Abstract
Introduction
Despite its numerous benefits, breastfeeding practices in Indonesia have faced several setbacks, especially after the pandemic, thus falling far short of the expected target. We need innovative technology-based solutions, like mobile health applications, to provide mothers with an alternative companion during nursing. This study aims to explore the experiences and feedback of first-time breastfeeding mothers using the Mommy-Be application.
Method
This study used a qualitative phenomenological approach involving six first-time breastfeeding mothers at a primary clinic in Makassar, Indonesia, from December 2023 to February 2024. We collected data through observation, structured in-depth interviews, and documentation. The Technology Acceptance Model (TAM) framework guided the thematic analysis of the data. Initial user responses indicated adaptive barriers that improved with the habit of accessing Mommy-Be. Mothers gave positive feedback on the visually appealing interface and found the application helpful in tracking breastfeeding routines and nutritional intake. The main challenges identified were internet connectivity issues and platform compatibility.
Results
The Mommy-Be application facilitates effective breastfeeding management and increases awareness of mental health and nutritional needs during breastfeeding. Positive feedback is consistent with previous studies emphasizing user-friendly interfaces and functionality. However, technical challenges highlighted the need for optimization for unstable network conditions and mobile platform compatibility.
Conclusions
This study received positive feedback for the Mommy-Be app, which aids in managing breastfeeding and monitoring nutrition. Future improvements should focus on network optimization and enhanced educational features. Ongoing training and support can further enhance user satisfaction and app acceptance.
Introduction
To ensure optimal infant growth and development, starting breastfeeding immediately after birth is the key to establishing a correct breastfeeding pattern. The World Health Organization (WHO) emphasizes the importance of starting breastfeeding within the first hour of birth and maintaining exclusive breastfeeding for the first 6 months. Following this period, introduce complementary solid foods and continue breastfeeding until the child reaches two or three years of age. This combination is a formula for achieving optimal benefits in many aspects of health protection, not only for infants but also for mothers (Meek & Noble, 2022a, 2022b) Despite the many benefits, the practice of breastfeeding in Indonesia continues to face challenges. The number of breast milk achievements that fall short of the target serves as evidence. UNICEF and WHO's recent data reveals a decline in breastfeeding practices, with only 48.6% of infants receiving breast milk within their first hour of life in 2021, a decrease from 58.2% in 2018. The exclusive breastfeeding rate for the first six months also fell from 64.5% in 2018 to 52.5% in 2021. This decline is partly due to the challenges posed by the coronavirus disease 2019 pandemic, which has overwhelmed health care systems and limited access to breastfeeding support and counseling (Unicef, 2023; WHO, 2022). The challenges of the pandemic provide us with numerous insights into the necessity of a rapid transition in health service transformation to ensure future health security. We require innovative solutions to overcome the limitations of limited access due to distance and time, particularly in countries where smartphone usage is widespread (Chib & Lin, 2018).
Mobile health (mHealth) applications offer a promising solution in a wide spectrum of health purposes. Various perceptions, particularly application characteristics such as relative advantage, complexity, compatibility, and observability, influence users’ adoption of mHealth applications (Lin & Bautista, 2017). Many apps have been developed especially to accompany mothers in their breastfeeding journey (Doan et al., 2023; Laws et al., 2023; Lewkowitz & Cahill, 2021). These apps are considered as another level of social support that can be personalized upon the breastfeeding mothers’ needs (Schindler-Ruwisch et al., 2018). These applications can provide support programs tailored to the needs of breastfeeding mothers, provide services related to lactation information, and improve the ability to recognize breastfeeding patterns, so that mothers can confidently assess their success in providing breast milk to their babies, especially for mothers who are breastfeeding for the first time (Entsieh & Hallström, 2016). New mothers often experience fluctuating emotions when breastfeeding for the first time, ranging from deep joy to uncertain anxiety and sadness (Vismara et al., 2016). This shows that they are in great need of assistance, especially knowledge about effective breastfeeding practices. Smartphones provide easy access to a variety of social media platforms today, yet the information remains overlapping. Therefore, the ideal opportunity for mHealth involvement in personalizing the needs of breastfeeding mothers is wide open(Qian et al., 2021). Health apps made to help with breastfeeding have many benefits. They raise awareness of how important breastfeeding is for meeting an infant's nutritional needs for healthy development, (Seyyedi et al., 2021), offer reliable, evidence-based advice from the time of birth until the child is 18 months old (Laws et al., 2023), teach mothers how important it is to be mentally healthy while breastfeeding (Syam et al., 2024) and indirectly improve the success of breastfeeding.
