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Fridelly Mairani; Grace Anastasia Br Ginting; Syukur Berkat Waruwu

Jurnal Pengabdian dan Pembangunan Lokal 2026 Lembaga Pengembangan Kinerja Dosen

Low public awareness of eye health and rational use of eye medications may increase the risk of eye disorders and infections. This community service activity aimed to improve public knowledge and awareness regarding the importance of maintaining eye health and applying the DAGUSIBU principle (Get, Use, Store, and Dispose of medicines properly) in the use of eye drops. The activity was conducted at the Klinik Pratama Nusantara Kesehatan through interactive counseling, demonstrations of proper eye drop administration techniques, and education on the prevention of common eye disorders and the role of healthcare professionals. Pre-test and post-test evaluations showed a significant increase of approximately 35% in participants’ knowledge regarding eye hygiene and correct eye medication use. This educational program is expected to contribute to long-term improvements in rational eye medication use, reduce the risk of misuse, and serve as a model for sustainable eye health education in a primary healthcare settings.

Restu Prihandini; Victor Palapessy; Derry Trisna Wahyuni; Nanda Azzahra

Jurnal Pengabdian dan Keberlanjutan Masyarakat 2026 Lembaga Pengembangan Kinerja Dosen

This community service program aims to enhance the knowledge and skills of the community in Pulau Akar, Setokok Village, Batam City, in utilizing Family Medicinal Plants (TOGA) for optimizing health based on traditional methods. The program was carried out through training involving housewives, community leaders, and local health cadres. The methods used include an initial survey, practical training on types of medicinal plants, their benefits, processing methods, and the distribution of TOGA seedlings to be planted at participants' homes. Additionally, group discussions were held to reinforce understanding and organize TOGA utilization within the community. The results of this program showed a significant increase in participants' understanding and skills regarding the use of TOGA for treating minor ailments and disease prevention. The community began planting TOGA around their homes, creating herbal gardens that can be used as a source of natural medicine. Furthermore, the emergence of local leaders actively disseminating knowledge about TOGA was an important outcome of this service. Social change was also evident as the community became more aware of the importance of managing health independently using local resources. It is hoped that this program will continue with regular training and the strengthening of TOGA utilization groups to ensure the sustainability of this program in the future.

Emilianus Eo Kutu Goo; Maria Dignata Sophina; Maria Marfani; Maria Vivilani; Markus Valentino Putra +1 more

Jurnal Ekonomi dan Keuangan 2026 Asosiasi Riset Ekonomi dan Akuntansi Indonesia

This study aims to analyze the development strategy of the Jeanete business, located in Maumere City, Jl.  Kesehatan No.  3, Lorong Masuk SDK Yos Sudarso, using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) approach.  The research employs a descriptive qualitative method with data collected through observation, interviews, and documentation of the Jeanete business operations.  The results indicate that the main strengths of the business include affordable product prices, unique item variations, and increasing consumer interest in preloved products.  However, Jeanete also faces several weaknesses, such as dependence on supplies from outside the region, limited stock availability, and fluctuating bale prices.  On the other hand, opportunities include the growing trend of thrifting among young consumers and rising demand for environmentally friendly products.  The threats faced by the business involve increasing competition, shifting consumer preferences, and the risk of products not passing quality control.  Based on these findings, the development strategy for Jeanete should focus on improving product quality, strengthening digital promotion, and maintaining more stable supply management.

Abul A’la Al-Maududi; Annisa Zahria Putri H; Laisyah Shava Zein H; Naisya Audya Zahra; Lanina Syahdila +2 more

Jurnal Pengabdian dan Pembangunan Lokal 2026 Lembaga Pengembangan Kinerja Dosen

HIV and AIDS remain a public health challenge, particularly among adolescents who are vulnerable to risky behaviors. A lack of proper understanding of HIV and AIDS, along with persistent stigma against people living with HIV and AIDS (PLWHA), potentially increases the risk of transmission and hinders prevention efforts. This activity aimed to improve adolescents' knowledge and attitudes regarding HIV and AIDS prevention through health education. The activity was conducted at Al-Hasra High School in Bojongsari District, Depok City, involving 25 students as participants. The method used was interactive education accompanied by pre-test and post-test evaluation. The evaluation results showed an increase in participants' knowledge after the intervention, as reflected in both average scores and the proportion of students in the good knowledge category. These findings demonstrate the critical role of health education in improving adolescents' understanding of HIV and AIDS prevention. Therefore, similar education activities should be conducted continuously as promotive and preventive efforts to reduce the risk of HIV transmission from adolescence.

