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FACTORS RELATED TO HAND WASHING BEHAVIOR WITH SOAP DURING THE COVID-19 PANDEMIC ON JUNIOR HIGH SCHOOL
STUDENTS
1Rina Oktavia, 2Andriyani, 3Triana Srisantyorini, 4Ernyasih
Public Health Study Program, Faculty of Public Health, Universitas Muhammadiyah Jakarta K. H. Ahmad Dahlan St., Cirendeu, South Tangerang 15419
Email: [email protected]
ABSTRACT
Based on the results of the Banten Province Basic Health Research, the hand washing behavior of the people in the 10-14year age group in Banten Province is 42%, and in the school children group, it is 44.5%.
In South Tangerang City, the proportion of good and correct handwashing behavior in 2018 was 69.12%.
Public awareness in carrying out hand washing behavior is still low. This study aims to determine the factors related to washing hands with soap during the Covid-19 pandemic—a cross-sectional design with a sample of 172 class VIII students. The sampling technique used was purposive sampling. Data analysis with Chi-Square (α = 0.005). Respondents with good Hand Washing Behavior with Soap or “Cuci Tangan Pakai Sabun” (CTPS) were 85.5%. Female respondents are 51.2%, have good knowledge of CTPS (62.2%), have good CTPS attitudes (64%), have peer support (50.6%), and have good facilities and infrastructure adequate (89%). There is a relationship between knowledge (p=0.024), attitude (p=0.013), facilities and infrastructure (p=0.009), and age (p=0.000) with the behavior of washing hands with soap.
There is no relationship between gender and peer support with the conduct of washing hands with soap.
The factors related to the behavior of washing hands with soap in students at SMP Negeri 6 Tangerang Selatan City are age, knowledge, attitudes, and facilities and infrastructure. The suggestion is to cooperate between the school and related parties to provide counseling about the behavior of washing hands with soap so that students can apply their knowledge and attitudes in everyday life.
Keywords: handwashing behavior with soap (CTPS), junior high school student, Covid-19
INTRODUCTION
The behavior of washing hands with soap or CTPS using running water is one of the habits of the community that reflects the Clean and Healthy Life Behavior (PHBS) (Sultan & Zikri, 2021). One clean and healthy lifestyle can be done by washing hands after carrying out activities to increase public health awareness through personal health care (Susantiningsih et al., 2019). Hands are the primary medium of disease transmission. According to Notoatmodjo (2003), due to a lack of hand washing habits, various health problems will arise, such as diarrhea, cholera, dysentery, typhus, intestinal worms, skin diseases, Acute Respiratory Infections (ARI), to death (Sinaga et al., 2020).
Based on the results of the Banten Province Basic Health Research, the hand washing behavior of the people in the 10-14year age group in Banten Province was 42%, and in the schoolchildren group, it was 44.5%. In South Tangerang City, the proportion of good and correct handwashing behavior in 2018 was 69.12%. The behavior of washing hands with soap is not a daily habit of the general public. Public
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awareness of hand washing behavior is still low, even though washing hands with soap effectively prevents disease transmission (Sianipar, 2021).
According to Notoatmodjo, health behavior has several related factors, including predisposing, supporting, and driving factors. Several variables that are believed to have a relationship with washing hands with soap are knowledge, attitudes, peer support, infrastructure, and individual characteristics such as age and gender (Ikasari & Anggana, 2020).
Based on research conducted by Khoiruddin (2016), a significant relationship was found between knowledge and hand washing behavior with soap before and after eating at SD Negeri Ngebel Tamantira, Kasihan Bantul (Khoiruddin et al., 2016). Likewise, Amar (2019) also found a relationship between knowledge and hand washing behavior with soap in students at SD Negeri 101893 with a p-value of 0.000 (Amar, 2019).
Sianipar's research (2021) found a relationship between attitudes and peer relationships with the behavior of washing hands with soap during the Covid-19 pandemic in Jambi University students with p values of 0.030 and 0.000. However, this study found no relationship between knowledge and infrastructure (Sianipar et al., 2021).
Currently, the world is facing a pandemic of Covid-19 (Coronavirus Disease) caused by the coronavirus. PHBS is the primary effort needed to prevent the transmission of Covid-19 in the community.
Measures to control the information of Covid-19 can be done by doing PHBS, such as washing hands with soap. This looks easy, but it is pretty challenging to implement because the community must continue to do it consistently (Andhani et al., 2020).
Clean and healthy living behavior, especially washing hands with soap, is one of the main focuses amid the Covid-19 pandemic, especially for school children. Therefore, researchers are interested in researching factors related to hand washing behavior with soap in students of SMP Negeri 6 Tangerang Selatan City in 2022.
METHOD
This type of research uses a cross-sectional design with a purposive sampling technique. Research conducted on May, 2022. The research sample in this study was 172 people from class VIII. The independent variables in this study were age, gender, knowledge, attitudes, peer support, and infrastructure.
At the same time, the dependent variable in this study is the behavior of washing hands with soap. Statistical analysis in this study was univariate analysis to see the data distribution and bivariate Chi-Square (0.05) analysis with a cross table model to see the relationship between variables and the odds ratio (OR) value.
