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Published: 2022-07-29

Factors Related to Father’s Behavior in Preventing Childhood Stunting Based on Health Belief Model

Faculty of Nursing, Universitas Airlangga, East Java 60115
Faculty of Nursing, Universitas Airlangga, East Java 60115
Faculty of Nursing, Universitas Airlangga, East Java 60115

Abstract

Childhood stunting is still a significant public health burden in Indonesia. Fathers' engagement in childcare could improve a child's health and help to prevent stunting. This study aimed to analyse factors related to the father's behaviour in preventing childhood stunting based on Health Belief Model. This study was used a correlational study design with a cross-sectional approach. This study involved 199 fathers who had children under five years old, recorded at Puskesmas (Public Health Center) Maronggela, East Nusa Tenggara, Indonesia. Samples were taken using the cluster random sampling technique. The independent variables were the father's perceived susceptibility, perceived severity, perceived benefit, perceived barrier, cues to action, and self-efficacy regarding childhood stunting and its prevention. The dependent variable was the father's behaviour in preventing childhood stunting. The questionnaire was used to collect the data. Data were then analysed using the Spearman Rho Test with a level significance of 95% (α < 0.05). The statistical analysis showed that perceived susceptibility (p = 0.023; r = 0.161) and cues to action (p = 0.004; r = 0.204) correlated with the father's behaviour in preventing childhood stunting, while perceived severity, perceived benefits, perceived barriers, and self-efficacy did not correlate. The current study suggests that fathers' behaviour to prevent stunting among children under five years was related to their perception of an illness and the cues that can trigger their decision-making process. These findings can be used to arrange health promotion programs to improve fathers' behaviour and engagement in childcare to prevent childhood stunting.

Keywords: childhood stunting, early life nutrition, father, health belief model, preventive behaviour

 

Abstrak

 

Faktor-faktor yang Berhubungan dengan Perilaku Ayah dalam Mencegah Stunting Pada Balita Berdasarkan Health Belief Model. Stunting pada balita masih menjadi beban kesehatan masyarakat yang signifikan di Indonesia. Keterlibatan ayah dalam pengasuhan balita dapat meningkatkan kesehatan balita dan membantu mencegah stunting. Penelitian ini menganalisis faktor-faktor yang berhubungan dengan perilaku ayah dalam mencegah stunting pada balita berdasarkan Health Belief Model. Penelitian ini menggunakan desain penelitian korelasional dengan pendekatan cross sectional. Penelitian ini melibatkan 199 ayah yang memiliki balita, yang tercatat di Puskesmas Maronggela, Nusa Tenggara Timur, Indonesia. Variabel independen adalah kerentanan yang dirasakan ayah, keparahan yang dirasakan, manfaat yang dirasakan, hambatan yang dirasakan, isyarat untuk bertindak, dan self-efficacy berkaitan dengan perilaku pencegahan stunting pada balita. Variabel terikat adalah perilaku ayah dalam mencegah stunting pada balita. Kuesioner digunakan untuk mengumpulkan data. Uji Statistik dilakukan menggunakan Spearman Rho dengan signifikansi 95% (α < 0,05). Analisis statistik menunjukkan bahwa persepsi kerentanan (p = 0,023; r = 0,161) dan isyarat untuk bertindak (p = 0,004; r = 0,204) berkorelasi dengan perilaku ayah dalam mencegah stunting pada masa kanak-kanak, sedangkan persepsi keparahan, manfaat yang dirasakan, hambatan yang dirasakan, dan efikasi diri tidak berkorelasi. Studi saat ini menunjukkan bahwa perilaku ayah untuk mencegah stunting pada balita terkait dengan persepsi mereka tentang suatu penyakit dan isyarat yang dapat memicu proses pengambilan keputusan mereka. Temuan ini dapat digunakan untuk menyusun program promosi kesehatan untuk meningkatkan perilaku dan keterlibatan ayah dalam pengasuhan balita untuk mencegah pengerdilan anak.

