Oshada (O) is a peer-reviewed open access international journal established to inviting scientists and educators around the world to exchange and disseminate theory and practice oriented across the Spectrum of Health Education. All submitted manuscripts will be reviewed by the editor and then evaluated by a minimum of two Reviewers through a double-blind review process. This is to ensure the quality of manuscripts published in the journal. The journal, which has been published since 2024, is published six times each year in February, April, June, August, October and December. Journal title : Oshada Initials : O Frequency : 6 (Six) times a year DOI : 10.62872 ISSN Online : 3047-017X Editor in Chief : dr. Dito Anurogo, M.Sc., Ph.D Managing Editor : Angga A.G, Assistant Editor : Rahmat Purnomo Publisher : PT. Anagata Sembagi Education Accreditation : Index Copernicus International
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The Effect of Mindfulness-Based Stress Reduction (MBSR) on Emotion Regulation among Older Adults with Type 2 Diabetes Mellitus in Bangun Rejo Village, 2025
Emotional regulation is an important aspect in maintaining the mental health of the elderly, especially those suffering from chronic diseases such as Type 2 Diabetes Mellitus. Chronic disease conditions often trigger psychological stress that impacts an individual's ability to manage emotions. One of the non-pharmacological interventions widely developed to overcome stress is Mindfulness-Based Stress Reduction (MBSR). This study aims to determine the effect of MBSR on emotional regulation in elderly with Type 2 Diabetes Mellitus in Bangun Rejo Village in 2025. This study used a quantitative design with a one-group pretest–posttest method. The study subjects were 30 elderly with Type 2 Diabetes Mellitus selected using a total sampling technique. The MBSR intervention was given for eight sessions, and emotional regulation was measured using the Emotion Regulation Questionnaire (ERQ) before and after the intervention. Data analysis was performed using descriptive statistics and the Paired Sample t-Test. The results showed a significant increase in emotional regulation scores, from an average of 34.67 before the intervention to 75.50 after the MBSR intervention. Statistical test results showed a significant difference between pretest and posttest scores (p < 0.05). Thus, MBSR has been proven effective in improving emotional regulation in elderly people with Type 2 Diabetes Mellitus. The MBSR program is recommended as a supporting intervention in elderly health services.
Copyright (c) 2025 Erika Erika, Indra Agussamad, Tahan Tahan (Author) https://creativecommons.org/licenses/by-sa/4.0
The Relationship Between The Use Of Lavender Aromatherapy And The Reduction Of Anxiety Levels In MRI Patients At The Radiology Installation Of RSI Siti Rahmah Padang
Magnetic Resonance Imaging (MRI) is a radiological imaging modality that does not use ionizing radiation, but it often causes anxiety. This anxiety is triggered by the relatively long examination duration, ranging from 30 to 45 minutes, and is triggered by the examination environment, which is shaped like a tunnel, which can trigger claustrophobia. One method that can be used to reduce anxiety is through complementary therapies, such as lavender aromatherapy, which is known to have a relaxing effect. This study aims to determine the effect of lavender aromatherapy on reducing anxiety levels in patients undergoing MRI examinations at the Radiology Installation of RSI Siti Rahmah Padang. The study design used was a quasi-experimental study with a pre-test and post-test with a control group design. The number of research samples was 54 people who were divided into two groups, namely the control group and the intervention group. The intervention group was given lavender aromatherapy before undergoing MRI examination, while the control group was not given any treatment. Anxiety levels were measured using the Magnetic Resonance Imaging-Anxiety Questionnaire (MRI-AQ) before and after the intervention of using Lavender aromatherapy. The results showed a significant decrease in patient anxiety levels in the intervention group after being given lavender aromatherapy (p-value = 0.001). Meanwhile, the control group did not show a significant change in anxiety levels (p-value > 0.05). Lavender aromatherapy is effective in reducing anxiety levels in patients undergoing MRI examinations. This study suggests that lavender aromatherapy can be considered as a complementary method to reduce patient anxiety in the MRI room, thereby improving the comfort and quality of radiology services in hospitals.
Copyright (c) 2025 Oktavia Puspita Sari, Santa Mareta, Yori Rahmadianti, Abdul Rahmad Sidik (Author) https://creativecommons.org/licenses/by-sa/4.0
Implementation of Local Wisdom Values as a Managerial Approach in Strengthening Public Health Programs
Strengthening community health programs requires managerial approaches that are not only technically effective but also culturally and socially contextualized. This study aims to analyze the implementation of local wisdom values as a managerial approach in strengthening community health programs and its implications for health behavior, social participation, and program sustainability. The study employs a qualitative approach with a multiple case study design through in-depth interviews, participant observation, and document analysis involving health stakeholders and local communities. Data were analyzed using thematic analysis to identify patterns of implementation, challenges, and impacts of integrating local wisdom. The findings reveal that local wisdom enhances policy legitimacy, strengthens community trust, promotes sustainable healthy behaviors, and increases community participation and program sustainability. However, its implementation continues to face institutional constraints, limited managerial capacity, and policy misalignment. This study underscores that integrating local wisdom constitutes a strategic foundation for building adaptive, equitable, and sustainable community health systems.