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This research has passed the ethics review from the Faculty of Public Health, University of Muhammadiyah Jakarta with an ethics eligibility number of 10.450.B/KEPK-FKMUMJ/IV/2022
RESULTS AND DISCUSSION
The following is the result of univariate analysis of factors related to the behavior of washing hands with soap in junior high school students:
Table 1. Distribution of Handwashing Behavior, Gender, Age, Knowledge, Attitude, Peer support, and Facilities and Infrastructure
Variable n %
Handwashing behavior
Good 147 85.5
Poor 25 14.5
Gender
Female 88 51.2
Male 84 48.8
Age
≥14 year 139 85.5
<14 year 33 19.2
Knowledge
Good 107 62.2
Poor 65 37.8
Attitude
Positive 110 64.0
Negative 62 36.0
Peer support
Support 87 50.6
Not support 85 49.4
Facilities and infrastructure
Complete 153 89.0
Incomplete 19 11.0
Based on the table above. it can be seen that the majority of respondents had good handwashing behavior with soap. as many as 147 people (85.5%). while respondents who had bad handwashing behavior with soap were as many as 25 people (14.5%). In addition. most of the respondents were female. as many as 88 people. 51.2%. and male. as many as 84 people (48.8%). In the age distribution. most of the respondents aged 14 years were 139 people (85.5%). and those aged <14 years were 33 people (19.2%). In the knowledge variable. most respondents have good knowledge. as many as 107 people (62.2%). and respondents who have poor knowledge. as many as 65 people (37.8%). On the attitude variable. most respondents have a good attitude. as many as 110 people (64%). and among respondents with a bad mood.
62 people (36.0%).
Most respondents have peers who support washing hands with soap. as many as 87 people (50.6%).
while respondents who do not have peers who support the behavior of washing hands with soap. as many
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as 85 people (49.4%). In the infrastructure variable. most respondents have facilities and infrastructure that support the behavior of washing hands with soap. as many as 153 people (89.0%). while respondents who do not have facilities and infrastructure that support the conduct of washing hands with soap are 19 people (11.0%).
Below is the result of a bivariate analysis of factors related to the behavior of washing hands with soap in junior high school students:
Table 2. Bivariate Analysis of Handwashing Behavior
Variable
Handwashing behavior
Total
OR (95% CI) P value
Good Poor
n % n % n %
Gender
1.696 (0.715-4.020) 0.321
Female 78 88.6 10 11.4 88 100
Male 69 82.1 15 17.9 84 100
Age
6.879 (2.754-
17.182) 0.000
≥14 year 127 91.4 12 8.6 139 100
<14 year 20 60.6 13 39.4 33 100
Knowledge
2.914 (1.219-6.945)
0.024
Good 97 90.7 10 9.3 107 100
Poor 50 76.9 15 23.1 65 100
Attitude
3.191 (1.334-7.633) 0.013
Positive 100 90.9 10 9.1 110 100
Negative 47 75.8 15 24.2 62 100
Peer support
1.650 (0.696-3.911) 0.353
Support 77 88.5 10 11.5 87 100
Not support 70 82.4 15 17.6 85 100
Facilities and infrastructure
4.357 (1.525- 12.551)
0.009
Adequate 135 88.2 18 11.8 153 100
Inadequate 12 63.2 7 36.8 19 100
Based on the bivariate analysis table for all variables. it was found that there was no significant relationship between gender and the behavior of washing hands with soap. with a p-value of 0.321 (CI 0.715-4.020). At the same time. the age variable found a significant relationship to the conduct of washing hands with soap with a p-value of 0.000 (CI 2.754-17-182). The same thing is also found in the knowledge variable. with a significant relationship between knowledge of the behavior of washing hands with soap with a p-value of 0.024 (CI 1.219-6.945). Likewise. for the attitude variable. a significant relationship was found between attitudes towards the behavior of washing hands with soap with a p-value of 0.013 (CI 1.334- 7.633). However. on the peer support variable. no significant relationship was found between peer support on the behavior of washing hands with soap. with a p-value of 0.353 (CI 0.696-3.911). Meanwhile. in the variables of facilities and infrastructure. a significant relationship was found between facilities and infrastructure on the behavior of washing hands with soap with a p-value of 0.009 (CI 1.525-12.551).
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According to Cahyani (2010). gender can affect a person's attitudes and behavior. including the conduct of washing hands with soap. Most girls have a good clean and healthy lifestyle compared to boys.
This can be a result of the behavior of washing hands with soap in girls and boys can be different.
The analysis of the relationship between sexes showed that the male respondents who had good handwashing behavior with soap were 69 people (82.1%). Of the female respondents with good hand washing behavior with soap. 78 people (88.6%). The statistical test results using Chi-Square with the Continuity Correction test obtained a p-value of 0.321. meaning that the gender variable does not have a significant relationship with washing hands with soap. This study's results align with Kartika's research (2016). Based on the results of statistical tests with the Chi-Square test conducted on 216 grade IV and V elementary school students. a p-value of 0.381 was obtained. so it was concluded that there was no significant relationship between gender and hand washing behavior with soap (Kartika, et al., 2016).
