Journal of Health Innovation and Environmental Education
Journal of Health Innovation and Environmental Education (Jou Hea. Inn. Env. Ed) is a double-blind peer-reviewed journal dedicated to disseminating advances in science and research in the field of health innovation, nursing assistants, education, and environmental health both in Indonesia and the global context developing country. Committed to excellence, the Journal of Health Innovation and Environmental Education publishes comprehensive research articles and invites reviews from leading experts in health innovation, nursing assistants, education, and environmental health. The selection criteria prioritize papers that demonstrate high scientific value, convey new knowledge, and significantly impact health innovation, nursing assistants, education, and environmental health, and related topics at the school and college levels. This respected journal covers original research articles, providing a platform for discussing cutting-edge research that integrates health with local culture and wisdom. These contributions aim to inform policymaking and improve health and environmental practices. In addition, this journal highlights important findings on health, the application of methodologies, health innovation, nursing assistants, education, and environmental health such as the development of learning materials and tools, advances in teaching strategies, and educational evaluations in the health and environmental fields. Journal of Health Innovation and Environmental Education is an open-access journal containing original research articles, review articles, and other scholarly contributions that advance our understanding of Healt education and its various dimensions. Jou Hea. Inn. Env. Ed publishes twice in June and December. This journal has adopted a double-blind review policy whereby reviewers and authors remain anonymous.
Authors who publish with this journal agree to the following terms: Authors retain copyright and acknowledge that the Journal of Health Innovation and Environmental Education is the first publisher licensed under a Creative Commons Attribution 4.0 International License. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges and earlier and greater citation of published work.
Analysis of Lead (PB) Levels in Snack Foods at Joyoboyo Terminal, Surabaya as a Public Health Risk
Purpose of the study: Study aimed to analyze the levels of lead (Pb) in snack foods sold at Terminal Joyoboyo, Surabaya, and to assess their potential risk to public health. Methodology: An analytical observational study with a cross-sectional design was conducted. A total of 30 snack food samples were collected using purposive sampling from vendors located inside and outside the terminal. Lead levels were measured using Atomic Absorption Spectrophotometry (AAS). Data were analyzed using descriptive statistics and an independent samples t-test to determine differences between groups. Main Findings: The findings showed that all samples contained detectable levels of Pb, with higher mean levels observed in foods sold outside the terminal (0.28 mg/kg) compared to those inside (0.19 mg/kg). Approximately 40.0% of samples from outside the terminal exceeded the safety limit, compared to 13.3% from inside. Statistical analysis indicated a significant difference between the two groups (p < 0.05). Novelty/Originality of this study: This study provides a micro-spatial analysis of Pb contamination by comparing food safety conditions within different zones of the same transportation terminal, offering more precise insights into environmental exposure risks.
Copyright (c) 2026 Ani Maryati, Chhea Sophearom, Ky Bunleang
Determinants of Nurses’ Clinical Performance in Implementing Nursing Care Standards within Inpatient Services: A Practice-Based Perspective at Kota Tinggi Hospital
Purpose of the study: This study aimed to analyze the determinants of nurses’ clinical performance in implementing nursing care standards within inpatient services at Kota Tinggi Hospital, Johor. Methodology: A quantitative analytical study with a cross-sectional design was conducted involving 98 nurses selected through total sampling. Data were collected using structured questionnaires and observation checklists. Statistical analysis included univariate, bivariate (Chi-square), and multivariate (logistic regression) analyses. Main Findings: The findings revealed that knowledge (p=0.001), motivation (p=0.002), leadership (p=0.000), and compensation (p=0.003) were significantly associated with clinical performance. Leadership was identified as the most dominant factor (OR=3.86). A majority of nurses (64.3%) demonstrated high clinical performance, although a notable proportion (35.7%) showed lower performance. Novelty/Originality of this study: This study provides a practice-based and integrative analysis of multiple determinants influencing nurses’ clinical performance in inpatient settings, emphasizing the role of leadership in bridging the gap between nursing standards and real clinical implementation.
Copyright (c) 2026 Viji Alex, Norazalina Mohamad Zah
Development of a Web-Based Patient Service Management Information System to Improve Administrative Efficiency at Su'adah Clinic, Palembang
Purpose of the study: This study aimed to develop and evaluate a web-based patient service management information system to improve administrative efficiency at Su’adah Clinic in Palembang. Methodology: This research employed a research and development approach using the Waterfall system development model. Problem identification was conducted using the PIECES framework (Performance, Information, Economy, Control, Efficiency, and Service). Data were collected through observation, interviews, and documentation analysis at the clinic. The developed system integrates patient registration, administrative data management, payment processing, and automated reporting into a single web-based platform. Main Findings: The implementation of the developed system significantly improved administrative performance at the clinic. The average patient registration time decreased from approximately 10 minutes to 3 minutes, while average patient waiting time was reduced from 25 minutes to 10 minutes. The time required to retrieve patient records decreased from 5–7 minutes to less than 1 minute, and the preparation of monthly administrative reports was reduced from 2–3 hours to approximately 15 minutes. In addition, daily paper usage decreased from about 120 sheets to around 30 sheets after system implementation. User evaluation results indicated high acceptance of the system, with an overall satisfaction score of 4.5 out of 5. Novelty/Originality of this study: The novelty of this study lies in the development of an integrated web-based patient service management system specifically designed for small-scale healthcare clinics, combining online patient registration, administrative management, payment documentation, and automated reporting within a single accessible platform.
