Evaluation of Usability and User Experience of Oncodoc 's M-Health Application for Early Detection of Cancer.

OBJECTIVE: Cancer is a non-communicable disease that accounts for 71% of deaths globally. The prevalence of people living with cancer in Indonesia increased from 1.4/1000 population (2013) to 1.8/1,000 population (2018). This study aims to evaluate usability, user experience, and user feedback on the use of the Oncodoc m-health application. METHODS:  The research method uses mixed methods with a cross-sectional approach and online survey sampling techniques (677 respondents), in December 2021-January 2022 in Indonesia. The instruments used are the System Usability Scale and User Experience Questionnaire. The variables measured include the characteristics of respondents, usability, user experience, and responses to using applications qualitatively. Quantitative data were analysed descriptively and the User Experience Questionnaire's analysis tool. Qualitative data were analysed thematically. RESULTS: Evaluation of the usability of Oncodoc's m-health application is in the "acceptable" category (70.88), and the adjective rating is in the "Good" category. Evaluations of the relative quality of user experience are in the "good" and "very good" types. The average user experience scale is (mean; SD): attractiveness (1.80; 0.99), perspicuity (1.82; 1.05), efficiency (1.78; 1.09), dependability (1.56; 1.01), stimulation (1.81; 1.06), and novelty (1.32; 1.10). The findings of this study are 1) the ability to accommodate user needs, 2) usage barriers, and 3) user expectations for the Oncodoc application. CONCLUSION: Overall, the Oncodoc m-health application is acceptable to users. We recommend developing a cancer early detection application with an approach that refers to user needs for further research.

Development and validation of digital health literacy competencies for citizens (DHLC), an instrument for measuring digital health literacy in the community.

COVID-19 is a new disease in human life and has become pandemic. Pandemic Coronavirus Disease (COVID-19) has been speeding up digital transformation in every sector. Implementation of digital technology in health should be supported by the community's readiness, such as digital health literacy to achieve the goals, optimize health service performance, and blockage infodemics and miss information. Implementation of digital technology in health should be supported by the community's readiness, such as digital health literacy to achieve the goals, optimize health service performance, and blockage infodemics and miss information. This study aims to develop a tool to measure digital health literacy in the community through three stages such as expert review, pre-test and field test. DHLC adopted the five competencies areas into 18 questions and put eight questions related to health literacy; the total items question of DHLC are 26 items questions. This study reveals that all of the score digital competencies areas below 4. Score 4 in DHLC indicates that the community still need guidance to doing activity in the digital environment. Elevating digital health literacy in the citizens is urgent to control the spreading misinformation and disinformation that could worsen pandemics. Future studies need to conduct to test the validity and reliability of DHLC in various settings.

Is Youth Smoking Related to the Density and Proximity of Outdoor Tobacco Advertising Near Schools? Evidence from Indonesia.

BACKGROUND: Smoking was among the top contributors to deaths and disability as the prevalence among male adults remains high, and that among male youth increases in Indonesia. While local studies have shown high visibility of outdoor tobacco advertising around schools, the country still has no outdoor tobacco advertising ban. OBJECTIVE: To examine the association between youth smoking behavior and measures of outdoor tobacco advertising density and proximity in Indonesia. METHODS: We combined two primary data sources, including outdoor tobacco advertising and smoking behavior among male youth in Semarang city. We randomly selected and interviewed 400 male students at 20 high schools in the city. In addition, we interviewed 492 male adults who lived near the schools for comparison. RESULTS: We found significant associations between smoking use among youth (but not among adults) and measures of outdoor tobacco advertising density and proximity in Semarang city. Youth at schools with medium and high density of outdoor tobacco advertising were up to 2.16 times more likely to smoke, compared to those with low density. Similarly, youth at senior high schools with proximity to outdoor tobacco advertising were 2.8 times more likely to smoke. Also, young people at poorer-neighborhood schools with a higher density of and proximity to outdoor tobacco advertising were up to 5.16 times more likely to smoke. CONCLUSIONS: There were significant associations between smoking use among male youth (but not among male adults) and measures of outdoor tobacco advertising density and proximity in Indonesia. This highlights the need to introduce an outdoor tobacco advertising ban effectively, at least near schools.