Kata Kunci: ayah, balita stunting, early life nutrition, health belief model, perilaku pencegahan

References

  1. Ares, G., Machín, L., Vidal, L., Aschemann-Witzel, J., Otterbring, T., Curutchet, M. R., Giménez, A., & Bove, I. (2020). How can we motivate people to use nutritional warnings in decision making? Citizen co-created insights for the development of communication campaigns. Health Education & Behavior, 47 (2), 321–331. doi: 10.1177/1090198119889086.
  2. Argaw, A., Hanley-Cook, G., Cock, N.De, Kolsteren, P., Huybregts, L., & Lachat, C. (2019). Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the demographic and health surveys. Nutrients, 11 (2485), 1–12. doi: 10.3390/nu11102485.
  3. Beal, T., Tumilowicz, A., Sutrisna, A., Izwardy, D., & Neufeld, L.M. (2018). A review of child stunting determinants in Indonesia. Maternal & Child Nutrition, 14 (4), e12617 (1–10). doi: 10.1111/mcn.1261712617.
  4. Bukit, D.S., Keloko, A.B., & Ashar, T. (2021). Father’s Support and Mother’s Behavior in Stunting Prevention Efforts. Journal of Health Science and Prevention, 5 (2), 100–105. https://doi.org/10.29080/jhsp.v5i2.521
  5. Catholic Relief Services. (2016). Father engagement in nutrition: A qualitative analysis in Muhanga and Karongi districts in Rwanda. Retrieved from https://www.crs. org/sites/default/files/tools-research/father-engagement-in-nutrition.pdf
  6. Compaoré, A., Ouedraogo, K., Boua, P.R., Watson, D., Kehoe, S.H., Newell, M.-L., Tinto, H., Barker, M., & Sorgho, H. (2021). ‘Men are not playing their roles’, maternal and child nutrition in Nanoro, Burkina Faso. Public Health Nutrition, 24 (12), 3780–3790. doi: 10.1017/S1368980020003365.
  7. Comrie-Thomson, L., Tokhi, M., Ampt, F., Portela, A., Chersich, M., Khanna, R., & Luchters, S. (2015). Challenging gender inequity through male involvement in maternal and newborn health: Critical assessment of an emerging evidence base. Culture, Health & Sexuality, 17 (sup2), 177–189. doi: 10.1080/13691058.2015.1053412.
  8. Davison, K.K., Haines, J., Garcia, E.A., Douglas, S., & McBride, B. (2020). Fathers’ food parenting: A scoping review of the literature from 1990 to 2019. Pediatric Obesity, 15 (10), e12654. doi: 10.1111/ijpo.12654.
  9. Diddana, T.Z., Kelkay, G.N., Dola, A.N., & Sadore, A.A. (2018). Effect of nutrition education based on health belief model on nutritional knowledge and dietary practice of pregnant women in Dessie Town, Northeast Ethiopia: A cluster randomized control trial. Journal of Nutrition and Metabolism, 2018, 6731815. doi: 10.1155/2018/6731815.
  10. Georgiadis, A., & Penny, M. E. (2017). Child undernutrition: opportunities beyond the first 1000 days. The Lancet Public Health, 2 (9), e399. doi: 10.1016/S2468-2667(17)30154-8.
  11. Glanz, K., Rimer, B.K., & Viswanath, K. (2015). Health behavior: Theory, research, and practice (5th Ed.). Jossey-Bass Public Health (Wiley).
  12. Green, E.C., Murphy, E.M., & Gryboski, K. (2020). The health belief model. In K. Sweeny, M.L. Robbins, & L.M. Cohen (Eds.), The Wiley encyclopedia of health psychology. John Wiley & Sons Ltd. doi: 10.1002/9781119057840.ch68.
  13. Hall, C., Bennett, C., Crookston, B., Dearden, K., Hasan, M., Linehan, M., Syafiq, A., West, S., & West, J. (2018). Maternal knowledge of stunting in rural Indonesia. International Journal of Child Health and Nutrition, 7 (4), 139–145.
