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All Journal Termometer: Jurnal Ilmiah Ilmu Kesehatan Dan Kedokteran Jurnal Ventilator: Jurnal Riset Ilmu Kesehatan dan Keperawatan Antigen: Jurnal Kesehatan Masyarakat dan Ilmu Gizi
M. Agung Rahmadi
Sekolah Tinggi Ilmu Kesehatan Sehati Medan
Dentistry Health Professions Nursing Public Health

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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.
Reconstruction of Mental Health Systems in Post-Revolution States Affected by the Arab Spring M. Agung Rahmadi; Luthfiah Mawar; Risa Ramadhani Br Panjaitan; Saschia Amanda; Clarisha Al Chaira Achmad; Helsa Nasution; Nurzahara Sihombing; Aisyah Umaira
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.v3i4.5616

Abstract

This study provides a comprehensive examination of the impact of the Arab Spring on the reconstruction of mental health systems in five major affected countries — Tunisia, Egypt, Libya, Yemen, and Syria — using a systematic review of 87 Research articles published between 2011 and 2024. The meta-regression analysis indicates a significant increase in the prevalence of mental disorders in the post-revolution period (OR = 2.87, 95% CI: 2.31–3.43, p < .001), with PTSD representing the highest proportion at 38.4%, followed by major depression at 27.6% and anxiety disorders at 24.2%, thus demonstrating a substantial psychopathological burden within the affected populations. Multi-level analysis reveals that countries with the highest levels of mental health infrastructure damage, particularly Libya (78.3%) and Syria (72.6%), experienced a drastic decline in the ratio of mental health professionals per 100,000 inhabitants, decreasing from 7.8 to 2.1, marking a severe limitation in service capacity. These findings expand upon the Research of Spagnolo et al. (2018), which highlighted the impact of conflict on mental health, by introducing an additional dimension concerning the effectiveness of community-based interventions that achieved a 67.8% success rate (p < .01), and by emphasizing the role of social resilience in mitigating psychological distress. Furthermore, unlike Refaat (2014), who focused on individual-level consequences, this Research underscores systemic patterns in the reconstruction of mental health services, with reintegration programs demonstrating a success rate of 58.4% (95% CI: 51.2–65.6%), thereby affirming the importance of holistic and integrated intervention strategies. The novelty of this study lies in the identification of a community resilience-based reconstruction model that demonstrates 73.2% greater effectiveness than conventional approaches, offering a strategically relevant perspective for the development of post-conflict mental health policy and practice in countries affected by the Arab Spring.  
Post-Conflict Trauma Recovery Models in the Middle East: A Comparative Analysis Helsa Nasution; Luthfiah Mawar; M. Agung Rahmadi; Sarah Aisyah Agusti; Lathifa Nurrahmah; Andine Mei Hanny; Nurzahara Sihombing; Dwi Keisya Kurnia
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.v3i4.5617

Abstract

This meta-analysis comprehensively examines the effectiveness of various post-conflict trauma recovery models in the Middle East by analyzing 78 studies involving a total of N=12,467 participants published between 2000 and 2024. The synthesis results indicate three dominant approaches occupying primary positions in intervention frameworks, namely Cognitive Behavioral Therapy (CBT) with an effect size of d=0.82 (95% CI: 0.76–0.88), Eye Movement Desensitization and Reprocessing (EMDR) with d=0.77 (95% CI: 0.71–0.83), and Narrative Exposure Therapy (NET) with d=0.69 (95% CI: 0.63–0.75). Moderator analysis reveals that the variables of intervention duration (β=0.31, p<0.001) and therapist qualification (β=0.28, p<0.001) play significant roles in determining therapeutic success. CBT demonstrates the highest effectiveness in addressing PTSD (r=0.73, p<0.001), whereas NET proves superior in managing collective trauma (r=0.68, p<0.001). Compared to the findings of Knaevelsrud et al. (2015) and Alzaghoul et al. (2022), which previously reported only moderate effectiveness within the range of d=0.45–0.60, this study shows a substantial improvement in trauma intervention outcomes. Furthermore, the latest findings indicate that integrating cultural-spiritual elements into CBT produces a 27% increase in effectiveness (p<0.001), representing a previously undocumented result in earlier meta-analyses and marking an original contribution of this study. Overall, the findings provide a robust empirical foundation for developing trauma intervention protocols that are more contextual, adaptive, and effective in conflict-affected regions.
Construction of Integrated Technology for Physical and Mental Health in Conflict-Affected Middle Eastern Regions : A Confirmatory Factor Analysis of the Dimensions of Digital Innovation, Infrastructure Readiness, User Competency, and Sustainability Luthfiah Mawar; M. Agung Rahmadi; Sal Sabila; Adzra Muzhaffirah; Mutiara Rengganis; Helsa Nasution; Nurzahara Sihombing; Aisyah Umaira
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.v3i4.2114

