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All Journal Scientia Psychiatrica Indonesian Community Empowerment Journal Sriwijaya Journal of Neurology
Novalika Kurnia
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Religion Humanities Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Public Health Social Sciences

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The Impact of Early Intervention on Motor Outcomes in Infants with Cerebral Palsy: A Longitudinal Study with Advanced Neuroimaging Correlates in Surabaya, Indonesia Habiburrahman Said; Novalika Kurnia; Fatimah Mursyid; Sophia Lucille Rodriguez; Theresia Putri Sinaga; Aline Hafidzah
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.29

Abstract

Introduction: Cerebral palsy (CP) is a prevalent neurodevelopmental disorder affecting motor function in children. Early intervention (EI) has been shown to improve motor outcomes in infants with CP, but the underlying neural mechanisms remain poorly understood. This longitudinal study investigated the impact of EI on motor outcomes and its association with neuroimaging correlates in infants with CP in Surabaya, Indonesia. Methods: We recruited 60 infants diagnosed with CP aged 6-18 months in Surabaya, Indonesia. Participants were randomly assigned to either an EI group receiving 6 months of individualized, home-based intervention or a control group receiving standard care. Motor function was assessed using the Gross Motor Function Measure (GMFM-88) at baseline, 6 months, and 12 months. Advanced neuroimaging techniques, including diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), were used to assess brain structure and function at baseline and 12 months. Results: Infants in the EI group demonstrated significantly greater improvements in GMFM-88 scores compared to the control group at 6 and 12 months (p < 0.05). DTI revealed increased fractional anisotropy (FA) in the corticospinal tract and corpus callosum in the EI group at 12 months, indicating improved white matter integrity. fMRI showed increased functional connectivity in motor networks in the EI group compared to the control group at 12 months. Conclusion: Early intervention significantly improved motor outcomes in infants with CP in Surabaya, Indonesia. These improvements were associated with enhanced white matter integrity and functional connectivity in motor-related brain regions. Our findings highlight the importance of early intervention in promoting neuroplasticity and improving motor function in infants with CP.
A Vicious Cycle: Probable Psychological Distress and Maladaptive Cognition as Barriers to Remediation Among Indonesian Medical Students Failing National Licensure Gladys Putri; Mary-Jane Wood; Zahra Amir; Novalika Kurnia
Scientia Psychiatrica Vol. 6 No. 2 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.193

Abstract

Introduction: Failure on high-stakes medical licensing examinations, such as the Indonesian Medical Doctor Competency Examination (UKMPPD), is a significant stressor. This study aims to delineate the current psychological profile of "repeat takers" (students who have failed at least once) to understand the psychological state associated with being in a cycle of academic failure. Methods: A multi-center, matched case-control study was conducted with 300 participants from five Indonesian medical faculties. The 'Case' group (n=150), recruited from remedial preparation courses, comprised students who had failed the UKMPPD at least once. The 'Control' group (n=150) consisted of peers from the same cohort who passed on their first attempt, matched for university, age, and gender. Psychological variables were measured cross-sectionally using the 10-item Connor-Davidson Resilience Scale (CD-RISC 10), the Brief COPE inventory, and the Self-Reporting Questionnaire-20 (SRQ-20) to screen for probable psychological distress. Results: Cases demonstrated a dramatically higher rate of probable psychological distress, with 62.0% of cases screening positive (SRQ-20 score ≥ 8) compared to 18.0% of controls (p < 0.001). Cases also reported significantly lower current resilience (Mean ± SD: 28.5 ± 5.4 vs. 34.1 ± 4.8, p < 0.001) and significantly greater use of avoidant/maladaptive coping (p < 0.001), driven specifically by Self-Blame (p < 0.001) and Behavioral Disengagement (p < 0.001). Binary logistic regression revealed that factors strongly associated with repeat-taker status included probable psychological distress (OR 5.2, 95% CI 3.1-8.7), lower resilience (OR 0.85, 95% CI 0.79-0.91), and Self-Blame (OR 2.1, 95% CI 1.4-3.2). Conclusion: The psychological state following licensure failure is characterized by a triad of high psychological distress, eroded resilience, and a reliance on self-blaming cognitive distortions. This profile, most parsimoniously interpreted as a consequence of initial failure, constitutes a formidable state of crisis and a critical barrier to successful academic remediation.
Enhancing 'First 1,000 Days' Nutrition Literacy via a Posyandu Kader 'Train-the-Trainer' Model: A Mixed-Methods Impact Evaluation on Child Nutritional Status in Eastern Indonesia Fatimah Mursyid; Novalika Kurnia; Sana Ullah; Lestini Wulansari; Muhammad Yoshandi
Indonesian Community Empowerment Journal Vol. 5 No. 1 (2025): Indonesian Community Empowerment Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/icejournal.v5i1.53

