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.

BACKGROUND

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.

PURPOSE: 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.

PATIENTS AND

METHODS

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.

RESULTS

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.

CONCLUSION

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.