Effectiveness and Practicality of Indonesian-Adapted Train-the-Trainer MDD Minds Module in Primary Care: A Community Based Training Implementation and Early Clinical Outcomes Study

Dewanto Andoko; Nicolaski Lumbuun; Darien Alfa Cipta; Marshell Timotius Handoko; Tirta Darmawan Susanto

doi:10.66641/pcsp.v1i2.27

Authors

Dewanto Andoko Pelita Harapan University https://orcid.org/0000-0003-3727-8148
Nicolaski Lumbuun Pelita Harapan University https://orcid.org/0000-0002-4176-1215
Darien Alfa Cipta Pelita Harapan University https://orcid.org/0000-0002-7680-7826
Marshell Timotius Handoko Pelita Harapan University https://orcid.org/0009-0006-5445-3154
Tirta Darmawan Susanto Pelita Harapan University https://orcid.org/0000-0002-4151-5946

Keywords:

Community Oriented Primary Care, Family Medicine, Major Depressive Disorder, Primary Care Training, Train the Trainers

Abstract

Background: Indonesia faces an 85% depression treatment gap, with only 0.27 psychiatrists per 100,000 population. Culturally adapted training for primary care physicians is urgently needed. This study evaluated the training effectiveness and early implementation outcomes of an Indonesian-adapted Train-the-Trainer (TtT) MDD Minds module. Methods: This Type 1 mixed-methods implementation study involved 30 primary care physicians who completed centralized TtT training (October–November 2024). Eighteen trained scholars subsequently delivered community training to 125 healthcare workers across 12 provinces (December 2024–February 2025). Patient outcomes were assessed over 3 months among 96 patients (58 with comorbid hypertension) treated by trained providers. No control group was included, consistent with the proof-of-concept design. Knowledge, perceived self-efficacy, practicality, and patient-level outcomes (PHQ-9, MMAS-8, blood pressure) were measured using validated instruments. Results: Knowledge scores improved significantly from 67.48% to 93.24% (Cohen's d=2.87, p<0.001), with sustained perceived self-efficacy at 4-week follow-up (2.3 to 3.7/5). Practicality was rated highly (3.65/4.0). Among patients, mean PHQ-9 decreased by 6.1 points (95% CI: 5.3–6.9, p<0.001); 64.6% achieved treatment response. Hypertensive patients showed improved medication adherence (MMAS-8 +1.8, p<0.001) and blood pressure control (SBP −14.4 mmHg, p<0.001). Conclusion: The Indonesian-adapted TtT MDD Minds module demonstrated significant training effectiveness, high practicality, and promising preliminary patient benefits. These proof-of-concept findings support broader dissemination pending Phase III randomized evaluation.

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