Dampak intervensi kesehatan seksual dan reproduksi pada niat perlindungan terhadap perilaku seksual pada remaja: nonequivalent control group design

https://doi.org/10.22146/bkm.44675

Fahrurrajib Fahrurrajib(1*), Mohammad Hakimi(2)

(1) Departemen Biostatistik, Epidemiologi, dan Kesehatan Populasi, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(2) Departemen Biostatistik, Epidemiologi, dan Kesehatan Populasi, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada
(*) Corresponding Author

Abstract


Latar belakang: Pendidikan kesehatan seksual dan reproduksi bertujuan untuk membekali anak-anak dan remaja dengan pengetahuan, nilai-nilai dan sikap, serta keterampilan dalam menyelesaikan masalah-masalah terkait kesehatan seksual dan reproduksinnya. Pendidikan kesehatan seksual dan reproduksi sangat dibutuhkan oleh remaja terutama mereka yang belum aktif secara seksual. Penelitian ini bertujuan untuk melihat dampak intervensi pendidikan kesehatan seksual dan reproduksi dalam meningkatkan niat perlindungan terhadap perilaku seksual pada remaja di Kota Bima Nusa Tenggara Barat. Metode: Desain penelitian nonequivalent control group design untuk mengevaluasi dampak intervensi pendidikan kesehatan seksual dan reproduksi pada remaja usia 13-18 tahun di Kota Bima Nusa Tenggara Barat. Subjek penelitian untuk kelompok eksperimen (n = 34), dan kontrol (n = 34). Intervensi disampaikan melalui metode presentasi dan diikuti dengan sesi diskusi. Dampak intervensi pendidikan kesehatan seksual dan reproduksi dalam meningkatkan niat perlindungan terhadap perilaku seksual dianalisis menggunakan uji independent samples t-test. Uji pearson correlation digunakan untuk menentukan prediktor dari niat perlindungan terhadap perilaku seksual, sedangkan pada analisis multivariabel menggunakan multiple linear regression. Hasil: Perbedaan yang signifikan dalam pengetahuan kesehatan seksual dan reproduksi (KSR) (difference (diff) = 0.37; 95% CI = 0.22, 0.51), keparahan (diff = 0.37; 95% CI = 0.24, 0.49), kerentanan (diff = 0.30; 95% CI = 0.13, 0.47), efikasi respon (diff = 0.39; 95% CI = 0.25, 0.52), efikasi diri (diff = 0.28; 95% CI = 0.15, 0.42), dan protektif niat perilaku seksual (diff = 0.23; 95% CI = 0.11, 0.35) lebih tinggi pada kelompok eksperimen dibandingkan kontrol post-intervensi. Perbedaan ini dipertahankan sampai 2 bulan, kecuali variabel kerentanan dilemahkan dalam 2 bulan. Prediktor dari protektif niat perilaku seksual termasuk jenis kelamin, pengetahuan KSR, keparahan, kerentanan, efikasi respon, dan efikasi diri. Simpulan: Pendidikan kesehatan seksual dan reproduksi yang komprehensif memberikan kontribusi yang besar dalam mencegah timbulnya niat perilaku seksual pada remaja. Untuk mempertahankan dan meningkatkan niat perlindungan terhadap perilaku seksual pada remaja di masa mendatang, maka kegiatan pembelajaran dan diskusi rutin harus dilakukan tiap bulan dengan konten-konten yang sesuai dengan kebutuhan remaja di sekolah.