Health apps designed as lactation companions have the potential to significantly impact breastfeeding practices by raising awareness of proper lactation patterns, noting the importance of nutrition in breastfeeding, offering evidence-based guidance, and encouraging higher rates of breastfeeding success (Feroz et al., 2017). Several similar apps have varying appeals. MoomMae has been developed with the intention to support Thai women in breastfeeding outside of their homes and in keeping their feeding records, this app has great potential as a useful self-management tool for breastfeeding mothers. My Baby Now is another app with a broader spectrum, covering aspects of parenting and lactation, as well as a forum for parents to share experiences and give each other advice (Laws et al., 2023).
Participants Profile.
Construct, Themes, and Responses from Breastfeeding Mothers who Have Used the Mommy-Be Application During Qualitative Interviews.
Review of the Literature
In recent years, mHealth applications have gained attention as innovative tools for supporting maternal and child health. Several studies have explored the adoption of mHealth technologies, with frameworks such as the Unified Theory of Acceptance and Use of Technology and the Health Belief Model offering additional perspectives on user acceptance (Janz & Becker, 1984; Venkatesh et al., 2012). These models emphasize factors like social influence, perceived threat, and self-efficacy, which complement the Technology Acceptance Model (TAM) framework by providing a broader understanding of user behavior in health-related contexts. The TAM was applied using three key dimension: (1) Perceived ease of use: Reflects how effortless participants found the app to use, especially during registration and navigation. (2) Attitude toward the App: Captures participants’ overall impression and frequency of app use. (3) Perceived usefulness: Encompasses specific features participants liked, benefits experienced, and expectations for future features (Davis, 1989; Kamal et al., 2020; Rajak & Shaw, 2021; Wallace & Sheetz, 2014). Integrating these models with TAM could provide a more holistic view of the factors influencing the acceptance of the Mommy-Be application.
Despite the widespread use of smartphones in Indonesia, in the other study, health application users tend to be young individuals with relatively high health literacy and higher education levels compared to non-users (Bol et al., 2018). This will be a consideration and a challenge in launching similar or personalized application, particularly given that Indonesia's sociodemographic conditions are still marked by significant demographic disparities. The app we developed, Mommy-Be, provides personalization in three aspects, namely lactation, nutrition, and mental health awareness. This app has an interesting perspective, combining lactation needs, comprehensive monitoring of the mother's diet, and also covering postpartum issues, such as postpartum depression, and focusing on these issues well. However, this app is still in development, so features may be improved. In the initial study, this application has been tested on a number of breastfeeding mothers and provided good benefits, especially in terms of lactation efficacy and depression awareness (Syam et al., 2024). However, it is still too early to recommend this application for further intervention. In addition, the age range of infants included in the previous study was too large, so it cannot be validated whether the same is felt by mothers who breastfeed for one month or six months in terms of the benefits of the application. The success of an application-based digital intervention depends on its acceptance and utilization by new mothers. Engaging mothers in the use of mHealth applications can be challenging, but it is very important to improve breastfeeding practices. Furthermore, the sociodemographic conditions of the mother must be taken into account, particularly when dealing with network infrastructure challenges, as well as the level of digital literacy. Before recommending this application as part of a breastfeeding intervention, it is important to understand its acceptance and impact on users. Exploring first-hand stories and feedback from mothers who have used this lactation companion application can provide valuable insights into its effectiveness and areas for improvement. This understanding can help tailor the app to better meet the needs of new mothers, ensuring it provides the support needed to promote healthy breastfeeding practices and improve overall maternal and child health outcomes. Therefore, this study sought to explore first-hand accounts detailing mothers’ experiences using the Mommy-Be app and the feedback provided, especially for first-time mothers.
Method
Study Design
This research study adopted a qualitative methodology, specifically using a phenomenological approach. The main objective was to investigate and gain a comprehensive understanding of the experiences faced by breastfeeding mothers who use the Mommy-Be application. The TAM, which aims to analyze user acceptance and engagement with new technologies, serves as the conceptual framework for this investigation. This study was conducted for three months, from December 2023 to February 2024, at one of the primary health clinics (Puskesmas) in Makassar City, Indonesia.