  14. Hall, C., Syafiq, A., Crookston, B., Bennett, C., Hasan, M.R., Linehan, M., West, J., Torres, S., & Dearden, K. (2018). Addressing communications campaign development challenges to reduce stunting in Indonesia. Health, 10 (12), 1764. doi: 10.4236/health.2018.1012133.
  15. Holschneider, S., Subandoro, A.W., Elvina, K., Anne Marie, P., Herkutanto, R., Ayuningtyas, P., Dharmawan, A., & Sudarjo, M.N. (2021). Improving the quality of frontline nutrition services in Indonesia’s health sector (No. 21; December). Retrieved from https://openknow ledge.worldbank.org/bitstream/handle/10986/36941/Improving-the-Quality-of-Frontline-Nutrition-Services-in-Indonesias-Health-Sector-Discussion-Paper.pdf?sequence=1&isAll owed=y
  16. Hupunau, R.E., Pradanie, R., & Kusumaningrum, T. (2019). Pendekatan teori health belief model terhadap perilaku ibu dalam pemenuhan kebutuhan nutrisi anak usia toddler. Pediomaternal Nursing Journal, 5 (1), 1–8. doi: 10.20473/pmnj.v5i1.12368.
  17. Januarti, L.F., & Hidayathillah, A.P. (2020). Parenting culture on the role of father in prevention of stunting in toddler. Babali Nursing Research, 1 (2), 81–90. doi: 10.373 63/bnr.2020.1211.
  18. Jones, C.G., Lee, T.C., & Lopez, I.A. (2014). Perceived susceptibility and prevention attitudes of African-American college students’ toward type 2 diabetes. Florida Public Health Review, 11 (8), 57–64. https:// digitalcommons.unf.edu/fphr/vol11/iss1/8
  19. Jones, C.L., Jensen, J.D., Scherr, C.L., Brown, N.R., Christy, K., & Weaver, J. (2015). The health belief model as an explanatory framework in communication research: Exploring parallel, serial, and moderated mediation. Health Communication, 30 (6), 566–576. doi: 10. 1080/10410236.2013.873363.
  20. Kansiime, N., Atwine, D., Nuwamanya, S., & Bagenda, F. (2017). Effect of male involvement on the nutritional status of children less than 5 years: a cross sectional study in a rural southwestern district of Uganda. Journal of Nutrition and Metabolism, 2017 (3427087), 1–9. doi: 10.1155/2017/3427087.
  21. Kavle, J.A., Pacqué, M., Dalglish, S., Mbombeshayi, E., Anzolo, J., Mirindi, J., Tosha, M., Safari, O., Gibson, L., & Straubinger, S. (2019). Strengthening nutrition services within integrated community case management (iCCM) of childhood illnesses in the Democratic Republic of Congo: Evidence to guide implementation. Maternal & Child Nutrition, 15 (Suppl 1), e12725. doi: 10.1111/mcn.12725.
  22. Kementerian PPN/ BAPPENAS RI. (2018). Strategi nasional percepatan pencegahan anak kerdil (stunting) periode 2018–2024. In Jakarta: Sekretariat Wakil Presiden Republik Indonesia. Retrieved from chrome-exten-sion://efaidnbmnnnibpcajpcglclefindmkaj/viewer.html?pdfurl=http%3A%2F%2Ftnp2k.go.id%2Ffilemanager%2Ffiles%2FRakornis%25202018%2FStranas%2520Percepatan%2520Pencegahan%2520Anak%2520Kerdil.pdf&clen=16134705&chunk=true
  23. Kim, S., & Kim, S. (2020). Analysis of the impact of health beliefs and resource factors on preventive behaviors against the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 17 (22), 8666. doi: 10.3390/ijerph17228666.
  24. Krisnana, I., Suryawan, A., & Muftiyaturrohmah, M. (2020). Analysis of fathers’ support based on maternal perceptions through stunting incidence in toddler at coastal areas. Systematic Reviews in Pharmacy, 11 (5), 761–767.
