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Intan Zainafree, Intan
Jurusan Ilmu Kesehatan Masyarakat Fakultas Ilmu Keolahragaan Universitas Negeri Semarang Gedung F1, Lantai 2, Kampus Sekaran, Gunungpati, Semarang
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Factors of Diabetic Retinopathy among Type 2 Diabetes Mellitus Patients in Central Java Province, Indonesia Casmuti, Casmuti; Zainafree, Intan; Cahyati, Widya Hary; Ningrum, Dina Nur Anggraini; Saefurrohim, Muhamad Zakki; Hakam, Abdul; Zaimatuddunia, Irma; Prasetya, Henky Yoga; Jusran, Alek; Irsam, Muhamad
Unnes Journal of Public Health Vol. 14 No. 1 (2025)
Publisher : Universitas Negeri Semarang (UNNES) in cooperation with the Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/ujph.v14i1.16126

Abstract

One of the microvascular complications of type 2 diabetes mellitus is diabetic retinopathy. The prevalence of diabetes mellitus in Central Java Province in 2022 by 10% increased to 12.52% in the third quarter of 2023. This prevalence rate has not reached the SDG's target, namely there is no increase in diabetes prevalence by 0%. The purpose of this study is to analyze factors associated the incidence of diabetic retinopathy in type 2 DM patients at Central Java Provincial Hospital in 2023. This research is quantitative research with a nested case control study design, using electronic medical record data from the Central Java Provincial Hospital in 2023. The variables in this study were gender, age, education level, employment status, marital status, health insurance status, BMI, DM diet, duration of DM, hypertension, other diseases, current blood glucose, and HbA1c. The analysis used was univariate, bivariate, and multivariate analysis (logistic regression). The results showed that there was association between age ≥70 years (p=0.006), DM diet (p<0.0001, OR=20.914), duration of DM (p=0.003, OR=3.010), hypertension (p=0.013, OR=2.619), other diseases including cataracts (p=0.040, OR=9.00), glaucoma (p=0.007), CHD (p=0.040, OR=9.00), and cardiomegaly (p=0.016), current blood glucose (p=0.045, OR=2.478), and HbA1c (p<0.0001, OR=6.152). DM diet is the most dominant factor associated with diabetic retinopathy in type 2 DM patients. 
STUDI KOMPARATIF IMPLEMENTASI KEBIJAKAN PEMBERIAN ASI EKSKLUSIF DI PUSKESMAS JEPANG DAN PUSKESMAS DAWE KABUPATEN KUDUS Oktabella, Zulvaida Haditya; Cahyati, Widya Hary; Zainafree, Intan
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 2 (2025): AGUSTUS 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i2.48980

Abstract

Pada tahun 2023, cakupan pemberian ASI eksklusif untuk bayi usia 0–6 bulan di Kabupaten Kudus mencapai 46,8%, dengan capaian tertinggi di Puskesmas Dawe sebesar 90,9% dan terendah di Puskesmas Jepang sebesar 19,7%. Penelitian ini bertujuan untuk menganalisis perbedaan pelaksanaan kebijakan pemberian ASI eksklusif di wilayah kerja Puskesmas Jepang dan Puskesmas Dawe, Kabupaten Kudus. Pada Mei hingga Juni 2025 penelitian ini dilakukan di kedua puskesmas tersebut dengan menggunakan pendekatan kualitatif dan desain deskriptif. Sebanyak 12 informan ditetapkan menggunakan teknik purposive sampling. Pedoman wawancara, observasi, dan dokumentasi digunakan untuk pengumpulan data, sementara teknik triangulasi digunakan untuk keabsahan data. Hasil penelitian menunjukkan adanya perbedaan implementasi kebijakan pemberian ASI eksklusif di Puskesmas Jepang dan Puskesmas Dawe, di mana komunikasi telah berjalan efektif melalui kegiatan sosialisasi, namun cakupan serta kejelasan informasi yang disampaikan masih terbatas. SDM dan fasilitas seperti ruang laktasi tersedia, tetapi pemanfaatannya rendah dan petugas merangkap tugas lain. Kebijakan ASI eksklusif belum didukung SOP dan pembagian tugas belum terstruktur, perlu diikuti peningkatan kapasitas tenaga kesehatan dan koordinasi lintas sektor. Petugas menunjukkan komitmen tinggi dan ramah, meski pemahaman kebijakan belum merata. Dukungan dari keluarga dan tenaga kesehatan cukup baik, tetapi hambatan sosial budaya dan kesadaran masyarakat masih variatif. Simpulan dari penelitian ini adalah terdapat perbedaan implementasi kebijakan ASI Eksklusif di Puskesmas Jepang dan Puskesmas Dawe.
Perceptions and beliefs of adolescent girls regarding adherence to iron supplementation: An analysis using the health belief model Kamal Agus Efendi; Ari Yuniastuti; Intan Zainafree
Nursing and Health Sciences Journal (NHSJ) Vol. 5 No. 3 (2025): September 2025
Publisher : KHD-Production