Participants
Participants were selected using purposive sampling. The inclusion criteria included first-time mothers who had used the Mommy-Be app for at least one month and were between the age of 21 and 35. Mothers who recruited from a primary clinic in Makassar, Indonesia, and all participant had minimum high school educational backgrounds. Selected six mothers are in terms of exclusives breastfeeding baby age (0–1 month). Exclusion criteria included mothers with prior experience using similar mHealth applications; or those who were not comfortable with mobile technology. Upon onboarding, each participant received a brief coaching session, including an in-app guide and demonstration. Participants were walked through each function and provided with a quick-start guide. Participants who encountered initial difficulties received one-by-one additional support from the research team, including downloaded video tutorials to ensure a smooth user experience. Additional support was available for any ongoing question via WhatsApp group.
Data Collection
Data collection employed several techniques, including observation, where the researcher closely monitors participants’ interactions and application usage in a real-time setting. Second, the researcher conducted structured interviews, utilizing a preplanned set of questions to encourage a thorough conversation and a deeper understanding of each participant's experiences. Thirdly, the collection of written materials, audio recordings from user interactions, and screen recordings of user data with the application, these recordings were conducted twice per-participant at their home, lasting approximately 20–40 min each, to capture in-depth app usage engagement. Data from these recordings highlighted user engagement patterns and provided detailed feedback on the app's functionality.
Data Validation and Triangulation
To enhance data validity, triangulation was conducted by cross-referencing responses from primary participants with observations from their husbands regarding daily routines and breastfeeding practices. While husbands were not direct study participants, their insight provided secondary validation, particularly in confirming the accuracy of self-reported app usage and daily caregiving patterns. Although they were not formal study participants, their perspectives contributed to triangulation and supported the credibility of mothers’ accounts. The researcher ensure the reliability of the results by conducting audit procedures and consulting with experts in maternal health and technology use. The experts involved, one in maternal health and the other in mHealth technology, were consulted throughout the study. They reviewed the application's usability and provided insight on key areas for improvement, such as lactation-specific content, nutritional guidance, and interface design, ensuring the app addressed the practical needs of breastfeeding mothers. The principal investigator meticulously prepare detailed reports, providing systematic documentation that enables other researchers to evaluate the results’ applicability in various contexts.
Data Analysis
Thematic analysis was conducted using NVivo 12, which facilitated the organization and coding of qualitative data. The software was used to systematically categorize data into themes based on the TAM framework. The process of approaching (thematic) data analysis involves a series of structured techniques, namely, data reduction, data presentation, and drawing conclusions. Data reduction focuses on identifying relevant information while simplifying large data sets for clarity, guided by the TAM framework. Readers can understand the data by compiling and sharing findings in the form of validated narrative text. To enhance the validity of the findings, participants were given the opportunity to review their interview transcripts and preliminary themes derived from the analysis. This member checking allowed participants provided feedback, which incorporated into the final analysis. Finally, the researcher verified the analysis of the collected data before reaching a definitive conclusion about the user experience of breastfeeding support through the Mommy-Be application. The detailed reports of the script are not included in a supplementals file but can be made available upon request.
Research Team
The researcher team consisted of five investigators, four of them are women. The principal investigator holds a PhD in Public Health and has nine years of experience in maternal and breastfeeding research. She also has extensive training in qualitative research method, also has several related qualitative published projects regarding the same breastfeeding and maternal health theme. The second and third investigators have over ten years’ experience in maternal clinical primary care services. This clinical background enabled them to effectively interpret non-verbal cues, such as gesture and body language, during in-depth interviews, enriching the depth and accuracy of data collection. Their ability to recognize subtle expressions and behaviors specific to breastfeeding challenge and maternal well-being contributed significantly to understanding participants experiences beyond verbal responses. Although the fourth and the fifth investigators were not directly involved in coding and data analysis, their expertise was instrumental in contributing to the discussion and conclusion sections to highlight implications for maternal health, and also supervise the ethical protocols and reviewing participant consent processes.
