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Apriliana Ovin; Yasinta Flarida Erviana; Magdalena Oktaviani; Maria Silvana Mariabel Carcia

Maslahah : Jurnal Manajemen dan Ekonomi Syariah 2025 STAI YPIQ BAUBAU, SULAWESI TENGGARA

This study aims to analyze the implementation of competency-based performance management in the digital era at Telkom Maumere. Amid the ongoing digital transformation, organizations are required to enhance employee performance through structured systems that are adaptive to technological changes. Competency-based management has become a key strategy to ensure that every individual possesses the skills and behaviors aligned with organizational goals. This research employs a qualitative descriptive approach with data collected through interviews, observations, and document analysis. The findings indicate that Telkom Maumere has adopted a performance management system integrated with digital technologies, such as the use of e-performance applications and online evaluation systems. However, challenges remain in terms of digital training and comprehensive competency mapping. The study concludes that competency-based performance management in the digital era can enhance work productivity, provided it is supported by adequate technological infrastructure and an adaptive organizational culture.

Cindy Amelia Sari; Ute Chairuz M. Nasution; Awin Mulyati

Jurnal Manajemen Kreatif dan Inovasi 2025 International Forum of Researchers and Lecturers

This quantitative research analyzes the influence of online promotion and shopping lifestyle on impulsive buying of jiniso fashion products on the Shopee e-commerce platform. The phenomenon of increased impulsive purchasing behavior is driven by online promotion strategies (discounts, vouchers, flash sales) and a tendency towards a consumptive shopping lifestyle. The population for this study comprises all individuals who have purchased Jiniso fashion products on Shopee, with a sample of 100 respondents determined using a non-probability sampling technique. Primary data were collected through online questionnaires via Google Forms, while secondary data were obtained indirectly from intermediary sources such as literature, articles, journals, and websites related to the research object. Based on SPSS test results, all research instrument indicators were found to be valid and reliable. Partial t-tests revealed that both online promotion and shopping lifestyle variables significantly influence impulsive buying. Furthermore, the F-test indicated that both independent variables simultaneously affect impulsive buying. Among the two variables, online promotion emerged as the dominant variable. The conclusion shows that online promotion and shopping lifestyle significantly impact impulsive buying behavior for Jiniso fashion products on Shopee, providing implications for fashion businesses to maximize online promotions and adapt marketing strategies to effectively increase sales.

A Dan Kia; Majesty, Gilbert Timothy

International Journal of Christian Education and Philosophical Inquiry 2025 Asosiasi Riset Ilmu Pendidkan Agama dan Filsafat Indonesia

Artificial Intelligence (AI) can be a transformational tool in Christian Religious Education in the digital era. Technological advancements bring significant changes to the way we learn and teach, including religious education, which demands innovative methods to remain relevant to the younger generation increasingly connected to technology. AI offers various opportunities to enrich the learning experience and deepen the understanding of Christian values through a more personal and interactive approach. This article discusses several AI applications in Christian religious education, such as virtual assistants for spiritual guidance, in-depth Bible text analysis, and adaptive learning platforms that can tailor materials to the needs of learners. With AI technology, Christian religious education can provide more interactive and responsive modules, allowing learners to delve into religious teachings both individually and in groups. Additionally, the use of AI in analyzing learning behavior allows for more effective curriculum personalization according to the spiritual needs of each individual. This approach can address the challenge of maintaining the relevance of religious values amidst the rapid influx of digital information. This article also examines the potential of AI in aiding faith development, for example through spiritual reflection applications tailored to the user's spiritual growth. This transformation is expected to prepare a generation of Christians who are not only technologically savvy but also spiritually strong, and empowered to face moral and ethical challenges in the future. Thus, AI-based Christian Religious Education can be a pathway to building a relevant and dynamic spiritual future in the digital era.

