Effectiveness of the UFESA Model: A Culturally Grounded Intervention to Improve Adherence to Lymphatic Filariasis Mass Drug Administration in Papua, Indonesia

Background: Lymphatic filariasis remains a public health challenge in Papua because of low adherence to mass drug administration (MDA). Objective: This study evaluated the effectiveness of the UFESA model—a culturally tailored intervention integrating health education, family support, and traditional leader engagement—in improving adherence to preventive filariasis medication in Sarmi District. Materials and Methods: A quasiexperimental pretest–posttest control group design was implemented across two health centers (intervention: Bagaiserwar; control: Sarmi Kota), with 160 participants recruited via multistage random sampling. The primary outcome was adherence across three MDA cycles; secondary outcomes included knowledge, attitudes, and support measures. The data were analyzed via chi-square, Mann– Whitney U, and Wilcoxon tests. Results: Adherence increased from 38.8% to 87.5% in the intervention group, whereas it increased from 26.2% to 52.5% in the control group (p < 0.001). All the adherence dimensions were significantly greater in the intervention group. Knowledge increased from 3.00 to 10.00 (intervention) versus 2.00 to 4.00 (control), with similar improvements in attitudes and support (p < 0.001). The instruments showed strong reliability (α > 0.80) and validity. The effect sizes were medium to large (Cohen's d=0.68–0.78; Cramer's V=0.38–0.45). Conclusion: The findings provide evidence of the effectiveness of the UFESA model in enhancing medication adherence and addressing psychosocial determinants, highlighting the value of culturally grounded, psychometrically rigorous interventions in public health.