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Purpose: Understanding patient's preferences is important to delivering good quality services. Patients' feedback provides healthcare providers with valuable information about the services provided. The increasing number of international students enrolling in Hungarian Universities raises the need to ensure the quality of services meets international students' requirements, which includes healthcare. This study aimed to assess service quality in the University Health Center (UHC) from the international student's point of view to be used to improve the quality of services. Methods: This cross-sectional study was conducted at the university health center. We used a mixed methods approach to collect both quantitative and qualitative data. We used the importance-performance analysis (IPA) for quantitative analysis to understand expectations and perceptions in service research. The qualitative analysis was conducted from responses to reflection questions. The qualitative data were then analyzed using thematic analysis. Results: 437 international students participated in the study, but only 402 (91.99%) were analysed. The gaps between the importance and performance of service quality were negative in all dimensions (P-value < 0.001). This suggests that there is an unmet need for student expectations and university health center performance. From the Importance factor, the highest and lowest were related to safety (4.54 ± 0.56) and efficiency (4.31 ± 0.66) dimensions. The Performance factor's highest and lowest mean scores were also related to safety (4.22 ± 0.72) and efficiency (3.91 ± 0.87), respectively. From qualitative analysis, there are two major themes several secondary themes from the thematic analysis of free-text responses were identified. Conclusion: The importance and performance analysis could provide useful information to university policymakers about university health center service quality. There is a need for improvement and obviating the importance-performance gaps, especially in the efficiency dimension. Decision-makers can use the IPA analysis results to allocate limited resources more effectively, giving special attention to possible organizational weaknesses for further direction. [ABSTRACT FROM AUTHOR]

This study investigated lifestyle factors among Hungarian and international students, utilizing lifestyle medicine principles to enhance overall well-being. Conducted at the University of Debrecen through a cross-sectional survey, we examined selected lifestyle factors, more specifically sleep patterns, weight management, nutrition, physical activity, mental well-being, and alcohol use. Hungarian (N = 122) and international (N = 139) students were compared, revealing significant differences. Hungarian students slept less (p = 0.041), desired weight loss (p = 0.040), ate more fruits and vegetables (p = 0.014), exercised longer (p = 0.002), and reported higher purpose and social support (p = 0.009), with higher alcohol use (p < 0.001). These findings highlight distinct experiences and challenges faced by these student groups including variations in sleep, weight management, diet, exercise, and social support. Targeted interventions and tailored support are essential to address their specific needs. To promote the well-being of both Hungarian and international students, educational programs addressing various facets of a healthy lifestyle are crucial. This study offers valuable insights into lifestyle factors and health outcomes among Hungarian and international students and underscores the importance of addressing the unique needs of each group through tailored interventions. [ABSTRACT FROM AUTHOR]

The aim of the present study was two-fold: Firstly, to estimate the prevalence of psychological distress among international students at a Hungarian university two years after the COVID-19 outbreak; and secondly, to identify its demographic and socioeconomic factors, with special regard to the students' food-security status. A cross-sectional study using a self-administered questionnaire was carried out from 27 March to 3 July 2022 among international students at the University of Debrecen. The questionnaire included information on demographic and socioeconomic characteristics, food-security status (six-item United States Department of Agriculture Food Security Survey Module (USDA-FSSM)), and psychological distress (Depression, Anxiety and Stress Scale (DASS-21)). Bivariate analysis was conducted to examine the potential associations between demographic/socioeconomic factors and psychological distress. Additionally, multiple logistic regression was employed to further analyze these associations. Of 398 participants, 42.2%, 48.7%, and 29.4% reported mild to extremely severe depression, anxiety, and stress, respectively. The ages 18–24 (AOR = 2.619; 95% CI: 1.206–5.689) and 25–29 (AOR = 2.663; 95% CI: 1.159–6.119), reporting a low perception of health status (AOR = 1.726; 95% CI: 1.081–2.755), and being food insecure (AOR = 1.984; 95% CI: 1.274–3.090) were significantly associated with depressive symptoms. Being female (AOR = 1.674; 95% CI: 1.090–2.571), reporting a low perception of health status (AOR = 1.736; 95% CI: 1.098–2.744), and being food insecure (AOR = 2.047; 95% CI: 1.327–3.157) were significantly associated with anxiety symptoms. Furthermore, being female (AOR = 1.702; 95% CI: 1.026–2.824)), living with roommates (AOR = 1.977; 95% CI: 1.075–3.635), reporting a low perception of health status (AOR = 2.840; 95% CI: 1.678–4.807), and being food insecure (AOR = 2.295; 95% CI:1.398–3.767) were significantly associated with symptoms of stress. Psychosocial programs combined with strategies to alleviate food insecurity are required to enhance international students' mental health and well-being. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) is the first pandemic in history where technologies and social media are used on a large scale to make people safe, informed, productive, and connected. At the same time, these technologies enabled the rise of the infodemic, which endangered pandemic control. This study aimed to assess COVID-19 information exposure in the community, the efforts to find related information in online media, and COVID-19 preventive behavior. A cross-sectional study was conducted with 909 participants in Indonesia using the consecutive sampling technique. Data were collected using a questionnaire distributed through social media (WhatsApp, Instagram, and Facebook) and analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that about 838 (92.2%) participants said they often or always obtain information about COVID-19 online, 662 (72.8%) participants stated that information from online sources increased their knowledge of the disease, and 728 (80.1%) said that online information enabled them to make preventive efforts. Marital status (AOR = 1.81, p-value = 0.002) and perceived susceptibility (AOR = 1.42, p-value = 0.011) were the most influential factors for COVID-19 preventive behaviors. Information sources and channels frequently accessed by the community must be professionally managed by the government as valuable tools for mitigating an epidemic or pandemic. [ABSTRACT FROM AUTHOR]

