{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:51:26Z","timestamp":1791312686438,"version":"4.3.1"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Maternal anemia remains a significant contributor to adverse pregnancy outcomes, particularly in low- and middle-income countries. Although universal health insurance has expanded access to antenatal care (ANC), coverage alone does not guarantee optimal utilization. Innovative approaches addressing behavioral, cultural, and motivational factors are needed. This study aimed to evaluate the effectiveness of a digital\u2013spiritual assistance Dzikry model in improving maternal hemoglobin status and ANC compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>A quasiexperimental nonequivalent control group design with pretest\u2013posttest measurements were conducted among 60 second-trimester pregnant women at a clinic in Tangerang, Indonesia. Participants were allocated to an intervention group receiving digital education, visit reminders, and spiritually oriented motivational support, or a control group receiving standard ANC services. Hemoglobin levels were measured at baseline and follow-up. Secondary outcomes included ANC compliance, maternal knowledge, and perceived communication quality. Data were analyzed using independent t-tests, Chi-square tests, ANCOVA, and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between groups. The intervention showed a significantly greater increase in Hb levels compared to the control group (mean difference 0.7 g\/dL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004). A greater reduction in anemia prevalence was also observed. Additionally, the intervention group demonstrated higher ANC compliance, improved knowledge, and better communication scores. Women in the intervention group were more than three times as likely to achieve normal Hb status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The digital\u2013spiritual assistance Dzikry model effectively enhances maternal engagement in ANC and improves hemoglobin levels, indicating its potential as a culturally adaptive strategy to maternal anemia in primary care settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jehp.jehp_507_26","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:01:43Z","timestamp":1788181303000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A digital\u2013spiritual assistance Dzikry model to improve hemoglobin levels and antenatal care compliance: A quasi-experimental study"],"prefix":"10.4103","volume":"15","author":[{"given":"Marthia","family":"Ikhlasiah","sequence":"first","affiliation":[{"name":"Faculty of Health Science, Universitas Faletehan, Serang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lastri M.","family":"Winarni","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, Universitas Yatsi Madani, Tangerang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfina","family":"Yulidar","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, Universitas Faletehan, Serang, Banten, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8]]},"reference":[{"key":"R2-20261006","first-page":"5541886","article-title":"The role of digital technology in preventing anemia among pregnant women: A scoping 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meta-analysis","volume":"103","author":"Rahman","year":"2016","journal-title":"Am J Clin Nutr"},{"key":"R12-20261006","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The behaviour change wheel: A new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Impl Sci"},{"key":"R13-20261006","doi-asserted-by":"crossref","first-page":"909","DOI":"10.54660\/.IJMRGE.2021.2.1.909-918","article-title":"Systematic review of digital maternal health education interventions in low-infrastructure environments","volume":"2","author":"Mustapha","year":"2021","journal-title":"Int J Multidiscip Res Growth Eval"},{"key":"R14-20261006","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.21608\/ejhc.2020.272613","article-title":"A Smartphone-based health behavioral intervention for pregnant women with iron deficiency anemia","volume":"11","author":"Fatthy","year":"2020","journal-title":"Egypt J Health Care"},{"key":"R15-20261006","doi-asserted-by":"crossref","first-page":"3556","DOI":"10.1038\/s41598-025-87957-x","article-title":"Effect of nutrition education and iron-folic acid supplementation on anemia among pregnant women in Ethiopia: A quasi-experimental study","volume":"15","author":"Anato","year":"2025","journal-title":"Sci Rep"},{"key":"R17-20261006","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1089\/heq.2018.0082","article-title":"Global inequality in maternal health care service utilization: Implications for sustainable development goals","volume":"3","author":"Yaya","year":"2019","journal-title":"Health Equity"}],"container-title":["Journal of Education and Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_507_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:00:31Z","timestamp":1791309631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_507_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/jehp.jehp_507_26","relation":{},"ISSN":["2277-9531","2319-6440"],"issn-type":[{"value":"2277-9531","type":"print"},{"value":"2319-6440","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-03-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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