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53713/nhsj.v5i3.570

Abstract

Iron deficiency anemia in adolescent girls is a significant public health issue with a high prevalence. Despite the government's launch of the Nutritious Action Program to tackle this problem, its effectiveness is still hindered by low adherence to Iron and Folic Acid (IFA) tablet consumption among adolescents. This qualitative study aims to analyze the factors influencing adherence to IFA tablet consumption in adolescent girls from the Health Belief Model (HBM) perspective. Using a case study design, this research collected data through in-depth interviews with four adolescent girls, one parent, and an expert from IAKMI Kudus. Data analysis was conducted interactively by identifying key themes relevant to the HBM components. The results show that adherence is influenced by the complex interaction of the six HBM components. Adolescents have a good perception of their susceptibility to and the severity of anemia, but this is not enough to overcome the perceived barriers. Physical barriers, such as side effects like nausea, dizziness, and unpleasant taste, are the strongest predictors of non-adherence. Adherence is highly dependent on external cues, such as supervision from teachers and parents, with behavioral differences observed between students living in boarding schools and those who are not. This study concludes that successful interventions must go beyond merely providing IFA tablets. A comprehensive strategy is needed to strengthen adolescents' self-efficacy to overcome barriers and ensure continuous social support from schools and families to achieve sustainable dietary behavior changes.
Evaluasi Program Rumah Pelita Daycare Sekar Kasih sebagai Salah Satu Upaya Zero Stunting di Wilayah Kerja Puskesmas Sekaran Puspita, Nabila; Zainafree, Intan
Malahayati Nursing Journal Vol 7, No 10 (2025): Volume 7 Nomor 10 (2025)
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v7i10.18316

Abstract

 ABSTRACT Stunting is one of the nutritional problems that still occurs in many developing countries, including Indonesia. Stunting is a condition where children grow smaller than their peers. Children are said to be stunted if they have a Z-Score value of less than -2 SD to -3 SD which means they are stunted, and less than -3 SD indicates severely stunted children. Stunting globally in 2022 has a prevalence of 22.3% or 148.1 million children under 5 years old experiencing stunting conditions. This study aims to evaluate the Rumah Pelita Daycare Sekar Kasih program as a special daycare for stunted children by improving parenting and child feeding patterns by the Semarang City Government. This research uses a qualitative approach with a case study design. The informants in this study consisted of 4 main informants and 8 triangulation informants. The instruments used in this research are interview guidelines and documentation. The results showed that the Input aspect in the implementation of this program was good. The Process aspect is still not maximally implemented, one of which is due to incomplete infrastructure. The Output aspect is declared good because Sekar Kasih Daycare has graduated 14 children from stunting. The conclusion of this study is that Daycare Sekar Kasih staff can increase their efforts in attracting parents with stunted children to register with Daycare Sekar Kasih. Another suggestion is that the Semarang City Government is expected to make a law or permanent regulation that can be used to regulate and supervise the implementation of the Rumah Pelita Daycare program as a whole. Keywords: Daycare, Stunting, Evaluation  ABSTRAK  Stunting merupakan salah satu permasalahan gizi yang masih banyak terjadi di berbagai negara berkembang, tak terkecuali Indonesia. Stunting adalah keadaan dimana anak tumbuh lebih kecil dibandingkan dengan anak seusianya. Anak dikatakan stunting apabila anak memiliki nilai Z-Score yang kurang dari -2 SD hingga -3 SD yang berarti menunjukkan anak pendek (stunted), dan kurang dari -3 SD menunjukkan anak sangat pendek (severely stunted). Stunting secara global pada tahun 2022 memiliki prevalensi sebanyak 22,3% atau 148,1 juta anak dibawah 5 tahun mengalami kondisi stunting. Penelitian ini bertujuan untuk mengevaluasi program Rumah Pelita Daycare Sekar Kasih sebagai tempat penitipan anak khusus untuk anak-anak stunting dengan memperbaiki pola asuh dan pola pemberian makan anak yang dilakukan oleh Pemerintah Kota Semarang. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Informan dalam penelitian ini terdiri dari 4 informan utama dan 8 informan triangulasi. Instrumen yang digunakan dalam penelitian ini yaitu pedoman wawancara dan dokumentasi. Hasil penelitian menunjukkan aspek Input (masukan) dalam pelaksanaan program ini sudah baik. Aspek Process (proses) masih belum terlaksana dengan maksimal yang salah satunya disebabkan karena sarana prasarana yang belum lengkap. Aspek Output (keluaran) dinyatakan baik karena telah Daycare Sekar Kasih meluluskan 14 anak dari stunting. Kesimpulan dari penelitian ini yaitu petugas Daycare Sekar Kasih dapat meningkatkan meningkatkan upaya mereka dalam menarik orangtua dengan anak-anak stunting untuk mendaftar ke Daycare Sekar Kasih. Saran lainnya yaitu Pemerintah Kota Semarang diharapkan membuat undang-undang atau peraturan tetap yang dapat digunakan untuk mengatur dan mengawasi pelaksanaan program Daycare Rumah Pelita secara menyeluruh. Kata Kunci: Daycare, Stunting Evaluasi
Service Quality Perception and Service Satisfaction of COVID-19 Vaccination in Indonesia: A Participants Vaccination Perspective Zainafree, Intan; Maharani, Chatila; Indrawati, Fitri; Wahyono, Bambang; Syukria, Nadia; Patriajat, Maria M. Rosaria; Hakam, Mohammad Abdul; Defi, Rahma; Suhito, Hanif Pandu
Jurnal Kesehatan Masyarakat Vol. 20 No. 4 (2025)
Publisher : Universitas Negeri Semarang in collaboration with Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI Tingkat Pusat) and Jejaring Nasional Pendidikan Kesehatan (JNPK)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v20i4.23600