Integration of Health Education Technology to Improve Mothers' Understanding of Toddler Nutrition in the Ciputat Timur Community Health Center Area, South Tangerang
Purpose of the study: This study aimed to analyze the effectiveness of integrating health education media in improving maternal knowledge regarding toddler nutrition in the working area of the Ciputat Timur Community Health Center, South Tangerang. Methodology: A quantitative study with a quasi-experimental design using a non-equivalent control group approach was conducted. The study involved 36 mothers of toddlers, consisting of 9 mothers of underweight toddlers (intervention group) and 27 mothers of well-nourished toddlers (control group). Data were collected using a structured questionnaire measuring maternal knowledge before and after the educational intervention. The intervention included health education using flipchart media and video-based educational materials, while the control group received education using flipchart media only. Main Findings: The results showed a significant improvement in maternal knowledge after the educational intervention. In the underweight toddler group, the median knowledge score increased from 65.00 to 80.00 (p = 0.007). In the well-nourished toddler group, the median knowledge score increased from 70.00 to 80.00 (p < 0.001). Furthermore, the proportion of mothers with knowledge scores above 70 increased from 0% to 66.7% in the underweight group and from 48.1% to 85.2% in the well-nourished group. Novelty/Originality of this study: The novelty of this study lies in the integration of multiple health education media, including flipcharts and video-based learning, within a community-based nutrition education intervention at the primary health care level, providing a more interactive and effective approach to improving maternal nutrition literacy.
Copyright (c) 2026 Wahyunita Gani Wintarti
Meaning of Childbirth Experiences Handled by Traditional Midwives for Mothers in Parung District, Bogor: A Phenomenological Approach in Public Health Studies
Purpose of the study: This study aimed to explore the meaning of childbirth experiences among mothers who delivered with the assistance of traditional birth attendants in Parung District, Bogor.] Methodology: A qualitative study with a descriptive phenomenological approach was conducted. Participants were selected using purposive sampling, consisting of eight mothers who had experienced childbirth assisted by traditional birth attendants. Data were collected through in-depth semi-structured interviews and analyzed using phenomenological thematic analysis to identify significant statements, meaning units, and emerging themes.] Main Findings: The findings identified four major themes shaping mothers’ childbirth experiences: emotional comfort and trust in traditional birth attendants, accessibility barriers to formal health services, influence of family and cultural traditions, and perceptions of safety during childbirth. Although traditional birth attendants provided emotional support and cultural familiarity, concerns regarding medical safety and emergency management were also reported by several participants. Novelty/Originality of this study: This study provides a phenomenological perspective on the lived experiences of mothers delivering with traditional birth attendants in a community where formal maternal health services are available. The research highlights the sociocultural and experiential factors that sustain traditional childbirth practices and offers insights for developing culturally responsive maternal health interventions.]
Nursing Assistant Students’ Digital Cultural Intelligence and Clinical Adaptability in a North African Health College: A Cross-Sectional Study
Purpose of the study: This study examined the predictive relationship between digital cultural intelligence and clinical adaptability among nursing assistant students at a health sciences college in Morocco. Methodology: A cross-sectional design was employed with 287 students who had completed at least one clinical placement. Data were analysed using partial leas squares structural equation modellingi (PLS-SEM) to test a theory-driven conceptual framework. Measurement model evaluation confirmed satisfactory reliability and validity (CR > 0.90; AVE > 0.50; HTMT < 0.85). Structural analysis revealed that digital cultural intelligence significantly predicted clinical adaptability (β = 0.64, p < 0.001), explaining 41% of the variance (R² = 0.41). Predictive relevance was supported (Q² = 0.29), and robustness checks using covariance-based SEM confirmed acceptable model fit indices. Main Findings: The findings indicate that the capacity to navigate culturally diverse interactions within digitally mediated healthcare environments is a substantial determinant of adaptive clinical reasoning, flexible communication, and ethical responsiveness. By empirically validating digital cultural intelligence as a multidimensional construct in vocational nursing education, this study advances theoretical integration between intercultural competence and adaptive expertise frameworks. Novelty/Originality of this study: This study contributes Global South evidence to international nursing education research and provides a predictive model for curriculum innovation in digitally transitioning healthcare contexts.
Copyright (c) 2024 Ridouane Oulhiq, Shi ching W, Pichayapor Ratt, Maurizio Martin Cavani Brain
Clinical Skills Development and Competency Assessment Needs among Nursing Assistant Students: A Design and Development Study
Purpose of the study: This study aimed to develop and validate a competency-based clinical skills development model for nursing assistant students and evaluate its effectiveness in improving clinical performance, procedural competence, and self-efficacy. Methodology: A Design and Development Research (DDR) approach with a sequential exploratory mixed-methods design was employed. Phase 1 involved qualitative needs assessment with 24 students and 6 clinical instructors to identify competency gaps. A competency-based learning model integrating structured simulation, standardized rubrics, DOPS-based formative feedback, and OSCE assessment was subsequently constructed and validated by seven experts (S-CVI = 0.92). Effectiveness was evaluated using a quasi-experimental pre-test–post-test control group design with 64. Outcomes included OSCE performance, DOPS ratings, and clinical self-efficacy. Data were analyzed using ANCOVA and effect size calculations. Main Findings: The intervention group demonstrated significantly higher post-test OSCE scores (82.6 ± 5.9 vs. 69.4 ± 6.7; p < 0.001; d = 1.95), improved DOPS ratings (4.3 ± 0.4 vs. 3.5 ± 0.5; p < 0.001), and increased self-efficacy (81.1 ± 7.5 vs. 64.3 ± 8.1; p < 0.001; d = 2.09) compared to controls. Skill retention at four weeks remained significantly higher in the intervention group (p < 0.001). Novelty/Originality of this study: Findings support structured operationalization of competency-based education in assistant-level nursing training and provide an empirically grounded framework for curriculum reform.