Copyright (c) 2025 Kimberly Hutapea, Dwight Mahaputera Marulitua Hutapea (Author) https://creativecommons.org/licenses/by-sa/4.0
The Role of Health Cadres in Promoting Child Vaccination in Areas with Low Education Levels
Background: Disparities in basic childhood immunization coverage remain evident in communities with low education levels, often associated with limited health literacy, vaccine hesitancy, and barriers to accessing health services. In this context, the role of health cadres is considered crucial in supporting childhood vaccination uptake at the community level. Method: This study employed a quantitative cross-sectional design involving 210 mothers with children aged 12–24 months. Data were collected using structured questionnaires and analyzed through binary logistic regression to examine the influence of health cadres’ roles on the completeness of basic childhood vaccination. Results: The findings indicate that health cadres’ roles significantly influenced complete basic vaccination (OR = 3.08; p = 0.001) after controlling for maternal education and socioeconomic status. Schedule reminders and interpersonal communication emerged as the strongest dimensions of the cadres’ role, while assistance during vaccination visits showed the weakest contribution due to logistical constraints. Conclusion: The results demonstrate that achieving complete childhood vaccination depends not only on formal health system mechanisms but also on strengthening the role of health cadres as social and educational agents within the community. Enhancing persuasive communication skills, improving logistical support, and integrating cadres into community-based follow-up systems are essential to ensure sustainable improvements in basic childhood vaccination coverage.
Copyright (c) 2025 Seno Lamsir (Author) https://creativecommons.org/licenses/by-sa/4.0
Community Preparedness for Health Disasters: A Study of Community Health Literacy
Background: Recent health disasters indicate that community preparedness is influenced not only by the availability of health services but also by community health literacy, which enables individuals to understand risks, assess health information, and make preventive decisions during emergencies. Method: This study employed a qualitative literature review approach to analyze the relationship between health literacy and community preparedness for health disasters. Results: The findings show that health literacy acts as a strategic determinant shaping risk perception, preventive behavior, psychosocial readiness, and community adaptive capacity during health crises. Community-based interventions, the involvement of community health workers, and cross-sector collaboration were identified as effective mechanisms for strengthening health literacy and collective preparedness. Conclusion: Integrating community health literacy into disaster management policies and sustainable public health development programs is essential to enhance community preparedness and resilience in the face of health disasters.
Digital Health in Kidney Care: The Role of Telemonitoring in Enhancing Self-Management Among Patients with Chronic Kidney Disease
Chronic kidney disease (CKD) requires long-term, continuous self-management to prevent disease progression and reduce complications. However, maintaining patient adherence and engagement in daily self-care remains a major challenge. The rapid development of digital health, particularly telemonitoring, offers new opportunities to strengthen self-management by enabling continuous home-based monitoring, real-time feedback, and enhanced patient–provider communication. This study aims to analyze the role of telemonitoring in improving self-management among patients with CKD and to identify the system design and adherence-related factors that determine successful implementation. A systematic literature review was conducted following the PRISMA framework, using articles published between 2020 and 2025 retrieved from Scopus, PubMed, Web of Science, and Google Scholar. The findings indicate that telemonitoring significantly improves key dimensions of self-management, including self-efficacy, treatment adherence, symptom awareness, patient engagement, and satisfaction with care. Clinical benefits include improved blood pressure control and enhanced early detection of complications. Nevertheless, long-term adherence remains a critical barrier, strongly influenced by system usability, monitoring burden, digital literacy, and integration within clinical workflows. In conclusion, telemonitoring represents a powerful instrument for strengthening CKD self-management, but its real-world effectiveness depends on human-centered system design, continuous professional support, and tailored strategies to sustain patient adherence over time.
Copyright (c) 2025 Martha Katarina Silalahi (Author) https://creativecommons.org/licenses/by-sa/4.0
Evidence-Based Perceptions of the 10,000-Step Target and Physical Activity Intentions: A Cross-Sectional Survey Using PLS-SEM
Low levels of physical activity have encouraged the widespread use of numerical targets, such as 10,000 steps per day, as public health promotion tools. Despite their popularity, the effectiveness of step-based targets depends not only on campaign exposure but also on how individuals perceive the scientific evidence underlying these recommendations. This study examines the effect of evidence-based perception of the 10,000-step target on physical activity intention using a Structural Equation Modeling–Partial Least Squares (SEM–PLS) approach. A quantitative explanatory cross-sectional survey design was employed, with data collected at a single point in time through a questionnaire from 220 adults exposed to step-based physical activity programs or information. Evidence-based perception was modeled as a latent construct reflecting scientific understanding, perceived validity, and rationality of the step target, while physical activity intention was measured through indicators of readiness and behavioral commitment. The results indicate that evidence-based perception has a positive and significant effect on physical activity intention, with a strong path coefficient and a moderate R-square value. These findings suggest that evidence-based understanding plays a critical role in shaping physical activity intention, beyond the normative function of step targets. The study concludes that step-based physical activity promotion will be more effective when accompanied by evidence-based communication that fosters rational and informed acceptance of health recommendations.