Development and validation of an instrument for measuring competencies on public health informatics of primary health care worker (PHIC4PHC) in Indonesia.

Because of the increasing adoption and use of technology in primary health care (PHC), public health informatics competencies (PHIC) are becoming essential for public health workers. Unfortunately, no studies have measured PHIC in resource-limited setting. This paper describes the process of developing and validating Public Health Informatics Competencies for Primary Health Care (PHIC4PHC), an instrument for measuring PHC workers' competencies in public health informatics. Method: This study developed a questionnaire that had three stages: the Delphi technique, a pretest, and field test. Eleven academicians from a university and 13 PHC workers joined 2 rounds of group discussion in the first stage. The second stage comprised two pilot studies with 75 PHC workers in Semarang Municipality. The third stage involved validating the questionnaire with 462 PHC workers in Kendal District. This study used Pearson's product-moment correlation for the validity check and Cronbach's alpha coefficient for determining the internal consistency. This study used the K-means algorithm for clustering the results of the PHIC4PHC questionnaire. Results and Conclusion: PHIC4PHC is the first comprehensive PHIC questionnaire administered in a resource-limited setting, consisting of 11 indicators and 42 measurement items concerning knowledge of health information systems, skills required for health data management, ethical aspects of data sharing and health information literacy. The final results of PHIC4PHC were clustered into three classes based on the K-means algorithm. Overall, 45.7% PHC workers achieved medium competency, whereas 25.6% and 27.7% achieved low and high competency, respectively. Men had higher competency than women. The higher the worker's level of education, the higher the PHIC level; the longer the worker's work experience, the lower the PHIC score; and the greater the worker's age, the lower the PHIC score. Measuring and monitoring PHIC is vital to support successful health IT adoption in PHC.

The implementation of an integrated e-leprosy framework in a leprosy control program at primary health care centers in Indonesia.

BACKGROUND AND OBJECTIVE: The implementation of health information systems (HIS) could overcome obstacles in human resources and infrastructure at primary health care centers (PHCs). This study involved an e-Leprosy framework being integrated into the real setting of a leprosy control program in Indonesia. The objectives of this implementation study were to integrate e-Leprosy into a leprosy control program at 27 PHCs in Pekalongan District. Central Java Province, Indonesia to explore factors related the success or failure of such an implementation regarding the usability, involvement, and acceptance of e-Leprosy by PHC staff and to evaluate the effect of the implementation on leprosy patient attendance at PHCs. This paper is based on the Standards for Reporting Implementation Studies (StaRI) statement. METHOD: This study used mixed methods implementation research with longitudinal analysis and involved two groups of participants: Leprosy Surveillance Officers (LSOs), patients, and the relatives of patients. This study involved four phases consisting of preparation, baseline assessment, intervention, and evaluation. The qualitative study conducted focus group discussions and in-depth interviews. The e-Leprosy program automatically sent SMS reminders regarding leprosy treatment to the LSOs, patients, and patients' relatives every month. FINDINGS: This study determined that LSO had difficulties related to their workloads in PHCs while managing information and monitoring treatment and contact after release from treatment. The baseline assessment phase found that LSOs in Pekalongan District were unfamiliar with email but familiar using the internet. Overall, LSOs had a positive perception of the e-Leprosy program. The usability of this e-Leprosy program tended to increase over time, while acceptance of the e-Leprosy exhibited a significant relationship with computer and internet fluency (r = 0.48, p < 0.05) and age (r = 0.621, p < 0.01). The responsible patients correlated (r = 0.67, p < 0.01) with involvement in the e-Leprosy program. This study revealed that patient reminders increased on-time attendance by 13.9 % (p < 0.01 with OR = 2.41). CONCLUSION: Factors that should be considered during implementation HIS included the digital gap, PHC's staff workload, as well as the level of commitment and leadership in the health office.