Abstract

The 'First 1,000 Days' (HPK) period is critical for preventing stunting, a significant public health challenge in Indonesia, particularly in Eastern provinces. Posyandu kader (community health volunteers) are pivotal, but their effectiveness is often hampered by inadequate and unstandardized training. This study evaluates the impact of a structured 'Train-the-Trainer' (ToT) model on kader nutrition literacy and, subsequently, on child nutritional status. We conducted a quasi-experimental, convergent parallel mixed-methods study in two districts of East Nusa Tenggara (NTT) province, Indonesia. The intervention district (n=50 kader, n=312 mother-child dyads) received the ToT intervention, while the control district (n=50 kader, n=309 mother-child dyads) continued standard practices. The ToT model involved training Puskesmas (health center) staff as 'Master Trainers' who then cascaded structured training and mentorship to kader over 12 months. Quantitative data (kader literacy scores, child anthropometry [Height-for-Age Z-score, HAZ]) were collected at baseline and 12-month follow-up, analyzed using Difference-in-Differences (DiD) and linear mixed-effects models (LMM). Qualitative data (n=24 in-depth interviews, n=6 focus group discussions) explored the intervention's mechanisms, fidelity, and contextual facilitators. At 12 months, kader nutrition literacy in the intervention group increased significantly (mean score change: +29.8 points) compared to the control group (+2.1 points, p < 0.001). The LMM analysis, controlling for covariates, showed a significant 'time × group' interaction effect on child HAZ (β = 0.28, 95% CI [0.15, 0.41], p < 0.001), indicating a meaningful improvement in child growth attributable to the intervention. Stunting prevalence (HAZ < -2 SD) in the intervention group decreased by 8.7 percentage points, while it remained stagnant in the control group. Qualitative themes revealed that the ToT model enhanced kader self-efficacy, shifted their role from passive data collectors to active counselors, and provided mechanisms to address local socio-cultural barriers to nutrition. In conclusion, the 'Train-the-Trainer' model is an effective and scalable strategy for enhancing kader nutrition literacy and precipitating measurable improvements in child nutritional status in high-burden settings. This model provides a sustainable framework for strengthening community health systems to combat stunting, aligning with Indonesia's national strategy and Sustainable Development Goal 3.
Buffering Effects of Extended Family: A Moderated Mediation Analysis of Maternal Depression, Parenting Stress, and Early Childhood Development in West Java, Indonesia Habiburrahman Said; Novalika Kurnia; Aline Hafidzah; Vania Delma; Fachrudin Sani
Scientia Psychiatrica Vol. 6 No. 2 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.201

Abstract

Introduction: In low- and middle-income countries (LMICs), maternal mental health significantly impacts early childhood development (ECD). West Java, Indonesia, presents a unique cultural context where extended family involvement is ubiquitous. This study aims to elucidate the mechanism linking maternal depressive symptoms to early childhood developmental delays, focusing on the mediating role of parenting stress and the moderating role of social support from extended family. Methods: A cross-sectional analytical study was conducted in five regencies of West Java (N = 842 mother-child dyads). Children were aged 12–36 months. We utilized the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms, the Parenting Stress Index-Short Form (PSI-SF) for stress, the Multidimensional Scale of Perceived Social Support (MSPSS) adapted for extended family, and the Ages and Stages Questionnaire (ASQ-3) for developmental monitoring. A moderated mediation model (Hayes Model 7) was tested using Structural Equation Modeling (SEM) with 5,000 bootstrap samples. Results: High maternal depressive symptoms were significantly associated with lower ECD scores (β = -0.42, p < 0.001). Parenting stress partially mediated this relationship (Indirect Effect = -0.18, 95% CI [-0.24, -0.13]). Crucially, extended family support moderated the path between depression and parenting stress (β = -0.15, p < 0.01). Specifically, the impact of depression on parenting stress was significantly dampened in households with high extended family engagement compared to those with low support. Conclusion: Parenting stress is a critical pathway through which maternal depression compromises child development. However, the collectivist family structure in West Java serves as a protective buffer. Interventions should target not only the mother but also mobilize the extended family network as a resource for 'kalyana mitra' (supportive friends/family).
Co-Authors Aline Hafidzah Fachrudin Sani Fatimah Mursyid Gladys Putri Habiburrahman Said Lestini Wulansari Mary-Jane Wood Muhammad Yoshandi Sana Ullah Sophia Lucille Rodriguez Theresia Putri Sinaga Vania Delma Zahra Amir