Social Media as a Tool to Improve Health Literacy on High School Students in Semarang, Indonesia Nurjanah, Sri Soenaryati, Enny Rachmani, Debby Aprilanawati, Maria Magdalena Dolorosa Bili, Serliati Dappa Ole Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University Presentation Outline Background Methods Results Conclusion Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University BACKGROUND An ability of people to gain access, understand, appraise and use information to promote and maintain good health. Health Literacy Health Literacy Faculty of Health Sciences Dian Nuswantoro University

Semarang Health Literacy Survey, 2014, n=1029 BACKGROUND Semarang Health Literacy Survey, 2014, n=1029 Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University BACKGROUND Age – General HL, 2014 (n= 1029) Faculty of Health Sciences Dian Nuswantoro University

Health Literacy on Health Students, online, 2014, n=69 BACKGROUND Health Literacy on Health Students, online, 2014, n=69 Fakultas Kesehatan Universitas Dian Nuswantoro Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University BACKGROUND Health Literacy on Health Students, 2015, n=82 Fakultas Kesehatan Universitas Dian Nuswantoro Faculty of Health Sciences Dian Nuswantoro University

Information: Confusing

BACKGROUND Research on adolescent health literacy is very important considering health literacy will help them maintain their health and get a good quality of life in the future.

Faculty of Health Sciences Dian Nuswantoro University Health literacy conceptual framework Upsize the font (Sørensen et al., 2012) Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University Purpose This study aims to determine the media, especially social media mostly used by adolescent and to formulate health messages most frequently discussed and needed by adolescents. Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University METHODS The two Public High School and Islamic High School in Semarang were selected to participate in the study. Firstly, the students were invited to fill the questionnaire voluntary, and there were 140 respondents participated in the survey. The the main instrument in the survey was HLS-16 added with eHEALS, media use behaviors and demographics variables. Secondly, two focused group discussions (FGDs) were conducted in each high school with 15 subjects to know the media using behavior, and the health information that students needed. Thereafter the researcher arranged the health massages and sent to students regularly by LINE. After received all messages, the students will invite to fill out the questionnaire again to measure the improvement of their health literacy  Only 46 respondents’ response The correlations between variables were analyzed by spearman rank test and comparison between pre and post test will be analyzed by related samples wilcoxon signed rank test Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University Methods The questionnaire consisted of HLS-EU-16 (Health Literacy Survey-Europe-16 Questions) and e-HEALS (e-Health Literacy Scale). Health literacy levels were measured by Likert scale 1-4. 1=very difficult 2=moderately difficult 3=fairly easy 4=very easy the answer is the dichotomous categorization, which is “very difficult” and “moderate difficult” answers were 0 score and the “fairly easy” and “very easy” were 1 score. All score were summarized and categorized: Inadequate HL (0-8) Problematic HL (9-12) Sufficient HL (13-16). Data analysis : Spearman Rank and Chi Square Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University Results Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University Activities Faculty of Health Sciences Dian Nuswantoro University

Media to Access Health Information Faculty of Health Sciences Dian Nuswantoro University

eHEALS (e-Health Literacy Scale) Variable Category f % Internet help to make health decision Not useful at all 0.0 Not Useful 1 0.7 Not sure 19 13.6 Useful 87 62.1 Very useful 33 23.6 Importance of accessing health information via internet Not important at all Not important 9 64.3 Important 90 Very important 39 27.9 Faculty of Health Sciences Dian Nuswantoro University

eHEALS (e-Health Literacy Scale) Variable Category f % Have skill to evaluate health information on internet Very not agree 1 0.7 Not agree 13 9.3 Not sure 46 32.9 Agree 68 48.6 Very agree 12 8.6 Able to differentiate the quality of information on internet 2 1.4 16 11.4 56 40.0 53 37.9 Faculty of Health Sciences Dian Nuswantoro University

eHEALS (e-Health Literacy Scale) Variable Category f % Sure to use health information on internet to make decision Very not agree 2 1.4 Not agree 27 19.3 Not sure 48 34.3 Agree 52 37.1 Very agree 11 7.9 Faculty of Health Sciences Dian Nuswantoro University

Result - Category of Health Literacy Faculty of Health Sciences Dian Nuswantoro University

Statistics test results Variable p-value Correlation coefficient Sex 0.398 Age 0.395 -0.073 Concentration 0.129 Attending Extracurricula 0.043* Discussing health in extracurricula 0.061 Medical/health training in the family 0.001** Access health information from television 0,415 0.069 Access health information from radio 0.794 -0.022 Access health information from internet 0.008* 0.224 Access health information from mobile phone 0.012** 0.213 Access health information from health training 0.399 0.072 Access health information from social media 0.000** eHEALS 0,421 Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University FGD Results All students use LINE Students need information about: Gastrointestinal diseases Reproductive health Quit smoking Beauty treatment Diet Alcohol and drug Mental health particularly for facing stress Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University Sending massages 32 messages send to Line group and indidually Some group discussions.... and chats... Faculty of Health Sciences Dian Nuswantoro University

Health Literacy category Compare Pre-Post; N=46 Health Literacy category Pre Test Post Test f % Inadequate 0.0 Problematic 12 26.1 5 10.9 Sufficient 34 73.9 41 89.1 Total 46 100.0 mean 13.6957 14.6087

Faculty of Health Sciences Dian Nuswantoro University CONCLUSION Low health literacy problems still happened on the students (29.3%) Factors associated with health literacy on student were frequency of access to health information through internet, mobile phone and social media and eHEALS. Students very easy to access online health information but had difficulties to evaluate the right and trusted health information among so many information that available in the internet. Broadcast health messages through social media is considered effective. Faculty of Health Sciences Dian Nuswantoro University

Faculty of Health Sciences Dian Nuswantoro University Thank you nurjanah@dsn.dinus.ac.id Faculty of Health Sciences Dian Nuswantoro University