Introduction: The Ministry of Health's primary healthcare transformation emphasizes a promotive and preventive approach through strengthening Integrated Primary Service Posts (Posyandu) throughout the lifecycle. Posyandu cadres play a crucial role in implementing ILP, but still face competency challenges in delivering integrated services. Digital training is one innovation to efficiently increase cadre capacity. This study aims to analyze differences in Posyandu cadre competency in five Core Training Courses (MPI) before and after participating in digital training in North Lampung Regency in 2025. Methods: The study used a one-group pretest-posttest pre-experimental design through the Plataran Sehat Learning Management System (LMS). The sample size was determined using WHO software using a two-sided hypothesis test for a population mean. Bivariate analysis used the Wilcoxon Signed Rank Test. Results: The analysis showed a significant difference in the competency of Posyandu cadres in all five Core Training Courses (MPI 1–MPI 5) before and after the digital training (p < 0.05). Conclusions: The digital training on Basic Skills for Posyandu Cadres effectively improved cadre competency and needs to be maintained and developed to support the transformation of primary healthcare services.

Introduction: Based on data from the Banten Provincial Office, the coverage of exclusive breastfeeding in Banten Province in 2017 was 75.7%, which did not meet the target set in 2016 in Banten Province (77%). The suboptimal rate of exclusive breastfeeding may be due to the low amount of breast milk produced by mothers. This study was conducted to determine the benefits of chemical galactagogues and herbs in increasing breast milk production in the Pontang Community Health Center working area. The population in this study consisted of 32 breastfeeding mothers with children aged 0-6 months in the Pontang Community Health Center working area, comprising 16 chemical and 16 herbal mothers. This study will be conducted in May-June 2024 at the Pontang Community Health Center. Methods: The research method used is a quasi-experiment with a cross-sectional approach. Data collection was carried out using breast milk pumps and breast milk bags. The data were then analyzed using univariate and bivariate (influence analysis) methods. Results: The results showed a significant p-value of 0.000 between galactagogues and increased breast milk production in the chemical intervention group compared to the herbal intervention group. Conclusions: The paired sample T-test showed a difference in mean values between the chemical intervention group and the herbal intervention group of 12.18, which means that the average breast milk production in the herbal group was much greater than the average breast milk production in the chemical group. It is hoped that health workers can provide information and disseminate or provide counseling when conducting practical visits about the benefits of galactagogues to the community, especially breastfeeding mothers.

Introduction: Nutritional problems among children under five in coastal areas remain relatively high, partly due to limited access to animal-based protein sources. On the other hand, the potential of marine resources has not been optimally utilized, including grouper fish scales (Epinephelus sp.), which are rich in protein, calcium, and collagen. The innovation of processing these wastes into complementary feeding (MP-ASI) stock powder holds potential as both a nutritional solution and an environmental management strategy. This study aims to analyze the effect of balanced nutrition education on mothers’ knowledge, perceptions, and intentions regarding the use of grouper fish-scale-based MP-ASI stock powder. Objectives: This study aimed to analyze the effect of balanced nutrition education on mothers’ knowledge, perceptions, and intentions regarding the use of grouper fish-scale-based MP-ASI stock powder. Methods: This research employed a pre-experimental design with a one-group pre-test–post-test approach involving 30 mothers with children aged 6–24 months in Mekar Jaya Village, Konawe Regency, Southeast Sulawesi. A structured questionnaire was used to measure knowledge, perception, and intention, with prior validity and reliability testing (Cronbach’s alpha ≥0.70). Data were analyzed using the Shapiro-Wilk normality test, Levene’s homogeneity test, paired t-test, Wilcoxon signed-rank test, and Pearson correlation test. Results: The findings demonstrated a significant improvement in knowledge (p<0.001), perception (p<0.001), and intention (p<0.001) after the educational intervention. Correlation analysis revealed positive associations between knowledge and perception (r=0.52; p=0.004), knowledge and intention (r=0.47; p=0.009), and perception and intention (r=0.61; p<0.001). Conclusions: Balanced nutrition education is effective in enhancing knowledge, fostering positive perceptions, and encouraging mothers’ intention to use grouper fish-scale-based MP-ASI stock powder. This study is relevant as a foundation for developing nutrition education strategies and food innovations based on local potential to support the improvement of child nutrition in coastal areas.

Introduction: Maternal nutrition during pregnancy is critical in supporting maternal health and fetal development. However, many pregnant women do not adhere to recommended dietary practices, which may increase the risk of complications. Nutrition counseling has been proposed to improve compliance with healthy dietary behaviors. Objectives: This study aimed to evaluate the effectiveness of nutrition counseling on improving dietary compliance among pregnant women. Methods: A quasi-experimental design with a non-equivalent pretest–posttest control group was employed. Forty pregnant women in their second and third trimesters were recruited and assigned to two groups: an intervention group receiving structured nutrition counseling and a control group receiving routine antenatal care. Dietary compliance was assessed using a validated questionnaire before and after a four-week intervention. Data were analyzed using paired t-tests for within-group comparisons and independent t-tests for between-group differences. Results: The intervention group showed a significant improvement in dietary compliance scores after counseling (mean increase 0.85, p < 0.005), whereas the control group demonstrated no significant change (mean increase 0.15, p = 0.120). Post-intervention comparisons indicated a significantly higher compliance score in the intervention group compared to the control group (p < 0.001; α<0.05). Conclusions: Nutrition counseling was effective in enhancing dietary compliance among pregnant women. Integrating structured counseling into antenatal care has the potential to foster healthier eating behaviors, reduce pregnancy-related complications, and improve maternal and fetal outcomes. Further research is needed to examine long-term effects and its scalability in different healthcare settings.

