Media Publikasi Promosi Kesehatan Indonesia (MPPKI)

Psychological Preparedness as a Component of Adolescent Disaster Readiness: Evidence from Secondary School Students in Yogyakarta

Novita Nirmalasari — 2026-05-06

Introduction: Indonesia’s recurrent exposure to earthquakes, floods, landslides, and volcanic eruptions places adolescents in schools under continuous disaster risk. Preparedness, however, is not built on technical knowledge alone. The ability to regulate emotions, maintain a sense of control, and act with confidence during emergencies may shape how students translate knowledge into action. Despite this, psychological preparedness is rarely examined as a distinct and measurable construct in large student populations, particularly in high-risk regions. As a result, the psychological dimension of readiness often remains secondary within school-based disaster programs. This study examined the levels of psychological preparedness and general disaster preparedness among junior and senior high school students in Yogyakarta and analyzed the relationship between the two constructs.

Method: A cross-sectional correlational design was applied. Of 760 invited students, 700 participated (response rate 92.1%) from five districts/cities. The Psychological Preparedness for Disaster Scale and the General Disaster Preparedness Scale were administered. Because the data were not normally distributed, Spearman’s Rho was used to assess correlation. An adjusted linear regression model was then performed to evaluate whether psychological preparedness remained associated with general preparedness after accounting for educational level, age, and gender.

Result: Most students demonstrated moderate levels of psychological preparedness (67.0%) and general disaster preparedness (65.8%). Psychological preparedness showed a positive correlation with general preparedness (r = 0.254; 95% CI 0.17–0.33; p < 0.001), indicating a small-to-moderate association. After adjustment, psychological preparedness remained independently related to general preparedness (? = 0.23, p < 0.001; R² = 0.14). The magnitude of the association was modest, yet stable across demographic controls.

Conclusion: Psychological readiness appears to function as one meaningful layer within adolescent disaster preparedness rather than as a dominant driver of behavior. In high-risk school contexts such as Yogyakarta, strengthening emotional regulation, perceived coping capacity, and decision-making confidence may complement technical training. Disaster education, therefore, may benefit from integrating psychosocial skill development alongside drills and hazard knowledge, while maintaining coordination between schools, families, and local disaster management agencies. Longitudinal and intervention-based research is needed to determine whether enhancing psychological preparedness leads to sustained behavioral improvements over time.

Environmental Sanitation and Household Rodent Presence Among Suspected Leptospirosis Cases: Findings from Makassar, Indonesia

Syamsuar Manyullei — 2026-05-06

Introduction: Leptospirosis is a zoonotic disease caused by the bacterium Leptospira interrogans. Residential areas frequently experience poor environmental sanitation, including waste accumulation, stagnant water, and rodent activity around households. Such conditions compromise environmental hygiene and facilitate the survival of Leptospira bacteria. Poor sanitation increases community exposure to environmental sources of infection, thereby elevating the risk of leptospirosis. Exposure may occur through direct or indirect contact with contaminated water or soil, particularly when stagnant water is contaminated with rodent urine. This study aimed to assess household rodent presence among suspected leptospirosis cases and to examine its association with environmental sanitation conditions. Polymerase chain reaction (PCR) testing and GIS-based spatial mapping were incorporated to support diagnostic and spatial interpretation.

Methods: This study employed a quantitative, descriptive cross-sectional observational design. The sample comprised 20 households of suspected leptospirosis patients selected through purposive sampling. Data were collected through direct household observation using a structured checklist.

Results: Chi-square analysis indicated no statistically significant associations between sanitation indicators and signs of rodent presence, including stagnant water (p = 0.068), waste accumulation (p = 0.068), rodent entry pathways (p = 0.178), drainage condition (p = 0.305), and wastewater disposal systems (SPAL) (p = 0.136). All examined variables demonstrated p-values greater than 0.05, indicating no statistically significant associations with observable rodent indicators. Nevertheless, the SPAL variable showed a non-significant trend toward association (p = 0.136), although it did not reach the conventional 5% significance threshold.

