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    § sciendo Community-based intervention of chronic disease management program in rural areas of Indonesia’ Original article Tantut Susanto™*, Kumboyono, Irawan Fajar Kusuma®, Adzham Purwandhono’, Junaiti Sahar* Fay and Recelved: 3 September 2021; Accepted: 23 November 2021; Published: 20 June 2022 Objective: Ths sty evalistes the communiy-bases intervention of chronic @sease management (CDM) tough te negrated N-Cammnuniadle Diseases Heat Post Paebndu-NCD) conducted by a community a heakh workers (CHWS) dames’ ual Methods: A cohort revospecive study evauted 577 paripant from Posindu-NCD in 7 publ health cetrs (PACS) n 2018. ‘Actas of rerveion of COM for Posindu-NCD Was ineute, ie rk Tact to NCOs, and provided counseling education and ote olow-ups based an tervews and measurement es Tarte five Desk systems hat recordin a medial recor as frm of he monty acy report each the fst mot, the 6 mans, andthe 12th mon Results: There were stasalysigieantteences for ach consumed and Gabetes melts (x? = 10455; P = 0.0%) Thre were soniicant erences on gender (= 3.968; P = 0047), on ent (7! 19.873; P< 0.001) an hypertension. bn aon there were also sgnfeantditerenes on etnety (z?= 15:07; P< 0001), vepelableconsumpon (z"= 4.435, P = 1085), physical exercise (z* = 6828; P = 0.012}, and te curet diseases of nypercholesterlenia ot parcipans armor, the Suva at among paints who have overaight, abdominal overweight, hypertension, dabeles rails, and iypercholesterlenainereased among patients wo reulty vised Posbnd-NCD compared wih ne nor-egulay oe. Conclusion: The COM progr’ communty-based InervensonIvoughPostindi-NCD conducted by CVs imgroved sual fates in Indonesia's rural areas Therefore, this program canbe futher developed in conducting COM inthe eammunty with he active imavemeat of CHW sa tat he communty becomes active regularly npartipaing in Posindu-NCD aces in ual eas of Indonesia. Keywords: ciranicdsease management + cormunty-basedinterenion *cormunty heath worker + noncommunicable disease © Shane Metal Parioccal Pes. “This projetwas supported by the Univer of mer for fncng 108 grand resaarch No, 25601UN26..1LT/2020 How to cite this article: Susanto T, Kumboyono, Kusuma IF, Purwandhono A, Sahar J. Community-Based Intervention of Chronic Diseases Management Program in Rural Areas of Indonesia, Front Nurs.2022:2:187—196. * Garespord mal ett spsk@une)ac i 7 Susant) 8 open Access. ©7072 Susana eta published by Scien, TEIEIEENH Ts works teonsed under the Creative Commons Dntrouton 4 Lean, 1. Introduction Chronic disease (CD) is the leading cause of death and disability in the world. CD cases increased glob- ally from all socio-economic classes and made up 73% of all deaths, 60% of the global disease burden, and 79% of deaths in developing countries.’ Mean while, CDs are increasing in Indonesia, such as 10.9% of people experiencing strokes, 2% diabetes, 1.5% heart diseases, and 8.8% hypertension Indo- nesia has been aware that CD is becoming one of the health Issues and cause of death, causing major global threats to Indonesia's economic development? Therefore, intervention to prevent CD should focus fon controlling key risk factors in a wellintegrated CD is linked by common and preventable bio- logical risk factors, notably high blood pressure, high blood cholesterol and overweight, and related major behavioral risk factors: unhealthy diet, physical inac- tivity, and tobacco use.' Therefore, developing an integrated approach that will control and prevent these factors should be implemented in a particularly com- ‘munity-based intervention program for primary care.* Primary care and community care are vital settings for, CD's effective management.*A self-management sup- port program effectively prevents CD in primary care.* Meanwhile, a selt-help group as social support was designed to solve CD in Indonesia's rural areas.” Fur- thermore, CD's risk factors in Indonesia are controlled by empowering the community through the Integrated Non-Communicable Diseases Health Post (Posbindu- NCD). The Posbindu-NCD operated by a community of health workers (CHWs) as cadres monitors and controls the CD each month." A previous study mentioned that effective integra- tion of CHWs within the primary care system is essential for CHWs capacity buildings, necessary supervisory arrangements, supply of logistics and medications, and effective recording and reporting systems for preven- tion and control of NCDs in Nepal? Meanwhile, Pos- bindu cadres’ performance in the Indonesian setting has fa strategic function for delivering CD's management because Posbindu agendas depend on cadres’ role in carrying out their duties and obligations." On the other hhand, itis possible to implement an intervention inte- grating CD prevention and management services into primary care settings as a community-based interven tion program.*® Therefore, this study aims to evaluate community based intervention of CD management programs conducted by CHWs in Indonesia's rural areas, 2, Methods 24. Design A cohort retrospective study was used to evaluate the data from the community-based intervention for CD ‘management program in 7 public health centers (PHCs) in7 of rural sub-districts of Indonesia in 2019, 2.2. Participant of this study Participants in this study were Posbindu-NCD par- ticipants who carried out regular monthly checks from January to December 2019 in 7 PHCs in 7 of rural sub-districts of Indonesia. The inclusion eriteria in this study were follows: (1) Posbindu-NCD partic- pants aged more than 18 years; (2) participants par- ticipating in a community-based intervention of CD management every month, either coming directly to Posbindu-NCO or having an examination at home; (3) participants with complete registration data for risk factor examination and measurement of the Posbindu- NCD card. The study exclusion criteria included par- ticipants who were hospitalized and moved to their residence. total of 770 medical records registered in Posbindu- NCD during 2019 were selected: 193 medical records were excluded in this study (103 not regularly partic- pated in Posbindu-NCD each month, 40 participants were not at home during home visi, 15 moved to ‘other sub-districts, 20 were sick and being cared for at the hospital, and 15 were dead). Finally, 577 medical records were analyzed in this study. 2.3, Description of the program ‘Community-based intervention for CD management program in Indonesia's rural areas in this study was inte- mus us 06> oH 0 isha. (isis ase (seo wo ores sai uo 99 emus wD 9S BH sous unnooay see Wenre (unde forme Woe wore aut szeses (red ses: Graze Gsden (eso) enor sau eee) ECL GTS uehOoL see oso ude sare oe aes worse Guzen «ome ees ERS! sem se Un mos MON Mba Ge Moen ON Meee Wm meen MeN Rm sa, Who had abdominal overweight ranged from 0.6 to 1.0 (Figure 28). The survival rate of participants with hyper- tension who regularly visited Posbindu-NCD ranged from (0.45 to 1.0 (Figure 2C). The survival rate of participants a) () ) With dlabetes melitus who regulaty visited Posbindu-NCD ranged from 0.2 to 1.0 (Figure 20). The survival rate of par- ticipants with hypercholesterolemia who regularly visited PPosbindu-NCD ranged from 0.65 to 1.0 (Figure 26) ®) Figure 2. (A) Survival for Overweight, (B) Survival for Abdominal Overweight, (C) Survival for Hypertension, (0) Survival for Diabetes Melitus. (E) Survival for Hypercholesterolemia, ven wear Nonseguar me? mata) a Tet aa? ages cog Fogobe 2 wo us) 6 1190 sora Aogubr 6.622 1190 Blood pressure Nenteguar ee maa) a0) rm aa anne

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