The Effectiveness of Self-Help Group (SHG) Intervention on Smoking Prevention of Adolescents in Aceh, Indonesia: A Controlled Field Trail.

OBJECTIVE: This study aims to examine the effectiveness of the Self-Help Group (SHG) intervention in smoking prevention among adolescents. METHODS: This study was carried out in 2 Junior High Schools in Aceh Besar using a quasi-experimental method, which was conducted in the intervention and the control groups with a pre-post design. The number of samples was determined based on power analysis with medium effect size and power (0.08) with 40 respondents per group. After randomizing the schools, a total of 40 students who met the criteria were randomly selected for each school. The data were collected by using a self-report questionnaire, consisting of knowledge, as well as smoking attitudes, intentions, and behavior. The SHG intervention consist of 6 sessions, each of which was conducted per week with a duration of 40-60 minutes per session. The data were analyzed using descriptive and inferential statistics. RESULTS: The results of statistical tests using the Mann-Whitney and t-test showed that there was an effect of the SHG intervention on knowledge (p-value 0.043), attitude (p-value 0.001), intention (p-value 0.029), and behavior (p-value 0.003). The average score of knowledge was higher in the SHG intervention group than in the control group, while the average score of attitude, smoking intention and behavior was lower in the SHG intervention group than in the control group. CONCLUSION: Health practitioners, specifically community nurses are suggested to implement SHG interventions as one of the strategies for preventing smoking among adolescents.

Effects of the World Health Organization Safe Childbirth Checklist on Quality of Care and Birth Outcomes in Aceh, Indonesia: A Cluster-Randomized Clinical Trial.

Importance: To address major causes of perinatal and maternal mortality, the World Health Organization developed the Safe Childbirth Checklist (SCC), which to our knowledge has been rigorously evaluated only in combination with high-intensity coaching. Objective: To evaluate the effect of the SCC with medium-intensity coaching on health care workers' performance of essential birth practices. Design, Setting, and Participants: This cluster randomized clinical trial without blinding included 32 hospitals and community health centers in the province of Aceh, Indonesia (a medium-resource setting) that met the criterion of providing at least basic emergency obstetric and newborn care. Baseline data were collected from August to October 2016, and outcomes were measured from March to April 2017. Data were analyzed from January 2020 to October 2021. Interventions: After applying an optimization method, facilities were randomly assigned to the treatment or control group (16 facilities each). The SCC with 11 coaching visits was implemented during a 6-month period. Main Outcomes and Measures: For the primary outcome, clinical observers documented whether 36 essential birth practices were applied at treatment and control facilities at 1 or more of 4 pause points during the birthing process (admission to the hospital, just before pushing or cesarean delivery, soon after birth, and before hospital discharge). Probability models for binary outcome measures were estimated using ordinary least-squares regressions, complemented by Firth logit and complier average causal effect estimations. Results: Among the 32 facilities that participated in the trial, a significant increase of up to 41 percentage points was observed in the application of 5 of 36 essential birth practices in the 16 treatment facilities compared with the 16 control facilities, including communication of danger signs at admission (treatment: 136 of 155 births [88%]; control: 79 of 107 births [74%]), measurement of neonatal temperature (treatment: 9 of 31 births [29%]; control: 1 of 20 births [5%]), newborn feeding checks (treatment: 22 of 34 births [65%]; control: 5 of 21 births [24%]), and the rate of communication of danger signs to mothers and birth companions verbally (treatment: 30 of 36 births [83%]; control: 14 of 22 births [64%]) and in a written format (treatment: 3 of 24 births [13%]; control: 0 of 16 births [0%]). Conclusions and Relevance: In this cluster randomized clinical trial, health facilities that implemented the SCC with medium-intensity coaching had an increased rate of application for 5 of 36 essential birth practices compared with the control facilities. Medium-intensity coaching may not be sufficient to increase uptake of the SCC to a satisfying extent, but it may be worthwhile to assess a redesigned coaching approach prompting long-term behavioral change and, therefore, effectiveness. Trial Registration: isrctn.org Identifier: ISRCTN11041580.

Mental distress and its association with sociodemographic and economic characteristics: community-based household survey in Aceh, Indonesia.

BACKGROUND: The role of sociodemographic and economic characteristics in mental distress has been rarely investigated in Indonesia. AIMS: To investigate the prevalence of common mental disorders (CMD) and identify any associations between mental distress and sociodemographic and economic characteristics among communities living in urban and rural (peri-urban) areas. METHOD: A community-based household survey was conducted in the province of Aceh, Indonesia, in 2018. The 20-item Self Reporting Questionnaire (SRQ-20) screening tool was used to measure symptoms of CMD. Information on sociodemographic characteristics, family functioning, labour market outcomes and healthcare costs was collected. Multivariate regressions were conducted to analyse the relationships between the measures of mental distress and sociodemographic and economic characteristics. RESULTS: We found that 14% of the respondents had CMD symptoms. SRQ-20 scores were higher for female, older and lower-educated individuals. CMD prevalence was higher among non-married participants and clustered within families. Participants with CMD perceive their families as performing significantly better in the dimensions of affective involvement and behaviour control compared with their counterparts. Their work was more often affected by negative feelings; they were also twice as likely to report a recent physical or mental health complaint and faced twice the treatment costs compared with their non-affected counterparts. CONCLUSIONS: The prevalence of mental disorders is especially high in disadvantaged population groups. Moreover, mental distress is associated with a lower perceived productivity and a higher physical health burden.