Conclusion: No statistically significant relationships were identified between household sanitation conditions including stagnant water, waste accumulation, drainage condition, wastewater disposal systems (SPAL), and clean water availability and signs of rodent presence. To mitigate rodent-related environmental health risks, communities are encouraged to improve environmental hygiene through proper waste management, routine maintenance of drainage systems, and the implementation of household-level rodent control measures.

The Association of Household Waste Management with the Risk of Scabies Incidence in Endemic Areas

Idham Halid — 2026-05-06

Introduction: Scabies is a contagious skin disease that remains a public health problem in endemic areas, especially in environments with poor sanitation and waste management. Ecosystem-based household waste management is believed to contribute to the prevention of environment-based diseases through improvements in sanitation and community behavior. This study aims to analyze the relationship between ecosystem-based household waste management and the risk of scabies in endemic areas, as well as to identify factors that play a significant role in its transmission.

Methods: The study used a cross-sectional design with 248 respondents from households in an area endemic for scabies, namely Rumak Village, West Lombok, Indonesia. Data were collected through structured interviews and field observations using a standardized questionnaire. Data analysis used the Chi-square test and logistic regression to determine the dominant factors associated with the incidence of scabies.

Results: A total of 39.1% of respondents reported having experienced scabies. Logistic regression analysis showed that the most influential factors affecting the incidence of scabies were poor local final waste management (p=0.001), followed by lack of waste sorting (p=0.004), presence of pets (p=0.004), and lack of organic composting (p=0.008). Other significant factors included poor personal hygiene (p=0.008) and low knowledge about scabies (p=0.023).

Conclusion: The results of the study confirm that ecosystem-based household waste management plays an important role in reducing the risk of scabies. Good environmental management practices, accompanied by hygienic behavior and increased public knowledge about scabies, are effective strategies for controlling this disease in endemic areas.

“BRASH Therapy” on Quality of Life Among Nursing Home Residents: A Pre-Experimental Study

Ni Luh Putu Dian Yunita Sari — 2026-05-06

Introduction: Elderly residing in nursing homes are susceptible to health issues, which can significantly impact their quality of life. This study aims to evaluate the effect of “BRASH Therapy” (Benson Relaxation, Affirmation, Butterfly Hug, and Self-Healing Touch Therapy) on the quality of life of the elderly.

Methods: A quantitative approach employing a pre-experimental pre and post-test design was utilized in this study. The sample consisted of 65 participants selected through purposive sampling technique. The inclusion criteria are able to communicate in Indonesian, able to stand, and had no injuries to the upper and lower extremities. Meanwhile, the exclusion criteria set were elderly people with mental and cognitive disorders, as well as chronic mobility disorders. The intervention provided was “BRASH Therapy” administered over five sessions, each lasting fifteen minutes. The quality of life of the elderly was measured pre an post the completion of all intervention sessions. The instrument used for this measurement was the WHOQOL-BRIEF, which has been validated and is reliable. Due to the data not being normally distributed, the Wilcoxon test was used for processing. This research has been declared ethically receivable with evidence of passing ethical review with Ethical Approval Number 283/EA/KEPK-BUB-2024.

Results: The majority of the respondents in this study were female (78,5%), with an average age of 74,3 years. The findings revealed median quality-of-life scores increased from 48,5 (IQR = 20,25-76,75) at baseline to 70,5 (IQR =20,25-80,50) post-intervention. The bivariate test indicated a statistically significant result (Z = ?6,758, p < 0,001). The calculated effect size was very large (r = 0,84, 95% CI: 0,74–0,90), indicating substantial practical significance. Thus, participation in “BRASH Therapy” showed statistically significant improvement of quality of life among elderly residing in nursing homes.

Conclusion: The findings can serve as a basis for considerating complementary interventions aimed at improving the quality of life of elderly residing in nursing homes.

Parental Feeding Practices and Nutritional Status Among Preschool Children in Urban Indonesia: Implications for Family-Centered Nursing

Widia Sari — 2026-05-06

Introduction: Parental feeding practices significantly influence children’s eating habits and growth. In Indonesian urban settings, shifting diets and lifestyles have created a double burden of malnutrition. This study examined the relationship between parental feeding practices and the nutritional status of preschool children in West Jakarta, Indonesia.

