Health Promotion Model on the Choice of Long-Term Contraceptive Method in Kendal, Central Java

Background: The incidence of long-term contraceptive use was still low among new contraceptive users in Kendal, Central Java, and continued to decrease. According to Basic Health Survey in Indonesia (SDKI) in 2012, the prevalence of long-term contraceptive use was only 10.9 percent, consisting of Intra Uterine Device (IUD) 4.9 percent, implant 2.8 percent, female surgical method 3.0 percent, and male surgical method 0.2 percent. This prevalence was lower than 14 percent in the previous year. Health promotion initiative had been implemented to couples of reproductive age (PUS) in the forms of interpersonal communication/ counseling using family planning decision tool aid. This study aimed to examine factors associated with the choice of long-term contraceptive method using theory of planned behavior, as the health promotion model. Subjects and Method: This was an analytic observational study with case control design. The study was conducted in Kendal, from May to August 2016. The target population was all new contraceptive users in Kendal, Central Java, with a total number of 22,454 users. A total sample of 100 couples of childbearing age was selected for this study consisting of 35 current users of long-term contraceptive method and 65 non-users of long-term contraceptive method. The dependent variable was the choice of long-term contraceptive method. The independent variables were intention, attitude, subjective norm, and perceived behavior control. The data was collected by questionnaire and analyzed by path analysis model. Results: Interpersonal communication/ counseling using family planning decision tool aid was positively associated with attitude toward long-term contraceptive (b= 0.98; 95% CI= 0.12 to 1.85; p= 0.025) and perceived behavior control (b= 1.56; 95% CI= 0.62 to 2.50; p= 0.001).Intention to use long-term contraceptive was positively associated with attitude toward long-term contraceptive (b= 4.02; 95% CI= 1.71 to 6.34; p= 0.001), subjective norm (b= 3.25; 95% CI= 0.92 to 5.59; p= 0.006), and perceived behavior control(b= 3.23; 95% CI= 0.71 to 5.75; p= 0.012). Conclusion: Interpersonal communication/ counseling using family planning decision tool aid is positively associated with attitude toward long-term contraceptive and perceived behavior control. Intention to use long-term contraceptive is positively associated with attitude toward long-term contraceptive, subjective norm, and perceived behavior control. Keywords: long-term contraceptive method, interpersonal communication/ counseling, attitude, subjective norm, perceived behavior control