Effectiveness of Modelling in Stunting Intervention to Improve Teenage Mothers’ Knowledge About Exclusive Breastfeeding
Keywords:
Exclusive breastfeeding, Knowledge, Modelling, Stunting, Teenage mothersAbstract
Stunting remains a persistent public health problem in Indonesia, strongly associated with early marriage, teenage pregnancy, and inadequate breastfeeding practices. Exclusive breastfeeding for the first six months of life is a key strategy for stunting prevention; however, adolescent mothers often face knowledge and experience barriers. This study aimed to evaluate the effectiveness of a modelling-based intervention in improving adolescent mothers’ knowledge of exclusive breastfeeding in Poso Regency, Central Sulawesi. A quasi-experimental one-group pretest–posttest design was applied, involving 31 adolescent mothers recruited through purposive sampling. The intervention consisted of a 60-minute session, including a 30-minute educational video and a 30-minute live demonstration covering the benefits of exclusive breastfeeding, breastfeeding techniques, breast care, and common breastfeeding challenges. Data were collected using a validated questionnaire (Cronbach’s Alpha = 0.612) and analyzed using paired t-tests with a significance level of p < 0.05. Results showed a significant increase in knowledge scores from pretest (mean = 5.81) to posttest (mean = 6.97), with a mean difference of -1.16 (p = 0.003), indicating improved understanding after the intervention. The findings suggest that modelling-based education integrating visual and practical components effectively enhances knowledge among adolescent mothers. Nevertheless, the absence of a control group and the small sample size limit causal inference and generalizability. These results provide preliminary evidence that modelling interventions are potentially useful pending further research in supporting exclusive breastfeeding promotion and stunting prevention programs
Downloads
References
J. Lojander et al., “The association between exclusive breastfeeding and quality of care and maternal factors in a tertiary maternity hospital in Finland: A cross-sectional study,” Sex. Reprod. Healthc., vol. 45, p. 101127, 2025, doi: https://doi.org/10.1016/j.srhc.2025.101127. DOI: https://doi.org/10.1016/j.srhc.2025.101127
A. Peña et al., “Co-creating and Mapping an Exclusive Breastfeeding Framework among Latino Populations in the United States: An Integrated Framework Adaptation Process and Scoping Review,” Adv. Nutr., vol. 16, no. 9, p. 100483, 2025, doi: https://doi.org/10.1016/j.advnut.2025.100483. DOI: https://doi.org/10.1016/j.advnut.2025.100483
G. E. Otoo et al., “A mixed-methods study of the drivers of stunting reduction among children under-5 in Ghana, 2003–2017,” Am. J. Clin. Nutr., vol. 121, pp. S95–S105, Apr. 2025, doi: https://doi.org/10.1016/j.ajcnut.2025.02.011. DOI: https://doi.org/10.1016/j.ajcnut.2025.02.011
S. Nurhaliza and R. N. Halik, “Distribution of Malnutrition Cases in Infants in Kabupaten Buol, Provinsi Sulawesi Tengah 2018–2020,” J. Epidemiol. Heal. Sci., vol. 2, no. 2, pp. 107–112, 2025, doi: https://doi.org/10.36685/jehs.v2i2.1353. DOI: https://doi.org/10.36685/jehs.v2i2.1353
