Parenting Education Intervention on the Growth and Development of Stunted Toddlers in the Puskesmas Fakfak Area, West Papua Province
DOI:
https://doi.org/10.35335/midwifery.v12i2.1573Keywords:
Attitudes, Behavior, Educational Intervention, Knowledge, Stunting, Toddlers, West PapuaAbstract
Background: Stunting remains a critical public health issue in Indonesia, particularly in remote areas such as the Puskesmas Fakfak area, West Papua Province. Stunting, which results from chronic malnutrition, affects the physical and cognitive development of children. Effective strategies to combat stunting are needed, focusing on improving parental knowledge, attitudes, and behaviors regarding child nutrition and care practices. Objectives: This study aims to evaluate the effectiveness of educational interventions in improving the knowledge, attitudes, and behaviors of parents in supporting the growth and development of stunted toddlers in the Puskesmas Fakfak area, West Papua Province. Methods: The research method employed was quasi-experimental with a pre-test and post-test design. The educational intervention consisted of counseling sessions and focused group discussions covering topics such as nutrition, the importance of exclusive breastfeeding, and proper parenting practices. Results: The results of the study indicated a significant increase in parental knowledge, with the average score rising from 3.5 before the intervention to 4.8 after the intervention (t = 7.89, p < 0.001). Parents also demonstrated a positive change in attitudes, as evidenced by an increase in the average score from 3.6 to 4.9 (t = 8.12, p < 0.001). Furthermore, parental behaviors showed a significant improvement, with the average score increasing from 3.4 to 4.8 (t = 7.65, p < 0.001). Conclusion: This research highlights the effectiveness of educational interventions in enhancing parental knowledge, attitudes, and behaviors, which, in turn, can contribute to the mitigation of stunting. It is recommended that similar programs be implemented in other areas facing stunting issues and that longitudinal studies be conducted to assess the sustainability of the interventions' impact.
Downloads
References
Admasu, J., Egata, G., Bassore, D. G., & Feleke, F. W. (2022). Effect of maternal nutrition education on early initiation and exclusive breast-feeding practices in south Ethiopia: A cluster randomised control trial. Journal of Nutritional Science, 11, e37. https://doi.org/10.1017/jns.2022.36
Andersen, C. T., Chopra, P. K., Dave, N., Hariprasad, D., Kak, M., Pandey, R., Tanwar, D., & Chaudhery, D. N. (2024). Maternal and child nutrition services associated with nutritional knowledge and practices, India. Bulletin of the World Health Organization, 102(1), 9–21. https://doi.org/10.2471/BLT.22.289129
Balantekin, K. N., Anzman-Frasca, S., Francis, L. A., Ventura, A. K., Fisher, J. O., & Johnson, S. L. (2020). Positive parenting approaches and their association with child eating and weight: A narrative review from infancy to adolescence . Pediatric Obesity, 15(10), e12722. https://doi.org/10.1111/ijpo.12722
Chua, J. Y. X., & Shorey, S. (2022). Effectiveness of mobile application-based perinatal interventions in improving parenting outcomes: A systematic review. Midwifery, 114, 103457. https://doi.org/10.1016/j.midw.2022.103457
Czarniecka-Skubina, E., Hamulka, J., & Gutkowska, K. (2024). How Can We Increase the Nutrition-Related Knowledge in Children Aged 7–12 Years: Results of Focus Groups Interviews with Parentsâ€â€ÂJunior-Edu-Å»ywienie (JEÅ») Project. Nutrients, 16(1), Article 1. https://doi.org/10.3390/nu16010129
De Rosso, S., Ducrot, P., Chabanet, C., Nicklaus, S., & Schwartz, C. (2022). Increasing Parental Knowledge About Child Feeding: Evaluation of the Effect of Public Health Policy Communication Media in France. Frontiers in Public Health, 10, 782620. https://doi.org/10.3389/fpubh.2022.782620
Ejemot-Nwadiaro, R. I., Ehiri, J. E., Arikpo, D., Meremikwu, M. M., & Critchley, J. A. (2021). Handâ€ÂÂwashing promotion for preventing diarrhoea. The Cochrane Database of Systematic Reviews, 2021(1), CD004265. https://doi.org/10.1002/14651858.CD004265.pub4