Fitri Fitri; Arfiani Arfiani; Nadya Auliya Ramadani; Mutiara Sabrina; Niken Stevani

Jurnal Pengabdian dan Pembangunan Lokal 2026 Lembaga Pengembangan Kinerja Dosen

Infant massage is an early stimulation method that plays a role in increasing infant weight gain, sleep quality, and comfort. However, limited parental resources and access to healthcare facilities prevent massage services from being optimally implemented. This community service activity aims to improve infant health through homecare-based infant massage services that are easily accessible to families. The activity was conducted on June 22, 2025, in Bulukumba Regency, targeting five infants aged 2–5 months. The activity methods included: (1) initial weight measurement, (2) education on correct massage techniques, (3) massage using olive oil for 15–20 minutes, and (4) monitoring infant sleep patterns and comfort. Repeat measurements were conducted after the intervention. Results showed post-intervention weight gain in all infants, improved sleep patterns (infants fell asleep more easily and slept longer), and increased appetite. Mothers also demonstrated improved self-massage skills. In conclusion, homecare-based infant massage has been proven effective in improving infant comfort, sleep patterns, and weight gain. This program is worthy of continuation and expansion to support community midwifery services

Herniyanti N; Nurul Hidayah Bohari; Lilis Qurani; Meri Karolina; Desi Ratnasari +1 more

Jurnal Pengabdian dan Pembangunan Lokal 2026 Lembaga Pengembangan Kinerja Dosen

Degenerative diseases are a major cause of morbidity in the elderly and continue to increase with age, lifestyle changes, and a lack of public awareness of the need for regular health check-ups. This community service activity aims to increase understanding and early detection of non-communicable diseases in people aged 30 years and older, particularly the elderly in the Appassarenge neighborhood, Bentenge Village, Ujung Bulu District, Bulukumba Regency. The activity methods included group exercise, blood pressure checks, blood sugar checks, health counseling, and referrals for participants with test results above normal limits. Data were analyzed descriptively to determine the proportion of participants with high blood pressure and blood sugar levels. The results showed that the majority of respondents had hypertension (70.97% of 31 participants), while 55.88% of 34 participants had high blood sugar levels. These findings indicate a high risk of non-communicable diseases in the elderly population related to diet, lack of physical activity, and a lack of regular health check-ups. This activity received a positive response because it provided easy access to health services and raised public awareness of the importance of early detection and adopting a healthy lifestyle. Overall, this community service activity contributed to increasing the elderly's knowledge and awareness of health, as well as supporting promotive and preventive efforts in preventing degenerative diseases.

Herni Hasifah; Rafi’ah Rafi’ah; Iga Maliga

Jurnal Inovasi Sosial dan Pengabdian 2026 Lembaga Pengembangan Kinerja Dosen

The biggest challenge faced by the community, especially vulnerable and poor groups, is the cost of managing chronic diseases. Even though there is national health insurance, non-medical costs, costs arising from self-medication, and limitations on certain benefits are still often obstacles that cause high out-of-pocket expenses for the community. The high costs of curative and rehabilitative care indicate that preventive and promotive efforts must be significantly improved, and one way to support the sustainability of these efforts is through a pre-emptive health financing scheme. Community service activities are carried out using a participatory approach so that community members are actively involved in the activities. The activities are carried out in three stages, that is preparation or needs identification, implementation and evaluation. The results of the activity show that the community's knowledge increased significantly because of the community service activity. Participants who took part in the activity also successfully designed a community-based financing scheme involving health savings, whereby each member makes agreed monthly contributions. This community service project demonstrates that community empowerment through the establishment of a pre-emptive financing scheme for chronic diseases can provide an effective, sustainable solution for improving public health.

