Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 A Predictive Model for Stunting Risk in Infants Using Health Belief Model Constructs and Feeding Indicators 195 203 28755 10.58209/hehp.14.2.195 EN M. Musni Department of Midwifery, Institute Batari Toja Bone, Bone Regency, Indonesia 0000-0003-1490-7896 D. Heriyana Department of Midwifery, Institute Batari Toja Bone, Bone Regency, Indonesia I. Irawati Department of Midwifery, Institute Batari Toja Bone, Bone Regency, Indonesia E. Bujawati Department of Midwifery, Institute Batari Toja Bone, Bone Regency, Indonesia A. Syam Department of Epidemiology, Faculty of Medicine and Health Sciences, Alauddin State Islamic University, Makassar, Indonesia M. Malik Department of Midwifery, Faculty of Midwifery Professional Education, Gunung Sari University, Makassar, Indonesia Journal Article 2026 05 07 Aims: Stunting in children under five remains a critical public health problem in Indonesia, particularly in rural areas where access to optimal complementary feeding practices and health literacy are limited. This study aimed to develop and validate a predictive model to identify infants aged 6-12 months at risk of stunting using maternal behavioral determinants and feeding indicators. Instrument & Methods: This analytical cross-sectional study was conducted on 401 mother–infant dyads in Kabupaten Bone, Indonesia. The model incorporated constructs from the health belief model, including perceived severity, benefits, barriers, self-efficacy, and cues to action in feeding, based on WHO/UNICEF criteria (minimum dietary diversity, minimum meal frequency, and minimum acceptable diet). Structural equation modeling was applied to test direct and indirect pathways to risk classification. Findings: Feeding practices were the strongest direct predictor of stunting risk (β=0.537; p<0.001). Barriers indirectly increased risk by negatively affecting feeding behavior. The model demonstrated an acceptable fit (standardized root mean square residual=0.061) and explained substantial variance in the primary outcomes (R²=0.825 for intention, 0.526 for feeding practices, and 0.542 for risk). Conclusion: Maternal beliefs and behavioral intentions highly influence complementary feeding practices, which in turn reduce the risk of stunting in infants.

https://hehp.modares.ac.ir/article_28755_86c26c7eb678214b9749fe1c5364cff2.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 Coastal Adolescent Empowerment for Reproductive Health and Early Marriage Prevention 205 213 28714 10.58209/hehp.14.2.205 EN Ruslan Majid Halu Oleo University Yusuf Sabilu Department of Public Health, Faculty of Public Health, Halu Oleo University, Kendari, Indonesia S. Suhadi Department of Public Health, Faculty of Public Health, Halu Oleo University, Kendari, Indonesia R. Rahman Department of Public Health, Faculty of Public Health, Halu Oleo University, Kendari, Indonesia L.A. Kalza Department of Public Health, Faculty of Public Health, Halu Oleo University, Kendari, Indonesia L.O. Ahmad Saktiansyah Department of Public Health, Faculty of Public Health, Halu Oleo University, Kendari, Indonesia S.T. Dewi Department of Public Health, Faculty of Public Health, Halu Oleo University, Kendari, Indonesia Journal Article 2025 12 03 Aims: Adolescents in coastal areas face heightened risks of early marriage and unintended pregnancy, attributed to limited access to reproductive health care and enduring socio-cultural norms. This study aimed to examine the impact of empowering coastal adolescents through youth Posyandu on the prevention of early marriage and unwanted pregnancy by assessing the roles of reproductive health knowledge and attitudes within integrated health post programs in coastal communities. Instrument & Methods: This quantitative cross-sectional study involved 210 teenagers selected through proportionate random sampling. Partial least squares-structural equation modeling was employed to examine direct effects, as well as mediating and moderating relationships among knowledge, attitudes, program-supporting and inhibiting factors, youth Posyandu empowerment, early marriage, and unintended pregnancy. Findings: Program supporters and inhibitors significantly influenced unintended pregnancy (t=2.881; p=0.004). Knowledge positively affected unintended pregnancy (t=6.644; p<0.001) and youth Posyandu empowerment (t=6.168; p<0.001). Attitudes had a positive effect on unintended pregnancy (t=6.09; p<0.001) but had no significant effect on empowerment (t=0.479; p=0.632). Empowerment significantly reduced unintended pregnancy (t=2.566; p=0.01). Empowerment partially mediated the effect of Knowledge on early marriage and unintended pregnancy (indirect effect=-0.061; p=0.035), whereas attitudes had no mediating role. Program characteristics did not moderate the impact of empowerment on unintended pregnancy (t=0.227; p=0.82). Conclusion: Enhancing adolescents’ understanding and empowering Youth Posyandu are critical strategies to prevent early marriage and unintended pregnancy in coastal communities.