Introduction: Chronic kidney disease, which involves lasting impairment of kidney function, can cause respiratory issues among various other systemic complications. Breathlessness is a common symptom that patients face, and if it goes unaddressed, it can worsen their overall health condition.. Objectives: The aim of this study is to assess the effectiveness of the semi-Fowler position in boosting oxygen saturation and decreasing the respiratory rate in chronic kidney disease patients receiving treatment in the Emergency Department. Methods: This investigation adopted a descriptive case study method focusing on two individuals who experienced breathing difficulties due to chronic kidney disease. Interventions included the provision of oxygen and repositioning the patients into the semi-Fowler position for four hours of monitoring. The gathered data included oxygen saturation levels and respiratory rates measured before and after the intervention. Results: After being positioned in the semi-Fowler setup, both patients exhibited notable improvements in oxygen saturation and reductions in respiratory rates. Oxygen saturation levels rose from 83–94% to 99–100%, while the respiratory rate declined from 30–32 breaths per minute to 26–28 breaths per minute. Conclusions: Positioning patients in the semi-Fowler posture has been shown to effectively enhance respiratory function in individuals with chronic kidney disease within the emergency setting. This method can serve as a first-line non-invasive nursing intervention to promote patient comfort and help maintain the stability of their condition.

This study aims to analyze the effect of consuming bitter melon juice on blood pressure in hypertensive patients in Jagamukti Village, Surade Health Center's working area. Hypertension is a non-communicable disease with a high prevalence that requires serious attention. This study used a quasi-experimental design with a one-group pretest-posttest design, involving 15 respondents selected using cluster sampling. Data were analyzed using parametric statistical tests with a T-test. The results showed that the average systolic blood pressure before the intervention was 151 mmHg, while after the intervention, it decreased to 145 mmHg. Statistically, there was a significant difference with a p-value of 0.000 (<0.05), indicating that bitter melon juice is effective in lowering blood pressure in hypertensive patients. Most respondents were female (60%) aged 46–55 years (66.7%), and the majority worked as housewives (60%). Bitter melon, rich in potassium and possessing diuretic effects, effectively lowers sodium levels in the blood, helping to reduce blood pressure. This study reinforces the potential of bitter melon as a safe and natural non-pharmacological intervention for hypertension. These findings are expected to encourage the use of herbal plants in the management of hypertension.

Introduction: The group of hand-rolled cigarette factory workers is a work group that is at risk of experiencing menstrual disorders. Excessive working time can cause employees to feel tired. Irregular menstrual cycles are a hormonal imbalance in the reproductive system between the hormones estrogen and progesterone. Objectives: The aim of this research is to investigate the connection between working duration and the menstrual cycle Methods: This study was based on a quantitative approach and used a cross-sectional design. Data were gathered through questionnaires from two groups: one group consisting of 37 cigarette factory workers and another group of 38 non-cigarette factory workers. The data were collected using a purposive sampling technique. In this study, work duration was the independent variable, and menstrual disorders were the dependent variable. A Chi-Square statistical test was performed to examine the relationship between these variables, with a significance level of <ɑ 0.05. Results: The outcomes of the statistical analysis indicated that in the factory worker group, the p-value was 0.000 < ɑ (0.05). The majority of respondents who did not experience menstrual disorders had a long duration of work, with a proportion of 96%, which was higher than those with a medium duration of work. Meanwhile, in the non-factory worker group, the p-value was 0.718 > ɑ (0.05). Most respondents who did not experience menstrual disorders had a light work duration, with a proportion of 86%, which was higher than those who experienced menstrual disorders due to moderate work duration. Conclusions: A significant association exists between work duration and menstrual disorders.

Introduction : In Indonesia the incidence rate of female adolescent knowledge about reproductive health is low, some of them have pregnant before married, married in young age, consume alcohol, and drug abuse. This study aims to know the correlation between duration and score of playing KEPO Game with knowledge, attitude, and skills of female adolescent reproductive health. Objectives : The design of this research is one group pretest-postest Methods: design with simple random sampling technique in 8th grade female students of junior high school in Bandung City. Results: The result of the analysis showed that there was no significant correlation between duration and score with knowledge, attitude, and skill of female adolescent in understanding reproduction health with p value >​​0,05 but there was an increase of pretest and posttest result with p value >0,05. Conclusions: This explains that KEPO Game can be used as adolescent learning media in studying reproduction health with improvement in Artificial Intelegence in every content of game, time calculation improvement on "replay" menu, should use pedagogy element in every question of KEPO Game and questionnaires, and the adolescents should have instruction about KEPO Game and about reproductive health so that teenagers can answer the questions properly and correctly with time that has been set in KEPO Game.

Tofu industry workers are a group vulnerable to heat strain due to high heat exposure during work. Heat strains can cause serious health problems such as heat stroke, heat exhaustion, and heat cramps. Purpose This study aims to analyze the factors associated with heat strain in tofu industry workers in South Kotabumi District, North Lampung Regency in 2024. This study used a cross-sectional design. The population was all tofu industry workers in South Kotabumi District, North Lampung Regency. Samples were taken using total sampling technique, namely 30 workers. Data were collected through interviews, measurements, and observations. Data analysis was performed using univariate, bivariate using the Chi-square test, and multivariate using logistic regression test. showed that the factors associated with heat strain in tofu industry workers were heat stress (p=0.001), age ( P =0.003), gender ( P =0.007), and obesity ( P =0.012). Environmental heat stress, age, gender, and obesity are factors associated with heat strain in tofu industry workers. Heat strain control efforts need to be carried out, especially through improving the work climate and weight loss programs for obese workers.