Think Aloud Testing in Usability Evaluation of the Love Your Breast Application to Enhance Self-Examination Behavior in Adolescents

Background: Adolescents are a key demographic for promoting early breast cancer detection through Self-Breast Examination (SADARI). Mobile health (mHealth) applications offer potential to increase awareness and encourage preventive behaviors, but their effectiveness depends on usability and user experience. Objective: This study aimed to evaluate the usability of the Love Your Breast mobile application using the Think Aloud method and to identify design improvements to enhance its effectiveness for adolescent users. Methods: A descriptive qualitative design was employed. Ten female high school students in Bandung participated in Think Aloud usability testing, performing seven task scenarios while verbalizing their thoughts. Quantitative data were analyzed through task success rate calculations, while qualitative data were examined using thematic analysis. Results: The application achieved an average success rate of 86%. Thematic analysis revealed three main usability themes: (1) general observation—issues with font size, color brightness, and background images; (2) performance expectancy—users could not access the video feature; and (3) effort expectancy—some users experienced slow downloads due to poor internet access. Although the app was considered informative and easy to use, these issues negatively affected the overall user experience. Conclusion: The Love Your Breast app shows promise as a tool for adolescent breast cancer awareness and early detection. Future updates should address visual consistency, enable offline video access, and improve performance under limited connectivity. These changes will enhance usability and align with user-centered mHealth design principles, supporting its broader adoption in adolescent health promotion

Effect of Roleplay Tabletop Disaster Simulation on Flood Preparedness Attitudes Among Junior High School Students

Background: Disaster preparedness training is essential for junior high school children as a vulnerable group to increase awareness and preparedness for disasters. RTDS is an appropriate intervention in improving disaster preparedness. Objective: This study aims to determine the effect of tabletop roleplay disaster simulation on students' flood disaster preparedness attitude at SMPN 1 Muncar in 2024. Methods: A pre-experimental one-group pre-test and post-test design was used in this study, involving 30 respondents selected through a purposive sampling technique. A role-playing tabletop disaster simulation was used as the independent variable instrument to measure its effect on students' preparedness attitudes as the dependent variable. To measure the attitude of flood disaster preparedness in junior high school students using a questionnaire on the attitude of student preparedness in facing flood disasters. The questionnaire has been tested for validity and reliability. The data analysis method used is the Wilcoxon test. Results: The results of the analysis showed that after being given the Roleplay Tabletop Disaster Simulation (RTDS), students' disaster preparedness attitudes increased significantly. Before the intervention, 63.0% of respondents were in the low category, while after the intervention, 87.0% of respondents were in the very high category. Wilcoxon test showed that this difference was significant (P = 0.000 < 0.05), indicating the effect of RTDS on students' disaster preparedness. Conclusion: RTDS helps students understand safety procedures and improves their adaptability during disaster events

Effect of Visual Learning Media and Guidebooks on Fluid Restriction Compliance Among Hemodialysis Patients

Background: Hemodialysis is vital for patients with end-stage renal disease, and adherence to fluid restrictions is crucial for preventing complications and improving quality of life. However, many patients struggle with fluid intake control due to limited understanding. Objective: This study aimed to assess the impact of visual learning media and guidebooks on fluid intake control, measured by Interdialytic Weight Gain (IDWG), in hemodialysis patients. Methods: A quasi-experimental design involved 26 participants in the intervention group, who received visual media and guidebooks, and 26 controls. IDWG was used to measure fluid restriction compliance. Data were analyzed using t-tests and multiple linear regression. Results: The intervention group showed a significant reduction in IDWG (p < 0.001), indicating improved compliance. Regression analysis found that education level (R² = 0.353, p = 0.008) was a significant predictor of fluid restriction compliance. Conclusion: Visual learning media and guidebooks significantly improve fluid restriction adherence in hemodialysis patients, leading to a reduction in IDWG. These tools are effective for enhancing patient education and improving clinical outcomes

Effectiveness of the Kalkulating Platform (Stunting Detection Calculator) for Increasing Hemoglobin Levels in Adolescents

