Theory of Planned Behavior Constructs in Predicting Iron Supplement Consumption Adherence among Female Adolescents in Kudus, Central Java, Indonesia

Authors

  • Pelangi Pagi Kalimasadha Master’s Program in Public Health, Faculty of Medicine, Universitas Sebelas Maret, Indonesia
  • Revi Gama Hatta Novika Master’s Program in Public Health, Faculty of Medicine, Universitas Sebelas Maret, Indonesia
  • Ika Sumiyarsi Sukamto Midwifery Study Program, Faculty of Medicine, Universitas Sebelas Maret, Indonesia
  • Okid Parama Astiri Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sebelas Maret, Indonesia
  • Arsita Eka Prasetyawati Master’s Program in Public Health, Faculty of Medicine, Universitas Sebelas Maret, Indonesia

DOI:

https://doi.org/10.26911/

Abstract

Background: Anemia among female adolescents remains a significant public health problem in Indonesia. One of the main strategies to prevent anemia is the routine provision of iron supple­mentation tablets (TTD) for female adolescents. However, compliance to iron tablet consumption remains suboptimal. This study aimed to analyze the influence of the constructs of the Theory of Planned Behavior, on adherence to iron tablet consumption among female adolescents.

Subjects and Method: This study employed a quantitative research design with a cross-sectional approach. The study was conducted among 275 female adolescents attending senior high schools at Ngembal Kulon and Jekulo sub districts, Kudus, Central Java, Indonesia. Participants were selected using proportional sampling. Data were collected using structured questionnaires and analyzed using logistic regression to determine the influence of attitude, subjective norms, perceived behavioral control, and intention on adherence to iron tablet consumption.

Results: The results showed that attitude (OR=0.78; 95% CI=0.45–1.37; p=0.397) and intention (OR=0.82; 95% CI=0.44–1.51; p=0.520) was not significantly associated with compliance to iron tablet consumption. In contrast, subjective norms (OR=1.80; 95% CI=1.03–3.15; p=0.040) and perceived behavioral control (OR=4.67; 95% CI=2.40–9.10; p<0.001) were significantly associated with adherence to iron tablet consumption. Among these variables, perceived behavioral control was identified as the strongest determinant.in non-smoking behavior than male respondents (AOR = 2.52; 95% CI = 1.22 to 5.21; p = 0.012). 

Conclusion: Subjective norms and perceived behavioral control significantly influence adherence to iron tablet consumption among female adolescents.

Keywords:

anemia, adherence, iron supplementation tablets, female adolescents, theory of planned behavior

Published

2026-04-16

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How to Cite

Theory of Planned Behavior Constructs in Predicting Iron Supplement Consumption Adherence among Female Adolescents in Kudus, Central Java, Indonesia. (2026). Journal of Health Promotion and Behavior, 11(2), 212-221. https://doi.org/10.26911/

How to Cite

Theory of Planned Behavior Constructs in Predicting Iron Supplement Consumption Adherence among Female Adolescents in Kudus, Central Java, Indonesia. (2026). Journal of Health Promotion and Behavior, 11(2), 212-221. https://doi.org/10.26911/

References

Ajzen I (1991). The theory of planned behavior. Organ Behav Hum Decis Process, 50(2):179–211. https://do-i.org/10.1016/0749-5978(91)90020-T.

Ajzen I (2002). Perceived behavioral con-trol, self‐efficacy, locus of control, and the theory of planned behavior. J Appl Soc Psychol, 32(4):665–683. https://-doi.org/10.1111/j.1559-1816.2002.tb0-0236.x.

Ajzen I (2005). Attitudes, personality and behaviour, 2nd edn. McGraw-Hill Education.

Bahtiar H, Yusriani, and Idris FP (2023). The compliance with blood adding tablet consumption based on theory of planned behavior. J Kesehat, 14(3): 135–141. https://doi.org/10.35730/j-k.v14i3.1099.

