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Community empowerment model to improve healthy living behaviors in rural areas: qualitative study

  • Mahendro Prasetyo Kusumo ,
  • Elsye Maria Rosa ,


Introduction: Limited knowledge is the leading cause of the high prevalence of type 2 diabetes (DM) in rural communities. Community empowerment is one strategy to increase knowledge regarding type 2 diabetes control. This study aims to design a rural community empowerment model to advance knowledge in controlling type 2 diabetes.

Methods: The method used was qualitative with an action research design. Data collection included interviews, focused group discussions (FGD), and literature reviews. The participants of study involve the health office and cadres. The criteria for participants is to understand the procedures for preventing non-communicable diseases (NCD’s). Participants were selected using a purposive sampling method. Triangulation and member check to test the validity of the data. The analysis technique used was the N-Vivo software.

Results: Four main themes related to the empowerment of rural communities to control type 2 diabetes were found: the DM control model based on community empowerment, cadres as health partners, types of health services in villages, and the families’ roles in increasing the success of controlling DM.

Conclusion: Community empowerment can help in controlling type 2 diabetes in rural areas. Suggestions for next investigators is to evaluate the implementation of community empowerment programs in rural for clinical improvement.


  1. Kementerian Kesehatan RI. Petunjuk Teknis Pos Pembinaan Terpadu Posbindu bagi Kader. 2019;1–60.
  2. Kleinberger JW, Pollin TI, Medicine G. Opportunities and Future Prospects. 2016;1346(1):45–56.
  3. Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Sci Rep. 2020;10(1):1–11.
  4. International Diabetes Federation. IDF Western Pacific Members. 2020.
  5. Kementrian Kesehatan RI. Infodatin 2020 Diabetes Melitus. Kementrian Kesehatan Republik Indonesia 2020; 2020.
  6. Dinas Kesehatan DIY DKDIY. Profil Kesehatan Daerah Istimewa Yogyakarta Tahun 2019. Yogyakarta; 2019. 165 p.
  7. Dinas Kesehatan Kabupaten Sleman. Profil Kesehatan Kabupaten Sleman Tahun 2020. Dinas Kesehatan Sleman. 2020.
  8. Alkhatib A, Tsang C, Tiss A, Bahorun T, Arefanian H, Barake R, et al. Functional foods and lifestyle approaches for diabetes prevention and management. Nutrients. 2017;9(12):1–18.
  9. Alsous M, Jalil MA, Odeh M, Kurdi R Al, Alnan M. Public knowledge, attitudes and practices toward diabetes mellitus: A cross-sectional study from Jordan. PLoS One. 2019;14(3):1–12.
  10. Kolb H, Martin S. Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Med. 2017;15(1):1–11.
  11. Ligita T, Wicking K, Francis K, Harvey N, Nurjannah I. How people living with diabetes in Indonesia learn about their disease: A grounded theory study. PLoS One. 2019;14(2):1–19.
  12. Tai S-Y, He J-S, Kuo C-T, Kawachi I. Urban–Rural Disparities in the Incidence of Diabetes-Related Complications in Taiwan: A Propensity Score Matching Analysis. J Clin Med. 2020;9(9):3012.
  13. Aung WP, Htet AS, Bjertness E, Stigum H, Chongsuvivatwong V, Kjøllesdal MKR. Urban-rural differences in the prevalence of diabetes mellitus among 25-74 year-old adults of the Yangon Region, Myanmar: Two cross-sectional studies. BMJ Open. 2018;8(3):1–9.
  14. Paz-Pacheco E, Sandoval MA, Ardena GJR, Paterno E, Juban N, Lantion-Ang FL, et al. Effectiveness of a community-based diabetes self-management education (DSME) program in a rural agricultural setting. Prim Heal Care Res Dev. 2017;18(1):35–49.
  15. Kusumo MP, Hendrartini J, Sufro ZM, Dewi FST. A Qualitative Study to Explore the Perception of Patients Towards Diet in Javanese Culture. Enferm Clin. 2020;30:183–7.