The number of married women and men who no longer want children in Bali Province is consistent with a relatively high contraceptive prevalence rate (CPR) of 67%, higher than the national average of 64%. The large proportion of couples of reproductive age (CRA) who no longer want children either at the national or provincial level in Bali is an interesting thing to be analyzed further to see the factors that influence it. This study investigated secondary data of the 2017 Indonesia Demography and Health Survey (IDHS) in Bali Province. The variables studied included socio-demographics and desire to have children. The sample size was 271 married women (15-49 years). We found that the age of women of reproductive age (WRA), occupation of WRA, number of children alive, and ideal number of children are the four significant factors that influence the desire to have no more children in married couples. Based on these findings, a better family planning program can hopefully be made in the Bali province. [ABSTRACT FROM AUTHOR]

Bali Province has the lowest unmet need achievement, namely 8.1%, meaning that it has a lowvalue gap between the availability of contraceptive services and the needs of the community. This study analyzed the factors that influence the incidence of unintended pregnancy among childbearing-age women in Bali. This research is a secondary data analysis from the Program Performance and Accountability Survey (PPAS) of the National Population and Family Planning Board in 2019. The variables studied were selected from the PPAS's Women data, with 1,214 samples of married fertile women aged 15-59 years in Bali. Multivariate analysis in the form of a logistic regression test is carried out to estimate factors that affect unintended pregnancy incidence in childbearing-age women in Bali. Factors influencing unintended pregnancy are age and having heard of family planning, understanding birth control, understanding population issues, and having listened to adolescent reproductive health. The multivariate analysis shown that age and having heard of family planning are two factors that significantly influence unintended pregnancy. Two factors that influence unintended pregnancy in Bali are age and having heard about family planning. Therefore, cross-sector engagement is required to provide a family planning program to the targeted fertile women's age found in this research to improve women's exposure to the program. [ABSTRACT FROM AUTHOR]

Objective: The current study focuses on how adolescent girls in urban Indonesia accept technology in a social media (SM) campaign to promote healthy eating habits.Design: The study was a qualitative evaluation of the online campaign. In-depth interviews using semi-structured interview guidelines and focus group discussions were used to collect data. Data were analysed using a general inductive approach to provide simple and straightforward answers to our study questions.Settings: The study was conducted in two urban areas in Indonesia: Jakarta and Jogjakarta.Participants: Adolescent girls aged 16-19 years.Results: The SM campaign was perceived as beneficial for increasing participants' knowledge. The campaign helped increase participants' awareness of healthy diets and the health risks of unhealthy diets as well as increase their motivation to change their behaviour and avoid foods containing salt, sugar and excess fat. The participants perceived information from the online campaign as complete and trustworthy. Instagram was cited as the easiest platform to use, while the website was cited as having the most complete information. YouTube provided the best viewing experience but was considered a data-heavy platform. The barriers to change were perceptions of taste, limited choices for healthy but affordable ingredients and family-related factors.Conclusions: The online nutrition campaign was well accepted by Indonesian urban adolescent females and motivated them to act to protect their health. Future nutrition-related SM campaigns aimed at this demographic should focus on platforms with the greatest benefit and ease of use. [ABSTRACT FROM AUTHOR]