Abstract

The COVID-19 vaccine is a crucial effort to break the chain of transmission of COVID-19. To achieve optimal, effective, and efficient results in community program implementation, monitoring and evaluation are essential. The purpose of this study was to evaluate the implementation of COVID-19 vaccination in Semarang. So, it was known that service quality perception, service satisfaction, and willingness to recommend vaccination to others. This study is an analytic observational study with a cross-sectional design in 2022. The total number of respondents was 512 people. Data collection was carried out directly by visiting respondents who had received COVID-19 vaccinations at public health centers and vaccination centers. The data obtained is then processed and analyzed with the final model using Binary Logistic Regression. Respondents with basic education (4.67 ± 0.449) and those using the collective registration mechanism (4.51 ± 0.495) showed a positive correlation with perceived service quality. Of the 9 procedural suitability items, 4 received higher satisfaction scores: staff asking about regular medication use (4.41 ± 0.612), confirmed COVID-19 history (4.42 ± 0.598), close contact history (4.42 ± 0.609), and post-vaccination observation for side effects (4.43 ± 0.608), all with p-value < 0.05. Overall, respondents were satisfied with the service quality, with 26.5% willing to recommend vaccination to others. This indicates that the COVID-19 vaccination service is running effectively and appropriately.
Causal Loop Diagram Analysis of Stunting Specific Intervention for Policy Recommendation: A Case from Pekalongan Regency Indonesia Yuniarti, Yuniarti; Bintari, Siti Harnina; Zainafree, Intan
Journal of Creativity Student Vol. 8 No. 1 (2025)
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jcs.v8i1.24652

Abstract

Stunting is still a global health issue, especially in lower-middle class countries, the problem of stunting reflects a multidimensional problem that has not been addressed effectively. In Indonesia, the prevalence of stunting has decreased significantly by 18.9% in 2023, but has not reached the target set at 14%. This study is a qualitative study with a causal loop diagram analysis approach, the causal loop diagram method was chosen because it is able to describe problems that interact dynamically as causality. Data collection by interviewing 23 informants and analyzing documents on the achievement of specific interventions in 2023 from the Pekalongan District Health Office. There are five key variables identified, namely the ability of officers, specific interventions, budget, community roles and access to health services. The results of the CLD analysis formed 26 causal links, strengthening one loop and balancing two loops. The findings highlight the disparity in access to health services and the role of the community that is not yet optimal. Policy recommendations, improve cross-sector coordination to improve the provision of health services and increase the role of the community, especially mothers of toddlers and cadres in specific nutrition interventions. The use of CLD analysis in holistic and strategic specific nutritional interventions in identifying stunting problems to determine the most appropriate interventions.
Service Strengthening Strategy Primary Through Engagement Health Cadres in The Community Subhi, Imam; Cahyati, Widya Hary; Zainafree, Intan
Journal of Creativity Student Vol. 8 No. 2 (2025)
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jcs.v8i2.25621