Copyright (c) 2026 Lachezar Manchev, Gedamu Gebreamlak Hailu, Maurizio Martin Cavani Brain, Pichayaporn Ratt, Taisia Chertenko
Continuity of Open Umbilical Cord Care and Risk of Neonatal Infection in a Primary Obstetric Setting: A Retrospective Cohort Study
Purpose of the study: This study aimed evaluate association between open umbilical cord care and neonatal infection within 28 days postpartum in primary midwifery facilities in Iseyin, Oyo State, Nigeria, and to identify independent biological and environmental predictors of infection risk. Methodology: A retrospective cohort design was applied to 980 term neonates delivered between January 2022 and December 2024 in six registered primary obstetric centers in Iseyin, Oyo State, Nigeria. Data were extracted from maternity registers and follow-up records. Multivariable log-binomial regression and 1:1 propensity score matching were performed using STATA version 17 to estimate adjusted relative risks (RR) with 95% confidence intervals. Main Findings: Neonatal infection occurred in 8.7% of the open cord care group and 6.5% of antiseptic group. After multivariable adjustment and propensity score matching, open cord care was not significantly associated with increased infection risk (aRR 1.15; 95% CI 0.76–1.73; p = 0.49). Low birth weight, prolonged rupture of membranes, and limited household sanitation were independent predictors, while early breastfeeding initiation was protective. Novelty/Originality of this study: This study provides context-specific effectiveness evidence on open umbilical cord care within real-world primary midwifery services in semi-urban West Africa. By integrating propensity score matching with routine service data, it bridges the gap between controlled antiseptic trials and implementation-level nursing practice, supporting risk-stratified and system-oriented neonatal infection prevention strategies.
Copyright (c) 2026 Aidevbo Otuyoma Eyaufe, Myada Ibrahim, Satya Narayan Yadav, Mylast Bilimon, Nurgul Rysalieva
Cupping Therapy Approach as a Nonpharmacological Strategy for Controlling Headaches in Outpatients
Purpose of the study: Headache is a highly prevalent neurological complaint commonly managed with pharmacological therapy, which may cause adverse effects with long-term use. This study aimed to evaluate the effectiveness of cupping therapy as a nonpharmacological strategy for controlling headache among outpatients. Methodology: A quasi-experimental one-group pretest–posttest design was employed involving 16 outpatients with headache. Pain intensity was measured before and after cupping therapy using the Visual Analog Scale (VAS). Data were analyzed using the Shapiro–Wilk normality test followed by paired sample t-test with a significance level of p < 0.05. Main Findings: The mean VAS score significantly decreased from 6.75 ± 1.29 before intervention to 3.12 ± 1.15 after intervention, with a mean reduction of 3.63 points (t = 14.21; p < 0.001). Severe pain prevalence declined from 56.2% to 6.2% following therapy. These findings indicate that cupping therapy effectively reduces headache pain intensity in outpatient settings. Novelty/Originality of this study: This study positions cupping therapy as an evidence-informed nonpharmacological intervention within structured outpatient healthcare services, quantitatively bridging traditional therapeutic practice with modern clinical evaluation using standardized pain measurement and statistical validation.
Copyright (c) 2024 Rahmatul Fithri Yanti, Mohamed M Babeker
The Effect of Audio Visual Educational Media in Increasing Knowledge Retention and Compliance with the Use of Personal Protective Equipment as an Effort to Prevent Occupational Health Risks among Apple Farmers
Purpose of the study: This study aimed to determine the effect of audio-visual health education media on knowledge retention and compliance with personal protective equipment (PPE) use as a strategy to prevent occupational health risks among apple farmers in Kuala Pilah, Malaysia. Methodology: A pre-experimental one-group pretest–posttest design was conducted involving 20 apple farmers selected through total sampling. Data were collected at four time points: baseline (T0), immediately after intervention (T1), one week (T2), and two weeks (T3) post-intervention. Knowledge was measured using a structured questionnaire, while PPE compliance was assessed through observation and self-report. Repeated measures analysis and paired categorical tests were applied with a significance level of p < 0.05. Main Findings: The mean knowledge score increased from 56.4 at baseline to 82.7 immediately after the intervention, and remained significantly higher at 78.9 (week 1) and 74.6 (week 2) (p < 0.001). PPE compliance improved from 30.0% at baseline to 70.0% post-intervention and was maintained at 70–75% during follow-up (p < 0.05). Novelty/Originality of this study: This study provides integrated evidence on both sustained knowledge retention and measurable behavioral compliance using repeated follow-up assessments in an agricultural occupational health context, demonstrating the effectiveness of audio-visual media beyond immediate learning outcomes.
Copyright (c) 2024 Payal Choundhury, Santiago Jorge Pereira
The Role of Cupping Therapy in Non-Pharmacological Approaches to Hypertension Control: Analysis of Changes in Systolic and Diastolic Blood Pressure
Purpose of the study: This study aimed to analyze changes in systolic and diastolic blood pressure following wet cupping therapy as a non-pharmacological intervention for hypertension control. Methodology: An analytical pre–post experimental study was conducted involving 32 adult participants undergoing wet cupping therapy. Blood pressure was measured before and after intervention using standardized procedures. Data were processed through editing and coding stages and analyzed using paired-samples t-test or Wilcoxon signed-rank test based on normality distribution. Statistical significance was set at p < 0.05. Main Findings: The mean change in systolic blood pressure was 1.09 ± 8.20 mmHg, while the mean change in diastolic blood pressure was 0.31 ± 7.06 mmHg. Twelve participants (38%) experienced a reduction in systolic blood pressure. However, overall differences in systolic and diastolic values before and after therapy were not statistically significant (p > 0.05). Novelty/Originality of this study: This study advances current evidence by positioning wet cupping therapy within an evidence-based non-pharmacological hypertension control framework and by separately analyzing systolic and diastolic hemodynamic responses using standardized statistical procedures.