Fontaine, F., Turjeman, S., Callens, K., & Koren, O. (2023). The intersection of undernutrition, microbiome, and child development in the first years of life. Nature Communications, 14(1), 3554. https://doi.org/10.1038/s41467-023-39285-9
Hossain, S. J., Rahman, S. M., Fisher, J., Rahman, A., Tofail, F., & Hamadani, J. D. (2024). Effect of a parenting and nutrition education programme on development and growth of children using a social safety-net platform in urban Bangladesh: A cluster randomized controlled trial. The Lancet Regional Health - Southeast Asia, 25. https://doi.org/10.1016/j.lansea.2024.100388
Karssen, L. T., Vink, J. M., de Weerth, C., Hermans, R. C. J., de Kort, C. P. M., Kremers, S. P., Ruiter, E. L. M., & Larsen, J. K. (2021). An App-Based Parenting Program to Promote Healthy Energy Balance–Related Parenting Practices to Prevent Childhood Obesity: Protocol Using the Intervention Mapping Framework. JMIR Formative Research, 5(5), e24802. https://doi.org/10.2196/24802
Khan, K. M., Chakraborty, R., Brown, S., Sultana, R., Colon, A., Toor, D., Upreti, P., & Sen, B. (2021). Association between Handwashing Behavior and Infectious Diseases among Low-Income Community Children in Urban New Delhi, India: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 18(23), 12535. https://doi.org/10.3390/ijerph182312535
Laksono, A. D., Wulandari, R. D., Amaliah, N., & Wisnuwardani, R. W. (2022). Stunting among children under two years in Indonesia: Does maternal education matter? PLOS ONE, 17(7), e0271509. https://doi.org/10.1371/journal.pone.0271509
Li, S., Nor, N. M., & Kaliappan, S. R. (2023). Long-term effects of child nutritional status on the accumulation of health human capital. SSM - Population Health, 24, 101533. https://doi.org/10.1016/j.ssmph.2023.101533
Maddocks, J. (2023). Introducing an attitude-based approach to emotional intelligence. Frontiers in Psychology, 13, 1006411. https://doi.org/10.3389/fpsyg.2022.1006411
Mandarić, D., Hunjet, A., & Vuković, D. (2022). The Impact of Fashion Brand Sustainability on Consumer Purchasing Decisions. Journal of Risk and Financial Management, 15(4), Article 4. https://doi.org/10.3390/jrfm15040176
Michaelsen, M. M., & Esch, T. (2023). Understanding health behavior change by motivation and reward mechanisms: A review of the literature. Frontiers in Behavioral Neuroscience, 17, 1151918. https://doi.org/10.3389/fnbeh.2023.1151918
Ogutu, E. A., Ellis, A., Rodriguez, K. C., Caruso, B. A., McClintic, E. E., Ventura, S. G., Arriola, K. R. J., Kowalski, A. J., Linabarger, M., Wodnik, B. K., Webb-Girard, A., Muga, R., & Freeman, M. C. (2022). Determinants of food preparation and hygiene practices among caregivers of children under two in Western Kenya: A formative research study. BMC Public Health, 22(1), 1865. https://doi.org/10.1186/s12889-022-14259-6
Oliver, T., Diewald, L., McKeever, A., & Shenkman, R. (2023). Achieving a healthy home food environment: Perspectives on parents’ nutrition education needs when living with food insecurity. Nutrire, 48(1), 17. https://doi.org/10.1186/s41110-023-00203-0
Outhwaite, L. A. (2023). App-based support for parental self-efficacy in the first 1,000 days: A randomized control trial. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.998170
Precious, F. K., Owhor, G. A., Opeyemi, M.-O. A., Igwe, S. C., Beauty, O. C., Sy, F. A. R., Yepes, P. I. G., Ayuba, D., Ogaya, J. B., & Lucero-Prisno, D. E. (2023). Chapter Sixâ€â€ÂWhy nutrition programs for children remain important. In M. J. Cohen (Ed.), Advances in Food Security and Sustainability (Vol. 8, pp. 187–215). Elsevier. https://doi.org/10.1016/bs.af2s.2023.08.002
Raut, S., KC, D., Singh, D. R., Dhungana, R. R., Pradhan, P. M. S., & Sunuwar, D. R. (2024). Effect of nutrition education intervention on nutrition knowledge, attitude, and diet quality among school-going adolescents: A quasi-experimental study. BMC Nutrition, 10(1), 35. https://doi.org/10.1186/s40795-024-00850-0
Admasu, J., Egata, G., Bassore, D. G., & Feleke, F. W. (2022). Effect of maternal nutrition education on early initiation and exclusive breast-feeding practices in south Ethiopia: A cluster randomised control trial. Journal of Nutritional Science, 11, e37. https://doi.org/10.1017/jns.2022.36