C. S. Boccolini et al., “Trends of breastfeeding indicators in Brazil from 1996 to 2019 and the gaps to achieve the WHO/UNICEF 2030 targets,” BMJ Glob. Heal., vol. 8, no. 9, p. e012529, Sep. 2023, doi: https://dx.doi.org/10.1136/bmjgh-2023-012529. DOI: https://doi.org/10.1136/bmjgh-2023-012529
E. F. Apara, D. B. Olawade, G. D. Olatunji, E. Kokori, N. Aderinto, and A. Clement David-Olawade, “Factors influencing nursing mothers’ exclusive breastfeeding practices and their effects on infants aged zero to six months in Nigeria: A review of current evidence,” Women Child. Nurs., vol. 2, no. 3, pp. 49–55, Sep. 2024, doi: https://dx.doi.org/10.1016/j.wcn.2024.07.001. DOI: https://doi.org/10.1016/j.wcn.2024.07.001
P. Krikitrat et al., “Relationships between Thai fathers’ self-efficacy to support breastfeeding and exclusive breastfeeding duration,” Midwifery, vol. 106, p. 103261, 2022, doi: https://doi.org/10.1016/j.midw.2022.103261. DOI: https://doi.org/10.1016/j.midw.2022.103261
A. F. Mahen, A. O. Wihongi, and C. P. Connolly, “Women’s perceptions of maternal and fetal health benefits of physical activity during pregnancy and what factors impact them—A cross-sectional study,” Midwifery, vol. 145, p. 104363, 2025, doi: https://doi.org/10.1016/j.midw.2025.104363. DOI: https://doi.org/10.1016/j.midw.2025.104363
Marni, A. Z. Abdullah, R. M. Thaha, H. Hidayanty, S. Sirajuddin, and M. Syafar, “Risk factor and interventions of behavioral changing strategy in acceleration of stunting prevention: A systematic review,” Enfermería Clínica, vol. 31, pp. S636–S639, 2021, doi: https://doi.org/10.1016/j.enfcli.2021.07.008. DOI: https://doi.org/10.1016/j.enfcli.2021.07.008
S. Zakiyyah Putri, Sitti Maryam Bachtiar, and S. Suprapto, “A Descriptive Case Series on Combined Education, Breast Care, and Oxytocin Massage for Lactation Support in Indonesia,” J. Public Heal. Sci., vol. 4, no. 02 SE-Research Articles, pp. 165–179, Jul. 2025, doi: https://doi.org/10.56741/IISTR.jphs.001030. DOI: https://doi.org/10.56741/IISTR.jphs.001030
L. A. Garina et al., “Maternal, Child, and Household Risk Factors for Children with Stunting,” Open Public Health J., vol. 17, no. 1, Sep. 2024, doi: https://doi.org/10.2174/0118749445321448240823112908. DOI: https://doi.org/10.2174/0118749445321448240823112908
L. A. Langi, N. N. Prihantini, and L. K. Indah, “Associations Between ANC History, Anemia, Exclusive Breastfeeding, and Maternal Diet with Nutritional Status of Children Aged 2–5 in Rural Indonesia,” J. Public Heal. Sci., vol. 4, no. 02 SE-Research Articles, pp. 134–148, Jun. 2025, doi: https://doi.org/10.56741/IISTR.jphs.00908. DOI: https://doi.org/10.56741/IISTR.jphs.00908
F. P. Utami and N. D. Dharmayanti, “Pengaruh Pemberdayaan Ibu Terhadap Pengetahuan Pemberian Asi Ekslusif Melalui Pendekatan Modelling,” J. Ilm. Kesehat., vol. 14, no. 1, pp. 160–165, Mar. 2022, doi: https://dx.doi.org/10.37012/jik.v14i1.2044. DOI: https://doi.org/10.37012/jik.v14i1.2044
K. M. Gurav, V. Shetty, V. Vinay, K. Bhor, C. Jain, and P. Divekar, “Effectiveness of oral health educational methods among school children aged 5–16 years in improving their oral health status: a meta-analysis,” Int. J. Clin. Pediatr. Dent., vol. 15, no. 3, p. 338, 2022, doi: https://dx.doi.org/10.5005/jp-journals-10005-2395. DOI: https://doi.org/10.5005/jp-journals-10005-2395
