The findings were published in the International Journal of Education and Psychological Science (IJEPS), Volume 4, Number 5, 2026, pages 615–626. The study explored an intervention designed to encourage older adults to remain mentally engaged, socially connected, and involved in meaningful productive activities.
Moving Beyond Passive Elderly Care
Older adults may experience various changes as they age, including declining physical and sensory abilities, retirement, reduced social roles, and social isolation. These changes can influence how individuals perceive themselves, interact with others, and maintain a sense of purpose in everyday life.
Many elderly health programs traditionally focus on physical examinations, counseling, or one-way health education. While these activities remain important, older adults may have limited opportunities to participate in creative and productive activities.
Ismiriyam, Wulansari, and Rosidi introduced the Mental Health Box as an empowerment-oriented approach. Instead of positioning older adults only as recipients of care, the intervention encourages them to participate directly in activities that produce tangible outcomes.
The Mental Health Box contains large-print mindfulness journaling sheets, positive affirmation cards, herbal tea materials, aromatherapy supplies, and simple packaging materials. The package is designed to accommodate the physical and cognitive needs of older adults.
The healthpreneurship concept combines health education, creative activities, and small-scale entrepreneurship. Participants are encouraged not only to engage in relaxation activities but also to create simple health-related products that can be displayed or introduced within their communities.
Forty Older Adults Participated in the Four-Week Program
The study involved 40 older adults selected through total sampling. Participants took part in group-based Mental Health Box activities for four weeks.
Their psychological well-being was measured before the intervention and again after the program ended. The researchers then compared the scores from the two measurements.
Psychological well-being in the study covered several dimensions, including autonomy, environmental mastery, personal growth, positive relationships with others, purpose in life, and self-acceptance.
Among the 40 participants, 26 were women, representing 65 percent of the sample, while 14 were men, representing 35 percent. The largest age group was 60–64 years, consisting of 15 participants or 37.5 percent of the sample.
Psychological Well-Being Scores Increased by 14.50 Points
The study recorded a clear difference in average psychological well-being scores following the intervention.
Before participating in the program, the participants had an average psychological well-being score of 62.40. After four weeks, the average score increased to 76.90.
This represented an average increase of 14.50 points.
A paired-samples t-test produced a t-value of 15.53 with a p-value below 0.001. Within the study's statistical framework, this indicates a statistically significant difference between psychological well-being scores before and after the intervention.
The researchers also reported a Cohen's dz effect size of 4.94, with a 95 percent confidence interval for the mean difference of 13.61–15.49. However, these findings need to be interpreted in light of the study design because there was no control group.
According to Ismiriyam, Wulansari, and Rosidi of Ngudi Waluyo University, the improvement may be related to the combination of psychological and productive activities incorporated into the Mental Health Box.
Participants completed mindfulness journaling, used positive affirmation cards, prepared herbal tea, created aromatherapy products, packaged products, and participated in product exhibition or presentation activities.
From Relaxation to a Greater Sense of Purpose
The intervention was designed to provide several forms of stimulation simultaneously. Reading instructions, completing journals, and following product-making steps provided cognitive engagement. Meanwhile, handling herbal ingredients and aromatherapy materials created sensory experiences, while packaging activities involved fine-motor skills.
Completing a product also gave participants an opportunity to experience successful task performance. Such experiences may contribute to confidence in carrying out productive activities.
The social component was another important feature of the program. Products created by participants could be displayed or introduced within the community. Recognition from others may help reinforce the perception that older adults can continue contributing and producing something meaningful.
The researchers argue that integrating mental health education with small-scale health entrepreneurship can support active participation among older adults. The approach is consistent with the broader concepts of active aging and productive aging, which emphasize that healthy aging involves more than the absence of disease. Social engagement, meaningful activities, and continued participation in everyday life are also important elements.
Potential Application in Community Elderly Health Programs
The findings suggest that a Mental Health Box could potentially be incorporated into community-based elderly health programs, including Posyandu Lansia and residential care settings.
Activities could be adapted to participants' abilities and local resources. Simple options may include guided journaling, positive affirmations, herbal tea preparation, aromatherapy activities, product packaging, and community exhibitions.
For healthcare workers and caregivers, this approach may provide an additional activity that combines psychosocial support with productive engagement. For communities, it can create opportunities for older adults to interact, learn new skills, and participate in activities that have practical outcomes.
However, the findings do not establish that the intervention alone caused the improvement in psychological well-being. The researchers used a one-group pretest-posttest design without a control group. Consequently, other factors may also have contributed to the observed change, including social interaction during the sessions, increased attention from facilitators, or support from family members.
The authors recommend that future research use stronger study designs, such as randomized controlled trials or quasi-experimental studies with comparison groups. Future studies should also involve larger and more diverse samples and conduct longer-term follow-up assessments to determine whether improvements in psychological well-being remain after the intervention ends.
About the Authors
Fiktina Vifri Ismiriyam is the corresponding author of the study and is affiliated with Ngudi Waluyo University. The article was co-authored by Wulansari and Imron Rosidi, also affiliated with Ngudi Waluyo University. Their study focuses on older adult empowerment, mental health, psychological well-being, and healthpreneurship-based approaches in community-oriented elderly care.
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