Abstract

Background: Strengthening primary and community health systems is crucial in improving population health, particularly in developing countries. Various studies have emphasized the importance of healthcare workers, such as physicians, physical therapists, and community health workers (CHWs), in promoting equitable and effective health service delivery. This study aims to analyze the roles, challenges, and innovations in developing primary and community health systems in resource-limited settings. Methods: This study employed a narrative literature review approach using peer-reviewed articles published between 2015 and 2023. Data sources included PubMed, Scopus, and ScienceDirect. Keywords used were “primary care,” “community health workers,” “health system strengthening,” and “developing countries.” Thematic analysis was conducted to identify patterns, innovations, and policy implications. Results: The review found that CHWs significantly contribute to cost-effective care and improved service coverage in underserved areas. Innovations such as insurance administration-free models and participatory research-based interventions in South Africa were effective in enhancing decision-making among CHWs. Additionally, interventions for non-communicable diseases (e.g., hypertension, diabetes) and pediatric oncology in Sub-Saharan Africa demonstrated the need for tailored health strategies. In the education sector, the integration of mental health and research ethics training for healthcare workers in South Africa and Uganda reinforced the importance of investing in human resources for health. Conclusion: The findings underscore the importance of empowering healthcare workers, implementing innovative service delivery models, and enhancing health education systems. Strengthening public health systems requires collaborative policy efforts and sustained investment to promote health equity and resilience, especially in low-resource settings.
The Health Promotion Models in Improving the Mental Health of Hemodialysis Patients: A Study on a Holistic Approach Fahrurozi, M.; Cahyati, Widya Hary; Zainafree, Intan
Journal of Creativity Student Vol. 8 No. 2 (2025)
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jcs.v8i2.25623

Abstract

Background: mental health is an important component in the treatment of hemodialysis patients, which is often overlooked. Patients face psychological distress due to lifestyle changes, physical limitations, and long-term therapeutic processes that have the potential to trigger depression and anxiety. Aim: This study aims to evaluate the effectiveness of the Health Promotion Model (HPM) approach in improving the mental health of hemodialysis patients through holistic interventions. Method The research used a mixed-methods approach with a pre-test and quasi-experimental post-test with a control group design. Interventions include health education, stress management, psychological counselling, and strengthening social support. The results of the quantitative analysis showed a significant improvement in patients' mental health scores in the intervention group compared to the control group. Qualitative data reveal changes in disease perception, improved adaptive coping strategies, and the important role of social support in maintaining emotional stability. Conclusion: The holistic application of HPM is effective in strengthening psychological resilience and improving the quality of life of hemodialysis patients. This intervention is recommended to be systematically integrated into hemodialysis services in health facilities.
The Effect of Health Promotion (With MCH Book) on Knowlegde, Attitude, Behavior of Utilizing MCH Books in Pregnant Women at UPTD Public Health Center of Pati Distric Retnoningsih, Heriani; Yuniastuti, Ari; Zainafree, Intan
Public Health Perspective Journal Vol. 8 No. 1 (2024)
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/phpj.v8i1.13248

Abstract

Health level is a measure of a country’ welfare. The purpose of this study was to determine the  impact  of health promotion with maternal and child health (MCH) books on knowledge, attitudes and health behavior of pregnant women at the UPTD Health Center of Pati Regency because high maternal mortality rate (MMR) indicates that maternal health is still poor.  The type of research is Quasy-Experiment (pre-experimental designs). The research design used Pretest-Posttest Control Group design. Sampling in this study was non-random sampling with purposive sampling type. Based on the population of pregnant women in 29 UPTD Health Centers in Pati regency, 2 Health Centers were determined to be objects of research, namely UPTD Kayen Health Center and UPTD Pati II Health Center. The results showed that frequency distribution of respondents’ answers in the control group or Pati II Health Center showed that the pretest and posttest values in responents did not increase in the value of the knowledge variable of pregnant women. Meanwhile, the frequency distribution of the respondents showed the pretest and posttest  in the experimental group or Kayen health Center respondents, where there was an increase in the value of the variable of knowledge of pregnant women which was getting better. The results of the Wilcolzon Signed Rank  Test in the control group showed that the sig pretest and posttest values of the behavioral variables in the control group were > 0.05 so it can be concluded that there was no change in the behavior or pregnant women in the control group. The results of the Wilcoxon signed rank test in the intervention group showed that the sig pretest and posttest values of the behavioral variables of pregnant women in the experimental group were <0,05 so it can be concluded that there was a change in the behavior of pregnant women in the intervention group.
Descriptive Analysis of Diabetic Retinopathy in Central Java Province (Case Study at RSUP Dr. Kariadi) Casmuti, Casmuti; Cahyati, Widya Hary; Zainafree, Intan; Parno, Parno
Public Health Perspective Journal Vol. 8 No. 2 (2024)
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/phpj.v8i1.13741