Copyright (c) 2025 Khodijah Adha Kamila (Author) https://creativecommons.org/licenses/by-sa/4.0
Risk of Leptospirosis in Flood Affected Areas and Environmental Health Control Measures
Flooding is an environmental disaster that consistently increases the risk of environment-related diseases, including leptospirosis. As a zoonotic disease, leptospirosis frequently emerges in post-flood settings due to sanitation damage, water stagnation, and increased human exposure to environments contaminated with Leptospira. However, existing studies on leptospirosis are predominantly clinical and epidemiological, while analyses positioning the disease as a structural environmental health issue in post-disaster contexts remain limited. This study aims to analyze leptospirosis risk in flood-affected areas and to examine relevant and sustainable environmental health control strategies based on scientific evidence. A qualitative descriptive-analytical method was employed using an Evidence-Based Environmental Health Review approach, synthesizing scientific literature, institutional reports, and policy documents related to leptospirosis, flooding, and environmental health. The findings indicate that flooding acts as a primary ecological determinant shaping leptospirosis risk through sanitation disruption, water quality degradation, increased reservoir populations, and interactions with social vulnerability. Environmental health–based control strategies—such as sanitation improvement, environmental management, ecological reservoir control, community education, and early warning systems—are shown to be more effective than reactive medical responses. This study reinforces the repositioning of leptospirosis as a structural environmental health issue to support sustainable post-disaster prevention strategies.
Copyright (c) 2025 Isah Fitriani, Ihsan Jaya Rauf (Author) https://creativecommons.org/licenses/by-sa/4.0
Modeling Evidence-Based Perceptions of the 10,000-Step Target and Its Impact on Physical Activity Intentions: A Structural Equation Modeling–PLS Approach
Copyright (c) 2025 Jenny Palulun, João Paulo Oki, João Bosco, Marcos S. Deo da Silva (Author) https://creativecommons.org/licenses/by-sa/4.0
Outcome of Patients with OA Grade III/IV, with Ligament Laxity Undergoing Proximal Fibular Osteotomy with Lateral Bending Gait and Dextrose 10% Injection : A Case Series
Knee osteoarthritis (OA) with varus deformity and ligament laxity presents a complex clinical challenge, particularly in patients experiencing chronic pain, joint instability, and functional limitations. While Total Knee Arthroplasty (TKA) remains the gold standard for severe OA, not all patients are willing or have access to this procedure. Proximal Fibular Osteotomy (PFO) has emerged as a minimally invasive and cost-effective alternative, which can be combined with rehabilitative and regenerative approaches to optimize function. This case series reports two female patients aged 55 and 62 years with grade III and IV knee OA, genu varus deformity, and mild-to-moderate ligament laxity, without a history of major trauma. Clinical examination revealed medial compartment pain, limited range of motion (ROM), and knee instability during gait. The patients underwent PFO, followed by lateral trunk lean gait training using video-assisted education and mirror exercises, and intra-articular injection of 10% dextrose to enhance ligament stability. Interventions were conducted over two months with periodic rehabilitation monitoring. Clinical evaluation using the Knee Society Score (KSS), Visual Analog Scale (VAS), and ROM demonstrated significant improvements. KSS scores improved across pain, function, satisfaction, and activity domains. VAS scores decreased from 8 to 2 (Mrs. Ng) and 7 to 1 (Mrs. Su), representing ≥75% pain reduction. ROM increased from 100° to 125° (Mrs. Ng) and 110° to 130° (Mrs. Su). Both patients were able to ambulate without assistive devices within 3–4 weeks; Mrs. Su reported no ongoing complaints, while Mrs. Ng experienced only mild fatigue and calf tension. PFO effectively reduced medial compartment pressure, lateral trunk lean gait modified knee biomechanics, and 10% dextrose supported ligament stability. This multimodal approach is a promising conservative strategy or bridge to TKA, improving function, reducing pain, and enhancing quality of life, particularly in resource-limited settings or in patients refusing TKA..
Copyright (c) 2025 Irfan Alfi Maulana, Aristida Cahyono, Lisa Nur Hasanah (Author) https://creativecommons.org/licenses/by-sa/4.0
Factors Influencing the Nutritional Status of Primary School Children in Suco Catral Caraic, Posto Administrativu Letefoho, Ermera Municipality, Timor-Leste
The nutritional status of primary school children remains a public health concern, particularly in rural areas where socioeconomic constraints and limited access to nutritious food persist. Understanding the factors associated with children’s nutritional status is essential to support effective and context-specific interventions. This study aimed to analyze factors associated with the nutritional status of primary school children in Suco Catral Caraic, Posto Administrativu Letefoho, Municipiu Ermera, Timor-Leste. A quantitative cross-sectional study was conducted among 384 primary school children using total sampling. Data were collected through structured interviews with parents or guardians and anthropometric measurements of children. The variables analyzed included age, sex, parental education, household economic status, daily dietary intake, and children’s health history. Data analysis was performed using Chi-Square tests and multinomial logistic regression. The proportion of children with normal nutritional status was 47.7%. Bivariate analysis showed no significant association between age (p = 0.956) or sex (p = 0.936) and nutritional status. Significant associations were observed between nutritional status and maternal education (p = 0.000), paternal education (p = 0.007), household economic status (p = 0.029), daily dietary intake (p = 0.000), and health history (p = 0.000). Multinomial logistic regression indicated that the model explained 50.2% of the variance in nutritional status (Nagelkerke R² = 0.502). Maternal education emerged as the most dominant factor (χ² = 87.118; p = 0.000), followed by dietary intake and health history. Maternal education, daily dietary intake, and health history were the strongest factors associated with the nutritional status of primary school children, whereas age and sex were not significantly related. These findings highlight the importance of family-based approaches and improved dietary practices to enhance child nutritional outcomes in rural settings.
