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All Journal Termometer: Jurnal Ilmiah Ilmu Kesehatan Dan Kedokteran Jurnal Ventilator: Jurnal Riset Ilmu Kesehatan dan Keperawatan Jurnal Riset Ilmu Kesehatan Umum dan Farmasi Antigen: Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Annisa Ardianti Br Tarigan
Universitas Islam Negeri Sumatera Utara
Dentistry Health Professions Nursing Public Health

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Development of a Culturally Grounded Trauma Assessment Protocol in the Middle Eastern Context Luthfiah Mawar; M. Agung Rahmadi; Luthfiyah Aqilah Siagian; Sasa Maghfirah Siregar; Andieni Pratiwi; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 4 (2025): Oktober : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i4.885

Abstract

This study systematically evaluates and develops a trauma assessment protocol based on local cultural contexts through a review and meta-analysis of 87 studies published between 2000 and 2023. Using JASP 0.16.1 and Comprehensive Meta-Analysis V3, results revealed a significant effect size (d = 0.78, 95% CI [0.65, 0.91], p < 0.001), indicating that culturally grounded protocols are more valid than conventional ones. Meta-regression analysis showed that cultural sensitivity accounted for 42.3% of improvements in diagnostic accuracy (β = 0.423, SE = 0.089, p < 0.001), highlighting the importance of cross-cultural understanding in assessment design. Moderator analysis identified three key factors influencing protocol effectiveness: knowledge of local cultural contexts (Q = 24.31, df = 3, p < 0.001), use of culturally appropriate language (Q = 18.76, df = 2, p < 0.001), and involvement of community leaders (Q = 15.92, df = 2, p < 0.001). The study’s heterogeneity was moderate (I² = 68.5%, τ² = 0.142), reflecting variations in implementation. These findings build on prior work by Alarcón et al. (2009) and Jackson et al. (2017), reinforcing the importance of integrating cultural values into trauma assessments. The results demonstrate a more adaptive, systematic framework with significant improvements in predictive validity (AUC = 0.89 compared to 0.76 in non-cultural protocols). This meta-analysis contributes significantly to developing trauma assessment protocols that are more culturally responsive, offering strong empirical evidence for integrating cultural elements into clinical practice.
An Early Warning Framework for Mental Health Crises in Conflict-Affected Areas of the Middle East Luthfiah Mawar; M. Agung Rahmadi; Sri Rahayu Sukirman; Nur Suci Ramadhani; Putri Widia Ramadhani Rambe; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi Vol. 3 No. 4 (2025): November: Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/antigen.v3i4.886

Abstract

This study examines the effectiveness of the Early Warning System (EWS) in anticipating and responding to mental health crises in conflict-affected regions of the Middle East through a systematic review of 47 scholarly articles published between 2014 and 2024. The meta-regression findings indicate a significant contribution of EWS implementation to the reduction of post-traumatic stress disorder (PTSD) symptoms with a coefficient of β = -0.67 (p < .001), as well as depressive symptoms with a coefficient of β = -0.59 (p < .001) among populations directly affected by armed conflict. Among 12,456 respondents analysed, 73.8% reported a reduction in anxiety symptoms following the implementation of EWS, with an effect size of d = 0.82 (95% CI [0.76, 0.88]). Digitally based early warning systems demonstrated a significantly higher level of effectiveness (OR = 2.34, 95% CI [1.98, 2.70]) than conventional systems, which are more manual and reactive. Moderator analysis indicated that age (β = -0.31, p < .01) and the duration of exposure to conflict (β = 0.44, p < .001) play important roles in moderating the relationship between EWS interventions and various mental health indicators. These findings expand upon the conclusions of Fu et al. (2020) and Salesi (2023), which previously explored psychosocial interventions in conflict zones, by adding a new dimension—examining digital technology and predictive algorithms within EWS frameworks. The study explicitly demonstrates that integrating machine learning models into EWS can enhance the predictive accuracy of potential mental health crises to 84.6%, representing a novel contribution that has not been comprehensively documented in prior academic literature
Community Based Prevention Strategies for Collective Trauma in Conflict Zones of the Middle East M. Agung Rahmadi; Luthfiah Mawar; Liza Adilia Pury; Naura Aqilah Rizal; Wilda Simangunsong; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi Vol. 3 No. 4 (2025): November: Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/antigen.v3i4.926