Arriana Puspita Sari; Cindy Claudia; Lailatul Fathya; Diva Ayunda Tobing; Dini Syah Fitri +2 more

Jurnal Ilmu Kesehatan Umum, Psikolog, Keperawatan dan Kebidanan 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

In today’s digital era, the rapid advancement of technology has reshaped the way people seek entertainment, with online games becoming a dominant pastime, particularly among university students. While gaming provides an outlet for relaxation and escapism, its excessive use often leads to addictive behaviors that interfere with academic responsibilities, physical health, and social functioning. This research was designed to explore how self-control influences the tendency toward online game addiction among students. Utilizing a quantitative correlational method, the study gathered data from 111 university students across various disciplines who actively engage in online gaming. The measurement tools consisted of validated Likert-scale questionnaires, and statistical analysis was conducted using simple linear regression. The findings revealed a statistically significant negative relationship between self-control and gaming addiction, indicating that individuals with stronger self-regulation skills are less likely to develop problematic gaming behaviors. These results highlight the vital role of self-control in maintaining a balanced academic and personal life. The study emphasizes the need for strategic interventions within educational settings to foster better emotional regulation among students as a preventative measure against gaming addiction.

Vera Maria; Vina Nailatul Nabila

Maeswara : Jurnal Riset Ilmu Manajemen dan Kewirausahaan 2025 Asosiasi Riset Ilmu Manajemen Kewirausahaan dan Bisnis Indonesia

Gen-Z has grown alongside rapid technological and digital media development, fostering frequent virtual interactions over face-to-face ones. This shift often triggers Fear of Missing Out (FOMO), where individuals feel anxious about missing trends or updates. Among Gen-Z, FOMO is strongly influenced by social media, driving consumptive behavior. This article explores how FOMO creates opportunities for Indonesian Micro, Small, and Medium Enterprises (MSMEs) through jasa titip (personal shopping services). Using the Dubai Chocolate trend as a case study, it highlights how social media-driven demand has spurred interest in personal shopping services to source and deliver such products. The research emphasizes the importance of social media as a tool for MSMEs to tap into FOMO-driven markets. It also encourages MSMEs to innovate by offering affordable, locally sourced alternatives to remain competitive. This approach enables MSMEs to thrive in a dynamic, trend-focused digital landscape.  

Muh Madhani Rahmatullah; Dealova Savara; Rizqika Ghina Salsabila; Fahma Ningrum Rahmasari

RISOMA : Jurnal Riset Sosial Humaniora dan Pendidikan 2025 Asosiasi Ilmuwan Pendidikan, Sosial, dan Humaniora Indonesia

The rapid growth of social media has significantly influenced the psychological dynamics of adolescents, particularly regarding their mental health. This study aims to examine the relationship between the five dimensions of the Big Five personality traits (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and adolescent mental health in the digital era. Using a qualitative method with a literature review approach, the study analyzed various recent scientific sources. The findings indicate that certain personality traits, such as high neuroticism, are positively correlated with mental health issues, while others, like extraversion and conscientiousness, serve as protective factors. The interaction between personality traits and social media usage patterns also affects adolescents' levels of stress, anxiety, and tendencies toward negative behaviors such as FOMO and digital addiction. These results highlight the importance of a personalized approach in supporting adolescents, involving parents, teachers, and counselors, to prevent psychological disorders and promote mental well-being based on individual personality characteristics.

M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing

Jurnal Praba : Jurnal Rumpun Kesehatan Umum 2025 STIKES Columbia Asia Medan

This study systematically evaluates the effectiveness of mental rehabilitation programs implemented for post-conflict populations in the aftermath of the Arab Spring. A meta-analytical approach was applied to 47 empirical studies encompassing 12,873 participants across five affected countries, Egypt, Tunisia, Libya, Yemen, and Syria, from 2012 to 2023. The analysis reveals a significant reduction in symptoms of Post-Traumatic Stress Disorder (PTSD) (d = -0.78, 95% CI [-0.92, -0.64], p < .001) and depression (d = -0.65, 95% CI [-0.79, -0.51], p < .001) following psychological intervention. Among the various therapeutic modalities, Cognitive Behavioral Therapy (CBT) exhibited the strongest effect (g = 0.89), followed by Narrative Exposure Therapy (g = 0.76) and Eye Movement Desensitization and Reprocessing (g = 0.71). Analysis of moderating variables demonstrated that both program duration (β = 0.31, p < .01) and family involvement (β = 0.28, p < .01) significantly contributed to enhancing the efficacy of the intervention. These findings advance the understanding beyond previous research by Bwirire et al. (2022) and Eskici et al. (2023), which were constrained to short-term outcomes. This study confirms that therapeutic gains may persist up to two years post-intervention (r = 0.67, p < .001). Moreover, the results underscore combining community-based interventions with individualized therapy yields more favorable outcomes than the one-dimensional strategies reviewed in earlier literature.