Andersen, C. T., Chopra, P. K., Dave, N., Hariprasad, D., Kak, M., Pandey, R., Tanwar, D., & Chaudhery, D. N. (2024). Maternal and child nutrition services associated with nutritional knowledge and practices, India. Bulletin of the World Health Organization, 102(1), 9–21. https://doi.org/10.2471/BLT.22.289129
Balantekin, K. N., Anzman-Frasca, S., Francis, L. A., Ventura, A. K., Fisher, J. O., & Johnson, S. L. (2020). Positive parenting approaches and their association with child eating and weight: A narrative review from infancy to adolescence . Pediatric Obesity, 15(10), e12722. https://doi.org/10.1111/ijpo.12722
Chua, J. Y. X., & Shorey, S. (2022). Effectiveness of mobile application-based perinatal interventions in improving parenting outcomes: A systematic review. Midwifery, 114, 103457. https://doi.org/10.1016/j.midw.2022.103457
Czarniecka-Skubina, E., Hamulka, J., & Gutkowska, K. (2024). How Can We Increase the Nutrition-Related Knowledge in Children Aged 7–12 Years: Results of Focus Groups Interviews with Parentsâ€â€ÂJunior-Edu-Å»ywienie (JEÅ») Project. Nutrients, 16(1), Article 1. https://doi.org/10.3390/nu16010129
De Rosso, S., Ducrot, P., Chabanet, C., Nicklaus, S., & Schwartz, C. (2022). Increasing Parental Knowledge About Child Feeding: Evaluation of the Effect of Public Health Policy Communication Media in France. Frontiers in Public Health, 10, 782620. https://doi.org/10.3389/fpubh.2022.782620
Ejemot-Nwadiaro, R. I., Ehiri, J. E., Arikpo, D., Meremikwu, M. M., & Critchley, J. A. (2021). Handâ€ÂÂwashing promotion for preventing diarrhoea. The Cochrane Database of Systematic Reviews, 2021(1), CD004265. https://doi.org/10.1002/14651858.CD004265.pub4
Fontaine, F., Turjeman, S., Callens, K., & Koren, O. (2023). The intersection of undernutrition, microbiome, and child development in the first years of life. Nature Communications, 14(1), 3554. https://doi.org/10.1038/s41467-023-39285-9
Hossain, S. J., Rahman, S. M., Fisher, J., Rahman, A., Tofail, F., & Hamadani, J. D. (2024). Effect of a parenting and nutrition education programme on development and growth of children using a social safety-net platform in urban Bangladesh: A cluster randomized controlled trial. The Lancet Regional Health - Southeast Asia, 25. https://doi.org/10.1016/j.lansea.2024.100388
Karssen, L. T., Vink, J. M., de Weerth, C., Hermans, R. C. J., de Kort, C. P. M., Kremers, S. P., Ruiter, E. L. M., & Larsen, J. K. (2021). An App-Based Parenting Program to Promote Healthy Energy Balance–Related Parenting Practices to Prevent Childhood Obesity: Protocol Using the Intervention Mapping Framework. JMIR Formative Research, 5(5), e24802. https://doi.org/10.2196/24802
Khan, K. M., Chakraborty, R., Brown, S., Sultana, R., Colon, A., Toor, D., Upreti, P., & Sen, B. (2021). Association between Handwashing Behavior and Infectious Diseases among Low-Income Community Children in Urban New Delhi, India: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 18(23), 12535. https://doi.org/10.3390/ijerph182312535
Laksono, A. D., Wulandari, R. D., Amaliah, N., & Wisnuwardani, R. W. (2022). Stunting among children under two years in Indonesia: Does maternal education matter? PLOS ONE, 17(7), e0271509. https://doi.org/10.1371/journal.pone.0271509
Li, S., Nor, N. M., & Kaliappan, S. R. (2023). Long-term effects of child nutritional status on the accumulation of health human capital. SSM - Population Health, 24, 101533. https://doi.org/10.1016/j.ssmph.2023.101533
Maddocks, J. (2023). Introducing an attitude-based approach to emotional intelligence. Frontiers in Psychology, 13, 1006411. https://doi.org/10.3389/fpsyg.2022.1006411
Mandarić, D., Hunjet, A., & Vuković, D. (2022). The Impact of Fashion Brand Sustainability on Consumer Purchasing Decisions. Journal of Risk and Financial Management, 15(4), Article 4. https://doi.org/10.3390/jrfm15040176
Michaelsen, M. M., & Esch, T. (2023). Understanding health behavior change by motivation and reward mechanisms: A review of the literature. Frontiers in Behavioral Neuroscience, 17, 1151918. https://doi.org/10.3389/fnbeh.2023.1151918