Copyright (c) 2025 Husnita Thamrin, Samaneh Rahmani
Examining the Relationship between Environmental Health Conditions and the Incidence of Acute Respiratory Tract Infections (ARI) Among Students at San Roque Elementary School
Purpose of the study: This study aimed to examine the relationship between environmental health conditions and the incidence of ARI among elementary school students. Methodology: An analytic observational study with a cross-sectional design was conducted among 80 students at San Roque Elementary School. Environmental health conditions were assessed using a structured observational checklist covering ventilation, sanitation, classroom density, waste management, and water availability. ARI incidence was determined through school health records and parental confirmation. Data were analyzed using Chi-square tests and multivariate logistic regression at a 95% confidence level. Main Findings: Of the observed classrooms, 40.0% were classified as having inadequate environmental health conditions. ARI prevalence among students was 36.3%. A significant association was identified between environmental health status and ARI incidence (p = 0.001). Students exposed to inadequate environmental conditions had 4.12 times higher odds of developing ARI (AOR = 4.12; 95% CI: 1.68–10.09; p = 0.002). Novelty/Originality of this study: This study advances prior research by operationalizing environmental health as a multidimensional composite construct within a real-world public elementary school setting, thereby generating context-specific empirical evidence linking structural environmental exposure to respiratory morbidity.
Copyright (c) 2026 Vinh Nguyen Hoang, Ellen Tsholofelo
Nursing Students’ Experiences of Basic Life Support Training and Its Role in Emergency Care Competence
Purpose of the study: This study explored how BLS training shapes emergency care competence development and early professional identity among vocational nursing students. Methodology: A qualitative descriptive design with thematic analysis was employed. Data were collected through semi-structured interviews with vocational nursing students following structured BLS simulation training. Data were analysed using NVivo to generate hierarchical coding structures and thematic integration. Main Findings: Four interrelated themes emerged: (1) transformative experiential learning through embodied simulation, repetition, and instructor feedback; (2) multidimensional construction of emergency competence characterised by confidence, situational awareness, and readiness to act; (3) emotional and contextual barriers including performance anxiety and fear of clinical error; and (4) emerging professional identity grounded in ethical responsibility and teamwork. Competence development was constructed not merely as technical mastery but as embodied readiness moderated by emotional regulation and supported by structured experiential exposure.. Novelty/Originality of this study: BLS training functions not only as a technical instructional strategy but as a formative process shaping cognitive preparedness, emotional regulation, and early professional identity. Integrating structured simulation, reflective debriefing, and role clarification into vocational nursing curricula may enhance emergency care competence development.
Copyright (c) 2025 N Adi Sumartawan, Grzegorz Wróbel, Florjana Rustemi
The Role of Telehealth in Strengthening Health Education and Health Service Quality: A Systematic Review
Purpose of the study: This study aims to systematically examine the role of telehealth in strengthening health education while simultaneously improving the quality of healthcare services, particularly in contexts with limited access to face-to-face healthcare delivery. Methodology: This study employed a systematic review method. Data were collected from PubMed, Scopus, ScienceDirect, and ProQuest databases using a PEO-based search strategy. Article screening followed PRISMA guidelines, and methodological quality was assessed using the Critical Appraisal Skills Programme checklist. Descriptive and thematic synthesis techniques were applied. Main Findings: The findings indicate that telehealth enhances healthcare accessibility, service efficiency, continuity of care, and patient engagement. Telehealth platforms such as video conferencing and audio-based communication support both clinical services and health education, enabling improved patient understanding, self-management, and satisfaction across diverse healthcare settings. Novelty/Originality of this study: This study offers a novel contribution by synthesizing evidence on telehealth as an integrated approach combining healthcare service delivery and structured health education. Unlike previous fragmented studies, this review highlights the dual function of telehealth in improving service quality and patient empowerment within digital health systems.
Copyright (c) 2025 Mawar Hatem Al-Obaidy, Zhian Abdulah
Redefining Early Childhood Growth and Development Surveillance: A Sustainable, Technology-Integrated Primary Care Ecosystem Linking Maternal Health Literacy, Digital Monitoring, and Predictive Analytics
Purpose of the study: This study aimed to analyze the relationships between maternal health literacy, digital monitoring utilization, growth and development surveillance behavior, and early developmental risk detection among mothers of toddlers. Methodology: A mixed-methods sequential explanatory design was employed at Arosbaya Public Health Center, Bangkalan, Indonesia. The quantitative phase involved a cross-sectional survey of 210 mothers with children under five years old. Data were analyzed using structural equation modeling–partial least squares (SEM-PLS) to examine relationships among variables. The qualitative phase consisted of in-depth interviews with mothers, healthcare workers, and community health volunteers to provide contextual explanations for the quantitative findings. Thematic analysis was used to interpret qualitative data. Main Findings: Maternal health literacy significantly influenced digital monitoring utilization (β = 0.54, p < 0.001) and surveillance behavior (β = 0.32, p = 0.002). Digital monitoring utilization significantly affected surveillance practices (β = 0.41, p < 0.001) and early developmental risk detection (β = 0.29, p = 0.004). Growth and development surveillance behavior demonstrated the strongest association with early risk detection (β = 0.46, p < 0.001). Qualitative findings revealed mothers who possessed higher health literacy were more capable of interpreting child development information and were more likely to utilize digital tools for monitoring their children’s growth. Novelty/Originality of this study: This study integrates maternal health literacy, digital monitoring utilization, and child growth surveillance behavior within a mixed-methods framework, providing a multidimensional understanding of early developmental risk detection in primary healthcare settings.