Muhammad Fikri Firmansyah; Kanzul Aras Nurjannah; Elfa Mazroatul Mawaddah; Fajar Zikri Ramdhan Cahyadi; Mu’alimin Mu’alimin

Jurnal Manajemen dan Pendidikan Agama Islam 2025 Asosiasi Riset Pendidikan Agama dan Filsafat Indonesia

Building effective leadership in schools is key to creating a productive and harmonious educational environment. A managerial psychology approach can provide in-depth insight into effective ways of leading, by considering psychological aspects that influence individual behavior and performance in school organizations. This approach focuses on understanding the psychological characteristics of leaders and team members, managing emotions, and effective communication in building mutually supportive relationships. In an educational context, managerial psychology can help school leaders to manage team dynamics, increase motivation, and create a positive work climate. Therefore, it is hoped that the application of managerial psychology principles in leadership in schools can produce more effective school management, both in the aspects of teaching, management and human resource development.  

Haswini Harun; Hary Chandra

Inovasi Kesehatan Global 2025 Lembaga Pengembangan Kinerja Dosen

Non-communicable diseases (NCDs) are the leading cause of death globally, with type 2 diabetes being one of the most prevalent conditions. Nutritional management for clients with type 2 diabetes requires strict adherence to the correct schedule, type, and quantity of food. To improve medication adherence, it is essential to implement preventive strategies that promote patient engagement and self-management. One such strategy is the Health Belief Model (HBM), which encourages patients to adopt healthy behaviors based on their perceptions of risk, severity, benefits, and barriers. This study aims to analyze the relationship between the Health Belief Model and medication adherence among type 2 diabetic patients in the Galala Community Health Center (Puskesmas) work area. A quantitative cross-sectional study design was used, with a sample size of 108 participants selected through simple random sampling. The independent variables in this study were perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, while the dependent variable was medication adherence. The results revealed significant relationships between all the HBM constructs and medication adherence. Specifically, perceived susceptibility (p=0.000), perceived severity (p=0.000), perceived benefits (p=0.000), perceived barriers (p=0.000), and cues to action (p=0.000) all had strong associations with adherence to medication. The findings suggest that the Health Belief Model is a valuable framework for improving medication adherence among type 2 diabetes patients. Additionally, the use of health information technology is an effective strategy to increase patient awareness of the risks of non-adherence and the importance of regular medication intake. A combination of education, social support, technology, and an individualized approach can create a supportive environment that encourages patients to manage their treatment effectively.

Regita Nova Adetyandini

Jurnal Mahasiswa Kreatif 2025 International Forum of Researchers and Lecturers

This study aims to analyze the role of psychological assessment in improving the effectiveness of guidance and counseling services in educational settings through a qualitative literature review. Psychological assessment is a fundamental component in counseling practice that allows counselors to understand clients in depth and comprehensively. The research method uses a qualitative approach with a literature review that analyzes journal articles, textbooks, and relevant academic publications from 2015- 2025. The results of the study indicate that psychological assessment has two main roles: first, helping counselors understand the internal dynamics, cultural context, strengths, and resources of clients; second, providing various types of assessment instruments that can be selected according to needs, including personality, cognitive, emotional, behavioral, projective, multicultural, and technology-based assessments. Appropriate assessment not only functions as a diagnostic tool but also as a therapeutic intervention that encourages client self-awareness. The implementation of quality psychological assessment is the foundation for designing effective and responsive counseling services to the individual needs of students, so that it can improve the overall quality of guidance and counseling services in educational settings.