Ethical Considerations
Before the study was conducted participants were informed that the primary researcher, who was responsible for conducting the interviews, was independent of the Mommy-Be app development team and had no prior relationships with the participants. This study received ethical approval from the Nani Hasanuddin Ethic Comissions, Approval Number 192/STIKES-NG/KEPK/VII/2023, July 24 2023 and all participants provided written informed consent, which included details on data protection and their right to withdraw any time. All participants signed an informed consent form, agreeing to participate in the study, share data, and adhere to privacy protocols. Participants were assured that their data would be used solely for research purposes and were given the right to withdraw at any time. This study not only highlights how breastfeeding mothers interact with technology tools such as Mommy-Be but also explores the broader implications related to the acceptance of technology in the context of healthcare that focuses on the mental well-being of breastfeeding moms. This study adheres to the COREQ checklist to ensure transparency and rigor in reporting this article. The checklist is provided separately from this report.
Results
General Description
All individuals who participated in this study were between 23 and 30 years old and had been using the Mommy-Be app for 2 to 3 weeks. There was a total of six participants involved, each with unique educational qualifications and professional experiences, but all participants were first-time mothers and were one week old when the interviews began. We implemented in-depth interviews for each informant, which took approximately 120 min per session, and repeated these interviews for three sessions. The informants in this study have the following characteristics as shown in table 1.
To collect data for this study, the researcher conducted comprehensive, in-depth interviews with these six participants. Using the researcher's own observations as an additional source of triangulation was an important aspect of ensuring the reliability of the data. This method not only increased the validity of the data but also confirmed findings related to how participants engaged with the app through detailed records from their individual user accounts during their usage sessions.
Analysis Results Thematic
The data collected from interviews and observations were analyzed using thematic analysis, guided by the TAM framework. Three researchers independently coded the transcripts, ensuring reliability and minimizing bias in theme identification. The analysis resulted in three major dimensions—Perceived Ease of Use, Attitude toward the App, and Perceived Usefulness—each encompassing ten subthemes derived from participants’ experiences and feedback. These themes are presented below with illustrative quotations to highlight key findings.
Mothers Perceive Ease of use the Mommy-Be app
The results of interviews with breastfeeding mothers who have used the lactation companion application (Mommy-Be) reveal their perceptions of its ease of use. In this case, the participants provided multiple responses after using the application for approximately 2 months. This theme encompasses several categories, including: (1) First impression when registering an account to the Mommy-Be application; (2) first impression when seeing the interface; and (3) first impression when introduced to menus. In general, users said that the process of registering for an account was uncomplicated and simple to finish, particularly when they were given directions that were readily understandable. On the other hand, consumers experienced difficulties when attempting to retrieve lost passwords, which highlights the necessity of enhancing user support throughout this process. A number of users have expressed their gratitude for the app's user-friendly interface, which features a well-organized structure, enticing colors, and clear visuals. The first visual appeal of the app was exceptionally well received by users. On the other hand, in order to avoid problems with resetting, a few consumers asked that certain features, such as the lactation monitor, be made more user-friendly. The menus of the application were judged to be well-organized and visually appealing by first-time users, which improved their ability to comprehend and utilize the application. throughout spite of this, initial confusion was rather common, particularly when navigating sophisticated menus; nevertheless, throughout the course of time, familiarity gained via consistent use and assistance
Mothers’ Attitudes Towards the Mommy-Be app
The results of the interview, which focused on mothers’ experiences with the lactation companion application (Mommy-Be), revealed several responses from participants who had used the application for approximately two months. This theme encompasses several categories: (1) First impression when opening the Mommy-Be app; (2) impressions while using the Mommy-Be app; (3) frequency of accessing the Mommy-Be app; and (4) ease and difficulties in using the Mommy-Be app. When users first started the application, they reported feeling some initial confusion. This was especially true for users who were not familiar with other programs that were of a similar kind. Although the learning curve was steep, users soon gained acclimated to the app's structure and capabilities as they continued to use it. This occurred despite the fact that the learning curve was high. A good opinion of the program was often created by users as a result of their increased familiarity with the capabilities of the application over the course of time. After overcoming the first learning period, users reported that the program was both helpful and simple to operate. This was the case despite the fact that there were still some small navigational challenges that persisted. The application was frequently utilized by users on a regular basis, particularly when they were engaged in activities that required specialist instruction, such as breastfeeding. In contrast, the frequency of usage varied depending on a number of factors, including personal habits, the dependability of the network, and the ease with which the program could be accessed at different times throughout the day. Users encountered challenges while attempting to complete particular tasks, such as navigating between data entries or accessing historical information, despite the fact that the app menus were generally deemed to be easy to use. The fact that these issues were commonly related to the requirement of completing repetitive processes or dependency on a reliable internet connection implies that there is space for improvement. Illustrative responses for each theme are presented in Table 2 below.
