en ● Service Quality مطالعه پروتکل Study Protocol <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Tahoma;"><span style="line-height:2;"><b><span lang="EN-ID">Background:&nbsp;</span></b><span lang="EN-ID">Tuberculosis and diabetes mellitus (TBDM) comorbidity poses a major public health challenge, particularly in rural Indonesia, where fragmented services and limited healthcare access worsen patient outcomes. Despite global recognition of nurse-led care models, there is limited evidence on their application in rural, community-based TBDM management within Indonesia. This study introduces NaCo-Care (Nurse-Led and Collaborative Community Care), an integrated model designed to strengthen nursing leadership and interdisciplinary collaboration at the primary healthcare level.</span><br> <b><span lang="EN-ID">Methods:</span></b><span lang="EN-ID"> The study comprises four stages: (1) initial epidemiological mapping of TBDM in Jember (descriptive spatial study); (2) iterative development of the NaCo-Care model based on patient and provider input (mixed-methods exploratory); (3) validation of the model through expert panel discussions (Delphi method) and usability testing; and (4) a quasi-experimental pretest-posttest with a control group design to assess the model&#39;s effectiveness. Key outcome measures include changes in HbA1c levels, systemic inflammatory and immunological responses (via MRT, AFB, and ELISA), treatment adherence (MMAS-8), and patient quality of life (WHOQOL-BREF). Data will be analyzed using descriptive statistics, thematic analysis, CVI, and ANCOVA.</span><br> <b><span lang="EN-ID">Expected Results:</span></b><span lang="EN-ID">&nbsp;The NaCo-Care intervention group is expected to show significant improvement in glycemic control, biomarker profiles, medication adherence, and quality of life compared to controls, sustained over a six-month follow-up.</span><br> <b><span lang="EN-ID">Conclusion:</span></b><span lang="EN-ID">&nbsp;This study is anticipated to provide empirical evidence for the effectiveness of a nurse-led, community-based intervention for TBDM in rural Indonesia, addressing a key gap in integrated chronic disease management.</span></span></span></span></div> Tuberculosis, Diabetes Mellitus, Nurse-led, Collaborative management, Community 10 10 http://jrh.gmu.ac.ir/browse.php?a_code=A-10-2809-1&slc_lang=en&sid=1 Andi Eka Pranata andiekapranata@uds.ac.id 0722098602 100319475328460047455 No Doctoral Student, Doctoral Program in Biotechnology, University of Jember, Jember, Indonesia Tantut Susanto tantut_s.psik@unej.ac.id 0005018003 100319475328460047456 Yes Faculty of Nursing, University of Jember, Indonesia Erma Sulistyaningsih sulistyaningsih.fk@unej.ac.id 0022027701 100319475328460047457 No Faculty of Medicine, University of Jember, Indonesia Erlia Narulita erlia.fkip@unej.ac.id 0005078004 100319475328460047458 No Faculty of Teacher Training and Education, University of Jember, Indonesia