Media Publikasi Promosi Kesehatan Indonesia (MPPKI)

Adolescents’ HIV Preventive Behavior: The Roles of HIV Literacy, HIV Sensitivity, AI Openness, and Chatbot Engagement

Masruroh Masruroh, Agus Susanto, Heny Noor Wijayanti — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Adolescents remain vulnerable to HIV due to gaps in knowledge, attitudes, and digital health engagement. Cognitive, attitudinal, and digital factors may influence preventive behaviors, yet their combined effects remain underexplored, particularly as adolescents increasingly interact with AI-driven platforms that shape health information access.

Objective: This study aimed to examine the associations of HIV literacy, HIV sensitivity, AI openness, and chatbot choice with HIV preventive behaviors among adolescents.

Methods: A cross-sectional study was conducted among 910 senior high school and vocational students in Sleman Regency, Indonesia. Participants completed a validated questionnaire assessing HIV preventive behavior (low vs. high) and four predictors: HIV literacy, chatbot choice, AI openness, and HIV sensitivity. Chi-square tests were used to assess bivariate associations. Multivariate logistic regression identified independent predictors, with odds ratios (ORs) and 95% confidence intervals (CIs) reported.

Results: Bivariate analyses showed that higher HIV literacy, greater HIV sensitivity, increased AI openness, and active chatbot choice were significantly associated with high-level HIV preventive behavior (all p < 0.001). Multivariate logistic regression confirmed all variables as significant independent predictors: HIV literacy (OR = 1.18, 95% CI: 1.12–1.24), chatbot choice (OR = 1.10, 95% CI: 1.05–1.16), AI openness (OR = 1.08, 95% CI: 1.02–1.14), and HIV sensitivity (OR = 1.10, 95% CI: 1.04–1.16). The model explained a meaningful proportion of variance in preventive behavior (Nagelkerke R² = 0.234).

Conclusion: HIV literacy, HIV sensitivity, and engagement with AI-based digital tools significantly predict adolescents’ HIV preventive behaviors. Interventions that enhance knowledge, strengthen attitudes, and promote informed digital decision-making may reinforce HIV prevention efforts among adolescents.

Effectiveness of Maranti Stimulation in Improving Growth and Development Among Stunted Toddlers: A Quasi-Experimental Study

Dewi Rokhanawati, Nidatul Khofiyah, Elika Puspitasari — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Stunting remains a major public health concern in Indonesia, particularly during the first 1,000 days of life, and reflects the cumulative effects of nutritional deficits, infection, and suboptimal caregiving within broader social and environmental conditions. This study draws on current national and global evidence to frame stunting as a developmental and ecological problem that requires integrated, family-centred interventions. This study aimed to assess the effectiveness of Maranti stimulation (massage therapy for stunting), in enhancing growth and development among stunted children.

Methods: This quasi-experimental study utilized a non-equivalent control group design and was conducted from August to November 2024 at two public health centers in Bantul, Yogyakarta, Indonesia. Participants were divided into two groups: the intervention group (n=23), which received weekly Maranti massage sessions over six weeks, and the control group (n=25), which was provided with educational booklets on child growth and developmental stimulation. Growth measurements were collected using anthropometric tools, and developmental outcomes were assessed using the BSID-III instrument. Data normality was assessed prior to analysis. Normally distributed variables were analyzed using independent t-tests, while non-normally distributed variables were analyzed using the Mann–Whitney U test in Stata.

Results: The findings revealed significant improvements in growth and development post-intervention in both groups, with more pronounced effects in the intervention group. Notably, Maranti therapy significantly increased body weight (p=0.016) and height (p=0.001). Language (p=0.025) and motor skills (p=0.045) also improved significantly. Cognitive development, however, did not show a statistically significant change (p=0.635). Effect size analysis indicated medium to strong effects for weight and height (Cohen’s d = 0.724 and 1.041), and moderate effects for language and motor development (Cohen’s d = 0.580 and 0.595).

Conclusion: Maranti stimulation demonstrates promise as an effective complementary strategy to improve physical growth and developmental outcomes in stunted children, though further research is needed regarding cognitive impacts. These findings suggest that culturally embedded tactile stimulation can serve as a feasible complementary approach for growth-promotion programs. The intervention holds potential for integration into community-based stunting-reduction strategies, particularly in settings where traditional practices remain influential.

