Mengidentifikasi Health Barriers Pencegahan ISPA Pada Lansia: Sebuah Kajian Systematic Literature Review Pada Masyarakat Urban Indonesia

Background: Acute respiratory infections (ARIs) represent a substantial health burden among older adults. In urban settings, environmental exposures may interact with behavioral and structural barriers to prevention. Objective: To synthesize evidence on barriers to ARI prevention among older adults, emphasizing air pollution, housing conditions, and green space in the context of urban Indonesia. Methods: Literature published between 2019 and 2025 was searched in PubMed, Scopus, Google Scholar, and ScienceDirect on 15 March 2025. Reporting was guided by PRISMA 2020. Findings were organized through thematic synthesis, distinguishing primary empirical research from methodological and policy literature. Results: Of 146 identified records, 28 duplicates and 40 records at title–abstract screening were excluded, and 21 publications remained after eligibility assessment. Because these publications comprised heterogeneous study types, not all could be classified as eligible primary studies. A cohort of 285 community-dwelling older adults associated indoor humidity with acute respiratory illness, whereas a randomized trial involving 135 aged-care residents found no statistically significant reduction in respiratory infection with HEPA filtration in the primary intention-to-treat analysis. The evidence highlighted health literacy, access to care, social support, air quality, housing conditions, and green-space exposure as relevant dimensions of prevention. Conclusion: ARI prevention among older urban populations requires an integrated understanding of individual, social, health-system, and environmental determinants. The proposed conceptual framework merits empirical evaluation in Indonesian cities.