Background: Anemia in adolescents is one of the contributing risk factors to stunting in early adulthood. Early detection and community-based interventions are essential for promotive and preventive efforts, particularly within school settings. One strategy implemented is the use of the adolescent stunting risk detection feature in the Kalkulating platform, applied by the Youth Information and Counseling Center (PIK R) at SMAN 1 Baregbeg. Objective: This study aimed to determine the effectiveness of the adolescent stunting risk detection feature in reducing anemia cases among adolescents. Methods: This study employed a quantitative descriptive design with a pre-post intervention approach. The subjects were students from SMAN 1 Baregbeg actively engaged in PIK R activities. Hemoglobin (Hb) levels were measured twice by the Baregbeg Public Health Center (Puskesmas Baregbeg), in October 2024 and May 2025. Initially, 44 adolescents were identified with anemia. After interventions including education and routine monitoring using the Kalkulating feature, a follow-up test showed only 10 cases of anemia. Results: There was a reduction of 34 anemia cases from a total of 44, indicating an effectiveness rate of 77.27% and Cohen’s 3,34. According to the effectiveness classification based on percentage change, this intervention falls under the effective category. Conclusion: The implementation of the adolescent stunting risk detection feature in the Kalkulating platform was effective in reducing anemia rates among adolescents. This model can be replicated in school-based health programs with multisectoral support, including primary healthcare providers such as community health centers

Enhancing Maternal Understanding of Infant Immunization Through Intensive and Discovery-Based Approaches: A Quasi-Experimental Study

Background: Children's health issues are one of the government's priorities in creating a quality generation. One effort to achieve this goal is that all children under five are given immunization. The challenge in implementing the immunization program which causes the immunization coverage target to not be achieved is the low level of knowledge. So the role of Health workers is to provide information using demonstration methods and discovery methods. Objectives : To determine the effectiveness of the demonstration method and discovery method on mothers' knowledge about the completeness of basic immunization for babies in the working area of the Cibadak District. Method: This research used quasi-experimental research with a sample size of 36 people. Data techniques include univariate analysis using frequency distribution and bivariate analysis using paired t test. Result: The results of this study show that there is an influence of health education methods and findings on maternal knowledge about the completeness of basic immunization, p value 0.000. Conclusions and Suggestions: Providing education using discovery is more effective than demonstration in increasing mothers' knowledge about basic immunization. It is hoped that the provision of education can be implemented to increase mothers' knowledge of basic immunization

Square Stepping Exercise for Stress Management in Among Elderly: An Experimental Study

Background : Stress is a common psychological issue among older adults, particularly those residing in nursing homes. This condition can negatively affect both physical and mental health. Physical activity-based interventions, such as Square Stepping Exercise (SSE), have been explored as a potential strategy to alleviate stress in the elderly. This study aims to analyze the effect of Square Stepping Exercise on stress levels among older adults living in nursing homes. Objective: This study aims to evaluate the effect of Square Stepping Exercise (SSE) on stress levels in elderly people living in nursing homes.  Method: The method used in this research is an experiment with a pre-test and post-test design. A total of 33 elderly people in nursing homes took part in the SSE program. The stress scale was measured before and after the intervention using a measuring tool, the Perceived Stress Scale (PSS). Result: The results of the analysis show that there is a significant decrease in the stress scale after SSE training, with a p value <0.05  and Δ = 10,7. This may indicate that SSE training is effective in reducing stress levels in the elderly. This reduction in stress is associated with increased physical activity, improved balance, and social interaction during exercise. Conclusion: Square Stepping Exercise can be used as an alternative intervention to reduce stress in elderly people in nursing homes, which has a positive impact on their quality of life

The The Relationship Between Internet Addiction and Academic Procrastination in Nursing Bachelor Students Who Are Compiling Thesis in Bandung

Background: Academic procrastination is a widespread issue affecting university students, often linked to behavioral factors such as uncontrolled internet use. Among final-year nursing students, extended time spent on non-academic online activities—exceeding four hours daily—may contribute to delays in completing academic responsibilities. Objective: This study aimed to explore the relationship between internet addiction and the tendency to procrastinate academically among undergraduate nursing students. Method: A correlational quantitative approach was utilized in this study. The target population included 90 final-year students, with 86 respondents selected using an accidental sampling method. Data were collected through two standardized questionnaires—one measuring internet addiction levels and the other assessing academic procrastination. Statistical analyses included both univariate and bivariate procedures, with Spearman's rank correlation used to examine the association between the two variables. Results: Of the 86 participants, 60 students (69.8%) demonstrated moderate internet addiction, while 56 students (65.1%) reported moderate levels of academic procrastination. Analysis showed a statistically significant positive correlation between internet addiction and procrastination behavior (p = 0.007; r = 0.288). These findings suggest that higher levels of internet dependency are associated with an increased likelihood of delaying academic tasks. Conclusion: There is a meaningful association between excessive internet use and academic procrastination. It is recommended that students develop better time management strategies by limiting recreational internet use and allocating focused periods for academic work to reduce procrastination tendencies and improve academic outcomes

The Relationship Between Peer Social Support and Anxiety in Final Year Students Who Are Writing Their Thesis