Online Registration Application Quality and User Satisfaction: A WebQual 4.0 and EUCS-Based Study at a Private Hospital in Indonesia

Khofidhotur Rofiqoh, Merita Arini — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: The digitalization of hospital services increasingly requires high-quality online registration applications to enhance efficiency and user experience. Ineffective registration processes characterized by long queues, delays, and occasional system bottlenecks remain a major barrier to service efficiency and patient satisfaction in many hospitals. Online registration applications are expected to address these issues, yet limited studies have specifically examined how the quality of such applications influences user satisfaction, particularly in private hospitals in developing regions. This study examines how application quality, measured using the WebQual 4.0 dimensions, influences user satisfaction based on the End-User Computing Satisfaction (EUCS) model. This integration allows a more comprehensive understanding of how system usability, information attributes, and service interaction collectively shape user perceptions in digital health settings.

Methods: A quantitative cross-sectional design was employed using validated instruments adapted from the WebQual 4.0 and End-User Computing Satisfaction (EUCS) models. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). To strengthen analytical depth and support theoretical interpretation, qualitative insights obtained from open-ended responses were incorporated to triangulate and enrich the quantitative findings.

Results: The Study found that application quality significantly influenced user satisfaction (p < 0.001). All WebQual 4.0 dimensions, Usability, information quality, and service interaction showed positive and substantial contributions to the model. These findings align with core assumptions of the EUCS model, which posits that user satisfaction emerges from perceptions of system usefulness, information relevance, and overall performance quality. Qualitative responses supported the quantitative findings, indicating that users generally perceived the application as easy to use and informative. However, some noted occasional technical issues and suggested improvement to enhance system performance.

Conclusion: Usability, information quality, and service interaction play critical roles in shaping user satisfaction with online hospital registration applications. The findings underscore the theoretical relevance of integrating WebQual 4.0 and EUCS, demonstrating that multidimensional system quality is essential for optimizing patient experience in digital hospital services. These results highlight the need for continuous system refinement to improve usability and service responsiveness, ultimately strengthening digital transformation efforts and enhancing patient-centered service delivery in hospital settings.

Antiretroviral Therapy Adherence as a Relational Process: The Roles of U=U Awareness, Discrimination, and Viral Suppression among People Living with HIV in Steady Partnerships in Indonesia

Dwi Kartika Rukmi, Rizqi Wahyu Hidayati, Kharisma Kharisma, Fika Lilik Indrawati — Tue, 03 Mar 2026 00:00:00 +0700

ntroduction: Adherence to antiretroviral therapy (ART) is a central determinant of treatment success among people living with HIV (PLWH). However, how relational and psychosocial factors operate within steady partnerships to shape adherence remains insufficiently understood in the Indonesian context. This study aimed to examine key predictors of ART adherence among PLWH in steady partnerships, focusing on individual, relational, and therapy-related factors in Yogyakarta, Indonesia.

Methods: A cross-sectional survey was conducted among 370 PLWH with steady partners across five districts in Yogyakarta between April and July 2025 using a self-administered questionnaire. Descriptive statistics, bivariate analyses, and binary logistic regression were applied to identify factors independently associated with ART adherence.

Results: Overall, 78.4% of respondents demonstrated good ART adherence. In the adjusted logistic regression model, understanding the Undetectable = Untransmittable (U=U) concept (AOR = 2.26; 95% CI: 1.02–4.98; p = 0.043), absence of HIV-related discrimination (AOR = 0.46; 95% CI: 0.26–0.82; p = 0.008), and having an undetectable viral load (AOR = 2.64; 95% CI: 1.61–4.32; p < 0.001) emerged as the strongest independent predictors of adherence. Other relational variables, including partner support and ART duration, were associated with adherence in bivariate analyses but did not remain significant after adjustment.

Conclusions: These findings indicate that ART adherence among PLWH in steady partnerships is primarily shaped by treatment-related knowledge, stigma-free social environments, and virological outcomes. HIV care programs should prioritize U=U–based education, stigma reduction strategies, and routine viral load monitoring to sustain adherence. Relational and partner-based approaches may hold programmatic relevance but warrant further investigation through longitudinal or intervention-based studies to clarify their independent contribution to ART adherence in Indonesia.

