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 ( > 0.05), namely, personal and cognitive behaviors ( = -0.01), cognitive and health promotion behaviors ( = 0.09), and affective and health promotion behaviors ( = -0.17). The strongest relationship is between empowerment and health promotion behavior ( = 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.