Feasibility and Preliminary Effects of a Culturally Adapted Internet-Based Mental Health Promotion Intervention for Indonesian Undergraduate Students (LifeHack: Menjadi Mahasiswa Tangguh): A Protocol for a Single-Arm, Pre–Post Feasibility Study

Background: Mental health problems are highly prevalent among university students globally and in Indonesia, yet the vast majority do not receive adequate care. Whilst existing digital mental health interventions in Indonesia have primarily targeted students with clinically elevated symptoms, no prior study has evaluated an internet-based intervention designed to promote positive mental health among Indonesian university students. LifeHack is an internet-based guided self-help intervention developed to promote positive mental health as part of the Caring Universities initiative within the WHO World Mental Health–International College Student (WMH-ICS) framework. LifeHack: Menjadi Mahasiswa Tangguh is a culturally adapted Indonesian version, developed through a systematic adaptation process guided by Bernal's Ecological Validity Model and the Heuristic Framework for Cultural Adaptation. Objectives: This study aims to evaluate the feasibility and acceptability of the adapted intervention, including its usability, participant satisfaction, adherence, and retention. Secondarily, it will examine preliminary signals of change in resilience, positive mental health, depression and anxiety symptoms, and coping strategies. Methods: This protocol describes a single-arm pre–post feasibility study involving 50 undergraduate students aged 18–25 years from Universitas Padjadjaran and Universitas Jambi, Indonesia. Participants will receive the culturally adapted LifeHack: Menjadi Mahasiswa Tangguh, a self-paced web-based guided self-help intervention supported by asynchronous personalised feedback from trained e-coaches. Participants may select modules according to their individual needs and complete the intervention over a flexible period of 1–6 weeks. Assessments will be conducted at baseline (T0), immediately following intervention completion or at the end of the six-week intervention period if participants have not previously indicated completion (T1), and three months after T1 (T2). Primary feasibility outcomes include usability, satisfaction, intervention adherence, retention, and intervention completion. Secondary outcomes include resilience, positive mental health, psychological distress, coping, and safety. Safety will be assessed through participant-reported negative effects and recorded adverse events identified through routine e-coach monitoring. Progression to a future randomised controlled trial will be evaluated using pre-specified traffic light criteria. Expected Outcomes: Findings will inform the feasibility, cultural appropriateness, and preliminary effects of the adapted LifeHack intervention for Indonesian students. Results will guide potential progression to a fully powered randomised controlled trial.

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Publication Details

Journal
medRxiv
Published
2026-10-28
DOI
https://doi.org/10.64898/2026.10.27.26364572
Primary Topic
Digital Mental Health Interventions
Type
preprint

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preprint

Feasibility and Preliminary Effects of a Culturally Adapted Internet-Based Mental Health Promotion Intervention for Indonesian Undergraduate Students (LifeHack: Menjadi Mahasiswa Tangguh): A Protocol for a Single-Arm, Pre–Post Feasibility Study

Aulia Iskandarsyah, Siti Raudhoh, Hari Setyowibowo, Sascha Y. Struijs
1 links
medRxiv
Digital Mental Health Interventions
preprint

Feasibility and Preliminary Effects of a Culturally Adapted Internet-Based Mental Health Promotion Intervention for Indonesian Undergraduate Students (LifeHack: Menjadi Mahasiswa Tangguh): A Protocol for a Single-Arm, Pre–Post Feasibility Study

Aulia Iskandarsyah, Siti Raudhoh, Hari Setyowibowo, Sascha Y. Struijs
preprint en

Abstract

Background: Mental health problems are highly prevalent among university students globally and in Indonesia, yet the vast majority do not receive adequate care. Whilst existing digital mental health interventions in Indonesia have primarily targeted students with clinically elevated symptoms, no prior study has evaluated an internet-based intervention designed to promote positive mental health among Indonesian university students. LifeHack is an internet-based guided self-help intervention developed to promote positive mental health as part of the Caring Universities initiative within the WHO World Mental Health–International College Student (WMH-ICS) framework. LifeHack: Menjadi Mahasiswa Tangguh is a culturally adapted Indonesian version, developed through a systematic adaptation process guided by Bernal's Ecological Validity Model and the Heuristic Framework for Cultural Adaptation. Objectives: This study aims to evaluate the feasibility and acceptability of the adapted intervention, including its usability, participant satisfaction, adherence, and retention. Secondarily, it will examine preliminary signals of change in resilience, positive mental health, depression and anxiety symptoms, and coping strategies. Methods: This protocol describes a single-arm pre–post feasibility study involving 50 undergraduate students aged 18–25 years from Universitas Padjadjaran and Universitas Jambi, Indonesia. Participants will receive the culturally adapted LifeHack: Menjadi Mahasiswa Tangguh, a self-paced web-based guided self-help intervention supported by asynchronous personalised feedback from trained e-coaches. Participants may select modules according to their individual needs and complete the intervention over a flexible period of 1–6 weeks. Assessments will be conducted at baseline (T0), immediately following intervention completion or at the end of the six-week intervention period if participants have not previously indicated completion (T1), and three months after T1 (T2). Primary feasibility outcomes include usability, satisfaction, intervention adherence, retention, and intervention completion. Secondary outcomes include resilience, positive mental health, psychological distress, coping, and safety. Safety will be assessed through participant-reported negative effects and recorded adverse events identified through routine e-coach monitoring. Progression to a future randomised controlled trial will be evaluated using pre-specified traffic light criteria. Expected Outcomes: Findings will inform the feasibility, cultural appropriateness, and preliminary effects of the adapted LifeHack intervention for Indonesian students. Results will guide potential progression to a fully powered randomised controlled trial.

medRxiv
Vrije Universiteit Amsterdam (NL), Padjadjaran University (ID)
Lembaga Pengelola Dana Pendidikan
Good health and well-being, Quality education
Digital Mental Health Interventions
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