Gap Analysis of Spiritual Education Provision for Hospitalized Patients: Integrating Health Promotion in Hospital Settings

Muhammad Syahwal, Arfiyan Sukmadi — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Spiritual health is an important component of holistic healthcare that influences clinical outcomes and patient recovery processes. In the PRECEDE–PROCEED health promotion model, the fulfillment of spiritual needs is influenced by predisposing, facilitating, and reinforcing factors. There is still a significant gap between patients' spiritual needs and the services provided, especially in relation to worship guidance and strengthening relationships with God during treatment. To analyze the discrepancy between expected and provided spiritual education interventions for inpatients through the lens of health promotion.

Methods: We conducted a quantitative descriptive study in a private hospital in Kendari City in June-July 2025. The participants were 76 inpatients (aged ?18 years with a minimum stay of 2 days) and 15 nurses (clinical experience ?6 months), who were recruited through purposive sampling. Data collection used a validated structured questionnaire with acceptable internal consistency (Cronbach's Alpha ?0.70). Descriptive analysis was performed using jamovi software, while the gap between expected and provided education was analyzed through percentage comparisons and unmet need ratio calculations.

Results: A significant discrepancy was found between patients' expectations of spiritual education and nursing practices. Only 9.2% of patients received education on strengthening spiritual connections, while 31.5% reported needing this support. Guidance on adjusting worship practices was provided to only 3.4% of patients, even though 12.7% expressed this need. Interestingly, 67.1% of patients continued their worship during illness, yet 88.2% of nurses did not offer guidance on worship adjustments. Conversely, over 85.5% of nurses provided education on patience, while only 29.8% of patients needed it. Major barriers included sensitivity to spiritual topics, limited time, and inadequate spiritual knowledge.

Conclusion: The significant gap between expectations and services indicates systemic weaknesses in competency, support, and care orientation. Comprehensive and multilevel interventions are essential to ensure the accommodation of spiritual care in nursing services.

Factors Associated with the Nutritional Status of Pregnant Women in Banjarmasin City: A Cross-Sectional Analytical Study

Tue, 03 Mar 2026 00:00:00 +0700

Introduction: The nutritional status of pregnant women is a critical indicator of maternal and fetal health. Chronic Energy Deficiency (CED) during pregnancy increases the risk of obstetric complications, low birth weight, stunting, and contributes indirectly to maternal mortality. Indonesia continues to report one of the highest maternal mortality ratios in Southeast Asia. This study aimed to analyze factors associated with the nutritional status of pregnant women in Banjarmasin City.

Methods: This analytical cross-sectional study involved 100 pregnant women selected using accidental sampling. Nutritional status was assessed based on mid-upper arm circumference (MUAC), with MUAC <23.5 cm indicating CED. Independent variables included maternal knowledge, parity, maternal age, and toothbrushing habits. Data were collected using a structured questionnaire and analyzed using univariate and bivariate analyses with the Chi-Square test. Effect sizes were reported as prevalence ratios (PR) with a significance level of 0.05.

Results: The prevalence of CED among pregnant women was 52%. The majority of respondents had low levels of knowledge (59%), risk parity (88%), risk maternal age (63%), and bad toothbrushing habits (58%). Bivariate analysis showed significant associations between maternal knowledge (PR=2.08; p=0.001), maternal age (PR=1.59; p=0.012), and toothbrushing habits (PR=1.95; p=0.000) with nutritional status. Parity was not significantly associated with nutritional status (p=0.076).

Conclusion: Maternal knowledge, age, and toothbrushing habits were significantly associated with the nutritional status of pregnant women in Banjarmasin City. Strengthening nutrition education and healthy lifestyle behaviors through Posyandu services and antenatal education programs is essential to prevent CED and improve maternal and fetal health outcomes.

Bibliometric Analysis of Trends in Human Vaccine Development, Law, and Ethics

Tue, 03 Mar 2026 00:00:00 +0700

Introduction: The global health crisis triggered by COVID-19 in 2020 placed unprecedented emphasis on the rapid creation and worldwide dissemination of vaccines, while also bringing ethical and legal questions to the forefront of public and academic debate.

Methods: Using a bibliometric framework, this study analyzes scholarly publications addressing vaccination in relation to ethics and law over the period 1970–2024, drawing on records indexed in the Scopus database. Research productivity and collaboration patterns were assessed based on publication year, authorship, country of origin, institutional affiliation, and document type. Network visualization performed with VOSviewer revealed five dominant thematic clusters shaping the vaccine research landscape.

