Efektivitas Pengingat Pemeriksaan Payudara Sendiri (SADARI) Melalui Chatbot WhatsApp Terhadap Keyakinan Kesehatan dan Kepatuhan akan Perilaku SADARI pada Mahasiswa

Dana Prayoga Irawan, Haryani, S.Kp., M.Kes., Ph.D.; Dr. Heny Suseani Pangastuti, S.Kp., M.Kes.

2025 | Tesis | S2 Magister Keperawatan

Latar Belakang: Perilaku deteksi dini seperti Pemeriksaan Payudara Sendiri (SADARI) masih rendah, terutama di kalangan remaja dan dewasa muda. Hal ini dapat disebabkan oleh rendahnya kerentanan dan keseriusan yang dirasakan terhadap suatu penyakit, rendahnya manfaat yang dirasakan terhadap tindakan pencegahan, tingginya hambatan dalam melakukan tindakan pencegahan, kurangnya isyarat untuk bertindak, dan efikasi diri yang rendah dalam melakukan tindakan pencegahan. Kecerdasan buatan, khususnya chatbot yang terintegrasi dengan aplikasi pesan instan seperti WhatsApp berpotensi untuk digunakan sebagai intervensi inovatif untuk meningkatkan perilaku deteksi dini kanker payudara. Namun, efektivitasnya terhadap keyakinan kesehatan dan kepatuhan akan perilaku SADARI masih perlu dianalisis lebih lanjut. Tujuan: Penelitian ini bertujuan untuk menganalisis efektivitas pengingat SADARI melalui chatbot WhatsApp terhadap keyakinan kesehatan dan kepatuhan akan perilaku SADARI pada mahasiswa berdasarkan teori Health Belief Model. Metode: Penelitian ini menggunakan desain quasi-experimental dengan rancangan pre-test and post-test with control group dengan melibatkan 54 responden pada kelompok intervensi (KI) dan 54 responden pada kelompok kontrol (KK) yang dipilih melalui teknik simple random sampling. Kriteria inklusi mencakup: (1) mahasiswi aktif tahun pertama, (2) tidak memiliki riwayat kanker payudara, (3) mampu berkomunikasi dalam bahasa Indonesia, (4) memiliki dan aktif menggunakan WhatsApp, serta (5) berusia ? 17 tahun. Kriteria eksklusi adalah sedang menjalani perawatan penyakit kronis yang dapat mengganggu keterlibatan dalam penelitian. Perlakuan berupa pengingat SADARI melalui chatbot WhatsApp (KI) dan buklet SADARI (KK) diberikan selama 30 hari. Pengukuran menggunakan kuesioner karakteristik faktor risiko kanker payudara, Indonesian version of Champion’s Health Belief Model Scale for Breast Self-Examination, dan logbook SADARI. Efektivitas intervensi terhadap keyakinan kesehatan dianalisis menggunakan uji t berpasangan dan uji Wilcoxon, sedangkan efektivitas terhadap kepatuhan perilaku SADARI dianalisis menggunakan uji McNemar. Hasil: Pengingat SADARI melalui chatbot WhatsApp secara signifikan efektif dalam mengubah enam dimensi keyakinan kesehatan mahasiswa pada kelompok intervensi ke arah yang lebih positif dibandingkan dengan kelompok kontrol, yang meliputi perceived susceptibility (KI: p = < 0>p = 0,622), perceived seriousness (KI: p = < 0>p = 0,265), perceived benefits (KI: p = 0,001; KK: p = 0,593), perceived barriers (KI: p = 0,001; KK: p = 0,728), cues to action (KI: p = < 0>p = 0,447), dan pada dimensi self-efficacy kedua kelompok mengalami perubahan yang signifikan (KI: p = < 0>p = < 0>p = < 0>p = 0,375). Kesimpulan: Pengingat SADARI melalui chatbot WhatsApp efektif dalam meningkatkan keyakinan kesehatan dan kepatuhan SADARI pada mahasiswa. Penggunaan chatbot dapat menjadi strategi yang inovatif untuk meningkatkan perilaku deteksi dini kanker payudara.

Background: Early detection behaviors such as Breast Self-Examination (BSE) remain low, especially among adolescents and young adults. This may be due to low perceived susceptibility and seriousness of the disease, low perceived benefits of preventive measures, high perceived barriers to taking preventive measures, a lack of cues to action, and low self-efficacy in taking preventive measures. Artificial intelligence (AI), particularly chatbots integrated into instant messaging applications like WhatsApp, has the potential to be used as an innovative intervention to improve early breast cancer detection behavior. However, its effectiveness on health beliefs and adherence to BSE behaviors needs further analysis. Purpose: This study aims to analyze the effectiveness of BSE reminders via WhatsApp chatbot on health beliefs and adherence to BSE behavior in students based on Health Belief Model theory. Method: A quasi-experimental design with a pre-test and post-test with a control group employed involving 54 respondents in the intervention group (IG) and 54 respondents in the control group (CG) selected through a simple random sampling technique. Inclusion criteria included: (1) active first-year female university students, (2) no history of breast cancer, (3) able to communicate in Indonesian, (4) have and actively use WhatsApp, and (5) aged ? 17 years. Exclusion criteria were undergoing treatment for chronic diseases that could interfere with participation in the study. Treatment in the form of BSE reminders via WhatsApp chatbot (IG) and BSE booklet (CG) was given for 30 days. Measurements used a questionnaire on breast cancer risk factors characteristics, the Indonesian version of the Champion’s Health Belief Model Scale for Breast Self-Examination, and a BSE logbook. The effectiveness of the intervention on health beliefs was analyzed using a paired t-test and the Wilcoxon test, while the effectiveness on BSE behavioral adherence was analyzed using the McNemar test. Results: BSE reminders via WhatsApp chatbot were significantly effective in changing six dimensions of students' health beliefs in the intervention group towards a more positive direction compared to the control group, which included perceived susceptibility (CI: p = <0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>Conclusion: BSE reminders via a WhatsApp chatbot were effective in increasing health beliefs and self-examination adherence among university students. The use of chatbots can be an innovative strategy for improving early breast cancer detection behavior.

Kata Kunci : adherence, breast self-examination, chatbot, health beliefs, reminders