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

印度尼西亚青少年生殖健康促进行为影响因素的结构模型

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 re-lationships 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 pro-motion 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(interper-sonal 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.

目的运用结构方程模式探索印度尼西亚青少年生殖健康的健康促进影响因素,建立结构模型并进行测试。方法采用横断面量性研究方法,调查108名12~16岁青少年。根据基于自我效能的健康促进模型和授权模型自设问卷,调查生殖健康促进行为的相关因素素。采用结构方程模型验证变量之间的关系。采用AMOS评估所提出的模型是否适用于所获得的数据。结果该模型数据拟合尚可。自变量之间存在相关关系(P<0.05),包括:个体因素与认知因素(r=0.01)、认知因素和健康促进行为(r=0.09)、情感和健康促进行为(r=0.17)。赋权与健康促进行为之间的关系最为密切(r=0.72)。情感(人际和情境影响)、直接竞争的要求和偏好,以及授权(参与和控制)都与生殖健康行为维持直接相关。同时,青少年的意愿、先前的相关行为、个人因素以及对行动计划的承诺与生殖健康行为维持间接相关。该模型解释了生殖健康行为维持43.9%的变异。结论健康促进模型和授权模型维护有助于确定青少年生殖健康行为维持的相关因素。促进印度尼西亚青少年生殖健康的干预应从儿童-家长-保健专业接触的水平开始,以改善青少年的生殖健康。