Abstract

This meta-analysis provides an in-depth examination of the effectiveness of community-based interventions in alleviating collective trauma experienced by populations in conflict zones of the Middle East, compiling 47 empirical studies (N = 12,483) published between 2000 and 2023. The synthesis indicates a significant impact of community-based interventions on reducing PTSD symptoms, with a substantial effect size (d = 0.82, 95% CI [0.76, 0.88], p < .001) and moderate heterogeneity (I² = 68%), reflecting inter-study variation yet remaining within interpretable bounds. Among the strategies analysed, community psychosocial support programs demonstrated the most pronounced effectiveness (β = 0.74, p < .001), followed by collective narrative therapy (β = 0.68, p < .001) and family-based rehabilitation interventions (β = 0.59, p < .001), all underscoring the relevance of approaches rooted in social networks and interpersonal relations. Moderator analyses revealed that longer program duration, particularly interventions spanning at least 6 months (β = 0.71, p < .001), and active engagement of local leaders (β = 0.65, p < .001) were critical determinants of intervention success. Furthermore, meta-regression findings indicated a strong and consistent correlation between the intensity of community involvement and reductions in collective trauma symptoms (R² = 0.73, p < .001), highlighting that social participation is not merely complementary but constitutes the foundation of program efficacy. In the researchers' view, these findings extend the contributions of prior studies by Hassan et al. (2016) and Morrison & Marrison (2024) by affirming the central role of local wisdom in trauma recovery processes, while offering a conceptual contribution in the form of an integrative framework that merges psychosocial interventions with community cultural values. Consequently, these results provide not only an empirical basis for developing more effective trauma-healing programs in Middle Eastern conflict zones but also underscore the urgency of contextual adaptation to ensure that interventions meet the most essential needs of affected populations.
Mobile Health Applications for Trauma Management in the Middle East Region Helsa Nasution; M. Agung Rahmadi; Rima Melati; Dinda Nurfadhilah; Siti Padila; Luthfiah Mawar; Nurzahara Sihombing; Sarah Mawaddah; Annisa Ardianti Br Tarigan
Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi Vol. 4 No. 1 (2026): February: Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/antigen.v4i1.963

Abstract

This meta-analysis assesses the effectiveness of mobile health (mHealth) applications in trauma management in the Middle East region, based on a systematic review of 47 empirical studies with a total of 12,486 participants published between 2015 and 2024. The quantitative synthesis results indicate that implementing mHealth has a statistically significant impact on improving trauma management, with a strong pooled effect size (g=0.78, 95% CI [0.65, 0.91], p<.001). Subgroup analyses reveal that the highest effectiveness is observed in interventions targeting Post-Traumatic Stress Disorder (PTSD) (g=0.86), followed by physical trauma management (g=0.74) and general psychological trauma (g=0.69). Further meta-regression findings identify the duration of application use (β=0.42, p<.001) and the level of intervention personalization (β=0.38, p<.01) as significant moderators influencing the magnitude of intervention effects. From an implementation perspective, user engagement reached 76.4%, and the retention rate was 68.2% after 6 months of use. Clinical outcome analyses demonstrate a significant reduction in PTSD scores with a mean difference of -14.6 points (p<.001) as well as a substantial improvement in quality of life (d=0.82). Comparatively, these findings extend the results of Goreis et al. (2020) and Kayrouz et al. (2018) by delineating more specifically the effectiveness of interventions in Middle Eastern populations. However, they differ from Yeager and Benight (2018) regarding the optimal duration of use. The principal contribution of this study lies in elucidating the central role of cultural adaptation, which shows a strong correlation with the effectiveness of mHealth applications (r=0.56, p<.001) in the context of trauma management in the Middle East.
Preventive Mental Health Programs for Children in Middle Eastern War Zones Luthfiah Mawar; M. Agung Rahmadi; Annisa Ardianti Br Tarigan; Kiki Asnanti; Siti Nurfaiza; Helsa Nasution; Nurzahara Sihombing; Rasil Hakim Hasibuan
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 4 (2025): Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran,
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i4.5615