Perceived Usefulness of the Mommy-Be app
The results of the interview with mothers who have used the lactation companion application (Mommy-Be) reveal the benefits they have experienced. This theme encompasses multiple categories: (1) Features that mother liked in the Mommy-Be app; (2) benefits experienced while using the app; and (3) future expectations of Mommy-Be. Because they offer both an incentive and an opportunity for involvement during breastfeeding, the breastfeeding and nutrition tracking features of the app were particularly well-liked by users. The capability of the application to monitor and record sessions was significant since it not only made the application helpful but also made it enjoyable to use. This was one of the most essential features of the application. The software offered users a great deal of aid in managing and monitoring their breastfeeding habits, as well as their nutritional intake and the patterns of their baby's sleep. In addition, the software helped users monitor and regulate their baby's movements. Users were able to make judgments that were more informed as a result of these capabilities, which enabled them to maintain control over their daily childcare routines. Users have expressed a need for continued enhancements, which include the provision of more detailed instructions for new users, the enhancement of personalization options, the facilitation of offline operation, and the simplification of the process of recovering forgotten passwords. Additionally, in order to further enhance the program's usefulness and efficiency, it was necessary to introduce aspects of reminders and instructional content into the application.
Discussion
The study demonstrated that users generally found the app easy to use, particularly after familiarizing themselves with its features. This investigation highlights the positive reception of the Mommy-Be application among lactating mothers. Although initial challenges were encountered during registration and first-time use, these difficulties were largely mitigated as users became more comfortable with the interface and functionalities. This finding supports the TAM, which posits that ease of use positively influences user acceptance and satisfaction (Rajak & Shaw, 2021). Participants perceived significant benefits in the recording and monitoring of their breastfeeding schedules. Despite initial difficulties, they ultimately found the application straightforward to operate and recognized its tangible advantages. This reinforced the importance of content quality, aesthetics, and functionality in the development of health applications.
The app was regarded as moderately beneficial, particularly for tracking breastfeeding duration, frequency, sleeping pattern, urination, defecation, mother's daily intake, and other growth monitoring. This finding aligns with TAM's assertion that perceived usefulness significantly impacted user attitudes and behavioral intention (Kamal et al., 2020). The ability to provide feedback and facilitate monitoring suggested that user found it helpful in reviewing their breastfeeding practices. The positive feedback aligned with prior research, which has emphasized the importance of integrating application functionality with a user-friendly interface (Stoyanov et al., 2016). These elements are important to encourage acceptance among individuals using health-related applications.
A particularly well-received feature was the Daily Nutrition menu, which assisted users in tracking and quantifying their nutritional intake. By comparing their nutritional intake with the duration of their most recent lactation session, mothers could indirectly assess their breast milk supply. The development of this application was guided by three fundamental factors influencing breast milk production: mechanical, physical, and mental. The mechanical factor is represented by the capacity to identify breastfeeding patterns, (Edmond et al., 2016) the physical factor is represented by the rest and adequate nutrition of breastfeeding mothers, (Jouanne et al., 2021) and the mental factor is represented by mental health awareness in the pursuit of optimal breastfeeding and the preservation of breast milk supply (Scarborough et al., 2022; Syam et al., 2021).
The evolution of user experience within this study reflects the core principles of the TAM (Kamal et al., 2020). Users’ willingness to adopt new technological solutions was strongly influenced by their perceptions of ease of use and perceived usefulness (Rajak & Shaw, 2021). As user's continued to engage with the app, their attitudes towards its use became increasingly positive. Despite initial uncertainty, overall satisfaction with the app's features suggested a potential for sustained use.
