Voices from Primary Care: A Needs Assessment Among Multidisciplinary Primary-Care Teams for a Health Promotion Model-Based E-Counseling Platform to Support Fall Prevention Among Older Adults in Indonesia.

Authors

Lina Safarina, Cecep Eli Kosasih, Iqbal Pramukti, Nucki Nursjamsi Hidajat

Published in

Journal of multidisciplinary healthcare. Volume 19. Pages 626707. Epub Aug 12, 2026.

Abstract

Falls are a leading cause of injury and disability among community-dwelling older adults, with a disproportionate burden in low- and middle-income countries (LMICs). In Indonesia, primary-care centres (puskesmas) and their multidisciplinary teams are the principal platform for older-adult care, yet most lack a structured fall-prevention protocol. Digital e-counseling could extend primary care, but its design in LMICs rarely begins with a bottom-up assessment of primary-care workforce needs.
To explore multidisciplinary primary-care programme holders' perspectives on fall risk, structural barriers, current digital practices, and requirements for an e-counseling platform grounded in Pender's Health Promotion Model (HPM), a framework linking perceived benefits, barriers, self-efficacy, interpersonal and situational influences, and commitment to action.
A qualitative descriptive design was used. Thirteen elderly-health programme holders from all 13 puskesmas in Cimahi City, West Java (nursing, medicine, public health, midwifery, nutrition), participated in two focus group discussions (FGDs; six and seven participants, with disciplines mixed across both groups). Sessions were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's reflexive thematic analysis with deductive mapping to HPM constructs. Trustworthiness was supported by independent dual coding, member-checking, an audit trail, and reflexive memos.
Four themes were generated: multifactorial fall causation; structural barriers (no fall-specific protocol in any centre, workforce shortages, large catchments, limited family engagement, and mobile-data costs); an existing WhatsApp-based digital substrate; and explicit e-counseling design needs (risk screening, multimedia education, asynchronous Q&A, tiered cadre-mediated access, reminders, home-safety checklist). Findings mapped onto perceived susceptibility and severity, perceived benefits and barriers, perceived self-efficacy, interpersonal and situational influence, and commitment-to-action plan.
Indonesian primary-care multidisciplinary teams articulate a system-level case for an HPM-based e-counseling platform that augments face-to-face care, integrates with WhatsApp, and includes cadre- and family-mediated channels, offering preliminary, context-specific insight for LMIC primary care.

PMID:
42605340
Bibliographic data and abstract were imported from PubMed on 17 Aug 2026.

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