Social Science and Human Research Bulletin

Digital transformation within primary healthcare services compels community health centers not merely to adopt technological infrastructure, but to cultivate employees' innovative work behavior. At UPTD Puskesmas Klungkung I, digital technologies remain predominantly confined to administrative functions, thereby failing to optimally catalyze service innovation—a condition presumed to stem from variation in employees' digital competence, self-efficacy, and perceived organizational support. This study investigates the direct and indirect effects of digital competence on innovative work behavior, mediated by self-efficacy and perceived organizational support. An explanatory quantitative approach with a cross-sectional design was employed. Data were collected via questionnaires administered to 84 employees of UPTD Puskesmas Klungkung I, selected through a saturated sampling technique, and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS 4.1. The findings reveal that digital competence exerts a positive and significant effect on innovative work behavior, self-efficacy, and perceived organizational support. Self-efficacy and perceived organizational support likewise positively influence innovative work behavior and partially mediate the relationship between digital competence and innovative work behavior. These findings substantiate Social Cognitive Theory and Organizational Support Theory, demonstrating that technical proficiency alone is insufficient to engender innovation absent reinforced self-belief and organizational support. Community health centers are therefore encouraged to sustain continuous digital training, strengthen employees' self-confidence through incremental mastery experiences, and furnish infrastructural support alongside a work culture conducive to innovative initiative.

Digital Competence, Self-Efficacy, Perceived Organizational Support, and Innovative Work Behavior