Ogutu, E. A., Ellis, A., Rodriguez, K. C., Caruso, B. A., McClintic, E. E., Ventura, S. G., Arriola, K. R. J., Kowalski, A. J., Linabarger, M., Wodnik, B. K., Webb-Girard, A., Muga, R., & Freeman, M. C. (2022). Determinants of food preparation and hygiene practices among caregivers of children under two in Western Kenya: A formative research study. BMC Public Health, 22(1), 1865. https://doi.org/10.1186/s12889-022-14259-6
Oliver, T., Diewald, L., McKeever, A., & Shenkman, R. (2023). Achieving a healthy home food environment: Perspectives on parents’ nutrition education needs when living with food insecurity. Nutrire, 48(1), 17. https://doi.org/10.1186/s41110-023-00203-0
Outhwaite, L. A. (2023). App-based support for parental self-efficacy in the first 1,000 days: A randomized control trial. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.998170
Precious, F. K., Owhor, G. A., Opeyemi, M.-O. A., Igwe, S. C., Beauty, O. C., Sy, F. A. R., Yepes, P. I. G., Ayuba, D., Ogaya, J. B., & Lucero-Prisno, D. E. (2023). Chapter Sixâ€â€ÂWhy nutrition programs for children remain important. In M. J. Cohen (Ed.), Advances in Food Security and Sustainability (Vol. 8, pp. 187–215). Elsevier. https://doi.org/10.1016/bs.af2s.2023.08.002
Raut, S., KC, D., Singh, D. R., Dhungana, R. R., Pradhan, P. M. S., & Sunuwar, D. R. (2024). Effect of nutrition education intervention on nutrition knowledge, attitude, and diet quality among school-going adolescents: A quasi-experimental study. BMC Nutrition, 10(1), 35. https://doi.org/10.1186/s40795-024-00850-0
Saleh, A., Syahrul, S., Hadju, V., Andriani, I., & Restika, I. (2021). Role of Maternal in Preventing Stunting: A Systematic Review. Gaceta Sanitaria, 35, S576–S582. https://doi.org/10.1016/j.gaceta.2021.10.087
Santosa, A., Novanda Arif, E., & Abdul Ghoni, D. (2021). Effect of maternal and child factors on stunting: Partial least squares structural equation modeling. Clinical and Experimental Pediatrics, 65(2), 90–97. https://doi.org/10.3345/cep.2021.00094
Sekretariat Wakil Presiden. (2022). Fortification, One of the Backbones for Stunting Preventionâ€â€ÂStunting. https://stunting.go.id/en/fortification-one-of-the-backbones-for-stunting-prevention/
Shrestha, A., Six, J., Dahal, D., Marks, S., & Meierhofer, R. (2020). Association of nutrition, water, sanitation and hygiene practices with children’s nutritional status, intestinal parasitic infections and diarrhoea in rural Nepal: A cross-sectional study. BMC Public Health, 20(1), 1241. https://doi.org/10.1186/s12889-020-09302-3
Soliman, A., De Sanctis, V., Alaaraj, N., Ahmed, S., Alyafei, F., Hamed, N., & Soliman, N. (2021). Early and Long-term Consequences of Nutritional Stunting: From Childhood to Adulthood. Acta Bio Medica : Atenei Parmensis, 92(1), e2021168. https://doi.org/10.23750/abm.v92i1.11346
Soviyati, E., Sulaeman, E. S., Sugihardjo, Ir., & Wiboworini, B. (2023). Effect of applying the health promotion model in stunting prevention and behavior control in Indonesia. Journal of Education and Health Promotion, 12, 227. https://doi.org/10.4103/jehp.jehp_276_23
Supadmi, S., Laksono, A. D., Kusumawardani, H. D., Ashar, H., Nursafingi, A., Kusrini, I., & Musoddaq, M. A. (2024). Factor related to stunting of children under two years with working mothers in Indonesia. Clinical Epidemiology and Global Health, 26, 101538. https://doi.org/10.1016/j.cegh.2024.101538
Woźniak, D., Podgórski, T., Dobrzyńska, M., Przysławski, J., Drzymała, S., & Drzymała-Czyż, S. (2022). The Influence of Parents’ Nutritional Education Program on Their Infants’ Metabolic Health. Nutrients, 14(13), 2671. https://doi.org/10.3390/nu14132671
Zare, Z., Hajizadeh, E., Mahmoodi, M., Nazari, R., Shahmoradi, L., & Rezayi, S. (2023). Smartphone-based application to control and prevent overweight and obesity in children: Design and evaluation. BMC Medical Informatics and Decision Making, 23(1), 201. https://doi.org/10.1186/s12911-023-02304-2
Zarnowiecki, D., Mauch, C. E., Middleton, G., Matwiejczyk, L., Watson, W. L., Dibbs, J., Dessaix, A., & Golley, R. K. (2020). A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children’s nutrition. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 17. https://doi.org/10.1186/s12966-020-0915-1