Abstract

Diabetic retinopathy is a serious complication of diabetes that affects the blood vessels in the retina, leading to nutritional disorders. In Central Java Province, the prevalence of diabetes mellitus increased from 10% in 2022 to 12.52% in the third quarter of 2023; this phenomenon has not reached the SDG's target of zero increase. This study analyzes the frequency distribution of diabetic retinopathy cases at RSUP Dr. Kariadi Semarang in 2023. Using a cross-sectional design, this observational descriptive research utilized electronic medical record data from RSUP Dr. Kariadi Semarang in 2023. The study examined various variables, including gender, age, education level, employment status, marital status, BMI, DM diet, duration of DM, hypertension, other diseases, current blood glucose, and HbA1c. Univariate analysis was used to determine the frequency distribution and present graphical representations of each variable. The study's findings showed the largest percentage of diabetic retinopathy patients were female (54.2%), aged 50-59 years (48.8%), with low education (38.0%), working (66.3%), married (92.8%), and obese (18.7%). Most patients had a duration of DM ≥ 5 years (51.2%), hypertension (73.5%), and other diseases such as azotemia, CKD, cataracts, and cardiomegaly; patients had blood glucose at ≥ 200 mg/dL (53.0%) and HbA1c ≥ 6.5% (88.0%).
Co-Authors Abdul Hakam Adi Nur Cahyono Afriyatin, Via Agnes Widanti Ahmad, Ari Praneza Alsriansyah, Ella Alvy Fajri Andreas Wilson Setiawan Anggun Dessita Wandastuti Anisa Prabaningrum Ari Yuniastuti Atika Aulia Atika Aulia Aufiena Nur Ayu Merzistya Aufiena Nur Ayu Merzistya Azizah, Azzahra Nur Bambang Budi Raharjo Bambang Wahyono Bela, Maria Vila Bramasto, Tegar BUDIONO SKM, M.Kes(Epid), IRWAN Cahyati , Widya Hary Casmuti, Casmuti Chatila Maharani Defi, Rahma Dewanto, Earlene Nadhira Dimarti, Safira Chairani Dina Nur Anggraini Ningrum Endang Wahyati y. Fahrurozi, M. Faizin, Miftahul Farida, Eko Faridho, Fikrifar Rizki Fitri Indrawati Fitria Ningsih Gian Lisuari Adityasiwi Hakam, Mohammad Abdul Hany Putri Antari Imam Subhi, Imam Irsam, Muhamad Irwan Irwan Isbandi Isbandi Julia Pertiwi Jusran, Alek Kamal Agus Efendi Kartika Pibrianti KH, Oktia Woro Kharazi, Akhmal Raziq Khasanah, Amelia Fitra Lili Amaliah Linda Riski Sefrina Lukman Fauzi Makhfudz, Rendy Adiyatmarijal Mardiana Mardiana Mernawati, Defi Minhajul Mubarok Mona Subagja Muhamad Anbiya Nur Islam Muhamad Syaiful Bachri Al Yunus Muhammad Aidil Fitrah Mustafa Daru Affandi Nissa, Fidia Nugraheni, Hana Putri Nur Wahidah Nur Wahidah Nurkhasanah, Maulia Wahyu Nurul Maulidiyah Oktabella, Zulvaida Haditya Oktia Woro Kasmini Handayani Oktia Woro KH Pangesti, Lely Tri Parno Parno Patriajat, Maria M. Rosaria Patriajati, Maria Margareta Rosaria Pibrianti, Kartika Prasetya, Henky Yoga Puspita, Nabila Putra, Tyar Bhatara Putri, Deva Amanda Putri, Wulan Apriyani Gusti Rahmadhani, Alda Adiestya Ratna Wahyuningtias Retnoningsih, Heriani Rohayati, . Rr. Sri Ratna Rahayu Saefurrohim, Muhamad Zakki Setyowati, Florensia Indah Shinta Ayu Respati Simanjuntak, Sugianto Parulian Siti Harnina Bintari Soesmeyka Savitri Sri Ratna Rahayu Suhito, Hanif Pandu Sulistio, Revan Aji Syukria, Nadia Tatik Atmini Trikinasih, Rusda Lintang Tsuroyya, Sabrina Luthfi Usnawati, Uus Utomo , Dewi Natalista Dwi Van Den , Emilia Widodo, Priskila Naomi Widya Hary Cahyati Wigatie, Ragil Ayu Yuniarti Yuniarti Zaimatuddunia, Irma Zakiyyah, Naeli Robikhati Zuyyinatun Muflikhah