The Relationship Between Blue Light Exposure from Digital Devices and the Acceleration of Premature Aging in Young Adults
The use of digital devices among young adults has increased substantially, leading to higher exposure to blue light in everyday life. Blue light exposure has been associated with oxidative stress and cellular dysfunction of the skin, which are closely related to the aging process. This study aims to examine the relationship between blue light exposure from digital devices and accelerated premature aging among young adults. A quantitative explanatory approach with a cross-sectional design was employed using Structural Equation Modeling–Partial Least Squares (SEM–PLS). The sample consisted of 210 young adults aged 18–35 years who actively use digital devices. The results indicate that blue light exposure has a positive and significant effect on premature aging. These findings confirm that daily digital exposure represents a lifestyle-related risk factor contributing to accelerated skin aging. This study provides empirical evidence to support preventive strategies for skin health in the digital era.
Copyright (c) 2025 Naima Lassie (Author) https://creativecommons.org/licenses/by-sa/4.0
Study of Factors Influencing of Traditional Medicines In Community Hae-Coni, Post Administrative Baguia, Baucau Municipality 2025
Introduction: Timor-Leste has a culture and traditional knowledge regarding the use of medicinal plants for treating illnesses. Although the government provides free treating with a modern medicines, but mostly the community still uses traditional medicine’s for the treating. As a community Hae-Coni village, the people still continue to rely on traditional medicine due to limited access to modern healthcare. Which is a cultural factors to influence the traditional medicines healthcare. This analisysaim to continue information and determine the interaction between inherited and scientific knowledge to all community in Baguai Village. Objective: This research aim to identify the factors of influence the use of traditional medicines in the Hae-Coni community, Baguia Administrative Post. Methodology: The study employed a quantitative, descriptive- cross sectional design, using interviews and structured questionnaires applied to residents of the Hae-Coni community. Results: Further results: Cultural aspects: intergenerational transmission (15.1% use; 84.9% do not); spiritual and symbolic values (23.2% use; 76.8% do not). Access aspects: availability of medicinal plants (23.5% use; 76.5% do not); time to access traditional remedies (15.4% use; 84.6% do not). Experience aspects: effective practice (18% use; 82% do not); sources of information (20.5% use; 79.5% do not). Economic aspects: average income (18.2% use; 81.8% do not); lower income (20.2% use; 79.8% do not). Conclusion: based on Data analysis: Culture and access to healthcare services have a significant relationship with the use of traditional treatments, means In the Timor-Leste community regarding with the particularly in Baguia Administrative Post, social and cultural factors is a fundamental role in the preference for traditional medicines. The use of medicinal plants as an still alternative therapy on historically rooted, predating formal modern health services. It is because of the Limited access to modern healthcare, education of traditional medicine still lacking to change community health practices
Copyright (c) 2025 Favião M. Moreira, Cipriana Gusmão, Surly E.F.R Henrique, Rosita S. Guterres, Domingas de F. Ximenes (Author) https://creativecommons.org/licenses/by-sa/4.0
The Use of Wearable Technology for Cardiovascular Health Monitoring: An Evidence-Based Perspective
Cardiovascular disease remains the leading cause of global morbidity and mortality, highlighting the need for more preventive and continuous health monitoring approaches. The rapid development of wearable technology offers real-time and continuous cardiovascular monitoring; however, the strength of scientific evidence supporting its effectiveness remains inconsistent. This study aims to systematically analyze the use of wearable technology in cardiovascular health monitoring from an evidence-based perspective. A Systematic Literature Review with an evidence-based approach was conducted using peer-reviewed journal articles retrieved from Scopus, PubMed, Web of Science, and ScienceDirect. Following a PRISMA-based selection process, 38 articles met the inclusion criteria and were qualitatively synthesized. The findings indicate that wearable technology demonstrates relatively strong effectiveness in heart rate monitoring and early screening of cardiac arrhythmias, while evidence for more complex clinical parameters such as blood pressure and heart failure monitoring remains limited and inconsistent. The existing literature is predominantly characterized by non-randomized studies and short-term clinical validation. This study concludes that wearable technology should be positioned as an adjunct to evidence-based clinical practice rather than a substitute for conventional medical examinations and underscores the need for stronger methodological designs and supportive regulatory frameworks in digital health.