Methods: A cross-sectional survey was conducted among 255 caregiver–child pairs (children aged 3-6 years) recruited from early childhood education centres in West Jakarta. Caregivers completed the Indonesian-adapted Child Feeding Questionnaire (CFQ), which classified feeding approaches as responsive or non-responsive. Children’s weight and height were measured, and nutritional status classified using WHO growth standards. Descriptive statistics were applied, followed by chi-square tests to examine associations between feeding practices and sociodemographic characteristics. Spearman’s rank correlation assessed the relationship between feeding practices and nutritional status. Multivariable multinomial logistic regression estimated adjusted associations controlling for maternal education, household income, recent illness, and participation in growth and development screening.

Results: Among caregivers, 143 (56.1%) reported responsive feeding, while 112 (43.9%) used non-responsive feeding. Higher maternal education and household income were significantly associated with responsive feeding (p < 0.05), whereas recent illness was associated with non-responsive feeding. Feeding practices showed a weak but significant correlation with nutritional status (r = 0.123; 95% CI: 0.001-0.242 p = 0.04), explaining 1.5% of the variance. However, after adjustment, feeding practices were not independently associated with nutritional status. Recent illness increased the odds of undernutrition (aOR = 3.16; 95% CI: 1.61-6.21), while participation in growth and development screening demonstrated protective associations against undernutrition and overnutrition.

Conclusion: Responsive feeding showed a modest association with nutritional status in bivariate analysis, while child health status and preventive service engagement emerged as stronger independent correlates. Integrating responsive feeding education into pediatric and community nursing practice may support family-centered strategies addressing determinants of child nutrition in urban settings.

Effects of Structured Health Education and Multimodal Intervention on Behavioural and Clinical Outcomes in Type 2 Diabetes Mellitus: A Quasi-Experimental Study

Sarmalina Simamora — 2026-05-06

Introduction: Type 2 Diabetes Mellitus (T2DM) is a chronic disease commonly found in individuals over the age of 40 and ranks among the top three diseases suffered by participants of the National Health Insurance (JKN) program. The management of T2DM often involves the long-term use of medications, both oral and injectable, which may extend throughout the patient's lifetime. This condition can worsen in the presence of complications. However, T2DM patients can maintain a good quality of life and reduce the risk of macrovascular and microvascular complications if their blood sugar, blood pressure, and cholesterol levels are well-controlled. Effective management requires more than just medication; proper dietary regulation and sufficient physical activity are also crucial. This study aims to enhance the understanding and behaviors of T2DM patients so that they can achieve optimal clinical parameters and reduce the risk of complications.

Method: The research employs a quasi-experimental pre–post design was applied involving 20 adults with T2DM divided into treatment and control groups. The intervention consisted of face-to-face education, booklets, and exercise videos. Behavioral and clinical outcomes were assessed before and after the intervention. Data were analyzed using the Wilcoxon signed-rank test and paired t-test based on data distribution.

Result: The results showed significant improvements in understanding and behavior related to medication use, meal practices, and physical activity in the treatment group based on the Wilcoxon test (p < 0.05). However, no significant improvement was observed in dietary-management understanding.

Conclusion: Structured health education combined with multimodal intervention demonstrated significant improvements in behavioral and selected clinical outcomes among patients with type 2 diabetes mellitus compared with the control group.

Effectiveness of an Informative Website on Behavioral Determinants of Community-Based Total Sanitation for Stunting Prevention: A True Experiment

Ratna Dian Kurniawati — 2026-05-06

Introduction: Stunting is a persistent nutritional problem that impacts children's growth and development, as well as the quality of future human resources. The stunting rate has not yet reached the national target. The informative website, the Libas Stunting Education System (SiEduk), focuses on implementing the five pillars of Community-Based Total Sanitation (STBM) to prevent stunting. This study aims to analyze the effectiveness of the informative website SiEduk Libas Stunting in Bandung Regency.

Methods: This quantitative research employed a purely experimental research design with a pretest-posttest control group design. The study was conducted from July to December 2025. The research sample consisted of 700 housewives and was taken randomly. Simple Random Sampling based on inclusion and exclusion criteria then divided into experimental group and control group. Data were collected from a questionnaire that had been tested for validity and reliability. Data analysis was performed using an independent t-test. Data came from pre-test and post-test questionnaires. Ethical approval from the ethics committee of Bhakti Kencana University with number 211/09.KEPK/UBK/VII/2025.