  25. Mallan, K.M., Nothard, M., Thorpe, K., Nicholson, J.M., Wilson, A., Scuffham, P.A., & Daniels, L.A. (2014). The role of fathers in child feeding: Perceived responsibility and predictors of participation. Child: Care, Health and Development, 40 (5), 715–722. doi: 10.1111/cch.12088.
  26. Martin, S.L., Matare, C.R., Kayanda, R.A., Owoputi, I., Kazoba, A., Bezner Kerr, R., Nnally, L., Khan, M., Locklear, K.H., & Dearden, K.A. (2021). Engaging fathers to improve complementary feeding is acceptable and feasible in the Lake Zone, Tanzania. Maternal & Child Nutrition, 17 (Suppl 1), e13144. doi: 10.1111/mcn.13144.
  27. McGovern, M.E., Krishna, A., Aguayo, V.M., & Subramanian, S.V. (2017). A review of the evidence linking child stunting to economic outcomes. International Journal of Epidemiology, 46 (4), 1171–1191. doi: 10.1093/ ije/dyx017.
  28. Ministry of Health Republic Indonesia. (2018). Major findings of indonesian basic health research. Ministry of Health Republic Indonesia. Retrieved from https://www.litbang .kemkes.go.id/hasil-utama-riskesdas-2018/
  29. Ministry of Health Republic of Indonesia. (2021). Buku Saku Hasil Studi Status Gizi Indonesia (SSGI) tingkat nasional, propinsi, dan kabupaten/kota tahun 2021. Ministry of Health Republic Indonesia. Retrieved from https://www.litbang.kemkes.go.id/buku-saku -hasil-studi-status-gizi-indonesia-ssgi-tahun-2021/
  30. Nenobais, D.I., & Katmini, K. (2021). Application of health belief model theory on prevention of stunting in toddlers through nutritional behavior. Journal for Quality in Public Health, 5 (1), 27–34. doi: 10.30994/jqph.v5i1.244.
  31. Onis, M.De, & Branca, F. (2016). Childhood stunting: A global perspective. Maternal and Child Nutrition, 12, 12–26. doi: 10.1111/mcn.12231.
  32. Phillips, J. (2021). The effects of religiosity on gender-differentiated household decision-making in Indonesia (No. 5–2021). Retrieved from https://scholarworks.uark.edu/ econuht/ 36
  33. Prendergast, A.J., & Humphrey, J.H. (2014). The stunting syndrome in developing countries. Paediatrics and International Child Health, 34 (4), 250–265. doi: 10.1179/2046905514Y. 0000000158.
  34. The National Medium-Term Development Plan for 2020-2024, Pub. L. No. Peraturan Presiden (PERPRES) No 18 (2020). Retrieved from https://peraturan.bpk.go.id/Home/Details/131386/perpres-no-18-tahun-2020
  35. Puspita, R.C., Tamtomo, D., & Indarto, D. (2017). Health belief model for the analysis of factors affecting hypertension preventive behavior among adolescents in Surakarta. Journal of Health Promotion and Behavior, 2 (2), 183–196. doi: 10.26911/thejhpb.2017.02.02.08.
  36. Rosenstock, I.M. (1974). Historical origins of the health belief model. Health Education & Behavior, 2 (4), 328–335. doi: 10.1177/109 019817400200403.
  37. Rosenstock, I.M. (1990). The health belief model: Explaining health behavior through expectancies. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education: Theory, research, and practice (pp. 39–62). Jossey-Bass/Wiley.
  38. Salari, R., & Filus, A. (2017). Using the health belief model to explain mothers’ and fathers’ intention to participate in universal parenting programs. Prevention Science, 18 (1), 83–94. doi: 10.1007/s11121-016-0696-6.
