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Bridging the Digital Divide: A Mixed-Methods Evaluation of the Efficacy, Accessibility, and Impact of Web-Based Mental Health First Aid Training for Community Health Volunteers (Kader) in Rural Indonesia Zahra Amir; Ni Made Nova Indriyani; Iis Sugandhi; Husin Sastranagara; Muhammad Rusli; Wisnu Wardhana Putra
Indonesian Community Empowerment Journal Vol. 5 No. 2 (2025): Indonesian Community Empowerment Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/icejournal.v5i2.46

Abstract

Significant disparities in mental health service access persist in rural Indonesia, where community health volunteers (known as Kader) represent a vital but undertrained resource. Digital training platforms offer a scalable solution to build mental health literacy, yet their efficacy and accessibility in low-resource, digitally diverse settings remain under-evaluated. This study aimed to evaluate the efficacy, accessibility, and user experience of a novel, web-based Mental Health First Aid (MHFA) training program for Kader in rural Indonesia. We employed a convergent parallel mixed-methods design with a single-group, pre-test/post-test framework. A total of 165 Kader from 15 rural districts across North Sumatra, West Sumatra, and South Sumatra provinces were recruited. Participants completed a 4-week, self-paced, web-based MHFA course. Quantitative data were collected using the Mental Health Knowledge Questionnaire (MHKQ), the Community Attitudes toward the Mentally Ill (CAMI) scale, and the System Usability Scale (SUS) at baseline and post-intervention. Qualitative data were gathered through semi-structured focus group discussions (FGDs) with a purposive subsample of 32 participants to explore user experience and perceived impact. The intervention yielded a highly significant improvement in mental health knowledge, with mean MHKQ scores increasing from 48.5 (SD=10.2) at pre-test to 89.7 (SD=8.8) at post-test (t(164) = -35.1, p < 0.001). Stigmatizing attitudes significantly decreased, as reflected by an increase in mean CAMI scores from 55.3 (SD=12.5) to 81.4 (SD=11.9) (t(164) = -18.9, p < 0.001). The platform's usability was rated favorably, with a mean SUS score of 81.2 (SD=13.4), indicating excellent user-friendliness. Qualitative analysis revealed three primary themes: (1) Digital Empowerment and Overcoming Barriers; (2) Cultural Resonance and Practical Skill Acquisition; and (3) The Emergence of a Supported Community of Practice. In conclusion, web-based MHFA training is an effective, accessible, and well-accepted modality for empowering Kader in rural Indonesia. This digital approach successfully bridges geographical and educational divides, significantly enhancing mental health literacy and reducing stigma. Scaling this model holds immense potential for strengthening community-based mental health services and narrowing the treatment gap in Indonesia and similar low- and middle-income countries.
Modulation of the Cognition–Sleep Nexus in Subjective Cognitive Decline: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial of a Standardized Cordyceps militaris Extract Vita Amanda; Daphne Marshall; Zahra Amir; Husin Sastranagara; Danniel Hilman Maulana; Karina Chandra; Fachrudin Sani
Eureka Herba Indonesia Vol. 6 No. 2 (2025): Eureka Herba Indonesia
Publisher : HM Publisher in collaboration with CMHC Research Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ehi.v6i2.130

Abstract

Background: Subjective cognitive decline (SCD) and sleep disturbance form a self-reinforcing cycle that accelerates neurodegeneration. Cordyceps militaris (CM), a medicinal fungus rich in nucleosides, has neuroprotective and adenosinergic (sleep-promoting) properties. Objective: To evaluate the efficacy of a standardized CM extract on the cognition–sleep nexus in adults with SCD. Methods: In a 12-week, single-center, randomized, double-blind, placebo-controlled, parallel-group trial in Palembang, Indonesia, 120 adults aged 45–65 years with SCD received 300 mg/day of a standardized CM mycelial extract (3% cordycepin) or matching placebo. The primary outcome was change in the Montreal Cognitive Assessment–Indonesian (MoCA-INA) score. Bonferroni-corrected key secondary outcomes were the Pittsburgh Sleep Quality Index (PSQI), Rey Auditory Verbal Learning Test (RAVLT) delayed recall and polysomnography-derived sleep efficiency (SE). Intention-to-treat analyses used a linear mixed-effects model (LMM). Results: A significant group-by-time interaction favored CM for MoCA-INA (adjusted mean difference [AMD] +1.95; 95% confidence interval [CI] 1.10, 2.80; p < 0.001). All three key secondary outcomes improved: PSQI (AMD −2.90; 95% CI −3.81, −1.99), RAVLT delayed recall (AMD +2.15; 95% CI 1.30, 3.00) and SE (AMD +5.8%; 95% CI 3.1, 8.5); all p < 0.001. After false discovery rate (FDR) correction, benefits were also seen for processing speed, rapid eye movement (REM) sleep percentage, serum brain-derived neurotrophic factor (BDNF) and high-sensitivity C-reactive protein (hs-CRP). The extract was well tolerated. Conclusion: Twelve weeks of standardized C. militaris extract improved cognitive function, episodic memory and both subjective and objective sleep in adults with SCD, with changes in neuroplasticity and inflammation markers consistent with a multi-target mechanism.
Participant-Wise Validation of Transcript-Only Models for Adolescent Depression and Anxiety Triage in MMPsy Winata Putri; Mischa Chantal Adella; Agnes Mariska; Husin Sastranagara
Scientia Psychiatrica Vol. 7 No. 4 (2026): Scientia Psychiatrica
Publisher : HM Publisher in collaboration with CMHC Research Center

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background. Digital interviews may offer scalable signals for identifying adolescents needing further assessment, but language models can appear accurate because of participant leakage, response length, or tuning-data evaluation. Objective. To develop and internally validate transcript-only probabilistic models of Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) screening positivity in the Multi-Modal Psychological Assessment (MMPsy) corpus and quantify incremental performance beyond response length. Methods. This secondary prediction-modeling study used 1,275 participants with Mandarin transcripts and complete PHQ-9 and GAD-7 scores. Transcripts were represented by term frequency-inverse document frequency character 2–4-grams and modeled with elastic-net logistic regression. Five-fold outer cross-validation estimated performance in unseen participants; four-fold inner cross-validation selected penalization, fitted Platt calibration, and set fold-specific thresholds targeting 0.80 sensitivity. Comparators were response length and training-fold prevalence. Intervals used 2,000 participant bootstraps. Results. Screening positivity occurred in 258 (20.2%) PHQ-9 and 136 (10.7%) GAD-7 participants. Transcript areas under the receiver operating characteristic curve were 0.791 (95% confidence interval 0.761–0.820) for PHQ-9 and 0.822 (0.784–0.857) for GAD-7; precision-recall areas were 0.453 and 0.356. Calibration intercepts were 0.02 and −0.02; slopes were 1.10 for both. At sensitivity-directed thresholds, sensitivity was 81.4% and 80.1%, positive predictive value 36.1% and 23.5%. Improvements over response length were small and uncertain. Decision-curve patterns favored transcript content more consistently for GAD-7 than PHQ-9. Conclusion. Participant-wise transcript models identified screening positivity with useful internal ranking and high negative predictive values, but incremental value and clinical utility were outcome-dependent. External, prospective, subgroup, and workflow validation are required before operational use.