Results: There were significant differences between the intervention and control groups in all variables studied, with a P value <0.001. The knowledge variable showed the highest increase with an average difference of 0.771, followed by perception at 0.371, attitude at 0.314, and motivation at 0.257. These results indicate that digital education through the informative website SiEduk Libas Stunting is effective in increasing the understanding and implementation of Community-Based Total Sanitation.

Conclusion: Digital-based informative websites like SiEduk Libas Stunting have proven effective in improving the knowledge, attitudes, perceptions, and motivation of housewives to implement the Five Pillars of Community-Based Total Sanitation to prevent stunting. Support from the Health Office and cross-sectoral collaboration are needed to maximize public access to the informative website.

Microplastic Threats: Urban–Rural Differences in Knowledge, Risk, and Psychosocial Factors among Households

Megawati Simanjuntak — 2026-05-06

Introduction: Microplastic pollution has emerged as an increasingly urgent environmental problem, highlighting the need to better understand the psychological and social factors that encourage households to engage in pro-environmental behavior. Grounded in the Theory of Planned Behavior, this study examines how microplastic knowledge, risk perception, attitudes, subjective norms, and perceived behavioral control shape pro-environmental intentions among urban and rural housewives, extending TPB by integrating knowledge and risk perception.

Methods: A quantitative research design was applied by distributing structured questionnaires to 600 respondents, comprising 300 urban and 300 rural housewives in Bogor City and Bogor Regency. Data analysis involved independent t-tests to identify differences between the two groups, and Structural Equation Modeling (SEM) to examine the causal relationships among the studied variables.

Results: The results show significant urban–rural differences in microplastic knowledge, risk perception, subjective norms, and perceived behavioral control, while attitudes and pro-environmental behavioral intentions are relatively similar across contexts. In urban areas, knowledge significantly influences risk perception, whereas attitudes, subjective norms, and perceived behavioral control predict pro-environmental behavioral intention. In rural areas, risk perception and perceived behavioral control are the main predictors, with no direct effect of knowledge.

Conclusion: Overall, knowledge alone is insufficient to promote pro-environmental behavioral intention. Instead, behavioral intentions follow context-specific pathways, driven primarily by attitudinal and normative factors in urban areas and by risk awareness and perceived behavioral control in rural settings.

Hazard Identification and Risk Assessment Using the HIRADC Framework in Travel and Tourist Activities at Mudal River Ecotourism, Kulon Progo, Yogyakarta

Andri Daeng Masiki — 2026-05-06

Introduction: Safety?and security are important considerations for nature-based tourism, even more so if destinations are prone to disasters that reinforce the risk of transport, environmental and activity-related hazards. Kulon Progo, Yogyakarta’s Mudal River Ecotourism reflects these issues through the presence of steep and curving roads, unpredictable hydrometeorological conditions and insufficient safety facilities which together increase risk exposure during travel to?the destination as well as when executing activities at site.

Methods: This research used a?qualitative case study approach that purposively juxtaposes the HIRADC framework with the DRR principles in a complex ecotourism context. Data were gathered through fieldwork, semi-structured interviews with managers, tourists and government organizations, document analyses; the risk assessment was based on the AS/NZS 4360:2004 standard considering probability (A–E) and?severity (1–5) scales.

Results: The findings identified critical hazards along the travel route (landslides, slippery and narrow roads, brake failure on steep slopes, and interaction with village traffic) and within the tourism area (slipping on rocks, sinking in deep pools, being swept away by strong currents, falls from heights, structurally vulnerable bridges, and animal bites). Most hazards were classified as high risk, particularly those associated with aerial recreation and landslide-prone access, leading to the management of a layered control package that combines engineering measures, administrative procedures, tourist safety education, and community-based monitoring aligned with disaster risk reduction strategies.

