We will develop a model for inclination to utilize the puskesmas and a separate model for actual utilization of the puskesmas. In the first model, we will develop an inclination score based on the questionnaire. Univariable analysis will be performed to identify a significant association of age, gender, and socioeconomic status, knowledge and disease severity perception, and geographical accessibility with this score using a t-test or Anova. Multivariable analysis for this model will be conducted by multiple linear regression. For the second model, since we will have actual utilization (yes or no), we will build a multiple logistic regression model of probability for seeking care to the puskesmas for ILI with knowledge and disease severity perception as explanatory variable while controlling for age and sex. We will also test the modifying effect of socioeconomic status and geographical accessibility in both models. We will use 95% confidence level for all statistical tests. We will use computer software R version 2.12.2 for basic & regression analysis, AccessMod 3.0 for geographical accessibility calculations, and Arc GIS version 10 for mapping.
Interviewees will sign informed consent forms approved by the ethical review committees in Indonesia and US. All data will be stored in secure database. Only de-identified data will be used for all analysis. Ethical clearance for this study will be obtained from Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia and COMIRB, Aurora, Colorado, US.
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