1. Al-Taie, B. F. K., & Khattak, M. N. (2024). The impact of perceived organizational support and human resources practices on innovative work behavior: Does gender matter? Kybernetes, 53(2), 645–664. https://doi.org/10.1108/K-03-2022-0412
2. Al Turki, A. A., & Elkhalifa, S. A. (2023). Perceived organizational support for innovation and its impact on employee work commitment among healthcare workers in Riyadh, Saudi Arabia. Healthcare, 11(9), 1301. https://doi.org/10.3390/healthcare11091301
3. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
4. Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman and Company.
5. Bindel Sibassaha, P., Lubis, H., & Simanjuntak, M. (2025). Influence of digital transformation on employee innovative behavior: Roles of challenging appraisal, organizational culture support, and transformational leadership style. International Journal of Data and Network Science, 9(1), 213–222. https://doi.org/10.5267/j.ijdns.2024.9.009
6. Cai, W., Khapova, S., Bossink, B., Lysova, E., & Yuan, B. (2024). Optimizing employee innovative behavior through digital transformation: A moderated mediation model of transformational leadership and job autonomy. Journal of Business Research, 172, 114418. https://doi.org/10.1016/j.jbusres.2023.114418
7. Cetindamar Kozanoglu, D., & Abedin, B. (2021). Understanding the role of employees in digital transformation: Conceptualization of digital literacy of employees as a multi-dimensional organizational affordance. Journal of Enterprise Information Management, 34(6), 1649–1672. https://doi.org/10.1108/JEIM-01-2020-0010
8. Chen, J., & Shen, L. (2025). The double-edged sword effect of employee digital competence on employee innovative behavior: The sequential mediating roles of digital self-efficacy and perceived organizational support. Behavioral Sciences, 15(1), 63. https://doi.org/10.3390/bs15010063
9. Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications.
10. De Jong, J., & Den Hartog, D. (2010). Measuring innovative work behaviour. Creativity and Innovation Management, 19(1), 23–36. https://doi.org/10.1111/j.1467-8691.2010.00547.x
11. Eisenberger, R., Huntington, R., Hutchison, S., & Sowa, D. (1986). Perceived organizational support. Journal of Applied Psychology, 71(3), 500–507. https://doi.org/10.1037/0021-9010.71.3.500
12. Hair, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., & Ray, S. (2021). Partial least squares structural equation modeling (PLS-SEM) using R: A workbook. Springer Nature.
13. Hassan, M., Alam, M. M., Wahab, S. A., & Hawlader, M. D. H. (2024). Decent work and innovative work behavior of academic staff in higher education institutions: The mediating role of work engagement and job self-efficacy. Heliyon, 10(3), e25466. https://doi.org/10.1016/j.heliyon.2024.e25466
14. Huu, P. N. (2023). Impact of employee digital competence on the relationship between digital autonomy and innovative work behavior: A systematic review. Artificial Intelligence Review, 56(12), 14193–14222. https://doi.org/10.1007/s10462-023-10492-6
15. Jarva, E., Oikarinen, A., Andersson, J., Tuomikoski, A. M., Kääriäinen, M., Meriläinen, M., & Mikkonen, K. (2024). Healthcare professionals' digital health competence profiles and associated factors: A cross-sectional study. International Journal of Medical Informatics, 184, 105363. https://doi.org/10.1016/j.ijmedinf.2024.105363
16. Jiang, L., Chen, Z., Yu, M., & Zhang, J. (2025). The roles of challenge appraisal and hindrance appraisal of artificial intelligence on employees' innovative behavior. Behavioral Sciences, 15(1), 14. https://doi.org/10.3390/bs15010014
17. Jishnu, V., & Hareendrakumar, V. R. (2024). Impact of HR practices on innovative work behaviour: The mediating role of organizational support, knowledge-sharing and employee creativity. Employee Relations, 46(8), 1746–1766. https://doi.org/10.1108/ER-05-2023-0246
18. Kementerian Kesehatan Republik Indonesia. (2024). Profil kesehatan Indonesia tahun 2024. Kementerian Kesehatan RI.
19. Kurtessis, J. N., Eisenberger, R., Ford, M. T., Buffardi, L. C., Stewart, K. A., & Adis, C. S. (2017). Perceived organizational support: A meta-analytic evaluation of organizational support theory. Journal of Management, 43(6), 1854–1884. https://doi.org/10.1177/0149206315575554
20. Laakkonen, A., Kuusisto-Niemi, S., Kääriäinen, M., Liikanen, E., & Heponiemi, T. (2024). Digital competence among healthcare leaders: A mixed-methods systematic review. BMC Health Services Research, 24(1), 358. https://doi.org/10.1186/s12913-024-10830-w
21. Mainz, J., Rasmussen, S. A., Lyng, K. M., Andersen, S., & Hjertholm, P. (2024). Measuring the digital competence of health professionals: Scoping review. Journal of Medical Internet Research, 26, e54923. https://doi.org/10.2196/54923
22. Messmann, G., & Mulder, R. H. (2023). Conditions for innovative behavior at work: A systematic literature review. European Journal of Innovation Management, 26(7), 92–128. https://doi.org/10.1108/EJIM-05-2021-0227
23. Nargotra, S., & Sarangal, M. (2023). Perceived organizational support and innovative work behavior: Role of psychological safety. International Journal of Organizational Analysis, 31(6), 2407–2425. https://doi.org/10.1108/IJOA-08-2021-2909
24. Newman, A., Tse, H. H. M., Schwarz, G., & Nielsen, I. (2018). The effects of employees' creative self-efficacy on innovative behavior: The role of entrepreneurial leadership. Journal of Business Research, 89, 1–9.
25. Rhoades, L., & Eisenberger, R. (2002). Perceived organizational support: A review of the literature. Journal of Applied Psychology, 87(4), 698–714. https://doi.org/10.1037/0021-9010.87.4.698
26. Schunk, D. H., & DiBenedetto, M. K. (2020). Motivation and social cognitive theory. Contemporary Educational Psychology, 60, 101832. https://doi.org/10.1016/j.cedpsych.2019.101832
27. Sugiyono. (2019). Metode penelitian kuantitatif, kualitatif, dan R&D. Alfabeta.
28. Van Laar, E., Van Deursen, A. J. A. M., Van Dijk, J. A. G. M., & De Haan, J. (2020). Determinants of 21st-century skills and 21st-century digital skills for workers: A systematic literature review. SAGE Open, 10(1). https://doi.org/10.1177/2158244019900176
29. World Health Organization. (2023). Global strategy on digital health 2020–2025. WHO Press.
30. Wu, W., Zhou, Y., Ma, R., & Cheng, X. (2022). Digital transformation and healthcare innovation: A systematic review. Journal of Health Informatics, 28(4), 210–225.