Results: The findings demonstrate a pronounced expansion in publication volume, particularly in the post-pandemic period, with the United States emerging as the most influential contributor.

Conclusion: This analysis highlights the critical role of cross-national collaboration and offers evidence-based insights to support the advancement of ethical governance, legal regulation, and public health policy in vaccination research.

The Effectiveness of Virtual Reality–Based Training for Family Caregivers in Supporting Post-Stroke Recovery: A Quasi-Experimental Study

Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Stroke survivors in low-resource settings often rely on family caregivers to provide essential daily care after hospital discharge. However, many caregivers lack the necessary knowledge, skills, and confidence to perform safe and effective home-based care. Virtual Reality (VR) offers an immersive, interactive, and practical training method that may enhance caregiver preparedness and is associated with improved patient outcomes during post-stroke recovery. This study evaluated the effectiveness of a VR-based caregiver training program on functional, psychological, physiological, and cognitive outcomes among stroke survivors.

Methods: A quasi-experimental pre–post design was conducted with 60 caregiver–patient pairs recruited from a community health center in South Sumatra. Participants were assigned to either a VR-based training group or a control group receiving standard discharge education. The intervention consisted of five immersive VR modules simulating stroke-care scenarios, including hygiene, feeding, transfer techniques, positioning, suctioning, and range of motion exercises. Outcome measures included systolic blood pressure, functional independence (Barthel Index), anxiety and depression (HADS), and cognitive status (MoCA).

Results: Patients whose caregivers received VR-based training demonstrated significant improvements in patient outcomes compared with the control group. The intervention group showed greater reductions in systolic blood pressure (p = 0.021), increased functional independence (p = 0.041), reduced anxiety (p = 0.017) and depression (p = 0.011), and enhanced cognitive function (p = 0.032). Effect sizes ranged from moderate to large, indicating clinically meaningful improvements.

Conclusion: VR-based caregiver training is a feasible, low-cost, and effective strategy associated with improved patient outcomes following caregiver training. Its immersive design provides experiential learning that may support caregiving activities in community health settings with limited resources.

Effect of PIONER (Oxytocin Massage with Electromagnetic Stimulation) on Breast Milk Production: A Repeated-Measures Intervention Study Among Postpartum Mothers

Rosida Hi. Saraha, Rabiah Umanailo, Darwis Durahim, Fahrul Islam — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Breast milk production is regulated by prolactin and oxytocin, and oxytocin massage is known to facilitate milk ejection. To address limitations of manual stimulation, an electromagnetic-assisted oxytocin massage device (PIONER) was developed to support postpartum mothers in improving breast milk flow. This study aimed to evaluate the effectiveness of the PIONER device in improving breast milk production indicators among postpartum breastfeeding mothers.

Methods: A quasi-experimental repeated-measures design was conducted involving 10 postpartum breastfeeding mothers selected using purposive sampling from three community health centers in Ternate City. PIONER-assisted oxytocin massage was administered on days 1, 3, 5, 7, and 9, twice daily for 10 minutes. Breast milk adequacy indicators urination frequency, defecation frequency, breastfeeding frequency, infant sleep duration, and infant weight were measured on days 2, 4, 6, 8, and 10. Data were analyzed using repeated-measures ANOVA (Greenhouse–Geisser correction) with a significance level of ? = 0.05.

Results: Significant time-based differences were observed for urination frequency (F = 13.500, p = 0.005), defecation frequency (F = 25.839, p < 0.001), and infant weight (F = 45.375, p < 0.001). No significant changes occurred in breastfeeding frequency or sleep duration. Confidence intervals could not be calculated because raw standard errors were not available.

Conclusion: PIONER effectively improved indicators of breast milk production, particularly urinary and fecal output and infant weight gain, with no adverse effects observed during the study. Larger controlled studies are recommended to strengthen generalizability.

Understanding the Psychosocial Roots of Adolescent Self-Harm: Findings from a Descriptive Cross-Sectional Study in Indonesia

Ike Mardianti Agustin, Tri Sumarsih, Irmawan Andri, Siti Mutoharoh — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Self-harm or torturing oneself by intentionally injuring or cutting which is done to relieve the suffering felt. Self-harm behavior is often done by teenagers who are followed by mental health disorders such as symptoms of depression and anxiety. The purpose of this research analyzing predisposing factors of self-harm in adolescence at SMA N 1 Pejagoan.