Copyright (c) 2025 Miter Elidanovan Harefa (Author) https://creativecommons.org/licenses/by-sa/4.0
Mobile Health Campaigns and Changes in Clean and Healthy Living Behavior in the Community (CHLB)
Background: The rapid development of mobile technologies has enabled health promotion activities to be delivered more rapidly, repeatedly, and responsively, creating new opportunities to influence clean and healthy living behavior (CHLB) across diverse community settings. Method: This study employed a narrative review by synthesizing academic literature published over the last ten years that examined the implementation of mobile health campaigns and their influence on CHLB. Results: The findings indicate that mobile health campaigns delivered through multiple platforms, including WhatsApp, SMS, Instagram, Facebook, mobile health applications, and educational videos, contribute to improvements in CHLB knowledge, attitudes, and practices. Multiplatform approaches were found to be more effective than single-platform campaigns due to complementary features such as scheduled reminders, visual demonstrations, and digitally mediated interpersonal communication that reinforces trust in health information. Conclusion: Sustainable improvements in CHLB require not only increased health knowledge but also ongoing digital social support and behavioral reinforcement through continuous messaging. Strengthening mobile health campaigns through culturally relevant content, sustained communication, and active community participation is essential for long-term CHLB adoption.
Copyright (c) 2025 Aulia Asman, Syamsul Arifin, Seno Lamsir (Author) https://creativecommons.org/licenses/by-sa/4.0
Digital Fatigue and Its Impact on Mental Health in Work-From-Home Workers
Background: The transition toward Work From Home systems provides flexibility but also increases the risk of digital fatigue due to intensive technology use, heightened digital responsiveness, and blurred work–life boundaries. Method: This study employed a Systematic Literature Review to examine the mechanisms of digital fatigue and its implications for the mental health of remote employees. Results: The findings reveal that digital fatigue arises from psychological pressure, cognitive overload, hyperconnectivity, work–family role conflict, and emotional strain. These conditions contribute to decreased productivity, reduced workplace well-being, diminished motivation, and an increased risk of burnout and other mental health problems. Conclusion: Mitigating digital fatigue requires organizational-level interventions, including limits on digital working hours, psychologically aligned job design, a supportive psychosocial safety climate, self-regulation training, and mental health support systems. The effectiveness of remote working depends on positioning technology as a human-centered productivity tool that prioritizes employees’ psychological well-being.
Green Healthcare: Strategies for Implementing Environmentally Friendly Concepts in Primary Health Care
Background: The global demand for sustainable healthcare has increased due to the significant contribution of healthcare facilities to carbon emissions, medical waste, and energy consumption. In response to these challenges, green healthcare has emerged as a paradigm that integrates environmental sustainability with the improvement of clinical services. This approach is particularly relevant for primary healthcare facilities, which function as the first point of patient contact and play a strategic role in shaping sustainable health service delivery. Method: This study employed a descriptive qualitative literature-based approach to examine the concept of green healthcare and to identify strategic pathways for its implementation in primary healthcare services. Relevant scholarly articles and policy-oriented literature were analyzed to capture key dimensions, practices, and enabling factors associated with green healthcare initiatives. Results: The findings indicate that the implementation of green healthcare contributes to enhanced operational efficiency, improved patient psychological comfort, more effective waste management, and higher overall service quality. These outcomes are supported through the integration of patient-centered care, green digitalization, evidence-based facility design, and the development of a sustainability-oriented organizational culture. At the same time, several challenges were identified, including budget constraints, workforce readiness, cultural resistance within organizations, and gaps in digital infrastructure, all of which may limit effective implementation. Conclusion: Green healthcare can be effectively realized only when it is adopted as a systemic transformation rather than a standalone technical initiative. Positioning sustainability as an integral part of organizational identity is essential to ensure the long-term success of green healthcare practices in primary healthcare services.
Copyright (c) 2025 Andi Hardianti, Purwo Setiyo Nugroho, Seno Lamsir (Author) https://creativecommons.org/licenses/by-sa/4.0
Variations in 0° and 8° Caudal Angulation in Lumbosacral Joint Lateral Projection Examinations with Clinical Low Back Pain to Show More Informative Anatomy in the Radiology Department of Pariaman Regional General Hospital
This quantitative experimental study, conducted at the Radiology Department of Pariaman Regional General Hospital, compared the diagnostic quality of lateral lumbosacral radiographs using 0° and 8° caudal beam angles. With a sample of three female patients assessed by five radiology specialists, results analyzed via the Wilcoxon test showed the 8° caudal projection (score: 3.87) was superior to the 0° angle (score: 3.07). The 8° angle provided a more optimal image, characterized by a well-opened intervertebral disc space and clear visualization of the spinous process without sacral overlap, making it more informative for clinical evaluation. In contrast, the 0° angle, while offering a clearer vertebral body outline, resulted in a less open disc and superimposed spinous process. The findings suggest that an 8° caudal beam angle enhances visualization of key anatomical structures in lateral lumbosacral radiography.
