Pengembangan Model Promosi Kesehatan melalui Pemberdayaan Masyarakat untuk Pencegahan Kejadian Obesitas dan Hipertensi pada Wanita Dewasa di Dusun Cupuwatu I, Kalurahan Purwomartani, Kalasan, Sleman

Yogi Fitriadi, Prof. Dr. dr. Adi Heru Sutomo, M.Sc ?; Dr. dr. Emy Huriyati, M.Kes ?

2025 | Disertasi | S3 Kedokteran Umum

Latar Belakang: Prevalensi obesitas dan hipertensi terus meningkat setiap tahunnya, terutama pada wanita dewasa. Kegiatan Posbindu PTM merupakan salah satu bentuk promosi kesehatan di masyarakat untuk mencegah kejadian obesitas dan hipertensi, namun belum merata pelaksanaannya karena keterbatasan sumber daya. Oleh karena itu, diperlukan inovasi promosi kesehatan yang berbasis pemberdayaan masyarakat dan terintegrasi dengan kegiatan sosial kemasyarakatan, sesuai sumber daya yang ada di masyarakat. 

Tujuan: Penelitian ini bertujuan untuk mengembangkan model promosi kesehatan melalui pemberdayaan masyarakat yang menyasar upaya pencegahan kejadian obesitas dan hipertensi pada wanita dewasa.
Metode: Penelitian dilakukan menggunakan pendekatanParticipatory Action Research(PAR) yang terdiri dari empat tahap: identifikasi masalah, pengembangan model, implementasi dan evaluasi program. Identifikasi masalah dan pengembangan program mengacu pada kerangkaBehavior Change Wheel (BCW) yang berpusat pada pendekatan Capability, Opportunity, Motivation – Behavior (COM-B), sedangkan evaluasi pelaksanaan program menggunakan kerangka Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE- AIM). Metode yang digunakan dalam identifikasi masalah dan pengembangan program adalah multi-method. Evaluasi program menggunakan metode convergent/pararel mixed-method. 

Hasil: Pada tahap identifikasi masalah terdapat tiga tema utama yang memengaruhi perilaku hidup sehat, yaitu aspek capability, opportunity, dan motivation. Model program yang dikembangkan, yaitu Program Serasi, yang mengintegrasikan pemberdayaan masyarakat dan pemberdayaan individu untuk pencegahan obesitas dan hipertensi. Evaluasi setelah intervensi menunjukkan bahwa Program Serasi berhubungan signifikan dengan peningkatan rerata konsumsi sayur serta penurunan tekanan darah sistolik, berat badan, Body Mass Index (BMI), lingkar pinggang, dan skor perceived stress scale pada kelompok intervensi dibandingkan kelompok kontrol, setelah mempertimbangkan faktor sosiodemografi dan biologis. 

Kesimpulan: Intervensi Program Serasi berhubungan signifikan dengan peningkatan rerata konsumsi sayur serta penurunan tekanan darah sistolik, berat badan, indeks masa tubuh, lingkar pinggang, dan skor perceived stress scale pada kelompok intervensi dibandingkan kelompok kontrol, setelah mempertimbangkan faktor sosiodemografi dan biologis. 

Background: The prevalence of obesity and hypertension has been increasing every year, particularly among adult women. The Posbindu PTM (Integrated Non- Communicable Disease Post) is one of the community based health promotion activities aimed at preventing obesity and hypertension. However, its implementation remains uneven due to limited resources. Therefore, there is a need for innovative health promotion strategies that are rooted in community empowerment and integrated into existing social activities and meet with resources in the community. 

Objective: This study aims to develop a health promotion model through community empowerment targeting the prevention of obesity and hypertension among adult women.
Methods: This research adopted a Participatory Action Research (PAR) approach, which involved four stages: problem identification, model development, implementation, and evaluation of the program. The problem identification and program development stages were guided by the Behavior Change Wheel (BCW) framework, which is centered on the Capability, Opportunity, Motivation – Behavior (COM-B) model. Program evaluation was conducted using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. A multi-method approach was used for the initial phases, while a convergent/parallel mixed-methods approach was applied during the evaluation phase. 

Results: In the problem identification stage, there are three main themes as factors that influencing healthy lifestyle behaviors: capability, opportunity, and motivation. The resulting program, named the Serasi Program, integrates both community and individual empowerment strategies to prevent obesity and hypertension. Post- intervention evaluation showed that the Serasi Program was significantly associated with increased in vegetable consumption, and reductions in systolic blood pressure, body weight, body mass index (BMI), waist circumference, and perceived stress scale score in the intervention group compared to the control group, after adjusting for sociodemographic and biological factors. 

Conclusion: The Serasi Program intervention was significantly associated with improvements in healthy lifestyle behaviors, including increased vegetable intake and reduced in systolic blood pressure, body weight, body mass index, waist circumference, and perceived stress scale score in the intervention group compared to the control group. 

Kata Kunci : perilaku hidup sehat, wanita, hipertensi, obesitas, pemberdayaan masyarakat