Qory Tifani Rahmatika, Ronal Surya Aditya, Neni Fidya Santi, Fitriana Kurniasari Solikhah, Muhammad Putra Ramadhan, Achmad Masfi, Nurma Afiani, Nurul Evi, Nadia Rohmatul Laili, Reem Iafi Al Mutairi
Introduction: Integrating physical activity into community-based primary care offers a promising, low-cost strategy for mental health promotion in resource-limited settings. In Indonesia, Posyandu represents a trusted and scalable platform, yet theoretically grounded and culturally embedded implementation models remain scarce. Aim: To co-create and theoretically operationalize a culturally grounded, Posyandu-integrated framework for community mental health promotion through structured physical activity. Methods: A six-month participatory ethnography was conducted across six mental health Posyandu in urban and semi-urban Indonesia (January–June 2025). Data were generated through participant observation, in-depth interviews, and focus group discussions with 24 purposively selected participants (community members, cadres, nurses, and health officers). Thematic analysis was conducted following Braun and Clarke’s six-phase approach. The analysis was primarily informed by Social Cognitive Theory, with selected constructs from the Health Belief Model used to interpret behavioural mechanisms. Results: Four interrelated themes were identified: (1) perceived psychosocial benefits (emotional regulation, sleep improvement, self-efficacy), (2) structural and gendered participation barriers, (3) peer-mediated behavioral reinforcement, and (4) cultural legitimization processes. Engagement was constrained by time, stigma, and gender norms, while sustained participation was facilitated through peer support and culturally embedded practices. Conclusion: This study advances a culturally grounded, Posyandu-integrated framework that translates behavioural theory into actionable community-primary care mechanisms. By embedding structured physical activity into a trusted local platform through co-creation, the framework offers a feasible basis for future adaptation and scale-up in early-stage community mental health promotion within resource-limited settings. © The Author(s) 2026.
Department of Nursing, Universitas Negeri Malang, Malang, 65145, Indonesia; Faculty of Nursing, Universitas Jember, Jember, 68121, Indonesia; Poltekkes Kemenkes Malang, Malang, Indonesia; Universitas Jember, Jember, Indonesia; University of Hail, Hail, Saudi Arabia
