ACCEPTANCE ANALYSIS OF ELECTRONIC APPLICATION READY FOR MARRIAGE AND PREGNANCY (ELSIMIL) BASED ON THE TECHNOLOGY ACCEPTANCE MODEL (TAM) APPROACH

Purpose: The Elsimil application is an intervention effort to prevent stunting by conducting health screening which is followed up with assistance for marriage and pregnancy readiness to prospective brides. The Elsimil application review rating on the Play Store / App Store on February 01, 2023, which is 3.2, is still low and there are many user complaints related to difficulties in registering, operating the application and frequent system problems. The purpose of this study was to analyze the acceptance of the Elsimil application using the Technology Acceptance Model approach. Metod: This study uses analytical quantitative research with a cross sectional approach. Primary data obtained from a closed questionnaire, which explores the perceived ease, perceived usefulness, user attitude, and interest in using the Elsimil application. The number of samples was 33 Catin, then the data obtained was analyzed using the Partial Least Square (PLS) method using smartPLS software. Results and Discussion: Based on the results of the analysis, it shows that there is a significant effect of perceived convenience on perceived usefulness (p-value 0.045), effect of perceived convenience on user attitudes (p-value 0.000), effect of perceived usefulness on user attitudes (p-value 0.029), influence between user attitudes on interest (p-value 0.000). and influence between perceived usefulness on interest in using (p-value 0.132) in using the Elsimil application. In conclusion, of the five hypotheses proposed, four of them have a significant effect and one has no significant effect on the use of the Elsimil application.


INTRODUCTION
A public health problem that is of serious concern in Indonesia is stunting.Based on data from the Indonesian Toddler Nutrition Status Survey (SSGBI) in 2021, the prevalence of stunting is currently still at 24.4% or 5.33 million toddlers.According to Presidential Regulation Number 72 of 2021 concerning the Acceleration of Stunting Reduction, the stunting rate is targeted to drop to 14% (fourteen percent) by 2024.At this time, the use of information systems is needed to assist in the prevention and reduction of stunting.Therefore, the National Population and Family Planning Agency (BKKBN) through the Directorate of Youth Resilience (Dithanrem) developed an application, namely Elsimil (Electronic Ready for Marriage and Pregnancy), which functions to conduct monitoring and assistance to ensure readiness to marry and become pregnant (Novita et al., 2021).
The Elsimil application as an intervention effort to prevent stunting is carried out by conducting screening which is followed up with assistance in marriage and pregnancy readiness to prospective brides.Health screening efforts for prospective brides are carried out with a focus on variables that are determinants of stunting, which then provide screening results in the form of a certificate/card stating that the catin is at risk or not at risk of giving birth to a stunted baby.This certificate/card will later become a requirement in marriage registration at the KUA/Dinas Kependudukan dan Catatan Sipil.In addition, the screening results are input for the Facilitator officers to be followed up in the Assistance process (Novita et al., 2021).
Based on data from the Representative of the National Population and Family Planning Agency (BKKBN) of East Java Province, the number of Elsimil application users was 150,455 users throughout 2022.The data was obtained based on the recapitulation of the Family Assistance Team (TPK) and Prospective Brides (Catin) in the Elsimil application as of January 2023.Of the 150,455 Catin using Elsimil, 73% or 110,396 of them have been accompanied by TPK.Elsimil itself has been visited by 220,000 people on its website until 2023.In addition to the website, Elsimil is also available on the Play Store and App Store.So that it can make it easier for Catin to use the application.The review rating of the Elsimil application on the Play Store / App Store on February 01, 2023, which is 3.2, is still low and there are many user complaints related to difficulties in registering, operating the application and frequent system problems.
Based on preliminary studies in the form of interviews conducted by researchers to the Coordinator Midwife in the UPTD work area.Wonokromo Health Center, stated that the catin had started using the Elsimil application and had received assistance from the Family Assistance Team (TPK).However, Catin does not fully understand how to use the Elsimil application.Many catin still find it difficult to register and operate the Elsimil application and still need help from the KIA officer at the puskesmas in operating it.User dissatisfaction with the Elsimil application is still high due to the lack of ability to use or operate information systems for users.