Copyright (c) 2025 Santa Mareta, Oktavia Puspita Sari, Nerifa Dewilza, Livia Ade Nansih, Nadhifa Shofikha Giani (Author) https://creativecommons.org/licenses/by-sa/4.0
Analysis of the Relationship of Maternal Age and Parity to Gestational Diabetes Risk
This study aims to analyze the association between maternal age and parity with the risk of gestational diabetes mellitus (GDM) using a quantitative analytic observational approach. Data were collected from scientific literature, epidemiological reports, and global health policy documents published between 2018 and 2025, focusing on the Southeast Asian region. The findings reveal that maternal age above 30 years is significantly correlated with higher GDM prevalence, with the risk sharply increasing among women aged ≥35 years. High parity (≥3 births) contributes to cumulative metabolic burden, greater insulin resistance, and elevated GDM likelihood. The interaction between maternal age and parity demonstrates a synergistic effect, reinforced by biological and social factors, including limited antenatal access and low nutritional awareness. From a public health perspective, these findings highlight the need for integrated maternal risk-based screening, preconception education, and digital health interventions to identify high-risk women early. Community-based preventive strategies and the use of digital health technologies can enhance GDM prevention, strengthen maternal and child health outcomes, and contribute to sustainable health development goals across Southeast Asia.
Copyright (c) 2025 Sri Wahyuni, Isah Fitriani, Risza Presty Nurmani, Nur Wahyuni (Author) https://creativecommons.org/licenses/by-sa/4.0
Evaluation of the Free Nutritious Meal Program in the 3T Region Areas Between Nutritional Equity and Infrastructure Challenges
This study aims to evaluate the effectiveness of the Free Nutritious Meal Program implemented in Indonesia’s frontier, outermost, and disadvantaged (3T) regions using a descriptive qualitative approach. The research focuses on three key dimensions: nutritional equity, infrastructural challenges, and community participation in sustaining program outcomes. Data were collected through the analysis of official policy documents, recent empirical studies, and relevant international literature. The findings indicate that although the program has improved access to nutritious food and public awareness of balanced diets, its implementation remains constrained by logistical barriers, weak intersectoral coordination, and limited human resource capacity at the regional level. Geographic isolation further exacerbates disparities in program effectiveness across regions. Nevertheless, evidence suggests emerging local innovations, including the utilization of local food resources, digital monitoring systems, and collaborative models involving communities and private sectors. The study concludes that achieving nutritional justice requires adaptive, participatory, and sustainable policy implementation that empowers local governance and community-based ownership. Strengthening these dimensions is essential for transforming national nutrition policy into an inclusive instrument for reducing inequality and promoting human development in Indonesia’s 3T regions.
Copyright (c) 2025 Noor Diah Erlinawati (Author) https://creativecommons.org/licenses/by-sa/4.0
The Community Empowerment Approach to Diabetes Prevention in Urban Areas
The increasing prevalence of type 2 diabetes in urban areas highlights the urgency of multidimensional interventions that go beyond conventional clinical approaches. Rapid urbanization, obesogenic environments, and unequal access to healthy food reinforce the social determinants of health, which systematically trigger metabolic risks. This study used qualitative methods through a review of current literature to identify patterns, structural determinants, and the effectiveness of community empowerment as a prevention strategy. The analysis shows that individual-based programs often fail due to a lack of environmental support, the dominance of ultra-processed foods, and economic barriers. Community empowerment has been shown to improve health literacy, strengthen positive social norms, and trigger active participation in advocacy for healthier environmental policies. The findings emphasize the need for public policy reforms to regulate the food industry, expand physical activity spaces, and direct budget allocations toward prevention efforts. Cross-sectoral integration, including urban planning, education, and active transportation, fosters the sustainability of interventions. Community capacity building has the potential to create stronger collective health resilience than top-down approaches. Therefore, the synergy between community empowerment and structural policies is considered a comprehensive strategy to control the epidemiological trends of diabetes in urban areas. This study highlights the need to reposition the role of communities as key actors in the urban health ecosystem.
Copyright (c) 2025 Sulistyo Andarmoyo (Author) https://creativecommons.org/licenses/by-sa/4.0
Telemidwifery: Transforming Maternal Health Care in the Digital Era
Telemidwifery represents a digital transformation in maternal health services by integrating information and communication technology into midwifery care. This study aims to analyze the effect of telemidwifery on maternal health service satisfaction in Indonesia using a quantitative approach with a survey of 150 respondents, consisting of pregnant and postpartum mothers who have used telemidwifery applications or online consultation platforms. Data were analyzed using simple linear regression to measure the relationship between the intensity of telemidwifery use and user satisfaction. The results show that telemidwifery has a positive and significant effect on maternal satisfaction (β = 0.486; t = 6.427; p = 0.000; R² = 0.302). This finding indicates that telemidwifery effectively increases accessibility, continuity of care, and user trust in midwifery services. The study also reinforces that digital health innovations play a crucial role in overcoming geographical barriers, especially in rural and remote areas. The implementation of telemidwifery aligns with global health trends toward sustainable, equitable, and technology-driven maternal care. Further development requires strengthening midwives’ digital literacy, integrating telehealth systems into national health policies, and ensuring data privacy and ethical standards.