Developing an Indonesia's health literacy short-form survey questionnaire (HLS-EU-SQ10-IDN) using the feature selection and genetic algorithm.

BACKGROUND AND OBJECTIVE: Measuring health literacy becomes more important because its association with health status and healthcare outcomes. Studies have developed at least 133 measurement tools for health literacy. HLS-EU-Q47 is a questionnaire consisting of 12 sub-dimensions and 47 questions developed by the Europe Health Literacy Consortium. Many countries in Europe and Asia have used HLS-EU-Q47 as a tool for measuring health literacy in the general public. Indonesia has conducted general health literacy survey using HLS-EU-Q47 but finding the difficulties because of the time-consuming interview. A shorter version of HLS-EU-Q47 is needed to apply in health literacy researches in Indonesia. This paper reports the results of feature reduction to develop a short Indonesian version HLS-EU questionnaire and measures the accuracy of the model compared with other short form like HLS-EU-SQ16 or HLS-SF12. METHOD: The analysis was performed on a population-based dataset from Indonesia-Semarang Health Literacy Survey for which there were specific target variables as the classification of health literacy level. All attributes were assessed as potential targets in the models derived from the full dataset and its subsets. The feature selection methods with genetic algorithm were used as the filter as well as validation (cross validation) and classification (k-NN:k-nearest neighbor). The predictive accuracy of health literacy level and the complexity of models based on the reduced datasets were compared among the methods and other short versions such as HLS-EU-SQ16, HLS-SF12. RESULT: The accuracy of the existing short form models were 90.64% with the HLS-EU-SQ16 and 88.67% with the HLS-SF12. This study proposed a model with 10 features as the construct of a short Indonesian-version (proposed as the HLS-EU-SQ10-IDN) since the model was with higher accuracy than the HLS-SF12, but fewer features for measuring general health literacy index. Moreover, the short version only completed part of 12 dimensions of the full questionnare. CONCLUSION: A data mining technique using feature selection with combination of genetic algorithm and k-NN algorithm was applied to develop a short version questionnaire and proved to have better accuracy, as compared with the short version developed by traditional statistical technique.

Encouraging On-Time Completion of Leprosy Patients Treatment: Implementing E-Leprosy Framework to Primary Health Care in Indonesia.

Low adherence to leprosy treatment is the main challenge in Indonesia. This is a quasi-experimental observational study in a real setting of a leprosy control program in Indonesia. The study is aimed at evaluating an e-leprosy framework in increasing the rate of on-time attendance at primary health care and on-time completion of treatment of leprosy patients. This study has implemented an e-leprosy framework for primary health care at Pekalongan District. The intervention was conducted for 19 months to observe a 1-episode long-term treatment of leprosy patients. The study collected data of 391 registered patients from June 2012 to March 2016. Based on the inclusion and exclusion criteria, this study selected 188 patients. The SMS (short message service) reminders proved to be effective in increasing on-time completion and on-time attendance rates by 21% and 14.6%, respectively. There is a trend for late collections of the drugs at the 3rd, 8th, and 11th multidrug therapy drug collections.

Health information system model for monitoring treatment and surveillance for leprosy patients in indonesia (case study in Pekalongan District, Central Java, Indonesia).

After India and Brazil, Indonesia has the third highest incidence/prevalence of leprosy in the world. Every year thousands of new cases and case with grade-2 disability are reported and, while the recovery rate lingers only 80-90 %. Therefore, more than 10 % of leprosy patients drop out of treatment and can be a source of new infections in the community. Our research was aimed at determining apparent difficulties in the leprosy control program as well as how a health information system (HIS) could assist the Indonesian leprosy control program. We used qualitative method with deep interview and observation of document. One of the difficulties which the Indonesian leprosy control program faces is discontinuity of patient's data due to rotating staff as well as the treatment monitoring and queries patients which should be monitored after treatment has ceased. Technology implementation is feasible through short message service (sms) reminders and web base applications. The leprosy control program urgently needs to implement continuous monitoring and recording of patients because of the particular characteristics of this contagious disease.