Conclusion: This study demonstrates how the application of the HIRADC framework and disaster risk reduction concepts can strengthen tourism safety governance in nature-based destinations exposed to geological and hydrometeorological hazards. The proposed safety management roadmap provides a practical reference for destination managers and policymakers and offers insights that can be applied to developing more resilient risk management models in similar ecotourism contexts.

Health Services for Marginalized Groups: A Sociological Study on Construction Workers in Paccerakkang, Makassar City

Andi Alim — 2026-05-06

Introduction: This study aims to gain an in-depth understanding of the experiences of construction workers in accessing health services in Paccerakkang Subdistrict, Biringkanaya District, Makassar City. As part of the informal sector workforce, construction workers face various health risks as well as structural limitations in obtaining adequate health services. This study adopts a health sociology perspective to examine how social, economic, and public policy factors influence access to health services among informal workers.

Methods: This study employed a qualitative approach with a phenomenological design. The research participants consisted of six construction workers selected purposively based on the criteria of being aged 18–60 years, actively working as construction workers, and having experience in accessing health services within the past year. Data were collected through in-depth interviews, participant observation in the workers’ work and residential environments, and documentation to strengthen the empirical context of the study. Data analysis was conducted using thematic analysis through processes of data reduction, categorisation, and meaning-making to identify patterns of experience and the participants’ interpretations of access to health services.

Results: The findings indicate that construction workers perceive health services not only as a means of medical treatment but also as a form of social protection that helps maintain work productivity and family well-being. The main barriers to accessing health services include economic constraints, unstable income, long working hours, and the lack of occupational safety facilities. Some participants also highlighted complicated administrative procedures and high treatment costs, although in general they did not experience discrimination from health professionals. To overcome these barriers, construction workers developed adaptive strategies such as utilising formal health services and traditional treatment, maintaining health through healthy lifestyles, and relying on social support from family members and co-workers.

Conclusion: This study concludes that the experiences of construction workers in accessing health services are shaped by the interaction of economic, social, occupational, and health policy factors. Therefore, stronger synergy between government institutions, health service providers, and worker communities is required to create a health service system that is more equitable, inclusive, and responsive to the needs of informal sector workers in urban settings.

Perceived Stress and Quality of Life Among Caregivers of Individuals with Schizophrenia: A Cross-Sectional Correlational Analysis in Indonesia

Tri Sumarsih — 2026-05-06

Introduction: Family caregivers of individuals with schizophrenia frequently endure chronic stress, adversely affecting their quality of life (QoL). This study addresses a significant research gap by exploring the relationship between stress and QoL in a low-resource context in Indonesia.

Methods: A cross-sectional correlational study was conducted involving 104 family caregivers in Kebumen, Indonesia. Data were gathered using the Perceived Stress Scale (PSS-10) and WHOQOL-BREF, followed by analysis through chi-square tests and multiple logistic regression to identify QoL predictors.

Results: The majority of caregivers reported moderate stress (57.7%) and good QoL (67.3%). A notable inverse correlation was identified between stress levels and QoL (p = 0.001). Logistic regression indicated that moderate-to-high stress levels (OR = 0.29; 95% CI: 0.11–0.72; p = 0.008), caregiving duration exceeding five years (OR = 2.74; 95% CI: 1.24–6.09; p = 0.013), and low income under Rp500,000 (OR = 0.31; 95% CI: 0.12–0.79; p = 0.011) significantly predicted QoL.

Conclusion: Perceived stress is a crucial factor influencing the well-being of caregivers for individuals with schizophrenia. Enhancing community-based mental health initiatives, including stress assessments and socioeconomic support, could improve caregiver QoL in rural Indonesian settings.

Medication Safety in Practice: Why Individual Knowledge and Supervisory Roles Show Limited Impact in Inpatient Wards

Tri Sudarwati — 2026-05-06

Introduction: Medication errors are a major and common threat to patient safety in hospitals and may lead to adverse clinical outcomes and poor-quality care. Executive nurses, who are responsible for providing primary care such as medication administration, and head nurses, serving as a nursing practice leader, are core?to reducing medication errors. The objective of this research is to examine the level of significance between practical nurses' knowledge and the head nurse’s role toward medication errors in?the inpatient ward at RSI Siti Aisyah Madiun.