Aim: This study aims to investigate international students' perspectives on service quality and analyse factors contributing to the perceived service quality of the university health centre., Background: International students are at increased risk of experiencing poor mental health, isolation from families and cultures, language barriers, financial stress and academic pressures. It is important that universities support international students to enable them to complete their degrees and reach their desired level of achievement and performance. One of the supports required by international students is the availability of healthcare services. Therefore, improving the quality of services to meet international students' requirements, including healthcare services, is essential., Methods: A three-phase exploratory sequential mixed methods design was used. Phase 1 aims to explore international students' perceptions of primary healthcare quality by conducting in-depth interviews and focus group discussions. Data were analysed using thematic analysis. Phase 2 is to form questionnaire items based on the results of the qualitative study. The questionnaire is subject to pilot testing to measure validity and reliability. Phase 3 analyses factors influencing international students' perceived primary healthcare service quality. Multiple regression was used to analyse factors contributing to the perceived service quality of international students., Findings: The qualitative strand revealed five major themes representing the study participants' thoughts about the quality of services in the university healthcare context. Perceived quality attributes identified in this study were primarily empathy, equity, effectiveness, efficiency and safety. The quantitative strand found that 35.57% of participants consider the perceived quality of the centre as good. The highest and lowest service quality attributes were related to safety and efficiency, with a score of 21.12 ± 3.58 and 19.57 ± 4.34, respectively. The multiple linear regression analyses showed that PhD students from Health Faculty and Scholarship awardees were significantly associated with the perceived quality of healthcare services. Thus, the university management needs to improve service quality considering the diversity of international students' socio-demographic characteristics.

Introduction: Repatriated Indonesian migrant workers are vulnerable to developing serious mental health problems during the COVID-19 pandemic. This study aimed to assess the prevalence and associated factors of depression, anxiety, and stress among these populations during the COVID-19 pandemic. Methods: Guided by the health belief model, a cross-sectional study design was employed among 335 participants, and primary data were collected through an online survey. Measured using DASS-21, anxiety, depression, and stress were the dependent variables. We performed descriptive and inferential statistical analyses-logistic regression was used to predict independently associated variables. STATA was used to execute all data analyses. Results: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers were 10.15, 9.25, and 2.39%, respectively. The risk of anxiety and depression was low among those aged 21-30 years old, who had completed a university degree, were married, and had quarantined for 14 days. Conversely, the risk of anxiety and depression was high among those who had bad perceived health status, high perceived susceptibility, and negative stigma perception. Conclusion: The prevalence of depression, anxiety, and stress among repatriated Indonesian migrant workers was relatively low compared to the general population. The risk of anxiety and depression was low among young people, educated people, and those under effective quarantine, but the risk was high among those who had negative perceptions about their health, stigma, and susceptibility to the disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Harjana, Januraga, Indrayathi, Gesesew and Ward.)

Introduction: Before the widespread availability of an effective COVID-19 vaccine, it is crucial to control the rate of transmission by ensuring adherence to behavioral modifications, such as wearing masks, physical distancing, and washing hands, all of which can be implemented as public health measures. Focusing on the conditions in Bali, this study explored the level of compliance to public health measures targeted at COVID-19 and identified the determinants of compliance via the values, rules, and knowledge approach. Materials and Methods: This cross-sectional study conducted an online survey using the Google Form application from June 29 to July 5, 2020. The minimum required sample size was 664. Inclusion criteria were set as follows: 18 years of age or older and residing in Bali during the data collection period. Adherence was measured based on nine protocol indicators that were rated using a four-point Likert scale. A multiple linear regression analysis was then conducted to determine the associated factors of adherence to public health measures. Results: Of the 954 survey respondents, data from 743 were included for analysis. The average level of adherence to public health measures was 32.59 (range of 20-36). The linear regression analysis showed that perceived health benefits from public health measures, being female, and having COVID-19 test histories were significantly associated with adherence to public health measures. Conclusions: For public health measures targeted at COVID-19, adherence was strongly associated with perceived social norms, in which individuals played social community roles by adapting to standardized public health measures. It is thus imperative for governments to support and monitor public health measures during the COVID-19 pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Indrayathi, Januraga, Pradnyani, Gesesew and Ward.)