The "ROSHE" Nutrition Education Model for Families in Stunting Prevention Efforts
Abstract
ntroduction: Stunting is a growth disorder in children caused by chronic undernutrition, recurrent infections, and inadequate psychosocial stimulation. A child is classified as stunted when their height-for-age falls more than two standard deviations below the median of the Child Growth Standards. Stunting has serious short-term consequences, including impaired brain development, reduced intelligence, delays in physical growth, and metabolic disturbances. In the long term, it contributes to decreased cognitive and learning performance, weakened immunity, and greater susceptibility to illness.
Methods: This study aimed to develop and analyze the impact of implementing the ROSHE nutrition education model on the cognitive abilities and attitudes of families in preventing stunting. The research utilized a Research and Development (R&D) design guided by the ADDIE approach to create the “ROSHE” educational model for families. Data collection involved needs analysis, one-to-one testing, and small-group testing through interviews and observations, while field testing employed validated pre-test and post-test questionnaires. The initial phase focused on analyzing stunting-related issues, followed by contextual and literature-based data gathering relevant to family-centered stunting prevention efforts.
Results: During the design stage, the Health Belief Model served as the primary theoretical foundation, integrated with the Social Cognitive Theory (SCT) and the Technology Acceptance Model (TAM). This integration produced a conceptual framework for the initial version of the ROSHE model, which was validated by three experts in information technology, educational technology, and nutrition science. One-to-one and small-group evaluations indicated that the model was easy for families of stunted children to use. Field test results demonstrated an increase in average knowledge and improvements in attitudes after the intervention. The Wilcoxon test yielded a p-value of 0.000, indicating a significant difference in knowledge and attitude changes before and after participation.
Conclusion: The ROSHE nutrition education model effectively enhances family knowledge and attitudes in efforts to prevent stunting.
References
World Health Organization (WHO). Levels and trends in child malnutrition [Internet]. World Health Organization. Geneva; 2021. Available from: https://www.who.int/publications/i/item/9789240025257
Handryastuti S, Pusponegoro HD, Nurdadi S, Chandra A, Pramita FA, Soebadi A, et al. Comparison of Cognitive Function in Children with Stunting and Children with Undernutrition with Normal Stature. J Nutr Metab. 2022;2022. DOI:/ https://doi.org/10.1155/2022/9775727
UNICEF. Situasi Anak di Indonesia: Gizi Anak dan Remaja [Internet]. Jakarta; 2020. Available from: https://www.unicef.org/indonesia/media/5291/file/Situasi Anak di Indonesia.pdf
Ministry of Health indonesian. The Significance of Tackling Stunting for The Economic Prosperity of A Nation – A Narrative Review. J Indones Spec Nutr. 2019;1(4):131–7.
Kementerian Kesehatan Republik Indonesia BKPK. Kementerian Kesehatan Republik Indonesia. 2022. Buku Saku Hasil Studi Status Gizi Indonesia (SSGI) Tahun 2022. Available from: https://www.badankebijakan.kemkes.go.id/buku-saku-hasil-studi-status-gizi-indonesia-ssgi-tahun-2021
Dinas Kesehatan Kabupaten Tanjung Jabung Timur. Profil Kesehatan Kabupaten Tanjung Jabung Timur Tahun 2021. Muara Sabak; 2022. Available from https://dinkes.tanjabtimkab.go.id/media/file/2024/07/17/56_profil-kesehatan-kabupaten-tanjung-jabung-timur-tahun-2022.pdf
Isma Ambarwati, Ratna Sari Dewi P. Faktor Risiko Kejadian Stunting Pada Balita Di Timur Risk Factors For Stunting In Toddlers In The Work Area Of The Simpang Pandan Community Health Center , Geragai District, Tanjung Jabung. J Healthc Technol Med. 2020;6(2):721–31. DOI:/ https://doi.org/10.33143/jhtm.v6i2.978
Abimayu L. Faktor Risiko Kejadian Stunting Pada Balita di Desa Pandan Sejahtera Risk Factors for Stunting in Toddlers in Pandan Sejahtera Village. J Heal Technol Med. 2022;8(2):1165–72. DOI:/ https://doi.org/10.33143/jhtm.v8i2.2372
Jeihooni AK, Mohammadkhah F, Razmjouie F, Harsini PA. Effect of educational intervention based on health belief model on mothers monitoring growth of 6 – 12 months child with growth disorders. 2022;1–10. DOI: https://doi.org/10.1186/s12887-022-03593-8