Marisa Aulia Gea

Sinar Kasih: Jurnal Pendidikan Agama dan Filsafat 2025 Sekolah Tinggi Teologi Injili Arastamar (SETIA) Ngabang

This article discusses the role of loving touch from parents in developing adolescent character. In facing the often complex and dynamic realities of life, a person's character plays a crucial role in shaping an individual's personality. Adolescents, as a group that tends to oppose or oppose the values held by their parents, require special guidance and attention in character formation. Using descriptive qualitative methods and literature studies, this article explores an understanding of how a parent's loving touch can influence the formation of a teenager's character. The discussion covers important aspects such as forming healthy emotional relationships, developing positive values and attitudes, boosting self-confidence, and developing empathy and social skills. The results of the analysis show that consistent and positive loving touch creates a strong foundation for adolescents' emotional, social and moral development. Parental love creates an emotionally safe environment, allowing teens to feel loved, appreciated, and have a safe place to express themselves. Apart from that, the role of parents as good role models provides examples of positive behavior that can be internalized by teenagers. The aim of developing adolescent character includes preparing them to face future challenges, forming positive values, strong attitudes, and correct orientation towards life goals. Thus, this article provides an in-depth understanding of how a parent's loving touch contributes to shaping the character of teenagers, so that it can help form a generation that has positive character, empathy and strong social skills to face the various complexities of life in the future.

Christian Wisnu Gunawarman Siwu; Gede Bayu Rahanatha

Jurnal Visi Manajemen 2025 Sekolah Tinggi Ilmu Ekonomi Pariwisata Indonesia Semarang

This research aims to analyze the role of brand image as a mediating variable in the relationship between electronic word of mouth (e-WOM) and purchase intention for iPhone smartphone products in Denpasar City. The study is grounded in Consumer Behavior Theory, which explains how external and internal factors influence purchasing decisions. The widespread use of e-WOM in the digital age is a significant external factor in shaping consumer perceptions. Conversely, brand image is a critical internal asset for a company to build customer trust and loyalty. By understanding the interaction among these three variables, this research is expected to provide strategic insights for marketers. The study’s population includes Denpasar residents who either use or intend to purchase an iPhone smartphone. The sample size is 100 individuals, selected using a purposive sampling technique based on specific criteria such as age, social media usage, and knowledge of iPhone products. Data was collected by distributing questionnaires to respondents. The data analysis methods used were descriptive and inferential analysis. Inferential analysis included the Classical Assumption Test to ensure the data met statistical requirements, Path Analysis to examine the direct and indirect relationships between variables, the Sobel Test to measure the significance of the mediation effect, and the Variance Accounted For (VAF) Test to determine the extent to which brand image mediates the relationship. The results show that brand image plays a partial mediating role in the effect of e-WOM on purchase intention. This indicates that e-WOM not only directly influences purchase intention but also indirectly through the formation of a positive brand image. This finding confirms the importance of brand image as a bridge connecting electronic word-of-mouth promotion with consumers’ purchasing decisions. The implications of this research are highly relevant for iPhone smartphone marketers.

Nofita Sari; Tutik Ekasari; Iit Ermawati

Jurnal Mahasiswa Ilmu Kesehatan 2025 STIKes Ibnu Sina Ajibarang

Anxiety is  a reaction to fear of or in a situation, anxiety shows a tendency to perceive a situation as threatening or stressful (stressful situation), Immunization is a health service that aims to protect individuals from diseases that can be prevented by immunization is an important component of primary health services and plays a major role in reduce the mortality rate of toddlers. The purpose is to find out the corellation between maternal anxiety about AEFI and IDL completeness. A type of correlational analytical  research with a cross sectional research design.The research was conducted in Bulujaran Kidul Village on June 10, 2024 by collecting repondents for the posyandu event. The population was 173 respondents. The study used technique. So that the sample was obtained by 49 respondents using the slovin formula that meets the inclusion requirements. The instrument uses an emergency questionnaire and an IDL completeness questionnaire using a KIA book. Data analysis using Chi-Square. The results of the study used showed that of anxiety data in mothers were mostly in the severe category of 23 respondents (47%). and the behavior of IDL completeness was mostly incomplete in the category of 38 respondents (78%). The results of the Chi-Square test were obtained that the p-value = 0.002 so  that the p-velue value  ≤ α = 0.05. This shows the corellation  between maternal anxiety about AEFI and IDL completeness. It is hoped that mothers will gain knowledge about the importance of IDL for children's gaps in the future and it is hoped that mothers will support their families to always make good decisions.

