ENHANCING MATERNAL MOTIVATION AND STUNTING PREVENTION PRACTICES THROUGH FAMILY ASSISTANCE PROGRAMS: EVIDENCE FROM A QUASI-EXPERIMENTAL STUDY IN JOMBANG, EAST JAVA PROVINCE, INDONESIA
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Abstract
Background: Stunting remains a major public health problem in Indonesia and is closely associated with inadequate nutritional practices, poor childcare behaviors, and limited family support. Maternal motivation plays an important role in the implementation of stunting prevention practices; however, evidence regarding the effectiveness of family assistance programs in improving maternal motivation and preventive behaviors remains limited.
Purpose: This study aimed to examine the effect of a family assistance program on maternal motivation and stunting prevention practices among families at risk of stunting in Jombang, East Java Province, Indonesia.
Methods: A quasi-experimental study with a non-equivalent control group pre-test and post-test design was conducted among 70 mothers with children under five years old in Jombang Regency, East Java, Indonesia. Participants were divided into an intervention group (n = 35) and a control group (n = 35). The intervention group received a structured family assistance program consisting of health education, home visits, counselling, and family mentoring for four weeks, while the control group received routine health services. Data were collected using questionnaires on maternal motivation and maternal behaviours in efforts to prevent stunting. Statistical analyses were performed using paired sample t-tests and independent sample t-tests with a significance level of p < 0.05.
Results: The findings showed significant improvements in maternal motivation and stunting prevention practices among participants in the intervention group following the family assistance program. Maternal motivation scores increased from 61.43 ± 7.25 to 84.27 ± 6.14 (p < 0.001), while stunting prevention practice scores increased from 58.76 ± 8.11 to 82.35 ± 5.88 (p < 0.001). In contrast, the control group showed no statistically significant changes in either maternal motivation or preventive practices. Post-test comparisons also demonstrated significantly higher scores in the intervention group compared with the control group (p < 0.001).
Conclusion: The family assistance program was effective in enhancing maternal motivation and improving stunting prevention practices among families at risk of stunting. Family-centered mentoring interventions may serve as a promising community-based strategy to strengthen maternal engagement in child health promotion and support stunting reduction efforts in Indonesia.
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References
Ajzen, I. (2020). The theory of planned behavior: Frequently asked questions. Human Behavior and Emerging Technologies, 2(4), 314–324.
Ariyanti, R., Rahayu, E. P., & Rahayu, A. P. (2025). Maternal Factors as Determinants of Stunting in Children Under Five Years Old: A Systematic Review. Panakeia: Journal of Epidemiology, 2(1), 46–57. https://doi.org/https://doi.org/10.30872/panakeia.v2i1.3075
Badan Kependudukan dan Keluarga Berencana Nasional. (2023). Strategi Penurunan Stunting di Indonesia 2023. Jakarta.
Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S., … Black, R. E. (2020). Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? The Lancet, 382(9890), 452–477. https://doi.org/https://doi.org/10.1016/S0140-6736(13)60996-4
Danaei, G., Andrews, K. G., Sudfeld, C. R., Fink, G., McCoy, D. C., Peet, E., … Fawzi, W. W. (2023). Stunting in developing countries: Risk factors and regional variation. Retrieved January 6, 2025, from Nestlé Nutrition Institute website: https://www.nestlenutrition-institute.org/
de Onis, M., Branca, F., & Victora, C. G. (2016). Childhood stunting: A global perspective. Maternal & Child Nutrition, 12(Suppl 1), 12–26. https://doi.org/https://doi.org/10.1111/mcn.12231
Halimatunnisa, M., Indarwati, R., Ubudiyah, M., Trihartuty, Putri, N. K., Sari, M., & Suhardin, S. (2020). Family Determinants of Stunting in Indonesia: A Systematic Review. International Journal of Psychosocial Rehabilitation, 24(9 SE-Articles), 815–822. https://doi.org/10.61841/wmfdcs02
Has, Eka Mishbahatul Marah, Krisnana, Ilya, & Efendi, Ferry. (2024). Enhancing Maternal Caregiving Capabilities Model to Prevent Childhood Stunting: A UNICEF-Inspired Model. Sage Open Nursing, 10, 23779608231226060. https://doi.org/10.1177/23779608231226061
Hossain, M., Choudhury, N., Adib Binte Abdullah, K., Mondal, P., Jackson, A. A., Walson, J., & Ahmed, T. (2017). Evidence-based approaches to childhood stunting in low and middle income countries: a systematic review. Archives of Disease in Childhood, 102(10), 903 LP – 909. https://doi.org/10.1136/archdischild-2016-311050
Kementerian Kesehatan Republik Indonesia. (2022). Laporan Nasional Survei Status Gizi Indonesia (SSGI) 2022.
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
Prabowo, B., Wardani, R., Dian, A., & Suwarto, S. (2025). Determinants of Family Empowerment and Complementary Feeding Quality: Evidence from a Transcultural Care Framework. Healthcare, Vol. 13, p. 2237. https://doi.org/10.3390/healthcare13172237
Prendergast, A. J., & Humphrey, J. H. (2021). The stunting syndrome in developing countries. Paediatrics and International Child Health, 41(4), 223–230. https://doi.org/https://doi.org/10.1080/20469047.2021.1886150
Ryan, R. M., & Deci, E. L. (2020). Self-determination theory: Basic psychological needs in motivation, development, and wellness. Guilford Press.
Setiawan, A., Syamsir, S. B., Rahmadiyah, D. C., Astuti, Atamou, L., Talilah, R., & Shorey, S. (2026). Effects of family-based nursing interventions on mothers’ knowledge, attitudes, and self-efficacy related to stunting prevention in Indonesia: A quasi-experimental study. International Journal of Nursing Sciences, 13(2), 113–121. https://doi.org/https://doi.org/10.1016/j.ijnss.2026.02.008
Siramaneerat, I., Astutik, E., Agushybana, F., Bhumkittipich, P., & Lamprom, W. (2024). Examining determinants of stunting in Urban and Rural Indonesian: a multilevel analysis using the population-based Indonesian family life survey (IFLS). BMC Public Health, 24(1), 1371. https://doi.org/10.1186/s12889-024-18824-z
Starkweather, C., Guarino, A., Bennion, N., Cottam, M., McGhie, J., Dearden, K. A., … West, J. H. (2020). An interpersonal nutrition campaign and maternal knowledge and childhood feeding practices: a case study from mothers in rural Indonesia. Archives of Public Health, 78(1), 62. https://doi.org/10.1186/s13690-020-00444-9
Taber, K. S. (2018). The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Research in Science Education, 48(6), 1273–1296. https://doi.org/10.1007/s11165-016-9602-2
United Nations Children’s Fund (UNICEF). (2023). Age prioritization of nutrition interventions for child survival, growth and development in resource-constrained contexts (programmatic guidance). New York, NY: UNICEF.
United Nations Children’s Fund (UNICEF), World Health Organization (WHO), & World Bank Group. (2023). Levels and Trends in Child Malnutrition: UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimates – Key Findings of the 2023 Edition. World Health Organization. Retrieved from https://data.unicef.org/resources/jme-report-2023/
World Health Organization [WHO]. (2023). WHO guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in infants and children under 5 years. Retrieved from https://www.who.int/publications/i/item/9789240082830
Yuniarti, T., Wahyuni, S., & Andriani, R. (2025). Determinants of family empowerment and complementary feeding quality: Evidence from a transcultural care framework. Healthcare, 13(17), 2237.
Sutrisnawati
https://orcid.org/0000-0002-0713-7005