Copyright (c) 2026 M Agus Suryadinata, Abel Girma, Shyam Sundar Tiwari, Faraja Mpemba
The Relationship between Health Education and Mothers’ Knowledge, Attitudes, and Practices in Early Detection of Toddler Growth and Development
Purpose of the study: This study aims to examine the effect of structured health education on mothers’ knowledge, attitudes, and practices in early detection of toddler growth and development at a community health center in Bangkalan, Indonesia. The study focuses on understanding how educational interventions influence maternal behavior in routine Posyandu services. Methodology: A pre-experimental one-group pretest–posttest design was employed. Data were collected using structured questionnaires and observation checklists. Health education was delivered through lectures, demonstrations, and discussions using flipcharts and leaflets. Participants were mothers with toddlers aged 12–36 months. Data were analyzed with descriptive statistics and the Wilcoxon signed-rank test. Main Findings: Health education significantly improved mothers’ knowledge, attitudes, and practices in early detection of toddler growth and development. Post-intervention scores increased for knowledge (45.2 → 68.7), attitudes (38.6 → 52.4), and practices (41.3 → 59.8), indicating effective translation of understanding and readiness into observable behavior during growth monitoring and developmental screening activities. Novelty/Originality of this study: This study integrates structured, hands-on health education with practical demonstrations at Posyandu, linking maternal knowledge and attitudes directly to behavior. Unlike previous research focusing on single KAP components, this approach evaluates all dimensions simultaneously in a real-world setting, offering new insights for designing effective, behavior-oriented maternal education programs in early childhood development monitoring.
Copyright (c) 2024 Winthrop O'Connor, Kang Kay
Strengthening Participant Education and Healthcare Service Delivery through Mobile JKN at BPJS Healt in Bantaeng Regency
Purpose of the study: This study aims to examine the role of the Mobile JKN application in strengthening healthcare service delivery and participant education within the National Health Insurance system at BPJS Kesehatan Bantaeng Regency, focusing on its function as a digital service innovation and an educational platform for JKN participants. Methodology: This study used a qualitative case study design. Data were collected through in-depth interviews, direct observation, and document review. Informants included BPJS Kesehatan officers and Mobile JKN users, selected purposively. Data analysis applied interactive qualitative analysis techniques, including data reduction, data display, and conclusion drawing. Main Findings: The findings show that Mobile JKN improves healthcare service efficiency, accessibility, and administrative convenience. The application reduces queues and physical visits while providing integrated educational features on JKN procedures, rights, and obligations. However, utilization remains uneven, with lower adoption among elderly participants and those with limited digital literacy and internet access. Novelty/Originality of this study: This study presents an integrative perspective by positioning Mobile JKN as both a healthcare service delivery tool and a participant education medium. It advances existing knowledge by emphasizing education as a core dimension of digital health innovation within a national health insurance system, supported by localized empirical evidence from a regional BPJS context.
Copyright (c) 2024 Christine Angela Palunsu
Assessing the Resilience of Primary Health Care Services: Evidence from Public Health Centers in Depok City
Purpose of the study: This study aims to quantitatively assess the resilience level of primary health care services at Public Health Centers (Puskesmas) in an urban setting by measuring multiple resilience dimensions under routine service conditions in Depok City, Indonesia. Methodology: This quantitative descriptive cross-sectional study used a structured questionnaire based on the WHO Primary Health Care Measurement Framework and the Oktari–Kurniawan resilience model. Data were collected via Google Forms from 100 purposively selected Puskesmas staff and analyzed using descriptive statistics with univariate analysis. Main Findings: The findings show that primary health care services demonstrated high resilience across all assessed dimensions. Good resilience was reported for physical conditions (83%), institutional roles (88%), staff capacity (83%), external relationships (84%), and environmental exposure (81%), indicating strong organizational readiness and service continuity at the primary care level. Novelty/Originality of this study: This study provides novel quantitative evidence on primary health care resilience during routine, post-crisis operational conditions rather than emergency phases. It integrates five resilience dimensions within a single empirical framework at the Puskesmas level, contributing localized urban evidence to strengthen primary health care resilience assessment and policy development.
Enhancing Schoolchildren’s Enterobiasis Prevention Through Booklet-Based Health Educatioan
Purpose of the study: This study aims to examine the effect of booklet-based health education on fifth-grade students’ knowledge and preventive behaviors regarding Enterobius vermicularis at Primary School Ye Twin Kaung, Ye Twin Kaung Village, Sagaing. The study focuses on assessing whether visual and verbal educational materials can improve hygiene practices to prevent pinworm infection. Methodology: A pre-experimental one-group pretest–posttest design was applied. Participants were 11 fifth-grade students selected by purposive sampling. Data were collected using structured knowledge questionnaires and observation checklists. The intervention consisted of a 30-minute booklet-based health education session with visual illustrations and verbal explanations. Data were analyzed using the Wilcoxon Signed-Rank Test. Main Findings: Booklet-based health education significantly improved students’ knowledge and preventive behaviors against Enterobius vermicularis. Knowledge levels increased from 9.1% to 90.9% for good knowledge, while good preventive behaviors rose from 18.2% to 81.8%. The intervention effectively translated understanding into observable hygiene practices, such as handwashing and avoiding soil contact, within three days post-intervention. Novelty/Originality of this study: This study introduces a visually engaging, age-appropriate booklet combined with facilitator-led discussion to improve both knowledge and practical preventive behaviors in elementary school children. Unlike prior research relying on static or passive educational materials, this intervention links cognitive understanding directly to action, offering a novel, sustainable approach for school-based enterobiasis prevention programs.