Hidayani Syam; Rifla Fasmawati; Sonia Sonia

RISOMA : Jurnal Riset Sosial Humaniora dan Pendidikan 2025 Asosiasi Ilmuwan Pendidikan, Sosial, dan Humaniora Indonesia

The family is the smallest social unit in society that plays an important role in individual development. Harmonius relationships within the family are the main foundation for creating individuals who are physically, emotionally, and psychologically healthy. Family Psychodynamics is an approach to family counseling that is rooted in psychoanalytic theory. This approach focuses on unconscious emotional patterns in relationships between family members, as well as the influence of childhood experiences on current family dynamics. Behavioral Social Family Counseling is an approach to family counseling that combines psychodynamic principles with social behavioral theory. This approach focuses on how social interactions and behaviors observed within the family affect the dynamics of relationships between family members.The Structural Family Approach is a counseling model that emphasizes family structure, including roles, hierarchies, and patterns of relationships between family members. This approach was developed by Salvador Minuchin, who believed that families have a structure that influences interactions between family members.  

Tuti Sahara; Yusnidar Yusnidar; Iklima Iklima

Jurnal Pelaksanaan Pengabdian Bergerak bersama Masyarakat 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

Rhinitis is one of the health conditions commonly found in the community, with a high prevalence both globally and in Indonesia. These disorders have a significant impact on an individual's quality of life, interfere with daily activities, and have the potential to lead to complications such as sinusitis and asthma. Educational efforts through health counseling are an important strategy in improving public knowledge, attitudes, and behaviors related to the prevention and management of rhinitis. This counseling activity aims to expand public understanding of rhinitis, including definitions, risk factors, symptoms, preventive measures, and self-management that can be applied in daily life. The methods used include interactive lectures, group discussions, and question and answer sessions, with the target of the general public who have risks or complaints related to rhinitis. The results of the activity showed a significant increase in participants' understanding of the condition of rhinitis and the importance of preventive measures. Participants showed a higher awareness of the importance of maintaining environmental cleanliness, avoiding exposure to allergens, and implementing a healthy lifestyle. In addition, there was an increase in participants' proactivity in seeking health information and a commitment to implement preventive behaviors consistently. This counseling has a positive impact on improving public health literacy and encouraging constructive changes in attitudes in dealing with rhinitis. It is hoped that similar activities can be carried out in a sustainable and widespread manner, so as to contribute to reducing the prevalence of rhinitis and improving the quality of life of the community in general. Community-based counseling has proven to be effective as a promotive and preventive approach in handling chronic and recurrent diseases such as rhinitis.

Aliyan Syarif Mukhtar; Jeni Fadhila; Faisal Kurnia; Tuti Rahmi; Utari Febriani

Jurnal Publikasi Ilmu Psikologi. 2025 Asosiasi Riset Ilmu Kesehatan Indonesia

Assertive is a form of learning that forms the identity of an individual. Assertive ability can also bring up communication skills that can assist individuals in carrying out their social demands. Assertive behavior is important for children to have to prevent sexual violence, bullying and communication difficulties in children. The purpose of this study was to determine the effectiveness of pop up books in increasing assertiveness in children. The method used in this study is an experimental research method which uses a pre-test post-test control group design. Data collection was carried out through observation with the checklist recording technique. Data analysis used is descriptive analysis. The subjects in this study were class II children of SD Negeri Padang Lua for the 2022/2023 academic year, aged 8-9 years. Based on the results of the pre-post test analysis, there was a significant difference in the form of an increase in assertive behavior in the experimental group. This proves that the use of pop up books is effective in increasing assertiveness in children. It is hoped that future researchers will implement this research in a more conducive environment and with a longer intervention time.

Herdinda Oktafani; Indah Sukmawati

Jurnal Ilmu Pendidikan 2025 Lembaga Pengembangan Kinerja Dosen

This research is motivated by the phenomenon that there are still students who do not understand premarital sexual behavior. It can be seen that there are students who hold hands with the opposite sex, there are students who are alone with the opposite sex in public places in school uniforms. The purpose of this study is to describe students' perceptions of premarital sexual behavior and describe the guidance obtained at school. The population in this study consisted of all X and XI grade students at SMK Negeri 1 Padang Panjang in the 2024/2025 school year, totaling 681 people. The research sample amounted to 253 students selected through stratified random sampling technique. Data collection was carried out by distributing instruments in the form of questionnaires measuring students' perceptions of premarital sexual behavior and guidance obtained at school. The results showed that (1) students' perceptions of premarital sexual behavior at SMK Negeri 1 Padang Panjang were generally in the good category (2) the guidance obtained at school was generally in the very good category. Based on the results of this study, counseling teachers can maintain and improve the quality of services that have been provided to prevent the emergence of premarital sexual behavior among students. This effort can be done through the provision of information services, individual counseling, and group guidance that specifically discusses topics regarding premarital sexual behavior.