Abul A’la Al Maududi; Rafa Zemy Amalia; Nayla Jasmine Fadillah; Syaharani Laila Chaerunnisa Tengku; Siti Neza Azmarina +3 more

Jurnal ilmu Kesehatan Umum 2026 Asosiasi Riset Ilmu Kesehatan Indonesia

Adolescent mental health is an essential component of optimal growth and development, yet it often receives less attention compared to academic achievement. Adolescents are in a vulnerable developmental stage characterized by emotional changes, social pressure, and environmental demands, which increase the risk of mental health problems. This activity aimed to improve knowledge and promote positive attitudes among junior high school students regarding adolescent mental health, including its definition, signs and symptoms, risk factors, and prevention strategies. The method used was a health education intervention employing a pre-test and post-test design. The activity was conducted at Al Amanah Junior High School, South Tangerang City, involving 25 students. The evaluation instrument consisted of a 10-item multiple-choice questionnaire with a maximum score of 100. The results showed that the average pre-test score was 98.40%, while the post-test score increased to 99.60%, indicating a 1.20% improvement. Although the increase was relatively small due to the high baseline knowledge (ceiling effect), the findings demonstrate that the educational intervention effectively reinforced students’ understanding of adolescent mental health. In addition, interactive discussions during the session contributed to increased awareness and reduced stigma related to mental health issues. This mental health education program has the potential to support early prevention efforts and foster a more supportive school environment for adolescents’ psychological well-being.

Khusnul Khotimah Rijie; Ardi Mustakim

Inovasi Kesehatan Global 2026 Lembaga Pengembangan Kinerja Dosen

Papaya fruit (Carica papaya L.) is a tropical plant widely consumed as food and known to contain various bioactive metabolites with potential health benefits. The increasing interest in natural products as functional resources highlights the importance of reviewing the chemical characterization and health applications of papaya bioactive compounds. This article aims to systematically review the types of bioactive metabolites found in papaya fruit, the chemical characterization methods applied, and their potential applications in the health sector. This review was conducted through a literature study of relevant scientific articles, focusing on metabolite identification and biological activity evaluation. The results indicate that papaya fruit contains diverse bioactive metabolites, including flavonoids, phenolic compounds, alkaloids, saponins, terpenoids, and proteolytic enzymes. These compounds are commonly characterized using chromatographic and spectroscopic techniques. Several studies have reported that papaya bioactive metabolites exhibit biological activities such as antioxidant, antimicrobial, anti-inflammatory, and antidiabetic effects. This review suggests that papaya fruit has promising potential as a functional natural resource for health and pharmaceutical applications.

Rolita C. Purba; Budianto Budianto; Indra Jaya; Rani Fransiska Saragih Sumbayak; Nuryustina Barasa

Jurnal Pengabdian dan Pembangunan Lokal 2026 Lembaga Pengembangan Kinerja Dosen

Pratama clinics, as first-level healthcare facilities, play a crucial role in providing healthcare services to the community and are also subject to tax obligations for their business activities. However, many clinics still lack a thorough understanding of Value Added Tax (VAT) and Income Tax (PPh) provisions for their transactions, particularly regarding the tax treatment of medical services, drug sales, and tax withholding and reporting obligations. This Community Service activity aims to improve Harapan Jaya Pratama Clinic's tax understanding and compliance through outreach and mentoring on VAT and PPh for clinic transactions. The implementation method includes outreach on relevant tax regulations, training in tax accounting-based transaction recording, and mentoring in identifying taxable objects, calculating, depositing, and reporting VAT and PPh in accordance with applicable regulations. The expected outcomes of this activity are increased tax literacy and awareness among clinic managers, more orderly transaction recording, and increased compliance of Harapan Jaya Pratama Clinic in fulfilling its tax obligations. This activity is expected to support better and more sustainable clinic financial governance.

Elvira Riska Hanifah; Syva Avrillia Putri; Geulis Uthlubil Irma R; Niken Nur Indahsari; Muhamad Fadli Muzaki +7 more

