Application of the Health Belief Model to Non-Alcohol Drinking Behavior Among Adolescents in Surakarta, Central Java, Indonesia
DOI:
https://doi.org/10.26911/thejhpb.2026.11.03.07Abstract
Background: Alcohol consumption among adolescents is an important public health concern due to its adverse physical, psychological, and social consequences. The Health Belief Model (HBM) provides a theoretical framework for understanding health-related behaviors based on individual perceptions and beliefs. This study aimed to analyze the relationships among HBM constructs and non-alcohol consumption behavior among adolescents.
Subjects and Method: A case control study was conducted in Surakarta, Central Java, Indonesia, from May to June 2025. A total of 200 adolescents aged 15–19 years were recruited, consisting of 100 adolescents who had consumed alcohol and 100 who had never consumed alcohol. Participants were selected using fixed disease sampling. Data were collected using a structured questionnaire measuring perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and alcohol consumption behavior. Data were analyzed using path analysis.
Results: Non-alcohol drinker behavior was negatively associated with high perceived susceptibility (β= −0.02; 95% CI= −0.05 to −0.01; p= 0.044). It was positively associated with strong self-efficacy (β= 0.98; 95% CI= 0.94 to 1.02; p<0.001). Non-alcohol drinker behavior was positively associated with strong cues to action, but it was statistically non-significant (β= 0.03; 95% CI= −0.01 to 0.07; p= 0.190). Self-efficacy decreased with high perceived severity (β= −0.08; 95% CI= −0.13 to −0.03; p= 0.002) but increased with high perceived barrier (β= 0.5; 95% CI= 0.93 to 0.96; p<0.001). Non-alcohol drinker behavior was indirectly associated with self-efficacy through cues to action (β= 0.98; 95% CI= 0.83 to 1.13; p<0.001).
Conclusion: Strong self-efficacy was an important factor associated with non-alcohol drinker behavior among adolescents. Strengthening adolescents’ confidence to refuse alcohol and increasing awareness of alcohol-related risks may support alcohol prevention efforts.
Keywords:
Adolescent, alcohol consumption, health belief model, self-efficacy, path analysisHow to Cite
References
Arni A, Alim A, Zamli Z (2024). Pengaruh edukasi Health Belief Models (HBM) terhadap perilaku remaja tentang minuman keras di SMK Mutiara Bangsa Kecamatan Reok Kabupaten Manggarai. Ensiklopedia J. 6(4):271–280. https://doi.org/10.33559/eoj.v6-i4.1643.
Champion VL, Skinner CS (2008). The health belief model. In: Glanz K, Rimer BK, Viswanath K, editors. Health Behavior and Health Education: Theory, Research, and Practice. 4th ed. San Francisco, CA: Jossey-Bass.
De Jans S, Hudders L, Van de Sompel D, Beuckels E, Pearce H, Koutra K, Lombardi L, et al (2026). Adolescents’ intention to reduce alcohol use: a health belief model approach to cancer prevention. Alcohol Alcohol. 61(3):agag010. https://doi.org/10.1093/alcalc/agag010.
Fathian-Dastgerdi Z, Khoshgoftar M, Tavakoli B, Jaleh M (2021). Factors associated with preventive behaviors of COVID-19 among adolescents: applying the health belief model. Res Social Adm Pharm. 17(10):1786–1790. https://doi.org/10.1016/j.sapharm.2021.01.014.
Guldager JD, Kjær SL, Grittner U, Stock C (2022). Efficacy of the Virtual Reality Intervention VR FestLab on alcohol refusal self-efficacy: a cluster-randomized controlled trial. Int J Environ Res Public Health. 19(6):3293. https://doi.org/10.3390/ijerph19063293.
Hurlock EB (1980). Developmental Psychology: A Life-Span Approach. 5th ed. New York: McGraw-Hill.
Kasmaei P, Shokravi FA, Hidarnia A, Hajizadeh E, Atrkar-Roushan Z, Karimzadeh Shirazi K, Montazeri A (2014). Brushing behavior among young adolescents: does perceived severity matter? BMC Public Health. 14:8. https://doi.org/10.1186/1471-2458-14-8.
Lee CK, Corte C, Stein KF, Feng JY, Liao LL (2020). Alcohol-related cognitive mechanisms underlying adolescent alcohol use and alcohol problems: outcome expectancy, self-schema, and self-efficacy. Addict Behav. 105:106349. https://doi.org/10.1016/j.addbeh.2020.106349.