https://hehp.modares.ac.ir/article_28714_8ca33d44648cc9feecef21e5a7123291.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 Emerging Human Viral Diseases; Drivers, Countermeasures, and Future Challenges 215 217 28937 10.58209/hehp.14.2.215 EN S.M.R. Kazemzadeh Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 0009-0002-3458-5206 M.M. Fazeli Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran H. Soleimanjahi Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran 0000-0003-1931-7801 Journal Article 2026 05 31 Introduction: Emerging viral diseases are driven by viral evolution, environmental change, human activities, and weaknesses in public health systems. Advances in vaccines, antivirals, monoclonal antibodies, and novel therapeutic approaches have improved outbreak preparedness and response. However, major challenges remain, including fragmented surveillance, inequitable access to countermeasures, health-system limitations, and misinformation. This review was conducted to summarize current evidence on the ecological, environmental, socioeconomic, and health-system drivers of viral emergence and re-emergence; review advances in preventive and therapeutic countermeasures; evaluate the contribution of the One Health framework; and identify major global preparedness gaps and potential solutions for future outbreaks. Conclusion: The One Health approach provides a framework for strengthening prevention, early detection, and coordinated response. Mitigating the increasing threat of emerging viral diseases requires a comprehensive and multidisciplinary strategy that combines biomedical innovation, integrated One Health surveillance, resilient health systems, equitable access to diagnostics, vaccines, and therapeutics, and sustained international collaboration. Addressing persistent preparedness gaps through coordinated governance, long-term investment, and cross-sectoral partnerships will be essential for strengthening global health security and improving readiness for future outbreaks.

https://hehp.modares.ac.ir/article_28937_bb01328b7c80115379ecf1765e027c36.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 Effectiveness of A Behavior Modification Intervention Model Based On Social Cognitive Theory to Improve Healthy Lifestyle Compliance Among Adolescents 1001 1011 29074 EN Pahrur Razi 0000-0003-2835-1710 Ervon Veriza 0009-0009-1712-5866 Surayah Surayah 0009-0004-6235-9235 Journal Article 2026 05 24 Background: Behavioral modification interventions based on Social Cognitive Theory are needed to improve healthy lifestyle compliance among adolescents. Objective: This study aimed to develop and examine the effectiveness of a behavioral modification intervention model based on Social Cognitive Theory to improve healthy lifestyle compliance among adolescents Methods: This study employed a mixed-method sequential exploratory design consisting of qualitative and quantitative approaches. The quantitative phase used a one-group pretest–posttest design involving 100 adolescents selected through purposive sampling. Data were collected using a healthy lifestyle compliance questionnaire that had been tested for validity and reliability. The intervention was conducted through four stages: introduction, preparation, action, and maintenance. Data were analyzed using paired t-test and Cohen’s d effect size analysis with a significance level of p < 0.05 using SPSS version 25.0. Results: The mean healthy lifestyle compliance score increased significantly from 61.42 ± 8.53 before intervention to 78.67 ± 7.14 after intervention, with a mean difference of 17.25 points (p < 0.001; 95% CI: 15.09–19.41). The intervention demonstrated a large effect size with Cohen’s d value of 1.24. Multivariate analysis showed that self-efficacy (p < 0.001), self-regulation (p = 0.001), family support (p = 0.003), and peer support (p = 0.005) were significantly associated with healthy lifestyle compliance after intervention. Conclusion: The behavioral modification intervention model based on Social Cognitive Theory was effective in improving healthy lifestyle compliance among adolescents.