Inovasi Kesehatan Global 2026 Lembaga Pengembangan Kinerja Dosen

Introduction: Clean and Healthy Living Behavior (PHBS) is an important indicator in improving health status, particularly among university students as a productive age group. Health knowledge plays a role as a predisposing factor in the formation of healthy behavior. Individuals with a good level of health knowledge tend to have higher awareness and motivation to implement PHBS. Conversely, a lack of knowledge may lead to behaviors that pose health risks. Objective: This study aimed to determine the relationship between the level of health knowledge and clean and healthy living behavior (PHBS) among students at Universitas Muhammadiyah Semarang. Methods: This study employed a quantitative design with a cross-sectional approach. The sample consisted of 55 students, including students from health-related and non-health-related faculties. Samples were selected using an accidental sampling technique, namely respondents who were encountered and willing to complete the questionnaire at the time of data collection. The research instruments were a health knowledge questionnaire and a PHBS questionnaire. Data analysis was conducted using univariate and bivariate analysis with the Spearman test. Results: The results showed that the majority of respondents had good health knowledge (89.1%) and good PHBS (90.9%). The Spearman test results showed a p-value of 0.001 (p < 0.05), indicating a significant relationship between the level of health knowledge and PHBS. Conclusion: It can be concluded that the better the level of students’ health knowledge, the better the implementation of clean and healthy living behavior.

Zahra Amelia; Mawar Sari; Fazrika Hummisyah; Vera Faujiah Siregar; Nur Ainun Dalimunthe +5 more

Jurnal Inovasi Pendidikan 2026 Lembaga Pengembangan Kinerja Dosen

Malnutrition in children remains a serious public health challenge in Indonesia because it directly impacts growth, cognitive development, and the child's future quality of life. Parents play a crucial role in maintaining children's health, particularly in providing balanced nutrition and preventing nutritional problems such as stunting and malnutrition. This study aims to analyze the role of parents in maintaining children's health due to malnutrition based on a literature review. The method used is a qualitative literature study, through a search of various written sources in the form of scientific journals, articles, and relevant books obtained from Google Scholar. The results of the study indicate that the level of knowledge, education, parenting patterns, socioeconomic conditions, and active involvement of parents in monitoring children's growth significantly influence children's nutritional status and health. Parents play a role as providers of nutritious food, nutrition educators, role models of healthy lifestyles, and regular monitors of children's growth and development. Parents' lack of understanding of balanced nutrition, the habit of consuming instant foods, and minimal participation in health programs are risk factors for malnutrition in children. Therefore, increasing parental education and involvement through a family-based approach is an important strategy in efforts to prevent and address child nutrition problems sustainably.

Mohammad Rudiyanto; Achmad Taufik; Imadoeddin Imadoeddin; Abdul Bari; Syaiful Syaiful +1 more

Jurnal Pengabdian dan Keberlanjutan Masyarakat 2026 Lembaga Pengembangan Kinerja Dosen

This community service programme was implemented in the coastal community of Padelegan Village, Pademawu Subdistrict, Pamekasan Regency, with a focus on strengthening health literacy and behaviour-based disease prevention at the household level. The background of the activity is based on the vulnerability of coastal communities to health problems related to hygiene, household drinking water management, and environmental cleanliness, as well as the need for an approach that not only increases knowledge but also encourages consistent preventive practices. The programme aims to improve residents' ability to understand and use health information in an applicable manner, while strengthening key disease prevention behaviours through education and mentoring. The activity will be carried out from February to April 2025 with a behaviour-based education design combined with practice demonstrations and community mentoring, involving 48 participants (40 residents/households and 8 posyandu/PKK cadres). The stages included initial assessment, development of KIE media (brief modules and leaflets/posters), two education-demonstration sessions, two home mentoring sessions, and final evaluation. The evaluation was conducted using pre-post knowledge, attitude, and practice (KAP) assessments and practice observation through a checklist. The results showed an increase in health literacy and improved consistency in preventive behaviour; knowledge increased from 5.4 to 7.8, and compliance with hand washing at critical times increased from 41.7% to 72.9%. Programme outputs included an information, education and communication (IEC) package, a household monitoring checklist, and capacity building for cadres as local facilitators. It was concluded that the integration of participatory education, practical demonstrations and cadre mentoring has the potential to be effective in encouraging preventive behavioural change in coastal communities, with recommendations for integrating monitoring into the routine agenda of integrated health service posts (posyandu) and community empowerment groups (PKK) and for follow-up monitoring for 3–6 months to maintain the sustainability of practices.