D. Schubbe et al., “Using pictures to convey health information: A systematic review and meta-analysis of the effects on patient and consumer health behaviors and outcomes,” Patient Educ. Couns., vol. 103, no. 10, pp. 1935–1960, 2020, doi: https://doi.org/10.1016/j.pec.2020.04.010. DOI: https://doi.org/10.1016/j.pec.2020.04.010
J. T. Wallenborn, G. A. Levine, A. Carreira dos Santos, S. Grisi, A. Brentani, and G. Fink, “Breastfeeding, physical growth, and cognitive development,” Pediatrics, vol. 147, no. 5, p. e2020008029, 2021. DOI: https://doi.org/10.1542/peds.2020-008029
D. Raj, R. S. Devi, C. Kumar, and S. B. Singh, “Evaluation of infant feeding knowledge and practices of mothers in rural communities of Uttarakhand India: A cross-sectional study,” J. Neonatal Nurs., vol. 31, no. 4, p. 101694, 2025, doi: https://doi.org/10.1016/j.jnn.2025.101694. DOI: https://doi.org/10.1016/j.jnn.2025.101694
T. T. H. Dinh, D. B. Lees, P. J. Van Dam, and D. E. McGarry, “Use of infant simulators as an aid in pregnancy and parenting educational interventions for school-aged students: a scoping review,” Health Educ. Res., vol. 39, no. 4, pp. 351–374, 2024, doi: https://dx.doi.org/10.1093/her/cyae012. DOI: https://doi.org/10.1093/her/cyae012
C. Welch, C. K. Wong, N. Lelijveld, M. Kerac, and S. V Wrottesley, “Adolescent pregnancy is associated with child undernutrition: Systematic review and meta‐analysis,” Matern. Child Nutr., vol. 20, no. 1, p. e13569, 2024, doi: https://dx.doi.org/10.1111/mcn.13569. DOI: https://doi.org/10.1111/mcn.13569
C. Couto, A. P. Prata, S. P. Souto, J. Machado, and C. R. Viana, “Nurse and midwife interventions to protect, promote and support breastfeeding: An umbrella review,” Midwifery, vol. 144, p. 104337, May 2025, doi: https://dx.doi.org/10.1016/j.midw.2025.104337. DOI: https://doi.org/10.1016/j.midw.2025.104337
S. Hargreaves, J. Ayton, S. Young, and E. Hansen, “Young mothers’ experiences of maternity care: A synthesis of qualitative research,” Midwifery, vol. 143, p. 104305, 2025, doi: https://doi.org/10.1016/j.midw.2025.104305. DOI: https://doi.org/10.1016/j.midw.2025.104305
M. Bruening, S. Perkins, and A. Udarbe, “Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Public Health and Community Nutrition,” J. Acad. Nutr. Diet., vol. 122, no. 9, pp. 1744-1763.e49, 2022, doi: https://doi.org/10.1016/j.jand.2022.04.005. DOI: https://doi.org/10.1016/j.jand.2022.04.005
J. Kehinde, C. O’Donnell, and A. Grealish, “The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review,” Midwifery, vol. 118, p. 103579, Mar. 2023, doi: https://dx.doi.org/10.1016/j.midw.2022.103579. DOI: https://doi.org/10.1016/j.midw.2022.103579
L. M. McGovern, F. M. McAuliffe, and S. L. O’Reilly, “Modifiable factors predicting breastfeeding intentions in early pregnancy: A multi-country study of women at risk of gestational diabetes,” Midwifery, vol. 148, p. 104521, 2025, doi: https://doi.org/10.1016/j.midw.2025.104521. DOI: https://doi.org/10.1016/j.midw.2025.104521
M. A. Haque et al., “Stunting Status of Ever-Married Adolescent Mothers and Its Association with Childhood Stunting with a Comparison by Geographical Region in Bangladesh,” Int. J. Environ. Res. Public Health, vol. 19, no. 11, p. 6748, May 2022, doi: https://dx.doi.org/10.3390/ijerph19116748. DOI: https://doi.org/10.3390/ijerph19116748