https://hehp.modares.ac.ir/article_29074_e3030406173074724559c34666f5830f.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 Dengue Prevention Behaviour from a Social Ecological Model Perspective: A Systematic Review 29075 EN Iskandar Arfan 0000-0001-7240-8046 Lilis Sulistyorini 0000-0002-5005-0677 Muji Sulistyowati Ayu Rizky Journal Article 2026 06 13 Aims Dengue remains a major public health problem in endemic regions. Its prevention is influenced by a complex interaction of behavioral, social, environmental, institutional, and policy factors. However, previous studies have often examined these factors separately, limiting a comprehensive understanding of their interrelationships. This Systematic review aims to synthesize recent evidence on determinants of dengue prevention behavior using the Social Ecological Model (SEM) as an integrated analytical framework. Material & Methods This systematic review was conducted through literature searches in Scopus, ScienceDirect, and PubMed, supplemented by manual searching of relevant studies published between 2013 and 2025. The findings were synthesized descriptively across five SEM levels, including intrapersonal, interpersonal, community, institutional, and policy domains. Findings Results show that dengue prevention behavior is shaped by interacting determinants across all SEM levels. At the intrapersonal level, knowledge, attitudes, risk perception, and self-efficacy play key roles. At the interpersonal level, social support and the involvement of community health workers strengthen preventive practices. At the community and institutional levels, environmental conditions, mosquito density, access to information, health system capacity, and communication strategies significantly influence prevention efforts. At the policy level, weak coordination and limited enforcement remain major barriers. In conclusion, dengue prevention requires integrated multi-level approaches. Conclusion The findings support strengthening strategic intervention programs aligned with Sustainable Development Goal 3, emphasizing coordinated action across individual, social, environmental, institutional, and policy levels to achieve sustainable dengue control. Keywords: Dengue Prevention, Social Ecological Model, Health Behavior, Systematic Review, Vector Control

https://hehp.modares.ac.ir/article_29075_b025330edaf516645245e837c04682f8.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 A School-based, Multi-Component Intervention To Prevent Adolescent Tobacco and Cannabis Use 29127 EN Dávid Pócs 0000-0001-6544-5148 Máté Millner Dóra Melinda Vaszkó Jezdancher Watti Oguz Kelemen Journal Article 2025 12 10 Background: Schools represent a key setting for substance use prevention during adolescence. Multi-component school-based programs aim to influence knowledge, attitudes, and social norms simultaneously, yet evidence regarding their effectiveness remains inconsistent. Objective: This prospective pilot study aimed to assess the feasibility, acceptability, and indicative effects of a multi-component school-based intervention targeting tobacco and cannabinoid use among adolescents. Methods: A prospective observational design was applied in a Hungarian secondary school. Anonymous self-report questionnaires were administered before, during, and after the intervention (n=417, n=497, and n=631, respectively). Outcome indicators included lifetime and 30-day prevalence of tobacco and cannabinoid use, knowledge, attitudes, and participation in individual program components. Results: Participation rates differed substantially across intervention components, with peer-led and digitally mediated elements attracting higher engagement. Students who participated in peer group activities or prevention quizzes reported significantly lower rates of cannabinoid experimentation (p<0.05). No significant reduction in overall substance use prevalence was observed over time. Conclusion: The pilot intervention proved feasible and acceptable within the school environment and successfully reached adolescents who had already experimented with tobacco or cannabinoids. While no clear reduction in prevalence was detected, the program enhanced transparency of substance use patterns and provided valuable insights for refining school-based prevention strategies.