Abstract

This study offers a comprehensive analysis of the integrated technology construct connecting physical and mental health services in conflict-affected Middle Eastern regions by employing confirmatory factor analysis within a Structural Equation Modelling approach. The research is based on 1,124 documents on digital health technology implementation published between 2017 and 2024 across fourteen countries. The measurement model demonstrates strong goodness-of-fit, evidenced by chi-square/df = 1.847, CFI = 0.971, TLI = 0.965, RMSEA = 0.041, and SRMR = 0.034, thereby confirming the structural soundness of the proposed framework. The analysis identifies four core dimensions—Digital Innovation (lambda = 0.893, CR = 13.672), Infrastructure Readiness (lambda = 0.847, CR = 12.184), User Competency (lambda = 0.819, CR = 11.453), and Sustainability (lambda = 0.865, CR = 12.738)—all significant at p < 0.001. Reliability indices are robust, with Cronbach's Alpha between 0.876 and 0.934, Composite Reliability ranging from 0.891 to 0.947, and Average Variance Extracted between 0.661 and 0.798, indicating strong internal consistency. The findings expand earlier digital health frameworks proposed by Mechael (2009) and Labrique et al. (2013) by emphasizing sustainability as a key component in conflict settings marked by limited resources. In contrast to Aranda-Jan et al. (2014), which addresses general technology adoption, this study underscores specific challenges in integrating both mental and physical health services in humanitarian contexts, thereby responding to the gap highlighted by Naslund et al. (2017) regarding fragmented digital mental health initiatives in crisis environments.
The Role of Community-Based Rehabilitation in the Mental Recovery of Populations in Middle Eastern Conflict Zones: An Outcome Analysis Luthfiah Mawar; M. Agung Rahmadi; Rasil Hakim Hasibuan; Zahra Aliyah Verisah; Dwi Keisya Kurnia; Helsa Nasution; Nurzahara Sihombing; Andieni Pratiwi
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.v3i4.2117

Abstract

This meta-analysis evaluates the effectiveness of Community-Based Rehabilitation (CBR) programs in promoting mental health recovery in communities affected by long-term conflict in the Middle East. Analyzing 47 studies with 12,487 participants published between 2000 and 2024, the research shows significant improvements in mental health, with a large aggregated effect size (g=0.83, 95% CI [0.76, 0.90]). Social support mechanisms were found to mediate 43% of the treatment effect. This study also highlights the importance of culturally adapted CBR, which demonstrated a 27% increase in effect size compared to non-adaptive interventions (g=0.92 vs. g=0.72, p<0.001). Additionally, peer support significantly improved the sustainability of outcomes (OR=2.14, 95% CI [1.87, 2.41]). These findings provide a deeper understanding of the specific factors that contribute to the success of CBR in conflict-affected regions and offer new insights into intervention strategies for mental health recovery.
Analysis of Early Intervention Systems for War-Related Trauma in the Middle East: (A Programmatic Synthesis) Nurzahara Sihombing; M. Agung Rahmadi; Naila Al Madina; Zulpiani Br Sipayung; Khaila Salsabila; Helsa Nasution; Luthfiah Mawar; Andine Mei Hanny
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.v3i4.2128

Abstract

This study critically examines the effectiveness of early intervention programs in addressing war-related trauma in the Middle East by meta-synthesizing forty-seven interventions implemented between 2010 and 2024. The analysis demonstrates that cognitive behavioral therapy (CBT) based interventions achieved a success rate of 78.3 percent with p value less than 0.001 in reducing post-traumatic stress disorder symptoms, with an effect size of d equal to 0.86 indicating substantial therapeutic strength. Group based interventions showed higher effectiveness (83.2 percent) than individual approaches (71.5 percent), and programs involving family support yielded better recovery outcomes (84.7 percent) than those without family involvement (69.3 percent). Regression analysis identified three primary predictors of successful intervention outcomes, namely intervention duration (beta 0.42, p value less than 0.001), therapist cultural competence (beta 0.38, p value less than 0.001), and the integration of social support systems (beta 0.35, p value less than 0.001). These findings expand on prior studies by Ennis et al. (2020) and Mawar et al. (2025), which were limited to evaluating CBT effectiveness, and also reinforce the significance of cultural dimensions and social support systems as critical determinants. In contrast to the meta analysis by Nocon et al. (2017), which reported an effectiveness rate of 65 percent for individual interventions, the present study reveals the superiority of group based approaches in communal Middle Eastern societies. The novelty of this study lies in its comprehensive identification of culturally sensitive determinants of early intervention success and the formulation of an integrative model positioning family support as an essential component in protocols for war-related trauma care.
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 Adzra Muzhaffirah Aisyah Umaira Andieni Pratiwi Andine Mei Hanny Andine Mei Hanny Annisa Ardianti Br Tarigan Clarisha Al Chaira Achmad Dwi Keisya Kurnia Helsa Nasution Helsa Nasution Helsa Nasution Isnaini Fajarwati Khaila Salsabila Lathifa Nurrahmah Liza Adilia Pury Luthfiah Mawar Luthfiah Mawar Luthfiah Mawar Mutiara Rengganis Naila Al Madina Naura Aqilah Rizal Nazwa Aqela Saragih Nurzahara Sihombing Rasil Hakim Hasibuan Risa Ramadhani Br Panjaitan Riska Wahyuni Hasibuan Sal Sabila Sarah Aisyah Agusti Saschia Amanda Wilda Simangunsong Zahra Aliyah Verisah Zulpiani Br Sipayung