Keywords


niat perilaku seksual; kesehatan seksual; kesehatan reproduksi



References

  1. Purdy CH. Fruity, Fun and Safe: Creating a Youth Condom Brand in Indonesia. Reprod Health Matters. 2006;14(28):127-134. doi:10.1016/S0968-8080(06)28256-9
  2. Wahdini M, Isarabhakdi P. Safe Sexual Behavior: The Use of Condom Among Never Married Male Adolescents in Indonesia. Safe Sex Behav use condom among never married male Adolesc Indones. 2016:166-169.
  3. Flanigan CM. Sexual activity among girls under age 15: Findings from the National Survey of Family Growth. B Albert, S Brown, C Flanigan. 2003;14:57-63.
  4. Daka D, Shaweno D. Magnitude of risky sexual behavior among high school adolescents in Ethiopia: a cross-sectional study. J Public Heal Epidemiol. 2014;6(7):211-215. doi:10.5897/JPHE2014.0639
  5. Johnson PB, Malow MS. Adolescents and Risk: Making Sense of Adolescent Psychology. Praeger Publishers; 2008.
  6. McNeely C, Blanchard J. The Teen Years Explained: A Guide to Healthy Adolescent Development. Jayne Blanchard; 2010.
  7. BPS. Survei Demografi dan Kesehatan: Kesehatan Reproduksi Remaja. 2017.
  8. Kincaid C, Jones JD, Sterrett E, McKee L. A review of parenting and adolescent sexual behavior: The moderating role of gender. Clin Psychol. 2012;32(3):177-188. doi:10.1016/j.cpr.2012.01.002.A
  9. Chemnasiri T, Netwong T, Visarutratana S, et al. Inconsistent Condom Use among Young Men Who Have Sex with Men, Male Sex Workers, and Transgender in Thailand. AIDS Educ Prev. 2010;22(2):100-109. doi:10.1521/aeap.2010.22.2.100
  10. Aho J, Koushik A, Diakité SL, Loua KM, Nguyen V-K, Rashed S. Biological validation of self-reported condom use among sex workers in Guinea. AIDS Behav. 2010;14(6):1287-1293.
  11. Bearinger LH, Sieving RE, Ferguson J, Sharma V. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. Lancet. 2007;369(9568):1220-1231. doi:10.1016/S0140-6736(07)60367-5
  12. Mueller TE, Gavin LE, Kulkarni A. The Association Between Sex Education and Youth’s Engagement in Sexual Intercourse, Age at First Intercourse, and Birth Control Use at First Sex. J Adolesc Heal. 2008;42(1):89-96. doi:10.1016/j.jadohealth.2007.08.002
  13. Kaye K, Suellentrop K, Sloup C. The Fog Zone: How misperceptions, magical thinking, and ambivalence put young adults at risk for unplanned pregnancy. 2009:80. https://powertodecide.org/what-we-do/information/resource-library/fog-zone.
  14. Reis M, Ramiro L, De Matos MG, Diniz JA. The effects of sex education in promoting sexual and reproductive health in Portuguese university students. Procedia - Soc Behav Sci. 2011;29(2010):477-485. doi:10.1016/j.sbspro.2011.11.266
  15. Darabi F, Yaseri M, Kaveh MH, Khalajabadi Farahani F, Majlessi F, Shojaeizadeh D. The Effect of a Theory of Planned Behavior-based Educational Intervention on Sexual and Reproductive Health in Iranian Adolescent Girls: A Randomized Controlled Trial. J Res Health Sci. 2017;17(4):e00400. https://www.ncbi.nlm.nih.gov/pubmed/29233954.
  16. UNESCO. International Technical Guidance on Sexuality Education.; 2018. http://www2.hu-berlin.de/sexology/BIB/ITG2.htm.
  17. Utomo ID, McDonald P. Adolescent reproductive health in Indonesia: Contested values and policy inaction. Stud Fam Plann. 2009;40(2):133-146. doi:10.1111/j.1728-4465.2009.00196.x
  18. Mathews C, Aarø LE, Grimsrud A, et al. Effects of the SATZ teacher-led school HIV prevention programmes on adolescent sexual behaviour: Cluster randomised controlled trials in three sub-Saharan African sites. Int Health. 2012;4(2):111-122. doi:10.1016/j.inhe.2012.02.001
  19. Story CR., Gorski J. Global Perspectives on Peer Sex Education for College Students. Int Educ. 2013;42(2):81-94. http://search.ebscohost.com/login.aspx?direct=true&db=eax&AN=87929733&site=ehost-live.
