Knowledge, attitude, and practice regarding type 2 diabetes and associated factors among rural adolescents in Indonesia: A cross-sectional study

medRxiv

Abstract

Abstract Background Type 2 diabetes (T2D) is increasingly affecting adolescents globally, yet there is limited evidence on their knowledge, attitudes, and practices (KAP) regarding the disease, which is essential for promoting preventive strategies. This study aims to evaluate KAP levels among adolescents, particularly in rural Indonesia, and identify factors associated with these outcomes. Methods A cross-sectional study was conducted in Kampar Regency, Riau Province, Indonesia, from September 2024 to February 2025. The study involved 1,546 senior high school students, who were selected through multistage cluster sampling. Data were collected using a validated KAP questionnaire. Descriptive statistics were used to summarize the levels of KAP, while multivariable binary logistic regression identified associated factors. Results About 70.6%, 70.3%, and 74.6% of participants showed good knowledge, positive attitudes, and good practices related to T2D. Higher likelihoods of good knowledge were linked to being female (AOR = 1.44; 95% CI: 1.13–1.83), non-Indigenous (AOR = 1.78; 95% CI: 1.40–2.28), studying in peri-urban areas (AOR = 1.43; 95% CI: 1.11–1.84), having longer school hours (AOR = 1.68; 95% CI: 1.07–2.63), being in higher grades (AOR = 1.51; 95% CI: 1.20–1.90), ranking in the top ten (AOR = 1.60; 95% CI: 1.24–2.05), participating in extracurriculars (AOR = 1.49; 95% CI: 1.16–1.92), and having a father with higher education (AOR = 1.32; 95% CI: 1.01–1.72). Positive attitudes and good practices were more common among students from periurban areas (AOR = 1.55; 95% CI: 1.20–2.00), those with longer school hours (AOR = 1.92; 95% CI: 1.22–3.02), higher grades (AOR = 1.33; 95% CI: 1.06–1.68), and top ten rankings (AOR = 1.63; 95% CI: 1.27–2.10). Additionally, adolescents aware of first-degree relatives’ T2D status were more likely to show positive attitudes (AOR = 0.70; 95% CI: 0.53–0.92) and good practices (AOR = 0.72; 95% CI: 0.54–0.96). Conclusion Adolescents in rural Indonesia demonstrated good knowledge, attitude, and practices related to T2D, but notable gaps remain across all domains. Targeted interventions in schools that consider significantly associated factors, along with active parental involvement in promoting healthy habits at home, are crucial for addressing these gaps and preventing future T2M burden in the country.

Authors 5

1. Nila Kusumawati corresponding

   University of Arizona

   Affiliation as printed

   Zuckerman College of Public Health: The University of Arizona Mel and Enid Zuckerman College of Public Health;

   Zuckerman College of Public Health: The University of Arizona Mel and Enid Zuckerman College of Public Health

2. Hanno Pijl Aachen

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center: Leids Universitair Medisch Centrum;

   Leiden University Medical Center: Leids Universitair Medisch Centrum

3. Emul Yani

   Institut Kesehatan Payung Negeri Pekanbaru

   Affiliation as printed

   STIKES Payung Negeri: Sekolah Tinggi Ilmu Kesehatan Payung Negeri

4. Desti Puswati

   Institut Kesehatan Payung Negeri Pekanbaru

   Affiliation as printed

   STIKES Payung Negeri: Sekolah Tinggi Ilmu Kesehatan Payung Negeri

5. Halimatou Alaofè

   University of Arizona

   Affiliation as printed

   Zuckerman College of Public Health: The University of Arizona Mel and Enid Zuckerman College of Public Health;

   Zuckerman College of Public Health: The University of Arizona Mel and Enid Zuckerman College of Public Health