Methods: The researchers employed a cross-sectional study and quantitatively collected the data. The entire population was counted through census sampling, which involved 100 managerial nurses and eight head nurses. The data were gathered by means of standardized and validated questionnaires. Statistical analyses such as Spearman's correlation and multiple linear regression were used to assess the separate and joint impacts of executive nurses’ knowledge and head nurses' roles on medication error occurrence.

Results: The results indicated that the occurrence of medication errors was not significantly influenced by the practical nurses' knowledge (p = 0.956). Moreover, the roles of head nurses could not be traced as factors affecting the rates of medication errors (p = 0.893). The combined effect of both variables, as analysed simultaneously, also revealed no significant association with medication errors (p = 0.989) as indicated by a coefficient of determination of only 0.2%. From these results, it can be concluded that the roles of head nurses and adequate knowledge of practical nurses are, by themselves, not sufficient to significantly decrease the occurrence of medication errors.

Conclusion: The absence of significant findings agrees with system-oriented patient safety theories, which argue that supervisory functions and an individual's knowledge cannot sufficiently prevent medication errors if there are no strong organizational and process, level safeguards. The study results point out the importance of system, based interventions. Examples of such interventions are building a positive patient safety culture, implementing risk management plans, standardizing medication procedures, and having non-punitive incident reporting procedures. Hence, the work for improving medication safety should be aimed at wide-ranging organizational and structural changes instead of merely individual qualifications.

Integrated Approach to Improve Hemoglobin in Adolescent Girls: A Quasi-Experimental Controlled Study

Dewi Erna Marisa — 2026-05-06

Introduction: A major public health issue affecting adolescent girls is anemia, largely as a result of insufficient iron intake, menstrual blood loss, and poor nutritional literacy. A single-component intervention either supplementation or education rarely produces more than a modest amelioration. Evaluating the effectiveness rates of an integrated intervention, consisting of an iron-rich diet as a component of the regimen, iron supplementation as supplementary factor, and structured nutritional education versus single-component strategies aimed to improve hemoglobin (Hb) among adolescent girls, this study aims to address limitations associated with a single-component intervention approach alone.

Methods: A quasi-experimental controlled non-randomized design with prospective follow-up was carried out with 180 adolescent girls between 12–18 years of age recruited from a stratified sampling. Participants were recruited in school and divided into three intervention arms to reduce contamination. In addition to the oral iron supplementation (60 mg, two times weekly for 12 weeks), the intervention utilized iron-rich dietary intervention, and included six structured education sessions based on the Health Belief Model. Hemoglobin levels were measured at baseline, Month 3, and Month 6 using the cyanmethemoglobin method. Dietary behaviour and adherence were assessed on the basis of validated instruments. Data were analyzed using repeated measures ANOVA and assumption diagnostics with appropriate revisions, Tukey post-hoc comparisons and multivariate linear regression adjusted for baseline Hb and all relevant covariates. Statistical significance was defined as p < 0.05.

Results: No differences between baseline hemoglobin levels (p = 0.632). All intervention arms showed significant increases of Hb over six months (time effect, p < 0.001). The integrated intervention achieved the most mean improvement (3.5 g/dL) than supplementation plus education (2.2 g/dL) and diet plus education (1.6 g/dL) and there were significant (p < 0.001) between-group differences. Intervention type and adherence level were still significant predictors of hemoglobin improvement in adjusted regression analysis.

Conclusion: The integrated intervention showed superior comparative efficacy compared with single-component approaches in improving hemoglobin levels among adolescent girls. The recommendations of this study are supported by evidence based on evidence-based, multi-component, and structured in school prevention and control programs in the development of adolescent health policies.

Role of Self-Esteem People Living with HIV (PLHIV) in HIV Prevention Behavior: A Literature Review

Kristiani Kristiani — 2026-05-06

Introduction: Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) remain significant public health challenges worldwide, impacting both clinical outcomes and psychosocial well-being. People living with HIV (PLHIV) often face stigma and discrimination, which can lower self-esteem. Reduced self-esteem is linked to increased engagement in risky behaviors that may facilitate HIV transmission. This study investigates how self-esteem influences HIV prevention behaviors among PLHIV.