Methods: This study employed a quantitative research using descriptive analytic method with cross sectional approach, sampling using proportional random sampling. The number of samples in this study were 285 adolescents at SMA N 1 Pejagoan. Using 2 questionnaires to determine self-harm behavior using (self-harm inventory instrument) and to determine predisposing factors of self-harm using a predisposing factor screening instrument which has been declared valid, The validity tests indicated that all variables were statistically significant with P-values of <0.001, confirming that the instruments accurately measured their respective constructs and reliable was assessed using Cronbach’s alpha with p-value 0.769 and 0.784. Data analysis using Descriptive statistics were applied for univariate analysis to summarize demographic characteristics and study variables.

Results: The results of this study were 271 (95.1%) respondents included in the Self-Harm Group and 14 (4.9%) respondents included in the non Self-Harm group. The majority of predisposing factors causing self-harm behavior were biological with a low category of 138 (48.4%) respondents, for psychological factors the majority were in the medium category of 186 respondents (65.3%) and for socio-cultural predisposing factors the majority were in the low category of 209 (73.3%) respondents.

Conclusion: The majority of teenagers are in the self-harm group as many as 271 (95.2%). The biological predisposition factors are mostly in the low risk category as many as 138 (48.4%) respondents, the psychological factors are mostly in the medium risk category as many as 186 (65.3%) respondents and the socio-cultural predisposition factors are mostly in the low category as many as 209 (73.3%) respondents. The results of this study are expected to be a reference material for the need to include mental health material in the school curriculum and recommend further research on the analysis of screening factors predisposing to self-harm in adolescents at SMA N 1 Pejagoan.

Development and Validation of the Healthy Lifestyles Knowledge Questionnaire for Elderly at Risk of Heart Disease

Hardyanti Pratiwi, Ali Khomsan, Sri Anna Marliyati, Mira Dewi — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Coronary heart disease (CHD) is a leading cause of mortality among the elderly. Promoting healthy lifestyles through balanced diets and regular physical activity is essential for prevention programs. However, the availability of standardized and validated instruments to measure knowledge of healthy lifestyles among elderly individuals is still limited, particularly in Indonesia. This study aimed to develop and validate a knowledge questionnaire focusing on diet and physical activity for elderly individuals at risk of CVD.

Methods: A mixed-method validation was conducted, involving qualitative and quantitative approaches. First, content validity was assessed by experts in community nutrition, clinical nutrition, and sport nutrition (n = 8) using the Content Validity Index (CVI) and multi-rates Kappa statistics. Second, face validity was tested with elderly participants (n = 10) to ensure clarity and comprehension. Finally, item validity and reliability testing were examined with elderly participants (n = 30) using the Pearson correlation test between item-total score and Cronbach’s Alpha to determine internal consistency.

Results: The I-CVI values for all items ranged from 0,75 to 1,00, and Kappa statistics from 0,72 to 1,00, indicating good to excellent agreement among experts. Face validation confirmed that most items were relevant and understandable, with brief wording adjustments required for clarity. The Cronbach’s alpha of 0,742 reflected good internal consistency. Overall, the validation process demonstrated that 19 of 28 items met the statistical criteria.

Conclusion: The healthy lifestyle knowledge questionnaire demonstrated strong validity and reliability in assessing knowledge among elderly individuals at risk of CHD. This instrument is practical and applicable for supporting health promotion and prevention programs focusing on diet and physical activity.

Determinants of Youth Health Insurance Utilization in Eastern Indonesia: Evidence from the 2023 SUSENAS

Melly Cosmalinda Widyaningsih, Mahmudah Mahmudah, Devina Dwi Kurnia — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Youth, as a transitional age group, are often vulnerable to health problems yet tend to underutilize health services despite experiencing complaints. Health insurance plays a critical role in ensuring equitable access, especially in Eastern Indonesia where regional disparities persist. This study aimed to identify key factors influencing health insurance utilization among youth aged 15-24 years in East Nusa Tenggara, Maluku, and Papua Highlands.