Abstract

This meta-review presents a comprehensive analysis of the effectiveness of preventive mental health programs targeting children growing up in Middle Eastern conflict zones, systematically examining 47 studies (N=12,487 children) published between 2000 and 2024. The meta-analysis indicates that school-based preventive interventions produce a significant positive impact in reducing the intensity of post-traumatic stress disorder (PTSD) symptoms (d=0.72, 95% CI [0.65, 0.79]), anxiety (d=0.68, 95% CI [0.61, 0.75]), and depression (d=0.64, 95% CI [0.57, 0.71]). Furthermore, programs integrating cognitive-behavioral approaches with social support demonstrated the highest effectiveness (R²=0.83, p<0.001), with recovery rates among children reaching 73.4% compared to control groups. In addition, active parental participation in interventions significantly enhanced children's resilience (β=0.56, p<0.001) compared to programs implemented without parental involvement (β=0.34, p<0.05). These findings extend the contributions of earlier studies, particularly those by Altawil et al. (2023) and Sullivan & Simonson (2016), which primarily focused on the trauma dimension, by identifying fundamental components of effective preventive programs and their therapeutic mechanisms of change. This meta-review also affirms that integrating local wisdom, community traditions, and embedded cultural values into interventions can enhance program effectiveness by up to 47%, a crucial dimension that has not been previously examined in depth in the related literature.  
Reconstruction Strategies for Mental Health Services in Post-Conflict Middle Eastern Regions: (A Policy Synthesis) Helsa Nasution; M. Agung Rahmadi; Nazwa Aqela Saragih; Isnaini Fajarwati; Riska Wahyuni Hasibuan; Luthfiah Mawar; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Jurnal Ventilator Vol. 3 No. 4 (2025): Jurnal Ventilator
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ventilator.v3i4.2129

Abstract

This study presents a comprehensive analysis of reconstruction strategies for mental health services in post-conflict regions of the Middle East, based on a meta-synthesis of 87 policies and intervention programs issued between 2010 and 2023. The findings indicate that 73.4 percent of initiatives did not meet their intended targets due to infrastructural limitations, resulting in a service dropout rate of 62.8 percent. The implementation of the Stepped Care Model shows a 47.2 percent improvement in service access (p = 0.001), while the integration of mental health services into primary health care systems increases overall coverage by 56.3 percent (p = 0.001). Task shifting to community health workers enhances efficiency by 38.9 percent (p = 0.01) with a cost-effectiveness ratio of 1 to 2.7, and community-based programs demonstrate a sustainability rate of 71.2 percent compared to 43.5 percent in conventional approaches. These findings build upon the work of Hamamra et al. (2025) and Werner et al. (2023) on post-conflict mental health interventions and show that hybrid models combining formal and informal structures yield better performance, with an effect size (Cohen's d) of 0.82. The main contribution of this study lies in identifying adaptive implementation patterns that align with resource limitations, socio-cultural dynamics, and systemic reconstruction needs in post-conflict settings.
Co-Authors Andieni Pratiwi Dinda Nurfadhilah Helsa Nasution Helsa Nasution Helsa Nasution Isnaini Fajarwati Kiki Asnanti Liza Adilia Pury Luthfiah Mawar Luthfiah Mawar Luthfiah Mawar Luthfiyah Aqilah Siagian M. Agung Rahmadi M. Agung Rahmadi M. Agung Rahmadi Naura Aqilah Rizal Nazwa Aqela Saragih Nur Suci Ramadhani Nurzahara Sihombing Putri Widia Ramadhani Rambe Rasil Hakim Hasibuan Rima Melati Riska Wahyuni Hasibuan Sarah Mawaddah Sasa Maghfirah Siregar Siti Nurfaiza Siti Padila Sri Rahayu Sukirman Wilda Simangunsong