Methods: A scoping review was conducted using the Population, Exposure, Outcome, Study Design (PEOS) framework. The literature search covered PubMed, ScienceDirect, EBSCO, and Google Scholar. Eligible articles were English-language primary studies published from 2020 to 2024. The search used the keywords: “HIV Infections” AND “PLHIV” AND “self-esteem” OR “self-concept.” The selection process followed PRISMA guidelines.

Results: Fifteen articles were analyzed. Findings indicate that self-esteem significantly influences HIV prevention behaviors, including status disclosure, antiretroviral therapy adherence, safe sex practices, and viral suppression. Self-esteem also acts as a mediator and protective factor against stigma and mental health disorders.

Conclusion: Self-esteem is a key psychosocial factor in preventing HIV transmission among PLHIV. Incorporating self-esteem interventions into HIV programs may improve prevention outcomes and quality of life.

Behavioral Drivers of First-Time Blood Donor Retention in Yogyakarta, Indonesia

Mohammad Adam Jerusalem — 2026-05-06

ntroduction: Voluntary blood donor retention is still challenging in blood stock issue, specifically in decentralization system like in Indonesia. Most of previous research has focused on logistic or survey-based study, hence it cannot explain the dynamics of actual donor behavior from time to time. Further, there is a lack of understanding of donor retention as a behavioral process that develops longitudinally. This research aims to identify the first-time donor retention pattern and also demographic characteristics and relevant service context as basis for developing more effective health promotion strategies.

Methods: This research implemented a retrospective longitudinal cohort design based on routine blood donor registration data of 26,170 first-time donors from five Blood Transfusion Units in the Province of Special Region of Yogyakarta during the period 2021–2024. Donor visit trajectories were analyzed using a sequence analysis approach with the optimal matching method and then grouped using the Partition Around Medoids algorithm. Cluster validity was determined using the silhouette and Dunn indeces and further analyzed descriptively and statistically to examine differences in characteristics among groups.

Results: The study found three main donor patterns, i.e. one-time donors, regular donors, and donors who have temporarily stopped donating. City of Yogyakarta has highest retention rate, while Gunung Kidul is dominated by donors-once. Male donors tend to dominant among regular donors, on the contrary female donors are more represented in temporarily stopped donating. The vital finding points out the first 6–12 months engagement after initial donation is strongly associated with donor behavioral intentions.

Conclusion: Blood donor retention is dynamic process that is influenced by demographic characteristics and service context. A limitation of this study is the lack of consideration of psychosocial as a variable. However, the use of actual longitudinal data is a major strength of this study. The managerial implication of this study is that segmentation-based strategies, strengthening interventions in the early phase, and gender-sensitive and community-based approaches are needed to increase donor retention in a sustainable manner.

Organizational and Behavioral Factors Associated with Infection Prevention and Control Policy Implementation among Nurses: A Cross-Sectional Study in a District Hospital

Rahmat Alyakin Dakhi — 2026-05-06

Introduction: Healthcare-associated infections (HAIs) remain a critical indicator of healthcare quality and patient safety. HAIs contribute to increased morbidity, prolonged hospitalization, higher healthcare costs, and mortality. At Lukas Hilisimaetano Hospital, the incidence of HAIs exceeded the national minimum service standard of <1.5%, reaching 10.73% in 2023 and 7.31% in 2024. These findings suggest that the implementation of infection prevention and control (IPC) policies in the hospital has not been fully optimized. Based on Edward III’s policy implementation theory, policy implementation is influenced by communication, resources, disposition, and bureaucratic structure. This study aimed to analyze organizational and behavioral factors associated with IPC policy implementation among nurses.

Methods: A cross-sectional analytical study was conducted from May to November 2025 at Lukas Hilisimaetano Hospital. All 45 nurses working in inpatient units were included using total sampling. Data were collected using structured questionnaires and observation sheets measuring communication, resources, disposition, bureaucratic structure, and IPC policy implementation. Instrument validity was assessed through expert review, and reliability testing showed acceptable internal consistency (Cronbach’s alpha >0.70). Data were analyzed using Chi-square and binary logistic regression.

