Integrated Socio Epidemiological Model for Leptospirosis Control in Tidal Flood Prone Areas

The Elderly populations in tidal flood-prone areas face heightened vulnerability to leptospirosis due to environmental hazards, recurrent inundations, and psychosocial stressors. This study analyzed an integrated socio-epidemiological model that accommodates a community-based intervention, targeting perceived stress, self-efficacy, and clean and healthy living behavior (PHBS), along with a system dynamics simulation to forecast leptospirosis incidence. This quasi-experimental study design was implemented with 70 participants (35 intervention and 35 control). The participants reside in flood-affected villages of Demak Regency, Indonesia, in 2024 (Purwosari, Sriwulan). Perceived stress (PSS-10), self-efficacy, and PHBS scores were measured at pre- and postintervention. Statistical analyses included Mann-Whitney, Wilcoxon, and paired t-tests. Delta scores were integrated into a stock-flow model (PowerSim Studio 10) incorporating behavioral and environmental risk variables to simulate leptospirosis cases for 2024–2029. The in- tervention group demonstrated significant improvements in self-efficacy (Δ=+5.69±8.17,p