Copyright (c) 2025 Hikmah Hikmah, Andi Nurhalizah Tenriyola A.p, Intan Rina Susilawati (Author) https://creativecommons.org/licenses/by-sa/4.0
Health as a Social Issue: a Narrative of Service Amidst Unequal Access to Medical Services
Health is understood as a universal basic right that is inseparable from human existence and requires state guarantees through fair and equitable access to services. Fulfillment of this right is not only related to the availability of medical facilities, but also to ensuring equal access without discrimination based on social, economic, or geographic status. The phenomenon of health service inequality in Indonesia shows the concentration of modern facilities in urban areas, while communities in rural and remote areas face structural barriers, including limited infrastructure, medical personnel, and funding. This condition not only increases morbidity and mortality but also reinforces social exclusion rooted in the unfair distribution of resources. On the other hand, narratives of the dedication of health workers in marginalized areas demonstrate dedication that transcends material limitations and becomes a form of social solidarity in fighting for the public's right to health. These narratives simultaneously critique the unequal distribution of health care systems and inspire the integration of empathy and compassion into medical services. This research uses a qualitative approach through a literature review, examining academic journals, policy documents, and international reports to identify key themes related to inequality in access and the social dimensions of health. The analysis was conducted using content analysis to reduce data, categorize issues, and synthesize relevant narratives to obtain a comprehensive picture of the links between health, social justice, and sustainable development. The study's findings confirm that health should be viewed as a strategic investment and a pillar of social justice, requiring data-driven policies, proportional resource distribution, and active community participation. Therefore, equitable fulfillment of the right to health is a crucial foundation for building a more equal, inclusive, and competitive nation
Copyright (c) 2025 Lyna M. N. Hutapea, Dwight Mahaputera Marulitua Hutapea (Author) https://creativecommons.org/licenses/by-sa/4.0
Digital Infrastructure Readiness in Supporting National Telehealth Services: A Comprehensive Review
The readiness of digital infrastructure is crucial for supporting effective national telehealth services, particularly in developing countries and remote areas. This comprehensive review examines the key factors influencing digital infrastructure readiness, including policy and regulation, connectivity and devices, digital competency and literacy, and equity of access. Through a systematic literature review of 21 scholarly publications from 2020 to 2025, this study identifies critical challenges in telehealth implementation, including infrastructure limitations, lack of trained human resources, regulatory barriers, and digital divides. The findings reveal that successful national telehealth implementation depends heavily on robust digital infrastructure, supportive policies, digital literacy, and equitable access. This research recommends strategic investments in infrastructure development, human resource training, adaptive policies, and inclusive technological solutions to ensure telehealth can truly expand access and improve healthcare service quality. The study contributes to both theoretical understanding and practical implementation of telehealth systems in resource-constrained settings
Copyright (c) 2025 Yumi Abimulyani, Suratno Kaluku (Author) https://creativecommons.org/licenses/by-sa/4.0
The Effectiveness of Reproductive Health Education in Reducing Fear of Pregnancy in Women of Childbearing Age
This study aims to analyze the effectiveness of reproductive health education in reducing fear of pregnancy among women of childbearing age through a qualitative approach based on literature review. Reproductive education is seen as a strategic instrument for improving reproductive literacy, strengthening self-efficacy, and correcting irrational perceptions of pregnancy risks. The literature review shows that women with high reproductive literacy tend to have a better scientific understanding of the reproductive system, enabling them to objectively assess pregnancy risks and reduce unfounded anxiety. Effective educational programs focus not only on knowledge transfer but also on psychological strengthening and social empowerment. Sociocultural factors, educational communication, and gender relations have been shown to be important determinants in the successful internalization of educational messages. Education that is sensitive to cultural values and participatory in nature can build trust, increase acceptance of the material, and expand the program's influence on the behavioral and emotional domains. The synthesis of results shows that comprehensively designed reproductive health education contributes significantly to reducing fear of pregnancy through the integration of cognitive, affective, and social aspects. These findings emphasize the importance of a multidimensional approach in reproductive health interventions to achieve a balance between scientific understanding and psychological well-being for women of childbearing age.
Copyright (c) 2025 Yumi Abimulyani (Author) https://creativecommons.org/licenses/by-sa/4.0
A Mediation Analysis of Digital Engagement on the Influence of Exposure to HIV/AIDS Educational Content on TikTok on Adolescents' Knowledge
Advances in digital technology have driven significant transformations in adolescents' information consumption patterns, particularly through short video-based platforms like TikTok. This medium serves not only as a space for entertainment but also as an effective educational platform for conveying health messages, including on the issue of HIV/AIDS, which still faces social stigma. This study aims to analyze the relationship between exposure to HIV/AIDS educational content on TikTok and increased adolescent knowledge, and to examine the role of digital engagement as a mediating variable in this process. Using a qualitative approach with a literature review method, this study combines narrative and thematic synthesis to comprehensively interpret empirical and conceptual results. The results indicate that digital engagement, such as commenting, sharing, or recreating content, plays a crucial role in strengthening the internalization of health messages through a reflective and participatory process. Repeated exposure to creatively and emotionally packaged educational content can enhance adolescents' understanding and critical awareness of HIV/AIDS. However, the challenge of misinformation demands increased digital literacy to ensure the credibility of messages received. The implications of this study emphasize that effective digital health education strategies require collaboration between health workers, educators, and content creators to create an interactive, inclusive, and evidence-based learning environment in the digital era.