The Mommy-Be app's aesthetic design and high-quality content played a pivotal role in enhanced the user experience. Participants expressed appreciation for its visually appealing layout, which was distinguished by well-organized menus and soft pastel colors. These visual elements are not merely decorative but served a functional purpose by increasing the likelihood of daily interactions with the application. Prior research on digital health applications has underscored the significance of design aesthetics and content quality in promoting consistent use. For instance,(Deady et al., 2018) examined mental health applicatios and found that users who perceived an app as both user friendly and beneficial were more likely to continue using it. This is consistent with the results of this study, which indicated that participants initially encountered navigational challenges but later experienced a sense of ease after receiving supplementary assistance. Similarly, (Dennison et al., 2013) determined that health applications featuring engaging design and high-quality content were more frequently used on a routine basis. Within the context of Mommy-Be, participants reported that the app's attractive layout and pastel color scheme enhanced their engagement and made daily use more appealing.
The rise of web technologies has transformed the way breastfeeding mother accessed information and also gained support. The platforms created online support network that connected mothers and professionals, providing real-time access to evidence-based information and fostering emotional support such as peer groups network. A recent study in Las Vegas Health Center highlighted the revolutionary role of web 2.0 in addressing challenges such as breastfeeding difficulties, limited healthcare support, and the need for accessible and reliable guidance (Díaz-Cano & Esplugues-Cebrián, 2024). The Mommy-Be app reflected this evolution by incorporating features that aligned with mothers’ need for guidance, tracking, and emotional support during their breastfeeding journey. This positive influence of mHealth empowered mothers to make informed decisions about their breastfeeding practices, ultimately promoting breastfeeding success.
The study provided more insights into user experience, highlighting both strength and areas for improvement. A user-centered approach ensured that the app development remains aligned with the needs for first-time mothers. The positive reception of the app's core menus, particularly monitoring and tracking functionalities, proposed that it had practical applicability to supporting mothers throughout breastfeeding journey and improve breastfeeding outcomes. However, several challenges were reported, particularly internet connectivity, iterations off the app on offline capabilities, and more intuitive menu structure, specifically in displaying graph or breastfeeding summary. Future research should expand the user base to assess how the app performs across different demographic groups. Based on overall findings and the alignment with TAM, Mommy-Be demonstrates strong potential as a tool for improving breastfeeding outcomes. The app enhances mothers’ understanding of breastfeeding practices while serving as a valuable tool for tracking essential aspects of infant care. Furthermore, integrating additional educational resources within the app could better address mothers’ needs for essential breastfeeding and infant care information, further enhancing its effectiveness.
Limitations of the Study
While the Mommy-Be app demonstrated positive usability and acceptability among first-time mothers, several limitations should be considered. First, the study was conducted in a single geographic location with a relatively small sample size, which may limit the generalizability of the findings to broader populations. Second, the study focused exclusively on first-time mothers, potentially overlooking the perspectives of experienced mothers who may have different app usability experiences. Additionally, internet connectivity and platform compatibility issues were highlighted as challenges, suggesting a need for further optimization of the app's functionality in low-resource settings. Lastly, while the study captured short-term user feedback, it did not assess long-term engagement and sustained use, which is critical for evaluating the app's long-term impact on breastfeeding outcomes.
Implications for Practice
The findings of this study provide valuable insights for nursing practice and maternal health interventions. The Mommy-Be app presents an innovative tool for supporting breastfeeding mothers, offering digital tracking, nutritional monitoring, and emotional support. The positive user experience suggests that integrating such mHealth solutions into routine maternal healthcare services could enhance breastfeeding education and self-management. However, addressing internet connectivity challenges and improving user onboarding through structured guidance will be crucial for optimizing its accessibility and effectiveness. Healthcare professionals, particularly nurses and lactation consultants, can leverage this app to provide remote breastfeeding support, ensuring that mothers receive continuous assistance even beyond clinical settings. Future app developments should consider incorporating more interactive educational resources and peer support features to strengthen user engagement and improve breastfeeding outcomes.
Conclusion
The Mommy-Be app, with its focus on ease of use and perceived usefulness, is well-positioned to support first-time mothers in their breastfeeding journey. While there are areas for improvement, the app's strengths suggest that it could be a valuable tool in intervention studies aimed at improving breastfeeding outcomes. Addressing the identified limitations and conducting further testing will be essential steps in ensuring the app's readiness for widespread adoption and effective intervention.
Footnotes
Acknowledgements
The authors would like to express their gratitude for the financial support, which made this study possible. Additionally, they thank all the participants and the research team for their valuable contributions to this study.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Ministry of Higher Education Indonesia (grant number 0667/E5/AL.04/2024).