  39. Sharma, A.J., & Subramanyam, M.A. (2021). Intersectional role of paternal gender-equitable attitudes and maternal empowerment in child undernutrition: A cross-sectional national study from India. BMJ Open, 11 (8), e047276. doi: 10.1136/bmjopen-2020-047276.
  40. Sholecha, R.P. (2018). Analisis faktor yang berhubungan dengan pencegahan stunting pada anak usia 2–5 tahun berdasarkan Health Promotion Model (HPM) penelitian deskriptif analitik [Universitas Airlangga]. https://repository.unair.ac.id/82064/
  41. Statistics Indonesia. (2019). Laporan Pelaksanaan Integrasi Susenas Maret 2019 dan SSGBI Tahun 2019. 1–69. Retrieved from https:// stunting.go.id/?smd_process_download=1&download_id=5219
  42. Stewart, C.P., Iannotti, L., Dewey, K.G., Michaelsen, K.F., & Onyango, A.W. (2013). Contextualising complementary feeding in a broader framework for stunting prevention. Maternal and Child Nutrition, 9 (S2), 27–45. doi: 10.1111/mcn.12088.
  43. Sukeri, S., Zahiruddin, W.M., Shafei, M.N., Hamat, R.A., Osman, M., Jamaluddin, T.Z.M.T., & Daud, A.B. (2020). Perceived severity and susceptibility towards leptospirosis infection in Malaysia. International Journal of Environmental Research and Public Health, 17 (17), 6362. doi: 10.3390/ijerph17176362.
  44. Thuita, F.M., Martin, S.L., Ndegwa, K., Bingham, A., & Mukuria, A.G. (2015). Engaging fathers and grandmothers to improve maternal and child dietary practices: Planning a community-based study in western Kenya. African Journal of Food, Agriculture, Nutrition and Development, 15 (5), 10386–10405. https://www.ajol.info/index.php/ajfand/article/view/128351
  45. Titaley, C.R., Ariawan, I., Hapsari, D., Muasyaroh, A., & Dibley, M.J. (2019). Determinants of the stunting of children under two years old in Indonesia: A multilevel analysis of the 2013 Indonesia basic health survey. Nutrients, 11 (5). doi: 10.3390/nu11051106.
  46. UNICEF. (2020). Improving young children’s diets during the complementary feeding period. In J. D’Aloisio (Ed.), UNICEF programming guidance. New York: UNICEF. UNICEF. Retrieved from https://www.unicef.org/me-dia/93981/file/Complementary-Feeding-Guidance-2020.pdf
  47. UNICEF, WHO, & The World Bank. (2021). Levels and trends in child malnutrition: UNICEF / WHO / The World Bank Group joint child malnutrition estimates: key findings of the 2021 edition. World Health Organization. Retrieved from https://apps.who.int/iris/hand le/10665/341135
  48. WHO. (2014). WHA global nutrition target 2025: Stunting policy brief. WHO Publication, 1–10. Retrieved from http://www.who.int/ nutrition/topics/globaltargets_stunting_policybrief.pdf
  49. WHO. (2015). Stunting in a nutshell. Nutrition. Retrieved from https://www.who.int/news/ item/19-11-2015-stunting-in-a-nutshell
  50. WHO. (2018). Reducing stunting in children: equity considerations for achieving global nutrition target 2025 (World Health Organization [ed.]). WHO. Retrieved from https://www. who.int/publications/i/item/9789241513647

How to Cite

Has, E. M. M., Asmoro, C. P., & Gua, W. P. (2022). Factors Related to Father’s Behavior in Preventing Childhood Stunting Based on Health Belief Model. Jurnal Keperawatan Indonesia, 25(2), 74–84. https://doi.org/10.7454/jki.v25i2.847