Manek LD, Takaeb AEL, Regaletha TAL (2019). Faktor yang berhubungan dengan perilaku mengkonsumsi minuman beralkohol remaja di Desa Lakanmau Kecamatan Lasiolat Belu (Factors Associated with Alcohol Consumption Behavior among Adolescents in Lakanmau Village, Lasiolat District, Belu Regency, Indonesia). Timorese J Public Health. 1(3):143–149. https://doi.org/10.35508/tjph.v1i3.2141.
Mares SHW, Lichtwarck-Aschoff A, Engels RCME (2013). Alcohol-specific parenting, adolescent alcohol use and the mediating effect of adolescent alcohol-related cognitions. Psychol Health. 28(7):833–848. https://doi.org/10.1080/08870446.2012.762453.
Ministry of Health of Indonesia (2021). Non-Communicable Disease Risk Factor Cohort Study 2021.
National Institute on Alcohol Abuse and Alcoholism (2023). Alcohol Facts and Statistics. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.
Peggy LPR (2015). Pengaruh penggunaan minuman keras pada kehidupan remaja di Desa Kali Kecamatan Pineleng Kabupaten Minahasa. Holistik J Soc Cult. 8(16):1–12. https://ejournal.unsrat.ac.id/v3/index.php/holistik/article/view/8671/.
Puspita RC, Tamtomo D, Indarto D (2017). Health Belief Model for the analysis of factors affecting hypertension preventive behavior among adolescents in Surakarta. J Health Promot Behav. 2(2):183–196. https://doi.org/10.26911/thejhpb.2017.02.02.08.
Rachmawati WC (2019). Promosi Kesehatan dan Ilmu Perilaku (Health Promotion and Behavioral Sciences). Malang: Wineka Media.
Rosenstock IM (1974). Historical origins of the Health Belief Model. Health Educ Monogr. 2(4):328–335. https://doi.org/10.1177/109019817400200403.
Setiyaningsih R, Tamtomo D, Suryani N (2016). Health Belief Model: determinants of hypertension prevention behavior in adults at community health center, Sukoharjo, Central Java. J Health Promot Behav. 1(3):160–170. https://doi.org/10.26911/thejhpb.2016.01.03.03.
Sinaga DE, Savira SI (2024). Hubungan Health Belief Model dan perilaku merokok pada mahasiswa. INCARE Int J Educ Resour. 5(1):89–102. https://doi.org/10.59689/incare.v5i1.909.
Solina E, Arisdiani T, Widyastuti YP (2018). Hubungan peran orang tua dengan perilaku konsumsi minuman alkohol pada remaja laki-laki. J Keperawatan Jiwa. 6(1):36–45. https://doi.org/10.26714/jkj.6.1.2018.36-45.
Stanhope M, Lancaster J (2016). Public Health Nursing: Population-Centered Health Care in the Community. 9th ed. St. Louis, MO: Elsevier.
Statistics of Indonesia (2023). Statistical Yearbook of Indonesia 2023. Jakarta: BPS-Statistics Indonesia.
Substance Abuse and Mental Health Services Administration (2024). Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality.
Syahara AF, Nurhadi, Rahman A (2020). Konsumsi alkohol di kalangan remaja di Kota Surakarta (Alcohol Consumption among Adolescents in Surakarta City). J Sosiol Nusantara. 6(2):173–192. https://doi.org/10.33369/jsn.6.2.173-192.
Tampomalu MS, Kerebungu F, Umaternate AR (2021). Perilaku penyalahgunaan minuman keras di kalangan remaja di Desa Suluan Kecamatan Tombulu Kabupaten Minahasa (Alcohol Abuse Behavior among Adolescents in Suluan Village, Tombulu District, Minahasa Regency, Indonesia). J Paradigma J Sociol Res Educ. 2(2):143–150. https://doi.org/10.53682/jpjsre.v2i2.1862.
WHO (2018). Global Status Report on Alcohol and Health 2018. Geneva: World Health Organization.
Yahja Y (2011). Psikologi Perkembangan (Development of Psychology). Jakarta: Kencana.
Yan XT, Guo WJ, Shen CF, Cui ZY, Wu JQ, Fang L, Zhao YC, et al (2024). Development and validity test of alcohol-related cognitive scale among adolescents based on health belief model. Fudan Univ J Med Sci. 51(4):465–472. https://doi.org/10.3969/j.issn.1672-8467.2024.04.003.