Desclarista Salwa Putri; Vallen Syiah; Fadila Ramadhani; Ari Suriani; Afriza Media

Jurnal Pendidikan dan Kewarganegara Indonesia 2025 Asosiasi Riset Ilmu Pendidikan Indonesia

This article aims to investigate the importance of instilling Pancasila values ​​in grade IV elementary school students as the main basis for children's moral development. This study was conducted using a literature review method through analysis of various articles from sources such as academic journals and Google Scholar, using the keywords "Instilling Pancasila Values ​​in Elementary Schools" that are relevant to the topic discussed. Pancasila functions as the nation's philosophy of life, which builds national identity while providing guidelines for acting morally and ethically for all individuals. Therefore, Pancasila values ​​must be instilled from an early age so that children can develop personalities that are in line with these values. The results of this study show that instilling Pancasila values ​​has a significant impact on the formation of behavior, character, and ethics of students at the elementary school level.

Ofelia Ersegofina Tahulending; Hi Suwandi Luneto; Tezar Nusi

VitaMedica : Jurnal Rumpun Kesehatan Umum 2025 STIKES Columbia Asia Medan

Work discipline is a behavior that must be instilled in every individual inside and outside the organization. Employee performance is influenced by several factors, including work discipline. The purpose of this research is to identify the relationship between work discipline and employee performance at Puskesmas Pintukota Kota Bitung.This research uses quantitative research with a cross sectional study design. Data analysis using Chi-Square with a level of significance (a < 0.05). The population in this study were all employees. With a sample size of 42 respondents obtained by total sampling technique.The statistical test obtained a value of <p=0.012 & 0.001 (a<O.002) on the work discipline variable. This means that Ha is accepted or there is a significant relationship between work discipline and employee performance. The conclusion of this research is that there is a relationship between work discipline and employee performance. The results of this research are expected that Puskesmas employees can maintain and improve work discipline so as to get good performance results in achieving each program that is arranged.

Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing

The Journal General Health and Pharmaceutical Sciences Research 2025 LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

This meta-analysis evaluates the cost-effectiveness of mental health interventions implemented in conflict-affected regions of the Middle East between 2010 and 2023, compiling data from 47 programs across eight countries. Statistical analysis reveals substantial variation in program effectiveness levels (Cohen's d = 0.78, 95% CI [0.65, 0.91], p < 0.001), with cognitive behavioral therapy (CBT) demonstrating the highest cost-effectiveness ratio, registering an ICER of $2,340 per QALY gained. Multilevel regression findings indicate that community-based intervention approaches consistently prove more cost-efficient than those conducted in clinical settings (β = 0.67, p < 0.001), yielding an average savings of 43% per participant. Remote teletherapy programs exhibit significant potential, particularly in regions with limited access to services, with an ROI reaching 1.89 (95% CI [1.65, 2.13]). The economic burden analysis estimates that untreated mental health conditions incur an average annual cost of $4,623 per individual, whereas intervention expenses amount to approximately $1,876 per patient per year, resulting in a benefit-cost ratio of 2.47. This study expands upon prior research by Tol et al. (2011) and McBain et al. (2016), which were limited to clinical outcomes without addressing the economic dimension. In contrast to the study by Reed et al. (1994), which explored general health economics within conflict zones, this research specifically quantifies the cost-effectiveness of mental health interventions in Middle Eastern conflict areas. It reveals that cultural adaptation within intervention programs can enhance return on investment by up to 31%. Finally, this review uniquely demonstrates that community-based mental health programs integrated within conflict zones can meet the cost-effectiveness thresholds recommended by WHO-CHOICE while maintaining a high level of clinical efficacy.