Damayanti F, Kusharisupeni, Adawiyah AR, and Hymawati (2025). Determinants of adherence to iron supplement tablet (TTD) consumption among adolescent girls at SMAN 02 Gunung Putri, Bogor Regency. J Untuk Masy Sehat JUKMAS, 9(1):15–31. https://-doi.org/10.52643/jukmas.v9i1.4891.

District Health Office of Kudus Regency (2023). Data on coverage of iron supplement tablets among adolescent girls in Kudus Regency 2023.

District Health Office of Kudus Regency (2024). Data on coverage of iron supplement tablets among adolescent girls in Kudus Regency 2024.

Hamranani SST, Permatasari D, and Murti SA (2020). Factors influencing adhe-rence to Fe tablet consumption among adolescents. J Penelit Perawat Prof, 2(4):579–590.

Health Development Policy Agency (2024). Indonesian Health Survey 2023 in figures. https://www.badankebija-kan.kemkes.go.id/ski-2023-dalam-angka/.

Laferani Y, Surtimanah T, and Sjamsuddin IN (2025). Path Analysis Using the Theory of Planned Behavior on Taking Blood Supplement Tablets and Eating Nutritious Food. BKM Public Health Community Med, 41(8): e22923. https://doi.org/10.22146/b-km.v41i08.22923.

Lindawati R (2023). Factors associated with adherence to iron tablet consumption among adolescent girls at SMA Negeri 3 Serang City, Banten Province, 2022. Detect J Inov Ris Ilmu Kesehat, 1(1):239–255. https://-doi.org/10.33024/hjk.v17i8.13480.

Lismiana H and Indarjo S (2021). Know-ledge and perception of adolescent girls toward adherence to iron tablet consumption. Indones J Public Health Nutr, 1(1):22–30. https://do-i.org/10.15294/ijphn.v1i1.45146.

Ministry of Health of the Republic of Indonesia (2018). Guidelines for the prevention and control of anemia in adolescent girls and women of reproductive age. Jakarta: Directorate General of Public Health.

Ministry of Health of the Republic of Indo-nesia (2023). Pocket book for anemia prevention in pregnant women and adolescent girls. Jakarta: Ministry of Health of the Republic of Indonesia.

Ministry of Health of the Republic of Indonesia (2024). Indonesia health profile 2023. Jakarta: Ministry of Health of the Republic of Indonesia.

Ministry of Health of the Republic of Indonesia (2025). Indonesia health profile 2024. Jakarta: Ministry of Health of the Republic of Indonesia.

Mukharomah U, Budiono I (2024). Deter-minants of Adherence to Consumpt-ion of Blood Supplement Tablets in Female Adolescents. J Kesehat, 17(1): 12–24. https://doi.org/10.23917/jk.v-17i1.2527.

Rahayuningtyas D, Indraswari R, and Musthofa SB (2021). Factors asso-ciated with iron tablet consumption practice among adolescent girls in the working area of Gilingan Public Health Center, Surakarta. J Kesehat Masy, 9(3):310–318.

Rohma SA, Maharani AR, Putri MAR, Salsabila HA, and Devy SR (2025). Analysis of Determinants of Pregnant Women’s Compliance in Comsuming Iron Supplement Tablets and Its Association with Pregnancy Anemia. Media Gizi Kesmas, 14(1):35–44. htt-ps://doi.org/10.20473/mgk.v14i1.2025.35-44.

Sulaeman ES (2025). Learning theories and models of health promotion and behavior: Concepts and applications, 2nd edn. Surakarta: UNS Press.

World Health Organization (2021). Anae-mia. 2021.

World Health Organization (2023). Anae-mia in Women and Children. 2023.

Yusriani, Bahtiar H, Idris FP, Asrina A, Haeruddin, and Mahmud NU (2023). Teacher, Peer, and Family Support is Associated with Compliance Behavior in Comsuming Blood Supplement Tablets. J Midwifery Nurs, 5(3):136–141. https://doi.org/10.35335/jmn.v-5i3.4178.

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