Copyright (c) 2026 Hnin Wint Aung, HtetMyat Tun
Effectiveness of Health Education and Short Message Service Reminders Reminders on Iron Supplement Adherence among Pregnant Women
Purpose of the study: This study aimed to evaluate effectiveness structured health professional led education embedded within routine antenatal care in enhancing iron supplement adherence among pregnant women. Methodology: A quasi-experimental pretest–posttest control group design conducted among 120 pregnant women at Masis Maternity Hospital. Participants allocated to intervention group. receiving structured professional-led education with reinforcement or a control group receiving routine care. Primary outcome was iron supplement adherence (≥80% consumption), while secondary outcomes included knowledge score and hemoglobin level changes over 8 weeks. Data analyzed using chi-square tests, independent and paired t-tests, and logistic regression. Main Findings: After 8 weeks, adherence significantly increased to 81.0% in .intervention group compared with 51.7% in control group (p < 0.001). The intervention group was nearly five times more likely to achieve adequate adherence (AOR = 4.83; 95% CI: 2.01–11.61). Knowledge scores improved by +5.27 points in the intervention group versus +1.78 in controls (p < 0.001). Hemoglobin levels increased by 0.86 g/dL in intervention group icompared to 0.32 g/dL control group (p < 0.001). Novelty/Originality of this study: This study advances maternal health practice by reframing health education as a structured, professionally embedded care model rather than a single counseling encounter, demonstrating measurable behavioral and clinical impact within routine antenatal services.
Copyright (c) 2026 Nare Karapetyan, Lilit Toyonan, Michelle Steenvoorden, Nour Albahri
Development and Validation of an Integrated Electronic Patient Progress Note-Based Healthcare Evaluation Instrument for Diabetes Management
Purpose of the study: This research sought to design and rigorously evaluate an Integrated Electronic Progress Note instrument intended to support frailty risk monitoring and strengthen care coordination among older adults. Methodology: A methodological research approach was undertaken, beginning with conceptual framework development and item generation, followed by expert review for content adequacy and empirical validation. Data were obtained from 210 healthcare professionals alongside 320 de-identified electronic progress notes collected at Uzsoki Street Hospital. Psychometric evaluation included content validity indexing, internal consistency assessment, and construct validation using Partial Least Squares Structural Equation Modeling with bootstrapping procedures to test structural relationships. Main Findings: The developed instrument demonstrated high content agreement among experts (S-CVI = 0.93) and strong reliability indicators, with composite reliability values exceeding 0.90. Convergent validity met recommended thresholds (AVE > 0.50), while discriminant validity was confirmed through HTMT ratios below 0.90. The structural analysis indicated that the model accounted for 68% of the variance in documentation quality (R² = 0.68) and showed meaningful predictive capability (Q² = 0.49). Among the examined constructs, Care Coordination exerted the most substantial positive influence on documentation quality (β = 0.41, p < 0.001). Furthermore, improved documentation performance was significantly linked to a lower likelihood of 30-day readmission (β = –0.32, p < 0.01). Novelty/Originality of this study: This study presents a validated multidimensional measurement tool that connects frailty risk assessment elements with the quality evaluation of electronic clinical documentation, thereby advancing the integration of geriatric clinical assessment and digital health governance frameworks.
Copyright (c) 2026 István Fedor, Taisia Chertenko, Junhong Kim
The Effect of Health Education on Childhood Diarrhea on Knowledge and Anxiety Levels of Parents with Toddlers at Abdul Wahab Syahranie Regional Hospital, Samarinda
Purpose of the study: This study aimed to assess the effect of health education on childhood diarrhea on parents’ knowledge and anxiety levels regarding their toddlers, focusing on improving both informational and emotional outcomes in a hospital setting. Methodology: A quasi-experimental design with pretest-posttest was employed involving 50 parents of toddlers admitted to the Melati ward at Abdul Wahab Syahranie Regional Hospital, Samarinda. Data were collected using structured questionnaires for knowledge and a validated anxiety scale. Paired t-tests analyzed pre- and post-intervention scores using SPSS version 25. Ethical approval and informed consent were obtained. Main Findings: The results showed a significant increase in parental knowledge scores from 55.2 ± 8.3 to 82.5 ± 6.2 (p < 0.001). Anxiety levels decreased significantly from 52.4 ± 10.1 to 38.7 ± 7.5 (p < 0.001). Health education effectively enhanced parents’ competence in managing diarrhea and reduced psychological stress, confirming the dual impact of the intervention. Novelty/Originality of this study: This study uniquely integrates both cognitive and emotional outcomes, demonstrating that structured health education simultaneously improves knowledge and reduces anxiety. Unlike previous research focusing only on information, this study highlights the psychosocial dimension of parental support, providing practical insights for hospital-based educational programs and contributing to holistic pediatric care strategies.
