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 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.