  20. Kaufman CE, Whitesell NR, Keane EM, et al. Effectiveness of circle of life, an HIV-preventive intervention for American Indian middle school youths: A group randomized trial in a northern plains tribe. Am J Public Health. 2014;104(6):106-112. doi:10.2105/AJPH.2013.301822
  21. Markham CM, Craig Rushing S, Jessen C, et al. Factors Associated with Early Sexual Experience among American Indian and Alaska Native Youth. J Adolesc Heal. 2015;57(3):334-341. doi:10.1016/j.jadohealth.2015.06.003
  22. Chambers R, Tingey L, Mullany B, Parker S, Lee A, Barlow A. Exploring sexual risk taking among American Indian adolescents through protection motivation theory. AIDS Care. 2016;28(9):1089-1096. doi:10.1080/09540121.2016.1164289
  23. Tingey L, Chambers R, Rosenstock S, Lee A, Goklish N, Larzelere F. The Impact of a Sexual and Reproductive Health Intervention for American Indian Adolescents on Predictors of Condom Use Intention. J Adolesc Heal. 2017;60(3):284-291. doi:10.1016/j.jadohealth.2016.08.025
  24. Kirby DB, Laris BA, Rolleri LA. Sex and HIV Education Programs: Their Impact on Sexual Behaviors of Young People Throughout the World. J Adolesc Heal. 2007;40(3):206-217. doi:10.1016/j.jadohealth.2006.11.143
  25. Mmbaga EJ, Kajula L, Aarø LE, et al. Effect of the PREPARE intervention on sexual initiation and condom use among adolescents aged 12-14: A cluster randomised controlled trial in Dar es Salaam, Tanzania. BMC Public Health. 2017;17(1):1-10. doi:10.1186/s12889-017-4245-4
  26. Chen X, Stanton B, Chen D, Li X. Intention to use condom, cusp modeling, and evaluation of an HIV prevention intervention trial. Nonlinear Dynamics Psychol Life Sci. 2013;17(3):385. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106698/pdf/nihms597049.pdf.
  27. Sun X, Liu X, Shi Y, Wang Y, Wang P, Chang C. Determinants of risky sexual behavior and condom use among college students in China. AIDS Care. 2013;25(6):775-783. doi:10.1080/09540121.2012.748875
  28. Lwin MO, Stanaland AJS, Chan D. Using protection motivation theory to predict condom usage and assess HIV health communication efficacy in Singapore. Health Commun. 2010;25(1):69-79. doi:10.1080/10410230903473540
  29. Stanton B, Cole M, Galbraith J, et al. Randomized Trial of a Parent Intervention. Arch Pediatr Adolesc Med. 2004;158(10):947-955. doi:10.1001/archpedi.158.10.947
  30. Wu Y, Stanton BF, Galbraith J, et al. Sustaining and Broadening Intervention Impact: A Longitudinal Randomized Trial of 3 Adolescent Risk Reduction Approaches. Pediatrics. 2003;111(1):e32-e38. doi:10.1542/peds.111.1.e32
  31. Chen X, Stanton B, Gomez P, et al. Effects on condom use of an HIV prevention programme 36 months postintervention. Int J STD AIDS. 2010;21(9):622-630. doi:10.1258/ijsa.2010.010039
  32. Diclemente RJ, Crittenden CP, Rose E, et al. Psychosocial predictors of HIV-associated sexual behaviors and the efficacy of prevention interventions in adolescents at-risk for HIV infection: What works and what doesn’t work? Psychosom Med. 2008;70(5):598-605. doi:10.1097/PSY.0b013e3181775edb
  33. Rogers RW. A Protection Motivation Theory of Fear Appeals and Attitude Change1. J Psychol. 1975;91(1):93-114. doi:10.1080/00223980.1975.9915803
  34. Milne S, Sheeran P, Orbell S. Prediction and intervention in health-related behavior: A meta-analytic review of protection motivation theory. J Appl Soc Psychol. 2000;30(1):106-143. doi:10.1111/j.1559-1816.2000.tb02308.x
  35. Anderson CL, Agarwal R. Practicing safe computing: a multimedia empirical examination of home computer user security behavioral intentions. MIS Q. 2010;34(3):613-643.
  36. Tingey L, Mullany B, Chambers R, et al. Respecting the circle of life: One year outcomes from a randomized controlled comparison of an HIV risk reduction intervention for American Indian adolescents. AIDS Care - Psychol Socio-Medical Asp AIDS/HIV. 2015;27(9):1087-1097. doi:10.1080/09540121.2015.1028879
  37. Yu S, Marshall S, Cottrell L, et al. Longitudinal predictability of sexual perceptions on subsequent behavioural intentions among Bahamian preadolescents. Sex Health. 2008;5(1):31-39. doi:10.1071/SH07040