Methods: This cross-sectional study used data from the 2023 National Socioeconomic Survey (SUSENAS) conducted by Statistics Indonesia (BPS). Analysis included 2,649 youth aged 15-24 who reported health complaints in the previous month. Descriptive, bivariate, and multivariate logistic regression analyses were performed to determine the main predictors of health insurance utilization.

Results: Although more than four-fifths of respondents were insured, only about one-fourth accessed health services. Regional disparities emerged as the strongest determinant of utilization. Youth in Maluku and East Nusa Tenggara were significantly less likely to be insured compared to their peers in Papua, while those living in rural areas showed higher odds of insurance use than those in urban settings. Individual characteristics such as age, gender, education, and employment status had minimal influence.

Conclusion: Health insurance utilization among youth in Eastern Indonesia remains limited and largely shaped by structural and regional inequalities. Strengthening youth health literacy, simplifying insurance procedures, and improving service accessibility are essential steps toward equitable and youth-responsive universal health coverage in Indonesia and comparable middle-income settings.

Transformational Leadership, Team Cooperation, and Motivation in Shaping Patient Safety Culture Among Healthcare Professionals

Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Patient safety remains a critical global health agenda, as emphasized by the WHO and IOM. Fostering a robust patient safety culture within hospitals is paramount for minimizing adverse events and improving the quality of care. Understanding the psychosocial factors that drive this culture is essential for effective organizational interventions. This study aims to explore the direct and indirect effects of transformational leadership and team cooperation on patient safety culture, with a particular focus on assessing the mediating function of motivation within these relationships among healthcare professionals.

Methods: An analytical cross-sectional research design was applied in this study. Study utilized a survey to collect data from 198 Healthcare Providers (HCPs) at Sulianti Saroso Infectious Disease (SSIDH). The primary instrument was the Hospital Survey on Patient Safety Culture (HSOPS) Version 2.0. Data analysis involved Structural Equation Modelling (SEM) based on Partial Least Squares (PLS-SEM) using SmartPLS 4.0 to test the proposed causal relationships.

Results: Descriptive analysis showed that the variables of Transformational Leadership, Team Cooperation, Motivation, and Patient Safety Culture were all in the moderate category. However, hypothesis testing revealed significant findings. Both transformational leadership and team cooperation demonstrated a direct and significant positive influence on patient safety culture. Crucially, motivation was found to significantly mediate the relationship between transformational leadership and safety culture, as well as the relationship between team cooperation and safety culture.

Conclusion: This study confirms that transformational leadership and teamwork are crucial factors that effectively enhance patient safety culture. The central finding of this study is the vital role of motivation as a psychological mechanism that translates managerial initiatives and team collaboration into proactive safety behaviors. Therefore, the practical recommendations from this research focus on strategies that directly target motivation, such as strengthening programs for recognition and responsibility, accompanied by improved interprofessional communication and more specific leadership training programs.

Body Image Dissatisfaction and Hormonal Therapy Effects in Indonesian Females with Turner Syndrome

Dinda Tiara Firdaus, Annastasia Ediati, Achmad Zulfa Juniarto — Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Turner Syndrome (TS) is a genetic disorder that impairs the development of secondary sexual characteristics and may negatively affect body image. Hormonal therapy is administered to stimulate puberty, but its impact on body image remains inconclusive. Data from Indonesia is still limited. This study aims to analyze the differences in body image assessment between females with and without TS, and to evaluate the relationship between the duration of hormonal therapy and body image perception in females with TS.

Methods: A cross-sectional case-control study was conducted at CEBIOR, Faculty of Medicine, Diponegoro University. Twenty-eight females with TS, aged 14-31 years, participated. Body image was assessed using a validated questionnaire, and secondary sexual characteristics were evaluated using the Tanner stage. Data were analyzed using the Mann-Whitney U test and Spearman's correlation.

Results: The mean Tanner stage was increased from 3.6 ± 1.1 to 6.2 ± 2.7 after hormonal therapy. No significant difference in overall body image dissatisfaction was found between females with TS and controls (MdnTS = 74.5 [34–120]; MdnC = 68.0 [31–109]; p = 0.512). However, females with TS showed significantly higher dissatisfaction scores in the sexual domain (MdnTS = 11 [4–20]; MdnC = 7.5 [4–16]; p = 0.013) and in height–weight perception (MdnTS = 7 [3–10]; MdnC = 6 [2–8]; p = 0.014). No significant correlation was found between therapy duration and body image scores, although a weak negative trend was observed for height–weight perception (r = –0.373; p = 0.051).

