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All Journal Termometer: Jurnal Ilmiah Ilmu Kesehatan Dan Kedokteran Jurnal Ilmu Kesehatan dan Gizi Detector: Jurnal Inovasi Riset Ilmu Kesehatan 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
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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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
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 : Pusat Riset dan Inovasi Nasional

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.
Technology Assisted Therapy Innovation for War Trauma: An Intervention Synthesis Nurzahara Sihombing; M. Agung Rahmadi; Laila Zahra; Putri Ramadhani; Ferius Lahagu; Helsa Nasution; Luthfiah Mawar; Siti Padila; Annisa Ardianti Br Tarigan
Detector: Jurnal Inovasi Riset Ilmu Kesehatan Vol. 3 No. 4 (2025): Jurnal Inovasi Riset Ilmu Kesehatan
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/detector.v3i4.5859

Abstract

This meta-synthesis examines in depth the effectiveness of technology-assisted therapy (TAT) in the treatment of war-related trauma through a systematic analysis of 47 empirical studies with a total of 6,842 participants published between 2010 and 2024. The quantitative synthesis indicates that the implementation of TAT demonstrates statistically significant effectiveness in reducing the severity of post-traumatic stress disorder symptoms (d=0.78, 95% CI [0.65, 0.91]), anxiety (d=0.69, 95% CI [0.54, 0.84]), and depression (d=0.72, 95% CI [0.58, 0.86]) among populations affected by armed conflict. Among the various digital modalities, Virtual Reality Exposure Therapy (VRET) exhibits the strongest therapeutic effect (d=0.85) compared with mobile-based intervention (d=0.71) and teletherapy (d=0.68). Further moderator analysis identifies the optimal intervention duration as 12 to 16 weeks, with a significant effect contribution (β=0.34, p<.001) and a relatively moderate dropout rate of 18.7%. These findings extend Tng et al. (2024) by confirming the superiority of VRET and by confirming the significance of therapist support for the effectiveness of TAT (Wu et al., 2025). In contrast to the meta-analysis by Eshuis et al. (2021), which emphasized a single approach, this study reveals that hybrid interventions that integrate multiple digital platforms simultaneously (d=0.89) are superior to single-platform interventions (d=0.67). Overall, the results of this meta-synthesis provide a strong empirical foundation for the development of more comprehensive, adaptive, and contextually relevant TAT protocols for war-related trauma.
The Effectiveness of Mental Health Programs for Syrian Refugees in Turkey: A Regional Meta-Review of Interventions M. Agung Rahmadi; Luthfiah Mawar; Zilva Husayri Zulvan; Nafiza Rizky Ramadhani Lubis; Maulidyah Azzahra; Helsa Nasution; Nurzahara Sihombing; Muhammad Wahyudi Berutu; Annisa Ardianti Br Tarigan
Jurnal Ilmu Kesehatan dan Gizi Vol. 4 No. 1 (2026): Januari: Jurnal Imu Kesehatan dan Gizi
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jig.v4i1.8402

Abstract

This meta-review evaluates the effectiveness of diverse mental health programs targeting Syrian refugees in Turkey over the period 2015-2023 through a systematic synthesis of 47 studies involving a total of 12,847 participants. Meta-regression results demonstrate a statistically significant reduction in Post-Traumatic Stress Disorder symptoms, with a large effect size (d = -0.86, 95% CI [-1.02, -0.70], p < .001), as well as a significant reduction in depressive symptoms (d = -0.72, 95% CI [-0.88, -0.56], p < .001) following intervention. Among the therapeutic approaches examined, Cognitive Behavioral Therapy exhibited the strongest therapeutic effect (β = 0.45, p < .001), followed by Eye Movement Desensitization and Reprocessing (β = 0.38, p < .001). Further moderator analysis revealed that group-based interventions were more effective than individual approaches (OR = 1.86, 95% CI [1.42, 2.30]). At the same time, program duration of 12-16 weeks showed a strong correlation with optimal clinical outcomes (r = 0.67, p < .001). These findings extend the results of Acarturk et al. (2022) regarding the effectiveness of CBT and reinforce the argument advanced by Shehadeh et al. (2016) concerning the superiority of group-based approaches, while also indicating a longer optimal intervention duration than previously reported. In contrast to the meta-analysis by Antuña-Camblor & Hernández (2025), which emphasized EMDR, this study identifies CBT as superior to EMDR among Syrian refugees in Turkey. The novelty of this study lies in its comprehensive analysis of program moderator factors and the identification of the most effective intervention duration parameters for the target population.
Co-Authors Andieni Pratiwi Ferius Lahagu Helsa Nasution Isnaini Fajarwati Kiki Asnanti Laila Zahra Luthfiah Mawar Luthfiyah Aqilah Siagian M. Agung Rahmadi Maulidyah Azzahra Muhammad Wahyudi Berutu Nafiza Rizky Ramadhani Lubis Nazwa Aqela Saragih Nur Suci Ramadhani Nurzahara Sihombing Putri Ramadhani Putri Widia Ramadhani Rambe Rasil Hakim Hasibuan Riska Wahyuni Hasibuan Sasa Maghfirah Siregar Siti Nurfaiza Siti Padila Sri Rahayu Sukirman Zilva Husayri Zulvan