Inneke Viviane Sumolang

Jurnal Tifa Medika 2026 Fakultas Kedokteran Universitas Cenderawasih Jayapura

Men who have Sex with Men (MSM) are a key population with a high risk of Human Immunodeficiency Virus (HIV) infection. In Papua, the increasing number of HIV cases among this group remains a public health challenge, highlighting the need for comprehensive analysis of sociodemographic and clinical characteristics. This study aimed to analyze the sociodemographic and clinical profiles of HIV/AIDS patients among the MSM population at the Kotaraja Reproductive Health Clinic, Jayapura City. An observational analytic study with a cross-sectional and retrospective approach was conducted using medical record data from 2023 to 2024. A total of 21 HIV/AIDS patients among MSM who met the inclusion criteria were included in the study. Data were analyzed descriptively to assess age, occupation, education level, ethnicity, marital status, clinical stage, sexual orientation, and the presence of sexually transmitted infections (STIs). The results showed that most patients were in the productive age group of 20–24 years (47.6%), had secondary education (71.5%), worked as private employees (57.1%), were non-Papuan (95.3%), and were unmarried (100%). The majority were diagnosed at WHO clinical stages I and II (95.6%). Most patients identified as homosexual (90.5%), while 9.5% identified as bisexual. Concomitant STIs were identified in 47.6% of patients, all of which were syphilis. In conclusion, HIV/AIDS among MSM in Jayapura predominantly affects young productive-age individuals with distinct social and clinical characteristics, emphasizing the importance of early screening and culturally sensitive, integrated HIV prevention strategies.

Emirza Nur Wicaksono

Jurnal Ilmu Pertahanan, Politik dan Hukum Indonesia 2026 Asosiasi Peneliti dan Pengajar Ilmu Hukum Indonesia

This research examines the disproportionate allocation of legal responsibility between doctors and nurses in Indonesia’s health care system and proposes measures to reorganize accountability in a more fair and proportional way. The issue addressed stems from shortcomings in existing regulations, which have not yet ensured legal certainty or balanced legal protection for both professions in clinical practice. The study uses a normative juridical method, applying both statutory and conceptual approaches. The statutory approach reviews laws and regulations that govern professional authority and legal liability of doctors and nurses, while the conceptual approach analyzes legal principles, doctrines, and concepts related to professional responsibility in health services. Legal materials are collected through library research, including primary, secondary, and tertiary legal sources, and are analyzed using qualitative descriptive methods. The results show that although statutory provisions formally regulate the distribution of authority and responsibility between doctors and nurses, there are still normative uncertainties, overlapping regulations, and legal gaps. These issues may lead to an unequal burden of legal responsibility, particularly in cases involving medical errors or negligence. Such conditions weaken legal protection for nurses and can negatively affect the quality of health care delivery. The study concludes that regulatory reform is needed to clarify legal responsibility in accordance with professional authority and to implement a more just and proportional system of accountability. The findings are expected to enrich health law studies and provide guidance for policymakers in developing a fairer legal responsibility framework for health professionals.  

Gama Bagus Kuntoadi; Ima Rusdiana; Miftah Parid Firmansyah

International Journal of Health and Medicine 2026 Asosiasi Riset Ilmu Kesehatan Indonesia

This study identified the use of abbreviations in Medical Treatment Consent Forms (SPTK) at X Hospital Indonesia. A quantitative cross-sectional descriptive approach was applied to 76 SPTKs in September 2024, and questionnaires were administered to 30 patient-responsible physicians (DPJP). The results showed that 75% of SPTKs contained abbreviations, even though 97% of respondents understood the risk of miscommunication to patient safety. The state of the art includes accreditation standards that prohibit the use of abbreviations in informed consent, with global orthopedic studies reporting a decrease from 54% to 22% after educational interventions, as well as Indonesian regulations, namely Peraturan Mentri Kesehatan (Permenkes) Republik Indonesia No. 24/2022, which emphasizes that medical records must be complete. The novelty lies in the first empirical analysis in Indonesian hospitals to reveal the disparity between high physician knowledge and low documentation compliance, contributing to the development of evidence-based monitoring for patient safety. These findings support recommendations for daily review of SPTK, ongoing socialization, and integration of digital checklists to reduce medical errors.