D. A. Larasati, T. S. Nindya, and Y. S. Arief, “Hubungan antara Kehamilan Remaja dan Riwayat Pemberian ASI Dengan Kejadian Stunting pada Balita di Wilayah Kerja Puskesmas Pujon Kabupaten Malang,” Amerta Nutr., vol. 2, no. 4, p. 392, Dec. 2018, doi: https://dx.doi.org/10.20473/amnt.v2i4.2018.392-401. DOI: https://doi.org/10.20473/amnt.v2i4.2018.392-401
A. K. Acheampong, M. Ganga-Limando, and L. Aziato, “Qualitative exploration of perceived barriers of exclusive breastfeeding among pregnant teenagers in the Greater Accra Region of Ghana,” BMC Public Health, vol. 22, no. 1, p. 1885, Oct. 2022, doi: https://dx.doi.org/10.1186/s12889-022-14277-4. DOI: https://doi.org/10.1186/s12889-022-14277-4
L. H. Ablett, H. Hopper, and S. Maslin, “How to promote exclusive breastfeeding with antenatal milk expression and implementation science: A mixed methods systematic review,” Heal. Sci. Rev., vol. 9, p. 100124, 2023, doi: https://doi.org/10.1016/j.hsr.2023.100124. DOI: https://doi.org/10.1016/j.hsr.2023.100124
B. A. Paramashanti, M. J. Dibley, T. M. Huda, and A. Alam, “Breastfeeding perceptions and exclusive breastfeeding practices: A qualitative comparative study in rural and urban Central Java, Indonesia,” Appetite, vol. 170, p. 105907, 2022, doi: https://doi.org/10.1016/j.appet.2021.105907. DOI: https://doi.org/10.1016/j.appet.2021.105907
A. Machowska, B. L. Bamboria, C. Bercan, and M. Sharma, “Impact of ‘HIV-related stigma-reduction workshops’ on knowledge and attitude of healthcare providers and students in Central India: a pre-test and post-test intervention study,” BMJ Open, vol. 10, no. 4, p. e033612, Apr. 2020, doi: https://dx.doi.org/10.1136/bmjopen-2019-033612. DOI: https://doi.org/10.1136/bmjopen-2019-033612
C. M. Doak, R. E. van der Starre, I. van Beusekom, M. Campos Ponce, M. Vossenaar, and N. W. Solomons, “Earlier introduction of agüitas is associated with higher risk of stunting in infants and toddlers in the Western Highlands of Guatemala1234,” Am. J. Clin. Nutr., vol. 97, no. 3, pp. 631–636, 2013, doi: https://doi.org/10.3945/ajcn.112.047621. DOI: https://doi.org/10.3945/ajcn.112.047621
V. A. Safitri, D. R. Pangestuti, and A. Kartini, “Pengaruh Video Edukasi Terhadap Pengetahuan dan Sikap Ibu dalam Pemberian ASI Eksklusif di Puskesmas Bulu Lor 2021,” MEDIA Kesehat. Masy. Indones., vol. 20, no. 5, pp. 342–348, Oct. 2021, doi: https://doi.org/10.14710/mkmi.20.5.342-348. DOI: https://doi.org/10.14710/mkmi.20.5.342-348
A. R. Miranda, P. E. Barral, A. V. Scotta, M. V. Cortez, and E. A. Soria, “An overview of reviews of breastfeeding barriers and facilitators: Analyzing global research trends and hotspots,” Glob. Epidemiol., vol. 9, p. 100192, 2025, doi: https://doi.org/10.1016/j.gloepi.2025.100192. DOI: https://doi.org/10.1016/j.gloepi.2025.100192
Masmuri, Nurul Hidayah, and Dodik Limansyah, “Efektivitas Video Pembelajaran Peduli Stunting Terhadap Tingkat Pengetahuan dan Keterampilan pada Kader Kesehatan,” Citra Delima Sci. J. Citra Int. Inst., vol. 8, no. 2, pp. 132–142, Jan. 2025, doi: https://dx.doi.org/10.33862/citradelima.v8i2.506. DOI: https://doi.org/10.33862/citradelima.v8i2.506
Published
How to Cite
Issue
Section
Copyright (c) 2025 Hatijar hatijar, Lilis Candra Yanti

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.









