Association Between Health Promotion Program Participation and Health Knowledge and Health-Promoting Behavior Among Adolescents in Pati Regency, Central Java: A Cross-Sectional Study

Abstract

Introduction: This study aimed to examine the association between participation in adolescent health-promotion programs and health knowledge and health-promoting behaviors among adolescents in Pati Regency, Central Java.

Methods: A quantitative analytic cross-sectional study was conducted from February to April 2025 across three sub-districts: Kecamatan Pati, Juwana, and Gabus. A total of 207 adolescents aged 13–19 years from six public junior and senior high schools were selected using multistage stratified random sampling. Data were collected using a structured self-administered questionnaire assessing sociodemographic characteristics, participation in Posyandu Remaja or Pelayanan Kesehatan Peduli Remaja (PKPR), health knowledge, and health-promoting behaviors. Data were analyzed using descriptive statistics, Chi-square tests, and multivariable binary logistic regression.

Results: Participation in Posyandu Remaja or PKPR was independently associated with adequate health knowledge after adjustment for sociodemographic factors (adjusted OR = 2.89; 95% CI: 1.68–4.97; p < 0.001). Participation was also associated with good health-promoting behavior in bivariate analysis (crude OR = 2.74; 95% CI: 1.63–4.60; p < 0.001). Reproductive health had the lowest proportion of adequate knowledge (43.0%), whereas physical activity had the highest (73.4%). Female sex was independently associated with adequate health knowledge (adjusted OR = 1.84; 95% CI: 1.09–3.10; p = 0.023).

Conclusion: These findings indicate statistical associations between participation in adolescent health-promotion programs and health-related outcomes. Because this was a cross-sectional study and exposure and outcomes were measured simultaneously, temporal sequence and causality cannot be established. The findings support continued strengthening of youth-friendly adolescent health-promotion

Keywords: Smartphone addiction; Anxiety; Adolescents; Mental Health