2026-10-07T12:07:34Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34026372 2026-09-29T17:30:12Z category_21 category_64 category_106 category_132 portal_5 item_type_3 month_year_09_2026

<p>Participant demographics.</p> Herni Susanti (7356302) Novitri Nurimani Asha (25138329) Penny Bee (456567) Heni Dwi Windarwati (17127892) Budi Anna Keliat (20867123) Atik Puji Rahayu (16449555) Amy Blakemore (3570152) Afni Handayani (25138332) Mochamad Ali Sodikin (25138335) Helen Brooks (397642) Biotechnology Cancer Science Policy Infectious Diseases xlink "> using resourced health system reflecting limited understanding people experiencing anxiety mental health problems many conflating lipis lay health workers largely unaddressed drivers distress became severe anxiety remain major alongside undercertainty regarding across 12 sites 21 focus groups study offers one strong perceived need promising subsequent uptake positive affective attitudes intensity psychological interventions xlink "> depression cultural alignment suggest study examines strong perceptions promising pathway affective attitude workload demands urgently needed treatment gap trained non traditional healers theoretical framework tfa ), tailored adaptations structured interviews stakeholder workshops stakeholder perspectives specialists offer southeast asia social judgment scarce resources scalable solutions rural areas religious leaders particularlyprivacy risks often delayed logistical burden local languages lmics ), independently back income countries <div> <p>Introduction</p><p>Depression and anxiety remain major, largely unaddressed drivers of disability in low- and middle-income countries (LMICs), where scarce resources and persistent stigma constrain access to care. Scalable solutions are urgently needed. Low-intensity psychological interventions, delivered by trained non-specialists offer a promising pathway to close the treatment gap. This study examines the prospective acceptability of these interventions in Java, Indonesia, an exemplar of an under resourced health system, to guide targeted cultural adaptation and inform optimal implementation.</p> <p>Methods</p><p>Using a qualitative descriptive design guided by the Theoretical Framework of Acceptability (TFA), we conducted semi-structured interviews (n = 33) with people experiencing anxiety and depression and 21 focus groups with families (n = 34), health workers (n = 36), and community/religious leaders (n = 37) across 12 sites in Java. Data were collected in Bahasa/local languages, transcribed, translated, and analysed using TFA informed Framework Analysis. 5% of translations were independently back-verified. Stakeholder workshops and advisory panels shaped study design and interpretation.</p> <p>Results</p><p>Low mental health literacy and stigma undermined intervention coherence and affective attitude, with many conflating LIPIs with general counselling. Help-seeking was often delayed until distress became severe, reflecting limited understanding of mental health problems and available support. Despite these challenges, strong perceptions of effectiveness and positive affective attitudes were driven by cultural values of self-reliance and community support. Concerns centered on ethicality, particularlyprivacy risks and fear of social judgment, alongside undercertainty regarding the role of traditional healers and the burden associated with time and workload demands. Trust in lay health workers was high in rural areas but more variable in urban contexts.</p> <p>Conclusion</p><p>Findings highlight that cultural, structural, and interpersonal factors shape anticipated intervention acceptability. While stigma and low literacy remain barriers, strong perceived need and cultural alignment suggest the potential for promising subsequent uptake. Addressing privacy, role clarity, and logistical burden through tailored adaptations and partnerships is critical. This study offers one of the first theoretically framed qualitative explorations of LIPI acceptability in Southeast Asia, highlighting culturally congruent pathways for subsequent LMIC implementation.</p></div> 2026-09-29T17:30:08Z Dataset Dataset 10.1371/journal.pone.0358869.t002 https://figshare.com/articles/dataset/_p_Participant_demographics_p_/34026372 CC BY 4.0