Copyright (c) 2025 Achmad Muzakir Rizani, Busarin Eiu-Seeyok
Purpose of the study: This study aimed to assess the effect of health education on childhood diarrhea on parents’ knowledge and anxiety levels regarding their toddlers, focusing on improving both informational and emotional outcomes in a hospital setting. Methodology: A quasi-experimental design with pretest-posttest was employed involving 50 parents of toddlers admitted to the Melati ward at Abdul Wahab Syahranie Regional Hospital, Samarinda. Data were collected using structured questionnaires for knowledge and a validated anxiety scale. Paired t-tests analyzed pre- and post-intervention scores using SPSS version 25. Ethical approval and informed consent were obtained. Main Findings: The results showed a significant increase in parental knowledge scores from 55.2 ± 8.3 to 82.5 ± 6.2 (p < 0.001). Anxiety levels decreased significantly from 52.4 ± 10.1 to 38.7 ± 7.5 (p < 0.001). Health education effectively enhanced parents’ competence in managing diarrhea and reduced psychological stress, confirming the dual impact of the intervention. Novelty/Originality of this study: This study uniquely integrates both cognitive and emotional outcomes, demonstrating that structured health education simultaneously improves knowledge and reduces anxiety. Unlike previous research focusing only on information, this study highlights the psychosocial dimension of parental support, providing practical insights for hospital-based educational programs and contributing to holistic pediatric care strategies
Copyright (c) 2026 Rizal Renaldy, Faruk Bojaxhi
Strengthening General Health Professions through the Integration of Educational Interventions and Traditional Health Services
Purpose of the study: This study aims to investigate the integration of educational interventions with traditional health services in Tanjung Raya Village, Way Kanan, to enhance community knowledge and align practices with Fiqh Siyasah principles, ensuring culturally and religiously compliant healthcare. Methodology: A qualitative field research design was employed, collecting primary data through observations, interviews with traditional practitioners, community leaders, and residents, and document reviews. Data were processed using editing, reconstruction, and systematization, and analyzed through qualitative content analysis to identify themes and patterns in traditional health practices. Main Findings: Traditional health services remain widely utilized and trusted. Educational interventions improved understanding of safe and permissible practices, increased compliance with Fiqh Siyasah, and encouraged a balance between traditional and modern health knowledge. Community trust, affordability, and cultural familiarity remain key factors in service utilization. Novelty/Originality of this study: The study integrates empirical, cultural, and religious perspectives to address a gap in previous research by combining health education with traditional practices under Fiqh Siyasah. This approach offers a novel model for culturally sensitive and legally compliant health interventions in rural communities, advancing knowledge on integrating tradition and modern education.
The Effect of Health Education on Mothers’ Knowledge, Attitudes, and Practices in Early Detection of Toddler Growth and Development
Purpose of the study: This study aims to assess the effectiveness of health education in improving mothers’ knowledge, attitudes, and practices regarding early detection of toddler growth and development at Posyandu Mawar, Puskesmas Arosbaya. The study focuses on maternal ability to monitor developmental milestones to prevent long-term developmental delays. Methodology: A pre-experimental one-group pretest-posttest design was used. Thirty mothers of toddlers aged 12–36 months participated. Data were collected using structured questionnaires, direct observation, demonstrations, and interactive health education sessions. Analysis was performed with the Wilcoxon signed-rank test (α = 0.05) to measure improvements in knowledge, attitudes, and practices. Main Findings: After the health education intervention, mothers’ knowledge improved with 60% achieving good knowledge and 40% sufficient. Positive attitudes increased from 23.3% to 53.3%. Practices also improved, with 50% demonstrating good practices and 50% fair practices. Statistical tests confirmed significant improvements (p < 0.05) in all three domains. Novelty/Originality of this study: This study integrates cognitive, affective, and psychomotor domains by simultaneously evaluating knowledge, attitudes, and practices. It positions mothers as the main subjects, applying interactive lectures, discussions, and demonstrations in a primary healthcare setting. The approach provides comprehensive insights into health education effectiveness in real-world community contexts, informing future promotive and preventive programs.
Mobile Technology Enhanced Diabetes Self-Management Education Improves Self-Efficacy and Glycaemic Control in Adults with Type 2 Diabetes
Purpose of the study: This study aimed to evaluate the effectiveness of a mobile technology enhanced diabetes self-management education and support (DSME) programme in improving glycaemic control and diabetes-related self-efficacy among adults with Type 2 diabetes in primary and community health care settings. Methodology: A parallel-group randomized controlled trial was conducted in primary and community health care facilities in Temburong District, Brunei Darussalam. Adults with uncontrolled Type 2 diabetes (n = 120) were randomized to a mobile-enhanced DSME intervention or standard care for 3 months. The primary outcome was change in HbA1c; the secondary outcome was diabetes self-efficacy. Analyses followed an intention-to-treat approach using ANCOVA and repeated-measures ANOVA. Main Findings: At 3 months, the intervention group demonstrated a significantly greater reduction in HbA1c compared with the control group (adjusted mean difference −0.71%, 95% CI −0.92 to −0.50; p < 0.001; Cohen’s d = 0.89). Mean HbA1c decreased by −1.06% in the intervention group versus −0.33% in the control group. A significant group × time interaction was observed for self-efficacy (F(1,118) = 32.47, p < 0.001), with the intervention group showing a larger increase in self-efficacy scores (+12.3 points) compared to the control group (+3.3 points; Cohen’s d = 0.95). Novelty/Originality of this study: A behaviourally grounded, mobile-enhanced DSME programme produced clinically meaningful metabolic improvement alongside significant gains in self-efficacy. Integrating structured digital self-management support into routine primary care may represent a scalable strategy to strengthen multidisciplinary diabetes management and reduce long-term complication risk.