https://hehp.modares.ac.ir/article_29127_0d65b82f59ffb7da013b93e7021f67f8.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 Effect of Structured Multicomponent Health Education on Tuberculosis Prevention Knowledge and Attitudes in Indonesian Primary Care: A Quasi-Experimental Study 29128 EN Linda Marni 0009-0003-2007-0081 Prima Yoselina Kheniva Diah Anggita Armaita Armaita Journal Article 2026 07 15 Aims: To assess baseline-adjusted differences in tuberculosis (TB)-prevention knowledge and attitudes after structured multicomponent health education in Indonesian primary care. Methods: This non-randomized pre-test-post-test control-group study enrolled 40 patients with active TB at Lubuk Alung Health Center, Padang Pariaman, during November-December 2024. Participants were allocated non-randomly to intervention (n=20) or routine-counseling control (n=20) groups. The intervention was a 15-20-minute education package covering TB information, preventive behavior, and household environmental risk reduction. Knowledge was assessed with eight items scored 1-3 (range 8-24), and attitude with 15 items scored 1-5 (range 15-75). Separate ANCOVA models compared post-test scores while adjusting for baseline. Findings: Knowledge increased from 17.25±2.10 to 20.45±1.57 in the intervention group and from 16.80±2.24 to 19.80±1.58 in the control group. The adjusted difference was 0.40 (95% CI -0.27 to 1.08; F(1,37)=1.47; p=0.233; partial η²=0.038). Attitude increased from 48.70±5.31 to 55.95±5.08 and from 45.20±4.07 to 49.20±3.75, respectively. The adjusted difference was 4.19 (95% CI 2.23 to 6.16; F(1,37)=18.72; p<0.001; partial η²=0.336); HC3 inference remained significant (p=0.002). Conclusion: The intervention was associated with a higher baseline-adjusted post-test attitude score but not a significant knowledge advantage over routine counseling. Non-random allocation limits causal interpretation, and objective environmental change was not measured.

https://hehp.modares.ac.ir/article_29128_24f1f625bd45de40d754ee728086e4dc.pdf

Tarbiat Modares University (TMU) Health Education and Health Promotion 2588-5715 14 2 2026 07 01 Gamification Approaches to Improve Learning Outcomes among Medical Students: A Systematic Review 29129 EN R. Nona Millani 0009-0002-3228-029X Abdul Khairul Rizki Purba 0000-0003-4943-6369 Hermanto Tri Joewono 0000-0002-9372-2656 Journal Article 2026 06 17 Introduction: Gamification has increasingly been incorporated into medical education to improve student engagement, motivation, and academic performance. By integrating game-related components, including points, rewards, leaderboards, and interactive challenges, gamification seeks to create a more engaging and student-centered learning environment. However, evidence regarding its effectiveness in improving knowledge acquisition and clinical competence among medical students remains inconsistent. This study aimed to systematically evaluate the effects of gamification-based learning interventions on knowledge outcomes, clinical skills, OSCE performance, and student motivation. Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, Google Scholar, and citation tracking sources through December 2025. Quantitative studies evaluating gamification interventions among undergraduate or professional medical students were included. Data were synthesized narratively, and meta-analysis was conducted using a random-effects model. Effect sizes were calculated using standardized mean differences with 95% confidence intervals, while heterogeneity was assessed using the I² statistic. Results: Fourteen studies met the inclusion criteria, and six studies were eligible for meta-analysis. The pooled analysis demonstrated a moderate positive effect of gamification compared with conventional teaching approaches. Greater benefits were observed in clinically oriented and skill-based learning activities, although substantial heterogeneity was identified across studies. Gamification also improved collaborative participation, learning satisfaction, and classroom interaction in several studies involving simulation-based educational activities among undergraduate medical education programs. Discussion: Gamification appears to be a promising educational strategy in medical education; however, additional high-quality studies are needed to establish more consistent evidence regarding its effectiveness across diverse educational settings.

https://hehp.modares.ac.ir/article_29129_55f16320eb523947f12d2e94d9630c6e.pdf