A Determinant Model of Sustainable Tuberculosis Treatment Compliance Based on the Health Belief Model in Tuberculosis Patients in the Surakarta Region
DOI:
https://doi.org/10.26911/thejhpb.2025.10.04.08Abstract
Background: Tuberculosis (TB) is an infectious disease that remains a major global and national public health problem, with Indonesia ranking second worldwide after India. Treatment adherence is a key determinant of therapeutic success, yet it continues to be challenged by high dropout rates and drug resistance. This study aims to examine the Health Belief Model in relation to treatment adherence among tuberculosis patients in Surakarta.
Subjects and Method: This was a cross-sectional study conducted in Surakarta. A total of 400 tuberculosis patients were selected as the study sample. The dependent variable was treatment adherence. Independent variables included perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and family support. Data were collected using a questionnaire and analyzed using path analysis.
Results: Treatment adherence increased with higher cues to action (b = 4.01; 95% CI = 0.80 to 7.22; p = 0.01), perceived susceptibility (b = 2.00; 95% CI = 0.46 to 3.53; p = 0.01), and perceived benefits (b= 3.05; 95% CI= 0.17 to 5.93; p = 0.01). In contrast, higher perceived barriers decreased treatment adherence (b= –2.70; 95% CI = –4.39 to –1.01; p = 0.001). Indirectly, cues to action increased family support (b= 2.10; 95% CI= 0.13 to 4.08; p = 0.010), and perceived barriers increased cues to action (b= 3.68; 95% CI= 1.13 to 6.23; p = 0.01). Perceived susceptibility decreased cues to action (b = –0.64; 95% CI= –1.25 to –0.03; p = 0.01) but increased perceived barriers (b = 4.85; 95% CI = 1.17 to 8.54; p= 0.01). Perceived severity increased perceived barriers (b = 1.75; 95% CI = 0.41 to 3.09; p = 0.01) and decreased family support (b = –0.83; 95% CI = –1.48 to –0.18; p = 0.01), while perceived benefits increased family support (b = 2.41; 95% CI = 0.32 to 4.50; p = 0.01).
Conclusion: Higher cues to action, perceived susceptibility, and perceived benefits, as well as lower perceived barriers, improve treatment adherence. Family support also plays an important mediating role in strengthening adherence among tuberculosis patients.
Keywords:
medication adherence, health belief model, cues to action, family support
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