Nasrul Zaman, Marthoenis, Umi Salmah, Yuseva Sariati, Atik Badi’ah
Purpose. Non-Communicable Diseases (NCDs) pose a critical burden on Indonesia's industrial workforce, yet participation in government-mandated screening remains suboptimal, indicating a disconnect between service availability and acceptance. This study aimed to analyse the determinants of perceived program effectiveness among workers, focusing on the mediating role of self-efficacy and distinct influences of multi-level social support. Material & Methods. A cross-sectional study involving 1,050 blue-collar workers from seven industrial estates was conducted. Data were analysed using Partial Least Squares Structural Equation Modelling (PLS-SEM) to test the structural relationships and mediation effects. Results. Family and peer support significantly built self-efficacy but did not directly influence program perception. While self-efficacy strongly predicted perceived effectiveness, a critical "legitimacy gap" emerged. Health professionals significantly influenced program perception and exerted an overwhelming influence on cadres, yet cadres themselves failed to affect program effectiveness directly. The structural model demonstrated substantial explanatory power, with the combined variables accounting for 35.8% of the variance in perceived program effectiveness (R2). Conclusions. These findings may challenge the universality of the WHO’s "Task-Shifting" model in paternalistic cultures. In Indonesia’s hierarchical context, relying solely on cadres may create a "legitimacy gap" as workers tend to prioritize the "epistemic authority" of professionals. Consequently, effective interventions require "legitimacy transfer" strategies to bridge the authority gap between medical professionals and community-based cadres. © 2026 The Author(s).
Department of Public Health, Faculty of Medicine, University of Syiah Kuala, Banda Aceh, Indonesia; Department of Nursing, Faculty of Nursing, University of Syiah Kuala, Banda Aceh, Indonesia; Department of Occupational Health, University of Sumatera Utara, Medan, Indonesia; Department of Midwifery, University of Brawijaya, Malang, Indonesia; Department of Health Promotion, Yogyakarta Health Polytechnic, Yogyakarta, Indonesia