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The Technology Acceptance Model (TAM) has been widely used to analyze the acceptance of an application.This is because TAM is used to study and understand the behavior of information system users.As research conducted by Christian, et al (2022) TAM can describe the effect of perceived usefulness on attitudes, the effect of perceived convenience on attitudes in the Pedulilindungi application.Other research was also conducted by Sudarmadji (2023) TAM can describe the influence of external factors on perceived ease, perceived usefulness and interest in using health applications.This is because TAM is a behavioral model that is useful for answering the question of why many information systems fail to be implemented because the user does not have the intention to use them.
Information system acceptance analysis has many behavioral models, one of which uses the Technology Acceptance Model (TAM).Therefore, to determine the level of acceptance of the Elsimil application that has been implemented, it is necessary to evaluate the Elsimil application regarding user acceptance of the Elsimil application.TAM is a model developed by Davis (1986) to explain the acceptance of technology used by technology users.TAM provides a strong and simple explanation for accepting technology and the behavior of its users (Jogiyanto, 2007).
Based on this description, it is necessary to conduct research to analyze the acceptance of the Elsimil application using the TAM theory approach, so that it can be used as evaluation material regarding its implementation in health screening activities for prospective brides.

MATERIALS
This study uses analytical quantitative research because this research is directed to test hypotheses and explain a situation or situation regarding the influence of Perceived Usefulness factors, perveived ease of use factors, attitudes towards using Elsimil, on behavioral intention to use Elsimil.

DATA COLLECTION PROCEDURES
The population studied in this study were prospective brides who used the Elsimil application in the Wonokromo Health Center work area, as many as 50 Catin, taken from the average catin visit at the Wonokromo Health Center, Surabaya City.The sample used is part of the bride-to-be who uses the Elsimil application in the Wonokromo Health Center working area, Wonokromo District, Surabaya City.Based on the sample calculation using the slovin formula, the number of samples used in this study was 33 catin.
The sampling method in this study is to use the Simple Random Sampling technique.
The data collection technique used in this study is a questionnaire to prospective brides at the Wonokromo Health Center who use the Elsimil application with the same questionnaire statement indicators between one user and another.The questionnaire distribution was carried out on a Likert scale with statements (1) strongly disagree, (2) disagree, (3) agree, and (4) strongly agree.For unfavorable items, the scale is reversed.

DATA ANALYSIS
The data analysis technique used in this research is Structural Equation Modeling(SEM) which uses PLS (Partial Least Square) Software.A model in the form of a structure of many dependent variables can be analyzed using SEM techniques.SEM is a statistical technique for testing and estimating casual relationships by integrating factor analysis and path analysis (Abdillah & Jogiyanto, 2015).

RESPONDENT CHARACTERISTICS
The characteristics of respondents in this study include gender, age, latest education and occupation.The following is a frequency distribution table of respondent characteristics.

3.2 HYPOTHESIS TESTING
To find out whether the hypothesis can be accepted or rejected.This researcher will use a significant value of alpha 0.05 or 5%.The relationship between variables can be said to be significant if the P value is smaller than the predetermined significant value (P < 0.05).The following are the P values obtained in this study.
Hypothesis testing is done by looking at the path coefficient output from the bootstrap resampling results as follows:

THE EFFECT OF PERCEIVED EASE OF USE ON PERCEIVED USEFULNESS IN ELSIMIL APPLICATION USERS
Based on testing the first hypothesis, it is known that the proposed H1 can be accepted.
The path coefficient output shows that the p-value for perceived ease of use on perceived usefulness is below 0.05, namely 0.04, so that the influence exerted by perceived ease on the construct of perceived usefulness is significant.The higher the perceived ease of use of the Elsimil application, the higher the perceived usefulness of the system.Based on this, it is known that the application is quite flexible when used and easy to use, so users will feel that the system provides benefits to users of the application.Logically, it can be perceived that a system that is easier to use will provide more benefits and usefulness.This is supported by research Priambodo, et al. (2022)shows that the perceived ease of use (PEU) variable has a significant positive effect on the perceived usefulness (PU) variable on the use of the Sikerja application.It can be perceived that Sikerja at the Ministry of Home Affairs is easy to learn, easy to use, and easy for users to understand, so users will feel that the system has benefits and answers the needs for employees in making the required work reports, because of the ease of using Sikerja Ministry of Home Affairs.