  16. Kusumo MP, Hendrartini J, Sufro ZM, Dewi FST. Theater performing art: A strategy to improve self-efficacy and social support in patient with type 2 diabetes mellitus (T2DM). J Glob Pharma Technol. 2020;12(6):70–6.
  17. Creswell JW, Clark VLP. Designing and Conducting Mixed Methods Research. 2ad Editio. Vicki Knight, Lauren Habib, Ashley Dodd CA, editor. Thousand Oaks, California: SAGE Publications, Inc.2455 Teller Road, Thousand Oaks California 91320; 2011.
  18. Kusumo MP, Prabandari YS, Dewi FST. Measuring the Knowledge, Attitude and Practice of Patients With Diabetes Mellitus—The Design and Development Process. Int Q Community Health Educ. 2021;0272684X2110221.
  19. Osarenmwinda MI, Erah PO, Eromhonsele PE. Incidence of Undiagnosed Diabetes Mellitus in Rural Community, Edo South, Benin City. Indian J Pharm Pract. 2020;13(3):232–9.
  20. Goode PhD DF-CP, Bartlett PhD R-BR, Wallace PhD RFD. The Value of Diabetes Self-Management Programs for African Americans in Community-Based Settings: A Review of the Literature. Int J Faith Community Nurs. 2017;3(1):20.
  21. Kuule Y, Dobson AE, Woldeyohannes D, Zolfo M, Najjemba R, Edwin BMR, et al. Community health volunteers in primary healthcare in rural Uganda: Factors influencing performance. Front Public Heal. 2017;5(MAR):1–8.
  22. Woldie M, Feyissa GT, Admasu B, Hassen K, Mitchell K, Mayhew S, et al. Community health volunteers could help improve access to and use of essential health services by communities in LMICs: An umbrella review. Health Policy Plan. 2018;33(10):1128–43.
  23. Misra R, Fitch C, Roberts D, Wright D. Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia. J Diabetes Res. 2016;2016.
  24. Kemenkes. Infodatin Hasi Diabetes Sedunia Tahun 2018. 2019;
  25. De Boer IH, Bangalore S, Benetos A, Davis AM, Michos ED, Muntner P, et al. Diabetes and hypertension: A position statement by the American diabetes association. Diabetes Care. 2017;40(9):1273–84.
  26. Frías-Ordoñez JS, Pérez-Gualdrón CE. Self-monitoring of blood glucose as control tool in the different management contexts for type 2 diabetes mellitus. What is its current role in non-insulin users? Rev Fac Med. 2019;67(3):293–303.
  27. Timpel P, Harst L, Reifegerste D, Weihrauch-Blüher S, Schwarz PEH. What should governments be doing to prevent diabetes throughout the life course? Diabetologia. 2019;62(10):1842–53.
  28. Pamungkas R, Chamroonsawasdi K, Vatanasomboon P. A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients. Behav Sci (Basel). 2017;7(4):62.
  29. Pesantes MA, Del Valle A, Diez-Canseco F, Bernabé-Ortiz A, Portocarrero J, Trujillo A, et al. Family Support and Diabetes: Patient’s Experiences From a Public Hospital in Peru. Qual Health Res. 2018;28(12):1871–82.
  30. Ravi S, Kumar S, Gopichandran V. Do supportive family behaviors promote diabetes self-management in resource limited urban settings? A cross sectional study. BMC Public Health. 2018;18(1):1–9.
  31. Reichert JR, Kristensen KL, Mukkamala RR, Vatrapu R. A supervised machine learning study of online discussion forums about type-2 diabetes. 2017 IEEE 19th Int Conf e-Health Networking, Appl Serv Heal 2017. 2017;2017-Decem(December):1–7.
  32. Habibzadeh H, Sofiani A, Alilu L, Gillespie M. The effect of group discussion-based education on self-management of adults with type 2 diabetes mellitus compared with usual care: A randomized control trial. Oman Med J. 2017;32(6):499–506.
  33. Susilo DH, Kusbaryanto K, Kusumo MP. Diabetes Mellitus Management during the Coronavirus disease-19 Pandemic : Literature Review. Open Access Maced J Med Sci. 2021;9:541–8.

How to Cite

Kusumo, M. P., & Rosa, E. M. (2021). Community empowerment model to improve healthy living behaviors in rural areas: qualitative study. Bali Medical Journal, 10(3), 1098–1102.




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Mahendro Prasetyo Kusumo
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Elsye Maria Rosa
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