Copyright (c) 2025 Armah Tengah, Wan Faizah Wan, Hồ Xuân Vĩnh Yusoff, Helmi Sajali, Terasut Sookkumnerd,
Modeling Impact of Perceived Service Quality on Revisit Intention: A Health Information Management Perspective from Primary Care
Purpose of the study: The present investigation was conducted to construct an empirical model explaining how patients intention to return is shaped by multiple dimensions of perceived service quality. Methodology: This research applied a quantitative method using a cross-sectional design to explore the associations among the studied variables at one specific point in time. A total of 75 outpatient respondents participated in the study. Data were gathered through a structured questionnaire consisting of closed questions measured likert scale. Collected responses were processed and analyzed using partial least squares–structural equation modeling (PLS-SEM) with assistance of SmartPLS version 4 to assess the suitability of the measurement model and to examine magnitude relationships among constructs. Main Findings: The analysis confirmed that every construct satisfied the established criteria for reliability and validity. Composite reliability values were all above 0.70, while.average variance extracted.(AVE) for each variable exceeded 0.50, indicating adequate convergent validity. Within the structural model, the independent variables jointly accounted for 68.4% of the variance in patients’ intention to revisit healthcare services (R² = 0.684), demonstrating substantial explanatory capacity. Each hypothesized path showed a positive direction and achieved statistical significance (p < 0.05). Of all examined determinants, service interaction quality emerged as the strongest predictor of revisit intention. Novelty/Originality of this study: The originality research lies in its theoretical contribution, as it broadens the application of the DeLone. and McLean information systems success model by adapting and contextualizing it within a healthcare service setting to better understand patient behavioral intentions.
Copyright (c) 2025 Halimatusa Diah, Martin N Kariuki, Joan S Awingan, John van der Graaf
Health Service Utilization Patterns Among Health Equity Fund Beneficiaries at Khmer-Soviet Friendship Hospital
Purpose of the study: This study aims to analyze health service utilization patterns among Health Equity Fund beneficiaries at the Khmer–Soviet Friendship Hospital (KSFH), Phnom Penh, with a particular focus on the distribution of service types and the role of HEF in facilitating access to advanced healthcare services. Methodology: A descriptive quantitative study was conducted using secondary data obtained from the medical records unit of KSFH. Data were processed through standardized procedures, including editing, coding, processing, and cleaning. Descriptive (univariate) analysis was employed to examine the frequency and percentage distribution of healthcare service utilization across outpatient, inpatient, emergency, surgical, diagnostic, and maternal services. Main Findings: The findings revealed that outpatient services were the most frequently utilized by HEF beneficiaries (38%), followed by inpatient care (26%) and emergency services (18%). Surgical services accounted for 10% of total utilization, with orthopedic and general surgeries being the most common. Diagnostic services (7%) and maternal and child health services (5%) were also accessed, indicating improved access to both essential and specialized care. Novelty/Originality of this study: This study provides novel evidence by systematically mapping HEF beneficiaries’ healthcare utilization patterns at a major national referral hospital using a structured SOFFIIWIER-based data processing framework.
Copyright (c) 2024 Rithea Ngeth, Duy Nguyen-Quang
A Wall Magazine of Postpartum Mothers' Health Literacy on Anemia at the Bangetayu Community Health Center, Genuk District
Purpose of the study: This study aimed to map the level of health literacy related to anemia among postpartum mothers at the Bangetayu Community Health Center, Genuk District, Semarang City, focusing on mothers’ knowledge, understanding, and awareness of anemia prevention and management during the postpartum period. Methodology: A descriptive quantitative study with a cross-sectional design was conducted involving 30 postpartum mothers selected through purposive sampling. Data were collected using a validated and reliable questionnaire consisting of 28 items assessing knowledge of postpartum anemia. Univariate data analysis was performed using SPSS version 21 to generate frequency distributions and percentages. Main Findings: The results showed that most postpartum mothers had a sufficient level of knowledge regarding anemia (76.7%), while 16.7% had good knowledge and 6.7% had poor knowledge. Respondents generally understood the definition, causes, and symptoms of anemia; however, misconceptions persisted regarding iron supplementation duration, nutritional sources of iron, and the long-term impact of anemia on maternal health. Novelty/Originality of this study: This study provides a structured health literacy mapping of postpartum mothers related to anemia at the primary healthcare level, which has rarely been explored in previous studies. The findings offer practical evidence to support the development of targeted, context-based health education interventions to improve postpartum anemia prevention and maternal health outcomes.
Transformation of Hospital Occupational Safety and Health as a Pillar of Medical Personnel Resilience and Patient Safety Quality at St. Ann's Bay Regional Hospital, Ocho Rios
Purpose of the study: This study aims to analyze the effectiveness of K3RS implementation from the aspects of policy, safety facilities, and medical personnel preparedness as the main pillars of improving patient safety and protecting health workers. Methodology: The research method uses a quantitative descriptive approach with survey techniques on medical and health workers, supplemented by data analysis through frequency and percentage distribution. Main Findings: The results of the study indicate that all three aspects of K3RS implementation are in the very good category, indicated by high average scores for regulatory completeness, availability of safety facilities, and a high level of medical personnel preparedness in facing occupational risks. These findings are supported by previous research that confirms that K3RS effectiveness has a direct impact on improving service quality and reducing safety incidents. Novelty/Originality of this study: The novelty of this research lies in the integration of the analysis of medical personnel resilience with patient safety quality in the context of the transformation of the K3RS system after the hospital management reform, which has not been widely explored in previous research