Abstract
INTRODUCTION: Adherence to taking iron tablets is a challenge in the Fe supplementation program. Self-identity is an essential factor to consider while enhancing teenage adherence to taking Fe tablets. Health Belief Model showed that likelihood of action is affected by health belief variables and eventually affected the actual behavior which is the adherence. PURPOSE: The purpose of this study is to examine the effect of high school adolescent self-identity on iron tablet consumption adherence using HBM variables such as expectation, perceived susceptibility and severity, and perceived threat, as well as iron tablet problem-solving abilities which represent the likelihood of action variable. MATERIAL AND METHODS: This was an analytical observational study using a cross-sectional design. The sample size was 375 adolescent girls students from Sidoarjo Regency, Indonesia. The sample approach used was multistage random sampling. Data collection was conducted from October to December 2022. Data analysis was carried out from December 2022 to February 2023. The data for this study was analyzed using structural equation model-partial least square with Smart-Partial Least Squares (PLS) software. RESULTS: Self identity was found to have significant effect on expectation (p-value < 0.001), perceived susceptibility and severity (p-value < 0.001), and problem solving ability (p-value 0.005). Self-identity also influences adolescents adherence through the problem solving ability p-value 0.042) and expectation (p-value < 0.001) and both problem solving ability and expectation (p-value 0.001). CONCLUSION: Adolescents' self-identity significantly influences their expectations and problem-solving abilities, which represent key constructs of the Health Belief Model, namely perceived benefits and likelihood of action, and these factors positively affect adherence to iron tablet consumption. The findings suggest that strengthening HBM-related constructs such as expectations, perceived susceptibility, and problem-solving abilities through self-identity development may effectively improve iron tablet adherence among high school adolescents.