Results: Communication (OR=7.90; p=0.003), resources (OR=9.44; p=0.001), disposition (OR=14.40; p=0.001), and bureaucratic structure (OR=8.20; p=0.001) were significantly associated with IPC policy implementation in bivariate analysis. Multivariate analysis showed that disposition (AOR=8.26; 95% CI: 1.77–38.58; p=0.008) and resources (AOR=4.71; 95% CI: 1.13–19.58; p=0.033) remained significantly associated. The strong association between disposition and IPC implementation highlights the importance of behavioral commitment among nurses in supporting infection prevention practices.

Conclusion: IPC policy implementation is associated with both organizational and behavioral factors, with disposition emerging as the strongest associated factor. Findings should be interpreted cautiously due to the cross-sectional design and small sample size. Strengthening behavioral commitment and ensuring adequate resources may support improved IPC implementation in similar settings.

Multidimensional Lifestyle Determinants of Hypertension in Indonesia: A Systematic Review with Implications for Population Level Prevention

Henny Kaseger — 2026-05-06

Introduction: Hypertension prevalence in Indonesia continues to increase, and unhealthy lifestyle factors such as high-salt diets, physical inactivity, and smoking are widely recognized as important modifiable risk factors. This study aims to examine the association between unhealthy lifestyle behaviors and hypertension in Indonesia.

Methods: A systematic review was carried out based on the PRISMA framework, aiming to identify, screen, and evaluate relevant studies published from 2015 to 2025. Articles were searched through the Scopus, PubMed, and ScienceDirect databases, focusing on studies examining the relationship between unhealthy lifestyles and hypertension in Indonesia

Results: Of the 19 studies analysed, most employed cross-sectional designs. High salt intake, smoking habits, and low physical activity were consistently associated with higher odds of hypertension. Several studies also indicated stronger associations among individuals with sedentary lifestyles. However, given the predominance of cross-sectional evidence, the findings primarily reflect associations rather than causal relationships.

Conclusion: Unhealthy lifestyle factors including high salt intake, low physical activity, smoking, alcohol consumption, stress, and poor sleep patterns are consistently associated with hypertension in Indonesia. These findings underscore the importance of population-level strategies promoting healthy dietary practices, increased physical activity, and behavioral risk reduction. However, given the predominance of cross-sectional evidence, further longitudinal and methodologically robust studies are needed to strengthen causal inference.

Influence of SERVQUAL Dimensions (Empathy and Responsiveness) on Patient Satisfaction at Mulawarman University Dental Hospital

Erwin Gunawan — 2026-05-06

Introduction: Mulawarman University Dental Hospital (RSGM Unmul), as a new teaching hospital in East Kalimantan, acts as both oral healthcare services and clinical education. Oral health service utilization of certain populations is still low in East Kalimantan, despite the strategic function of oral health service, it indicates ongoing challenges with regard to access and patient engagement. However, only few studies empirically explore the relationship between specific service management dimensions and patient satisfaction in a dental teaching hospital context, particularly with regard to empathy and responsiveness as related to SERVQUAL. So far, there has been no systematic study at RSGM Unmul,which is obviously an empirical and contextual research gap.

Objective: The study aims to determine influence of dental healthcare service management on patient satisfaction at Mulawarman University Dental Hospital Empathy And Responsiveness.

Methods: This study had a descriptive-analytic quantitative approach with cross sectional design involving 81 patients in RSGM Unmul that was selected by purposive sampling. Data collection utilized a modified SERVQUAL questionnaire with Likert type responses on the intervals of 1–5. All statistical analyses were performed with SPSS version 25, Mann-Whitney test was applied for comparison of satisfaction levels between patients from rural and urban areas (? = 0.05).

Results: Patient satisfaction scores were high for both empathy and responsiveness averaged over rural (empathy 3.95 ± 0.715; responsiveness 3.93 ± 0.722) and urban areas (empathy 4.30 ± 0.640; responsiveness 4.28 ± 0.655). There were no significant regional differences for either dimension of patient satisfaction (p > 0.05), although mean scores tended to be higher among urban participants.

Conclusion: Overall, RSGM Unmul has excellent performance in the aspect of empathy and responsiveness on dental healthcare service management resulting in high patient satisfaction levels.