Conclusion: Hormonal therapy increased Tanner stage but did not reduce overall body image dissatisfaction. Females with TS reported greater dissatisfaction in specific domains. These findings suggest that psychosocial interventions are crucial for enhancing body image and overall well-being in this population.

Promoting Clean and Healthy Living in Schools: A Pre-Experimental Study on Disease Prevention

Tue, 03 Mar 2026 00:00:00 +0700

Introduction: Clean and Healthy Living Behavior (PHBS) includes practices such as handwashing with soap, maintaining personal and environmental hygiene, proper waste disposal, and consuming nutritious food. According to the World Health Organization (WHO, 2021), up to 60% of childhood diarrhea cases can be prevented through proper hand hygiene. The Indonesian Ministry of Health (2020) also reports that the PHBS program in schools significantly reduces the incidence of infectious diseases. This study aims to evaluate the effectiveness of a PHBS education program in promoting disease prevention and improving health behaviors among elementary school students.

Methods: A pre-experimental design was used, involving 50 students from SDN Bawakaraeng III Makassar. Data were collected through pre- and post-intervention tests and observational checklists. The program, conducted over four days, with sessions on personal hygiene, environmental cleanliness, and healthy eating habits. Statistical analysis was performed using the Wilcoxon signed-rank test to compare pre- and post-test scores, and McNemar’s test was used to assess changes in students' health practices.

Results: Pre-test results showed an average score of 65 (out of 100), while post-test results increased to an average score of 85, indicating a significant improvement of 20 points (p-value = 0.031) based on the Wilcoxon test. The improvement was greater among female students, with an average increase of 23 points, compared to male students, whose average increase was 17 points. Observations revealed that 50% of students did not know the correct handwashing steps before the intervention, which increased to 75% after the program. Additionally, students' adherence to PHBS practices improved significantly, rising from 50% to 70% (p-value = 0.013) as assessed by McNemar’s test.

Conclusion: The findings demonstrate that the PHBS education program significantly improved students' awareness and practices regarding disease prevention, as evidenced by the measurable increases in knowledge and behavior change.

Baduanjin Exercise for Frailty Management in Frail or Prefrail Older Adults: A Systematic Review and Meta-Analysis

Tue, 03 Mar 2026 00:00:00 +0700

Introduction: This systematic review and meta-analysis evaluated the effects of Baduanjin, a traditional Chinese mind-body exercise, on frailty and multidimensional health outcomes in older adults.

Methods: Following PRISMA guidelines, we systematically searched multiple databases for RCTs on Baduanjin in frail adults aged ?60 years. Data were pooled using fixed- or random-effects models to calculate MDs or SMDs with 95% CIs. Heterogeneity was quantified by the I² statistic, with random-effects models applied if I² > 50%. Publication bias was assessed by funnel plots and Egger’s test, with the trim-and-fill method used for adjustment when indicated.

Results: Fifteen RCTs (n = 1,044) were included. Baduanjin significantly reduced frailty severity (SMD = -1.12; 95% CI: -1.59 to -0.65) and improved physical function outcomes, including grip strength (MD = 2.39 kg, 95% CI: 2.17 to 2.62, P < 0.001), 6-minute walking distance (MD = 33.72 m; 95% CI: 12.47 to 54.97), and short-distance walk time, although the pooled effect (MD = -0.31 s; 95% CI: -0.57 to -0.06) was moderated by test distance with significant heterogeneity. Mental health improvements encompassed reduced anxiety/depression (SMD = -0.73; 95% CI: -1.11 to -0.35) and enhanced sleep quality (MD = -2.48; 95% CI: -3.21 to -1.76). Cognitive function (MMSE: MD = 2.81; 95% CI: 0.11 to 5.51) showed a statistically significant improvement, though with wide confidence intervals. Quality of life (SF-12/SF-36: SMD = 0.75; 95% CI: 0.48 to 1.02) also improved significantly.

Conclusion: Despite methodological limitations in the included trials, pooled evidence suggests that Baduanjin may confer clinical benefits for managing frailty in older adults. Given its simplicity, safety, and adaptability, Baduanjin should be considered for integration into standard geriatric care and community health programs.