In this study. an analysis of the relationship between age and the behavior of washing hands with soap was conducted. A significant association was found between age and the behavior of washing hands with soap in students at SMP Negeri 6 Tangerang Selatan City. However. this study's results differ from Randhika (2020) to 51 grade IV students of SD Negeri Karangtowo. Demak. Central Java. Based on the results of statistical tests with a cross-sectional design. found insignificant results between the age variable and the behavior of washing hands with soap with a p-value = 0.593.
In the knowledge variable. a significant relationship was found between knowledge and the behavior of washing hands with soap in SMP Negeri 6 Tangerang Selatan City students. with a p-value of 0.024. This research is in line with that conducted by Isnaini (2020) on 55 respondents at SMP Negeri 15 Banjarbaru using a cross-sectional study design with a p-value of 0.000; it can be concluded that there is a relationship between knowledge and behavior in washing hands with soap (Isnaini, et al., 2020). However.
this study is not in line with or contradicts research conducted by Rizal (2017) which states that there is no relationship between knowledge and handwashing behavior with soap in grades IV. V. and VI of SD Negeri 010 Palaran (Rizal, 2017).
According to Juanita (2017). a person's knowledge is obtained from the experiences he has gone through or information that can awaken him based on his knowledge. The amount of information received by a person can increase a person's ability which gives rise to a separate understanding of himself in carrying out activities (Nurhidayah, et al., 2021)
According to Wawan (2020). attitude is one of the predisposing factors to be able to do or not do a specific behavior. So. in this case. attitude is an individual self-awareness. Attitude to a person can affect the behavior of washing hands with soap. The more positive the attitude towards someone. the greater the likelihood that this behavior will arise (Octa, 2019). This is in line with what was found in this study. that
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there is a relationship between attitudes towards hand washing behavior with soap in students at SMP Negeri 6 Tangerang Selatan City with a p-value of 0.013.
However. this study differs from the results of Kartika's (2016) research based on the bivariate analysis results. which show that the Chi-Square test shows a p-value of 0.076. So it can be concluded that there is no significant relationship between attitude and behavior of washing hands with soap in Sambiroto 01 State Elementary School Semarang City (Kartika, et al., 2016).
On the peer support variable. no significant relationship was found on the behavior of washing hands with soap. The p-value obtained is 0.353 (> 0.05). This study's results differ from the research conducted by Kartika (2016) on fourth and fifth-grade students at SDN Sambiroto 01 Semarang City as many as 216 respondents with a cross-sectional study design. Based on the statistical test with the Chi- Square test. the study showed a p-value of 0.026. So it can be concluded that the study has a significant relationship between peer support and the behavior of washing hands with soap (Kartika et al.. 2016). The results of this study are also supported by Berliana's research (2016) which shows a significant relationship between peer support and the behavior of washing hands with soap with a p-value of 0.000 (Berliana, 2016).
According to Sarafino (2006). peer support is a form of natural social support that comes from interactions between individuals and individuals. The state of peer support can be providing information.
assistance. or specific materials (Putra, 2015).
In the facilities and infrastructure variables. a significant relationship was found between the behavior of washing hands with soap with a p-value of 0.009 for students at SMP Negeri 6 Tangerang Selatan City. The existence of facilities and infrastructure to implement clean and healthy living behavior will have a positive influence on students at school and at home. The better the availability of facilities and infrastructure. it is hoped that it can bring up clean and healthy living behavior habits for students (Sarah, et al., 2020).
This study's results align with Murwaningsih's (2016) research. which found a significant relationship between facilities and infrastructure on hand washing with soap in SD Negeri II Karang Bandar Lampung City. This research was conducted on all students of class VI. totaling 80 people. and obtained a p-value of 0.039 (Murwaningsih. 2016). Likewise. Sa'adah (2018) found a relationship between facilities and infrastructure with hand washing behavior with soap at SDN 12 Tarung-Tarung Selatan with a p-value of 0.038 (Sa'adah, 2018).
CONCLUSIONS AND SUGGESTIONS
Based on the results of research conducted on 172 respondents. the researchers concluded that the factors related to the behavior of washing hands with soap in students at SMP Negeri 6 Tangerang Selatan
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City were age (p-value 0.000. OR = 6.879). knowledge (p-value 0.024 OR = 2.914). attitude (p-value 0.013 OR = 3.191). and infrastructure (p-value 0.009 OR = 4.357). While the unrelated factors are gender (p- value 0.321 OR = 1.696) and peer support (p-value 0.353 OR = 1.650).
It is hoped that schools will collaborate with the health office. health center. or non-governmental organizations to provide further education regarding clean and healthy living behavior. especially the behavior of washing hands with soap. In addition. students are expected to apply their knowledge about clean and healthy living behavior. especially the behavior of washing hands with soap in everyday life. both at home and school.
ACKNOWLEDGMENT
Thank you to many parties who have done this research well. especially to all respondents who have participated in it. to SMP Negeri 6 Tangerang Selatan City. who has permitted to conduct this research there. and to the Faculty of Public Health. Universitas Muhammadiyah Jakarta lecturers who have guided this research.
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