Ana, Vilda, Setyawati V, Herlambang BA, Kesehatan F, Dian U. Model Edukasi Gizi Berbasis E-booklet untuk Meningkatkan Pengetahuan Gizi Ibu Balita. J Inform Upgris. 2015;1:86–94. DOI: https://doi.org/10.26877/jiu.v1i1%20Juni.810
Zulaekah. Pendidikan Gizi dengan Media Booklet terhadap Pengetahuan Gizi. J Kesehat Masy. 2012;7(2):127–33. DOI: https://doi.org/10.15294/kesmas.v7i2.2808
Lestari F, Indrayani T, Choirunissa R. The effect of education using booklet media on pregnant women ’ s knowledge about Chronic Energy Deficiency ( CED ). Nurs Heal Scienes J. 2025;05(03):411–9. DOI: https://doi.org/10.53713/nhsj.v5i3.578
Gabrielli S, Dianti M, Sci C, Maimone R, Sci C, Betta M, et al. Design of a Mobile App for Nutrition Education ( TreC-LifeStyle ) and Formative Evaluation With Families of Overweight Children. JMIR Publ Adv Digit Heal open Sci. 2017;5. DOI: https://doi.org/10.2196/mhealth.7080
Khusnul Khotimah Arum Nurcahyanti IR. Efektivitas Pemanfaatan Stunting Mobile untuk Pencegahan Stunting dengan Meningkatkan Pemahaman Kebutuhan Asupan Makan di Kabupaten Banyumas. J Multidisiplin Indones. 2023;2(3):594–9. DOI: https://doi.org/10.58344/jmi.v2i3.199
Okpatrioka. Research And Development ( R & D ) Penelitian Yang Inovatif Dalam Pendidikan. DHARMA ACARIYA Nusant J Pendidikan, Bhs dan Budaya. 2023;1(1):86–100.DOI: https://doi.org/10.47861/jdan.v1i1.154
Dick W, Carey L CJ. The systematic design of instruction. 4th ed. New York: Harper Collins College Publishers.; 1196.
Rahmadani RA, Setiawati A, Aris I, Lontaan A. Effectiveness of nutrition education on stunting prevention behavior in mothers under five. 2025;1–8. DOI: https://doi.org/10.61099/junedik.v3i1.68
Siti hardiyanti et al. Indonesian Journal of Global Health Research. Indones J Glob Heal Res. 2024;6(3):1231–42. DOI: https://doi.org/10.37287/ijghr.v6i3.3058
Feny ditya Hanifah syahrizal. Implementation of Stunting Prevention Program in Indonesia: Literature Review. Indones J Heal Promot. 2024;7(5):1183–91. DOI: https://doi.org/10.56338/mppki.v7i5.5205
Hien A, Somé JW, Meda RN tiero, Zeba AN, Traoré I, Ouedraogo GA, et al. Effect of a Nutrition Education Intervention on Mothers ’ Infant and Young Child Feeding Knowledge and Practices in the Peri-Urban Areas of Bobo-Dioulasso : Before and after Study. Food Nutr Sci. 2023;175–99. DOI: https://doi.org/10.4236/fns.2023.143013
Thow AM, Karn S, Devkota MD, Rasheed S, Roy SK, Suleman Y. Opportunities for strengthening infant and young child feeding policies in South Asia : Insights from the SAIFRN policy analysis project. BMC Public Health. 2017;17(2). DOI: https://doi.org/10.1186/s12889-017-4336-2
Oktarina ND, Wijayanti F. Health Education Using Videos to Increase Mothers ’ Knowledge about Stunting Prevention in The First 1000 Days of A Child ’ s Life Journal of Integrated Health Research. 2025;1(2):33–9. DOI: https://doi.org/10.70109/jinher.v1i2.9
Biks GA, Tariku A, Wassie MM, Derso T. Mother ’ s Infant and Young Child Feeding ( IYCF ) knowledge improved timely initiation of complementary feeding of children aged 6 – 24 months in the rural population of northwest Ethiopia. BMC Res Notes. 2018;1–7. DOI: https://doi.org/10.1186/s13104-018-3703-0
Rachmi Ilma Zahtira NIS. The The Effect of Nutrition Education Using Videos and E-booklets on Increasing Knowledge of Balanced Nutrition in High School Students in Jakarta. J Glob Nutr (JGN)l. 2022;2(22). DOI: https://doi.org/10.53823/jgn.v2i2.42
Rosnah et al. Edukasi Gizi Dan Pemanfaatan Pangan Lokal Untuk Ibu Balita Dalam Pencegahan Stunting Pada 1000 Hpk. J STUNITNG DAN Apl. 2023;2(1):25–32. DOI: https://doi.org/10.36990/jspa.v2i1.1566
Rahmah GZ, Kurniasari R, Kesehatan FI, Karawang US. Literature Review : The Influence of Nutrition Education Media Forms on Increasing Mother’s Knowledge to Prevent Stunting in Children. J Gizi dan Kesehatan. 2023;15(1):131–9. DOI: https://doi.org/10.35473/jgk.v15i1.281
Copyright (c) 2026 Media Publikasi Promosi Kesehatan Indonesia (MPPKI)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with Media Publikasi Promosi Kesehatan Indonesia retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:
-
Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.
-
Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Media Publikasi Promosi Kesehatan Indonesia.
-
License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.
