding in the group of nursing mothers who were sensitive and sensitive to local culture in Jember. Method. This study used a quasi- experimental design with a nonrandomized control group design with pretest and posttest. The data were analyzed using frequency distributions and the Wilcoxon signed rank test were used to compare the behavior of lactating mothers, family independence, the ability of health workers, and management of exclusive breastfeeding services are culturally sensitive and locally sensitive to the treatment group and the control group. Results. The results showed no significant difference between the behavior of lactating mothers, family independence, and management services exclusive breastfeeding before san after the intervention program (p value 0.000) and no significant difference between the ability of health workers before and after the intervention (p value 0.001). Discussion. Exclusive breast feeding can run continuously if the full support of breastfeeding mothers own motivation, family support, health worker visits, and the clinic. Keywords: Exclusive Breast Feeding, Family Friendly, Mother’s Behavior, Cadre Capability.

Local-food-based complementary feeding for the nutritional status of children ages 6–36 months in rural areas of Indonesia

Purpose This study aimed to evaluate a pilot project of the Nursing Feeding Center “Posyandu Plus” (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6–36 months at community health centers in Indonesia. Methods A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from 6 rural areas. The NFCPP was conducted for 9 weeks, comprising 2 weeks of preintervention, 6 weeks of intervention, and one week of postintervention. The LFCF intervention consisted of 12 sets of recipes to be made by mothers and given to their children 4 times daily over 6 weeks. The weight-for-age z score (WAZ), height-for-age z score (HAZ), weight-for-height z score (WHZ), and body mass index-for-age z score (BAZ) were calculated using World Health Organization Anthro Plus version 1.0.3. Results LFCF intervention significantly increased WHZ, WAZ, and BAZ scores but decreased HAZ scores (P<0.001). Average scores of WHZ (0.96±0.97) and WAZ (0.45±0.72) increased; BAZ increased (1.12±0.93) after 6 weeks of LFCF. WAZ scores postintervention were 50.5% of normal, and WHZ scores were 77.1% of normal. However, the HAZ score decreased by 0.53±0.52, which indicated 57.8% had short stature. Conclusion The NFCPP program with LFCF intervention can improve the nutritional status of children in rural areas. It should be implemented as a sustained program for better provision of complementary feeding during the period of lactation using local food made available at community health centers.

Structural model of factors relating to the health promotion behavior of reproductive health among Indonesian adolescents

Objectives We aim to explore the factors related to the health promotion behavior of reproductive health (RH) among Indonesian adolescents via structural equation modeling. Methods A cross-sectional quantitative study was used to measure 108 adolescents aged 12–16 years. We employed a self-administered questionnaire developed from the health promotion model (HPM) and the empowerment model (EM) on the basis of self-efficacy to determine the factors related to health promotion in maintaining RH behavior. Structural equation modeling (SEM) was used to examine relationships among the variables. The Analysis of Moment Structures (AMOS) approach was used to evaluate if the proposed model is suitable for the data based on goodness-of-fit indices. Results The model is appropriate for the data. Three interrelationships emerge among independent variables (P > 0.05), namely, personal and cognitive behaviors (r = −0.01), cognitive and health promotion behaviors (r = 0.09), and affective and health promotion behaviors (r = −0.17). The strongest relationship is between empowerment and health promotion behavior (r = 0.72). Affection (interpersonal and situational influences), immediate competing demands and preferences, and empowerment (participation and control) are directly related to RH behavior maintenance. Meanwhile, willingness of adolescents, prior related behavior, personal factor, and commitment to a plan of action are indirectly related to RH behavior maintenance. The model explains 43.9% of the variance in maintaining RH behavior. Conclusions The HPM and EM models help determine the factors related to RH behavior maintenance among adolescents. Intervention to promote RH among Indonesian adolescents should begin from the level of child–parent–health care professional encounter for empowering the RH of adolescents.