Copyright (c) 2025 Gusti Ayu Tirtawati, Suryo Ediyono (Author) https://creativecommons.org/licenses/by-sa/4.0
Effectiveness of Health Education Program on Self-Management of Elderly with COPD (Chronic Obstructive Pulmonary Disease)
Chronic Obstructive Pulmonary Disease (COPD) is a major cause of decreased quality of life in the elderly, requiring optimal self-management skills. Poor understanding of symptom management and treatment by the elderly is a major barrier to long-term care. This study aims to analyze the effectiveness of a health education program on improving self-management in the elderly with COPD. The study design used a quasi-experimental pretest–posttest control group with 150 respondents (75 experimental and 75 control) selected through purposive sampling. The education program was administered for four weeks with a focus on improving knowledge, attitudes, and symptom management skills. Data analysis used the Shapiro–Wilk test, paired t-test, independent t-test (Welch), and ANCOVA at a significance level of 0.05. The results showed a significant increase in self-management skills in the experimental group compared to the control (t = 10.64; p < 0.001; Cohen's d = 1.74). The average score increased by 14.66 points in the experimental group and 2.61 points in the control group. It was concluded that the health education program was effective in improving self-management in elderly with COPD, so it is recommended as a routine intervention in elderly health services.
Copyright (c) 2025 Erika Erika (Author) https://creativecommons.org/licenses/by-sa/4.0
Benefits of Telemedicine for Maternal Health: Access, Education, and Monitoring
This study aims to analyze the benefits of telemedicine on maternal health through three main dimensions: service access, health education, and technology-based pregnancy monitoring systems. Using a qualitative approach with a literature review method, this study examined 25 scientific articles published between 2020 and 2025 that were relevant to maternal health and telemedicine issues. A thematic analysis was conducted to identify patterns of findings indicating that telemedicine contributes significantly to increasing equitable access to antenatal care, strengthening maternal health literacy, and optimizing real-time pregnancy monitoring. The study results indicate that the use of digital platforms not only expands the reach of services but also increases pregnant women's participation in self-care and accelerates early detection of complications. However, the effectiveness of telemedicine is still influenced by infrastructure, digital literacy, and ethical and data security aspects. This study confirms that the integration of these three dimensions creates an adaptive, inclusive, and prevention-oriented maternal service ecosystem. These findings are expected to serve as a conceptual foundation for the development of equitable and sustainable technology-based maternal health policies in Indonesia.
Copyright (c) 2025 Enggar Enggar, Parti Parti, Eki Nawang Wulandari (Author) https://creativecommons.org/licenses/by-sa/4.0
Implementation of an ISO 45001-Based Occupational Health and Safety Management System in Healthcare Companies
The implementation of an ISO 45001-based Occupational Safety and Health (OHS) Management System in healthcare companies is a strategic effort to improve workforce safety and the quality of healthcare services sustainably. This study uses a qualitative method with a literature review approach to examine the effectiveness, obstacles, and strategies for strengthening the implementation of ISO 45001. The analysis results indicate that the implementation of this standard can reduce the rate of workplace accidents, increase compliance with safety procedures, and strengthen an organizational culture oriented towards risk prevention. However, obstacles such as limited human resource competency, work culture resistance, and financial constraints remain significant challenges. Effective strengthening strategies include transformative leadership, continuous training, quality management system integration, and the use of digital technology to strengthen audits and reporting. The implementation of ISO 45001 has been proven not only to improve operational efficiency but also to build public trust in the professionalism of healthcare organizations. In conclusion, the successful implementation of an ISO 45001-based OHS management system is determined by the synergy between managerial commitment, structural readiness, and a sustainable safety culture, which together serve as an important foundation for improving the quality and sustainability of healthcare services.
Copyright (c) 2025 Siti Nurmanis Sari, Andi Yepita Deviyanti, Hardianty Hardianty (Author) https://creativecommons.org/licenses/by-sa/4.0
The Influence of Occupational Safety Training on Compliance With The Use of PPE in Health Facilities
This study aims to analyze the effect of occupational safety training on compliance with the use of Personal Protective Equipment (PPE) in healthcare facilities. The background of the study is based on the high risk of exposure to occupational hazards faced by healthcare workers and the low consistency in the correct use of PPE. This study used a quantitative method with a survey approach and simple linear regression analysis of 100 healthcare worker respondents consisting of nurses, midwives, and laboratory personnel. The results showed that occupational safety training had a positive and significant effect on compliance with PPE use with a regression coefficient value of 0.684, a t-test of 9.247, and a significance level of 0.000. The coefficient of determination (R²) value of 0.468 indicates that the training was able to explain 46.8% of the variation in healthcare worker compliance. These findings indicate that structured, interactive, and simulation-based training is more effective in increasing awareness and compliance with safety procedures. Organizational support and ongoing supervision also strengthen the training outcomes so that safe behavior can be maintained in the long term. This study confirms that occupational safety training is a strategic instrument for strengthening OSH culture and creating a safe and productive work environment in the healthcare sector.
Copyright (c) 2025 Hardianty Hardianty, Siti Nurmanis Sari, Andi Yepita Deviyanti (Author) https://creativecommons.org/licenses/by-sa/4.0