The Effect of Mindfulness in Inflammation Markers (IL-6, TNF-A, CRP and Cortisol) Among Survivors of Tidal Flooding in Sayung Demak

August 27, 2026 updated by: Natalia Dewi Wardani, MD

Recurrent tidal flooding (rob) in the coastal areas of Sayung District, Demak Regency, poses a continuous environmental threat that inflicts housing damage, economic instability, and prolonged socioeconomic uncertainty on local residents. These chronic stressors frequently trigger significant psychological distress, including elevated levels of stress, anxiety, and depression, while simultaneously activating systemic inflammatory pathways and dysregulating the hypothalamic-pituitary-adrenal (HPA) axis.

Mindfulness body scan is a structured, non-pharmacological mind-body technique that involves directing non-judgmental attention to physical sensations across the body. Within a psycho-neuro-immunological framework, mindfulness practice is hypothesized to reduce physiological stress responses, promote autonomic nervous system balance, and downregulate pro-inflammatory pathways.

This randomized controlled trial evaluates the effectiveness of a structured 8-day mindfulness body scan intervention on both biological inflammatory markers and psychological outcomes among tidal flood survivors. Participants recruited from Sayung 1 Primary Health Center will be randomly allocated into two groups:

  1. Intervention Group: Receives structured 8-day Mindfulness Body Scan training.
  2. Control Group: Receives standard health monitoring. All participants will undergo baseline and post-intervention assessments, which include venous blood sampling to analyze key inflammatory and stress biomarkers-Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), C-Reactive Protein (CRP), and Cortisol. In addition, psychometric instruments will evaluate changes in depression, anxiety, stress, sleep quality, and overall quality of life. The primary objective is to determine whether a short-term mindfulness body scan practice can effectively reduce systemic inflammation and improve post-disaster psychological well-being in coastal communities.

Study Overview

Detailed Description

Background: Recurrent tidal flooding in coastal Sayung, Demak, exposes residents to chronic environmental and socioeconomic stress, contributing to psychological distress and elevated systemic inflammation. Within a psychoneuroimmunological framework, mindfulness practices-specifically the body scan technique-may suppress pro-inflammatory pathways and regulate the hypothalamic-pituitary-adrenal (HPA) axis.

Study Design: This is a randomized controlled trial conducted at Sayung 1 Primary Health Center, Demak. Eligible adult survivors of tidal flooding will be randomly allocated to either the intervention group or the control group.

Intervention & Control:

  • Intervention Group: Receives structured 8-day Mindfulness Body Scan training.
  • Control Group: Receives standard health monitoring.

Assessments: Baseline and 1-week post-intervention evaluations will be conducted for all participants:

  1. Biomarkers: Venous blood samples to analyze Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), C-Reactive Protein (CRP), and Cortisol.
  2. Psychometric Assessments: Standardized questionnaires evaluating depression, anxiety, stress, sleep quality, and quality of life.

Study Type

Interventional

Enrollment (Estimated)

75

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Natalia Dewi Wardani Dr. dr. Sp.KJ(K)
  • Phone Number: +6281325683134
  • Email: anatdew@gmail.com

Study Locations

    • Central Java
      • Demak, Central Java, Indonesia
        • Puskesmas Sayung 1

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age 18 years or older.
  • Resident of Sayung District, Demak Regency, affected by tidal flooding (rob).
  • Registered patient at Sayung 1 Primary Health Center.
  • Capable of providing written informed consent and participating in the intervention sessions.

Exclusion Criteria:

  • Severe cognitive impairment, active psychosis, or severe psychiatric conditions preventing participation.
  • Uncontrolled systemic autoimmune or inflammatory diseases.
  • Current use of long-term systemic corticosteroid or immunosuppressive therapy.
  • Inability to complete questionnaires or follow basic mindfulness instructions.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mindfulness Body Scan
Participants undergo structured Mindfulness Body Scan training over an 8-day period alongside standard care
A structured 8-day mind-body exercise where participants systematically direct non-judgmental attention to physical sensations throughout the body from head to toe
No Intervention: Control Group
Participants receive standard health monitoring without the mindfulness body scan intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Serum Interleukin-6 (IL-6) Levels
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured from venous blood samples using ELISA to evaluate changes in pro-inflammatory cytokine levels (concentrations reported in pg/mL).
Baseline (Day 0) and post-intervention (Day 8)
Change in Serum Tumor Necrosis Factor-alpha (TNF-α) Levels
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured from venous blood samples using ELISA to assess systemic inflammatory responses (concentrations reported in pg/mL)
Baseline (Day 0) and post-intervention (Day 8)
Change in Serum C-Reactive Protein (CRP) Levels
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Evaluated via laboratory blood analysis as an indicator of acute phase systemic inflammation (concentrations reported in mg/L).
Baseline (Day 0) and post-intervention (Day 8)
Change in Serum Cortisol Levels
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured via venous blood samples to assess HPA axis regulation and physiological stress response (concentrations reported in micro-g/dL).
Baseline (Day 0) and post-intervention (Day 8)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Depression Score
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured using the Patient Health Questionnaire-9 (PHQ-9). Scores range from 0 to 27, where higher scores indicate greater severity of depression.
Baseline (Day 0) and post-intervention (Day 8)
Change in Anxiety Score
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured using the Generalized Anxiety Disorder 7-item scale (GAD-7). Scores range from 0 to 21, where higher scores indicate greater severity of anxiety.
Baseline (Day 0) and post-intervention (Day 8)
Change in Stress Score
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured using the Perceived Stress Scale (PSS-10). Scores range from 0 to 40, where higher scores indicate higher levels of perceived stress.
Baseline (Day 0) and post-intervention (Day 8)
Change in Sleep Quality Score
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured using the Pittsburgh Sleep Quality Index (PSQI). Global scores range from 0 to 21, where higher scores indicate worse sleep quality.
Baseline (Day 0) and post-intervention (Day 8)
Change in Quality of Life Score
Time Frame: Baseline (Day 0) and post-intervention (Day 8)
Measured using the 36-Item Short Form Health Survey (SF-36) Physical Component Summary. Scores range from 0 to 100, where higher scores represent better health-related quality of life.
Baseline (Day 0) and post-intervention (Day 8)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

February 1, 2027

Study Completion (Estimated)

April 1, 2027

Study Registration Dates

First Submitted

August 24, 2026

First Submitted That Met QC Criteria

August 24, 2026

First Posted (Actual)

August 27, 2026

Study Record Updates

Last Update Posted (Actual)

September 1, 2026

Last Update Submitted That Met QC Criteria

August 27, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The data are not publicly available due to privacy or ethical restrictions. The dataset involves sensitive information about mental health, and sharing it publicly would compromise participant confidentiality as per the ethical approval obtained.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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