  38. Spruijt LC. Sexual reproductive health capabilities: girls’ voices heard: A study on the influence of economic, social and cultural factors on girl’s experiences of sexual reproductive health and education in Magu, Tanzania. 2014;(November). https://dspace.library.uu.nl/handle/1874/301414.
  39. Parekh J. Implementation and Replication of Evidence Based Sexual Reproductive Health Programs. 2016.
  40. Greco L Del. Questionnaire development:2. Validity and reliability. Can Med Assoc J. 1987;136:699-700.
  41. Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53-55. doi:10.5116/ijme.4dfb.8dfd
  42. DeVellis RF. Scale Development: Theory and Applications. Vol 26. Sage publications; 2016.
  43. Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997;314(7080):572. doi:10.1136/bmj.314.7080.572
  44. Nunnally JC, Bernstein IH. Psychometric Theory (McGraw-Hill Series in Psychology). Vol 3. McGraw-Hill New York; 1994.
  45. Cronbach LJ, Neto CAS, Veronese MAV. Fundamentos Da Testagem Psicológica. Artes Médicas; 1996.
  46. Nunnally JC, Bernstein IH. Psychometric Theory McGraw-Hill New York Google Scholar. 1978.
  47. Kinsler J, Sneed CD, Morisky DE, Ang A. Evaluation of a school-based intervention for HIV / AIDS prevention among Belizean adolescents. 2004;19(6):730-738. doi:10.1093/her/cyg091
  48. Lee GY, Lee DY, Lee GY. Effects of a life skills-based sexuality education programme on the life-skills , sexuality knowledge , self-management skills for sexual health , and programme satisfaction of adolescents adolescents. Sex Educ. 2018;00(00):1-15. doi:10.1080/14681811.2018.1552584
  49. Thongnopakun S, Pumpaibool T. The effects of an educational program on knowledge , attitudes and intentions regarding condom and emergency contraceptive pill use among Thai female university students. 2018. doi:10.1108/JHR-05-2018-033
  50. Wellings K, Collumbien M, Slaymaker E, et al. Sexual behaviour in context: a global perspective. Lancet. 2006;368(9548):1706-1728.
  51. Kelsey M, Walker JT, Layzer J, Price C, Juras R. Replicating the Safer Sex Intervention : 9-Month Impact Findings of a Randomized Controlled Trial. 2016;106:53-59. doi:10.2105/AJPH.2016.303372
  52. Cuffee JJ, Hallfors DD, Waller MW. Racial and Gender Differences in Adolescent Sexual Attitudes and Longitudinal Associations with Coital Debut. J Adolesc Heal. 2007;41(1):19-26. doi:10.1016/j.jadohealth.2007.02.012
  53. Kotchick B, Shaffer A, Forehand R, Miller K. Adolescent sexual risk behavior: a multi-system perspective. Clin Psychol Rev. 2001;21(4):493-519. doi:10.1016/S0272-7358(99)00070-7
  54. Ajide KB, Balogun FM. Knowledge of HIV and Intention to Engage in Risky Sexual Behaviour and Practices among Senior School Adolescents in Ibadan, Nigeria. HHS Public Access. 2018;6(1):3-8.
  55. Guilamo-Ramos V, Jaccard J, Dittus P, Gonzalez B, Bouris A. A conceptual framework for the analysis of risk and problem behaviors: The case of adolescent sexual behavior. Soc Work Res. 2008;32(1):29-45.
  56. Bachanas PJ. Predictors of Risky Sexual Behavior in African American Adolescent Girls: Implications for Prevention Interventions. J Pediatr Psychol. 2002;27(6):519-530. doi:10.1093/jpepsy/27.6.519
  57. Rink E, Tricker R, Harvey SM. Onset of Sexual Intercourse among Female Adolescents: The Influence of Perceptions, Depression, and Ecological Factors. J Adolesc Heal. 2007;41(4):398-406. doi:10.1016/j.jadohealth.2007.04.017



DOI: https://doi.org/10.22146/bkm.44675

Article Metrics

Abstract views : 1434 | views : 805

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Copyright (c) 2019 Berita Kedokteran Masyarakat

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Berita Kedokteran Masyarakat ISSN 0215-1936 (PRINT), ISSN: 2614-8412 (ONLINE).

Indexed by:

 

Web Analytics Visitor Counter