Background: The demands of completing a final project, coupled with an individual's lack of preparedness, can give rise to psychological problems such as anxiety, stress, and depression. Factors influencing anxiety include social support, trust, and modeling. Among these, peer social support plays a particularly significant role in the academic environment. Objective : This study aimed to examine the relationship between peer social support and anxiety among final-year students preparing their undergraduate thesis in the Nursing Study Program. Methods: This study employed a quantitative research design with a cross- sectional approach. A total of 110 final-year students were selected using stratified random sampling. Data were collected using standardized questionnaires: the Hamilton Rating Scale for Anxiety (HRS-A) to measure anxiety levels and the Peer Social Support Scale to assess peer social support. Data were analyzed using univariate and bivariate techniques, with the chi-square test applied to determine the relationship between variables. Results: The results of the study showed that out of 110 respondents, 10 (9.1%) had panic anxiety, 30 (27.3%) were severe, 20 (18.2%) were mild, and 24 (21.8%) had no anxiety. Peers were found to be 28 (25.5%) low, 53 (48.2%) moderate, and 29 (26.4%) high. The results of the relationship analysis obtained a P value of 0.0001 (α <0.05), which shows that there is a relationship between peer social support and anxiety. Conclusion: Based on the results of research and discussion regarding the Relationship between Peer Social Support and Anxiety in final-year students Who Are Writing Their Thesis in the Nursing Study Program (S-1), Faculty of Health Science and Technology, Jenderal Achmad Yani Universit

Integrating Maternity Gymnastics and Effleurage Massage into Midwifery Care: A Complementary Strategy for Maternal Comfort and Efficient Labor

Background: Maternal morbidity and mortality remain significant public health challenges in Indonesia. Complications such as labor pain, sleep disturbances, and fetal malposition continue to affect maternal outcomes. Complementary therapies, including maternity gymnastics and effleurage massage, have emerged as potential strategies to enhance maternal comfort and promote efficient labor. Objective: This study aimed to evaluate the effects of integrating maternity gymnastics and effleurage massage into midwifery care on improving maternal sleep quality, fetal descent, and labor outcomes. Methods: A quasi-experimental, one-group pretest-posttest design was employed. Forty-two pregnant women between 32 and 36 weeks gestation were recruited consecutively from a public health center in West Java, Indonesia. Participants engaged in weekly maternity gymnastics sessions and received effleurage massage during the first stage of labor. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and labor outcomes were recorded using a validated checklist. Data were analyzed using paired t-tests and descriptive statistics. Results: There was a significant improvement in sleep quality following the intervention, with the mean PSQI score decreasing from 8.6 ± 2.1 to 5.2 ± 1.8 (p < 0.001). The mean duration of the first stage of labor was 4.3 ± 1.1 hours. A high proportion of participants achieved spontaneous vaginal delivery (90.5%), and early fetal head engagement at admission was observed in 83.3% of cases. Labor pain intensity was moderate, with a mean Visual Analog Scale (VAS) score of 5.7 ± 1.4. Conclusion: Integrating maternity gymnastics and effleurage massage into midwifery care effectively improved maternal sleep quality, facilitated fetal engagement, and promoted shorter labor duration. These findings support the incorporation of complementary therapies into routine antenatal and intrapartum care to enhance maternal comfort and optimize labor outcomes

The Effectiveness of Audio-Visual-Based Education on Type 2 Diabetes Mellitus in Enhancing Self-Awareness Among Adolescents at Risk: A Quasi-Experimental Study

Aims: Aims of this study to determine the effect of providing audio-visual-based type 2 diabetes mellitus education on self-awareness in adolescents at risk of type 2 diabetes mellitus. Methods: A two-group quasi-experimental design is used in quantitative research, and G-Power 3.1 is used as a selection method. The 100 students in the study were split into two groups: the intervention group and the control group. The Public Awareness of Diabetes questionnaire was used. To be eligible, people had to be in the low to moderate risk group for DM and have a gadget. The Paired Sample T-test and Wilcoxon's rank were used to analyze the data. Results: The Paired Sample T-test analysis revealed a significant difference in the intervention group following education on type 2 diabetes mellitus, with a p-value of <0.001 and a t-value of 3.744. Simultaneously, the control group employed Wilcoxon's rank, yielding a p-value of 0.079 and an r-value of 1.756. Conclusions: There was an effect of providing type 2 diabetes mellitus education on self-awareness in adolescents at risk of type 2 diabetes mellitus in the intervention group. However, there was no effect of providing type 2 diabetes mellitus education on self-awareness in adolescents at risk of type 2 diabetes mellitus in the control group. This may be because there are differences in the treatment given to the two groups