THE EFFECT OF PERCEIVED EASE OF USE ON ATTITUDES TOWARDS ELSIMIL APPLICATION USERS
Based on the second hypothesis testing, it is known that the proposed H1 can be accepted.The path coefficient output shows that the p-value for perceived ease of use on user attitude has a p-value below 0.05, namely 0.00.This happens because the more catin feels the ease of using the Elsimil application, it will lead to an interest in the application which then creates a good attitude in using the application.The Elsimil application provides convenience in recording health screening and the features in the Elsimil application are quite easy to learn, this will create a positive user attitude and encourage users to use the application as a tool in completing tasks or work on an ongoing basis.
This research is in line with research conducted by Marthus, et.al (2019) stated that there was an effect of perceived convenience on attitudes towards using the maternal health service information system at the Bungo Regency Health Office.This is because the features provided on the maternal health service information system at the Bungo Regency Health Office are easily understood by midwives because the sub menu format on the Pregnant Women's data menu is almost the same as the pregnant women's cohort feature so that midwives are familiar and uncomplicated in entering data on the Pregnant Women's Data Form.However, this research is not in line with research conducted by Christian, et al, (2022) stated that perceived ease of use has no effect on user attitudes, so a person's level of perceived ease of use is low or high will not affect the attitude of Pedulilindungi application users.This happens because a person's attitude towards the application does not only affect because of convenience but also Based on testing the third hypothesis, it is known that the proposed H1 can be accepted.
The path coefficient output shows that the p-value for perceived usefulness on user attitudes is also below 0.05, namely 0.02.so that the higher the perceived usefulness of the Elsimil application, the better the attitude towards using the application.This happens because using the Elsimil application can save time when inputting screening data and is faster than inputting manually, the more benefits or usefulness to users will affect the user's attitude to use the system to improve their performance.
The results of this study are in line with research conducted by Rijatullah, et al, (2020) stated that perceived usefulness is related to attitudes towards using electronic prescriptions.
This proves that there is a positive relationship between perceived usefulness and attitudes towards using electronic prescriptions.The perceived usefulness of properly implemented electronic prescription services is expected to provide better access for citizens to higher quality health care, in addition to increasing efficiency for the health system.Electronic prescriptions also have the benefit of transferring data between health care providers to pharmacies.
However, this research is not in line with research conducted by Rani (2020) stated that the usefulness variable had no effect on the attitude of JKN KIS BPJS Health application users, this happened because participants thought that the Mobile JKN application was considered troublesome because JKN KIS participants were required to have the application.The respondent said that he already had many applications downloaded on his smartphone.So that the respondent feels burdened if he has to download the application again.

THE EFFECT OF PERCEIVED USEFULNESS ON BEHAVIORAL INTEREST IN USING THE ELSIMIL APPLICATION
Based on testing the fourth hypothesis, it is known that the proposed hypothesis H1 cannot be accepted.The path coefficient output shows that the p-value for the construct of perceived usefulness on interest in using is greater than 0.05, which is 0.13.These results indicate that there is no influence between perceived usefulness on interest in using.The perceived usefulness or usefulness of using the Elsimil application is not a factor that influences interest in using the application.Whereas almost all studies show that the construct of perceived whether the surrounding people use and the level of security of the application.Technology Acceptance Model (Tam) Approach ___________________________________________________________________________ Rev. Gest.Soc.Ambient.| Miami | v.18.n.5 | p.1-12 | e05628 | 2024.9 3.5 THE EFFECT OF PERCEIVED USEFULNESS ON THE ATTITUDE OF ELSIMIL APPLICATION USERS

Table 1
Respondent Characteristics The distribution of renposden characteristics based on gender can be seen that most are female with a percentage of 57.6%.Based on age, it can be seen that most respondents are in the age group 17-25 years with a percentage of 51.5%.Based on the latest education, most of them are in the high school level of education with a percentage of 60.6%.Based on occupation, it can be seen that almost half of the respondents work as private employees with a percentage of (48.5%).Wonokromo puskesmas workarea are private employees, therefore private employees are quite good at understanding android-based information systems.Technology Acceptance Model (Tam) Approach ___________________________________________________________________________ Rev. Gest.Soc.Ambient.| Miami | v.18.n.5 | p.1-12 | e05628 | 2024.

Table 2
Output Path Coefficients