Aini Nadilla; Nabilla Putri; Ria Novia; Utin Anindya Cahyadewi

Jurnal Siti Rufaidah 2026 PPNI UNIMMAN

The increasing elderly population in Indonesia necessitates the development of more comprehensive health services, yet various obstacles continue to hinder the fulfillment of these needs. This study aims to identify the main barriers experienced by older adults in accessing contemporary healthcare services and to outline the essential health service needs relevant to this age group. A literature study method was employed by analyzing scientific publications related to elderly health across physical, social, economic, and healthcare system dimensions. The findings indicate that older adults encounter limitations such as reduced mobility, low health literacy, insufficient elderly-friendly facilities, high healthcare costs, and a shortage of healthcare professionals trained in geriatrics. Meanwhile, their primary health service needs include continuous promotive and preventive care, easily accessible healthcare facilities, family support in managing health routines, and user-friendly health technologies. These results highlight the importance of developing more inclusive, affordable, and sustainable health services to improve the quality of life of the elderly in Indonesia.

Marwati Marwati; Sofiyati Sofiyati

Nusantara: Jurnal Pengabdian kepada Masyarakat 2026 Pusat Riset dan Inovasi Nasional

The increasing proportion of the elderly population in Indonesia has led to a rise in degenerative health problems, one of which is osteoporosis. Osteoporosis is a bone disease characterized by decreased bone density, increasing the risk of fractures, particularly among elderly women. Low calcium intake, lack of physical activity, and limited knowledge regarding osteoporosis prevention are major contributing factors. This community service activity aimed to improve the knowledge of Aisyiyah women in Cirebon Regency regarding osteoporosis in the elderly, including its definition, risk factors, impacts, and prevention strategies through proper nutrition and regular physical activity. The activity was conducted from October to December at the Aisyiyah Study Hall in Cirebon Regency, targeting pre-elderly and elderly women. The methods used included health education through lectures and interactive question-and-answer sessions, supported by laptops, LCD projectors, and PowerPoint presentations. Evaluation of participants’ knowledge was carried out using oral pre-tests and post-tests related to the delivered material. The results indicated an improvement in participants’ understanding of osteoporosis, the importance of adequate calcium intake, and the role of physical activity in maintaining bone health. This community service program is expected to contribute to increasing health awareness and reducing the risk and prevalence of osteoporosis among the elderly.

Bangkit Ina Ferawati; Setiana, Mira

Jurnal Riset Rumpun Ilmu Kesehatan 2026 Pusat riset dan Inovasi Nasional

This study aims to develop an educational application based on a Graphical User Interface (GUI) using MATLAB App Designer that functions as an interactive simulation for evaluating blood pressure. The application allows users to input systolic and diastolic blood pressure values along with supporting information such as name and age. The input data are then analyzed and classified into several blood pressure categories according to the standards of the American Heart Association (AHA), including normal, hypotension, stage 1 hypertension, stage 2 hypertension, and hypertensive crisis. The classification results are presented visually through an interactive pie chart with dynamic percentages and legends to enhance user understanding. In addition, all data are automatically stored in a Microsoft Excel file containing a summary of blood pressure categories and session timestamps. The system is designed with a simple interface and intuitive interaction, making it suitable for early health education purposes. Although the application still relies on manual data input, it has the potential to serve as an effective learning tool for increasing public awareness of the importance of regular blood pressure monitoring. 

Kamariah Kamariah; Rosalia Putri; Dian Rahayu

Jurnal Riset Rumpun Ilmu Kesehatan 2026 Pusat riset dan Inovasi Nasional

The prevalence of correct handwashing behavior with soap in Aceh Province is 36%. School-age children are the time to instill PHBS values ​​and have the potential to be agents of change to promote PHBS both in the school environment, family, and society. The impact of lazy handwashing with soap can cause various diseases such as diarrhea, flu, hepatitis A, and impetigo (a contagious infection that usually occurs in children who rarely wash their hands, this disease is characterized by red skin which then develops into small blisters). The purpose of this study is to determine the effectiveness of mini posters as a health promotion media on handwashing behavior with soap in elementary school students. The research method is one group pretest posttest design. The sampling technique is total sampling, while the number of samples in this study was 80 students from grades 5 and 6 of elementary school. The results of the study obtained before the intervention of mini posters washing hands with soap behavior of elementary school students 77.5% of students did not wash their hands with soap after urinating and defecating. After the intervention of mini posters washing hands with soap behavior of elementary school students 87.5% did wash their hands with soap. There is an effect of mini poster intervention on increasing handwashing behavior in elementary school students with a p value of 0.000 < 0.05. The results show that mini posters are a reference for the effectiveness of health promotion in preventing infectious diseases in elementary school children by implementing a handwashing program with soap in the school environment