Disertasi

DEVELOPMENT AND VALIDATION OF INSTRUMENTS FOR ASSESSING INFANT AND YOUNG CHILD FEEDING COUNSELING COMPETENCY OF FILIPINO VILLAGE NUTRITION WORKERS. = PENGEMBANGAN DAN VALIDASI INSTRUMEN UNTUK PENILAIAN KOMPETENSI TENAGA GIZI DESA FILIPINA DALAM MELAKUKAN KONSELING PEMBERIAN MAKANAN BAYI DAN ANAK.

BACKGROUND: The Barangay (Village) Nutrition Scholars (BNS) has been trained to do infant and young child feeding (IYCF) counseling but the absence of a validated competency instruments constrained the assessment of their competency to do IYCF counseling to their client. This study was designed to develop and validate the instruments to assess the competency of BNS on IYCF counseling and answer the question: how valid and reliable were the developed instrument to measure the competency of trained BNS on IYCF counseling? METHODS: Methodological research design were used to develop and validate the instruments to measure IYCF counseling competency based on knowledge, attitude and skills in terms of frequency, intensity and activity designed for the BNS, supervisor and client, respectively. The instruments were pilot-tested to assess 320 BNS. Item analyses results were used for revisions prior to field test to 280 BNS. Experts checked the content validity; internal consistency and construct validity were assessed using Cronbach’s alpha and exploratory and confirmatory factor analysis, respectively. The weighting distribution for knowledge, attitude and skills and cut-off score for each construct and instrument were established based on sensitivity and specificity using ROC Curve to calculate the score and to identify competent BNS. RESULTS: The validated instruments included: 1) 28 items for BNS knowledge test with true or false, fill-in-the-blanks and multiple-choice formats; 2) 10 items for BNS attitude test with four scale Likert scale to assess personal view, attitude towards implementation, and perceived barriers on IYCF counseling; 3) 18 items of five-scale frequency instrument for BNS to assess listening, giving support, assessment and action skills; 4) 18-item four-scale instrument for BNS supervisor to assess the intensity in doing the counseling process, assessment and use of IYCF materials; and 5) 17-item activity checklist designed for client to assess giving support, assessment and actions skills. These constructs were combined into competency assessment instruments KAS-WOR, KAS-SUP, KAS-MOM and KAS-COM with 75%, 50%, 80% and 65% as cut-off score. Based on the 20-10-70 weighting distributions for knowledge-attitude-skills competent BNS on IYCF counseling was about 30%. CONCLUSIONS: The assessment instruments developed to measure the IYCF counseling competency of BNS had relatively moderate to high internal consistency and validity. This assures that the results of the tests can be relied upon for making dependable judgments and interpretations.
KEYWORDS: IYCF counseling, Barangay Nutrition Scholar, instrument development and validation, competency assessment.



LATAR BELAKANG: Katiadaan instrumen penilaian kompetensi yang valid menyulitkan penilaian praktik konseling terhadap tenaga gizi desa (Barangay Nutrition Scholars, BNS) yang mendapat pelatihan konseling pemberian makanan pada bayi dan anak (infant and young child feeding, IYCF). Studi ini dirancang untuk mengembangkan dan memvalidasi instrumen penilaian kompetensi BNS dalam memberikan konseling IYCF. METODE: Desain penelitian metodologi digunakan untuk mengembangkan dan validasi instrumen pengukur kompetensi konseling IYCF meliputi pengetahuan, sikap, dan keterampilan, berdasarkan frekuensi, intensitas, dan aktivitas. Instrumen ini ditujukan penggunaanya oleh BNS, supervisor, maupun klien. Uji coba dan revisi berdasarkan hasil analisis item dilakukan pada 320 BNS dan dilanjutkan dengan uji lapangan terhadap 280 BNS. Validitas isi (content validity) dikaji oleh beberapa pakar, sedangkan konsistensi internal (internal consistency) dan validitas konstruk (construct validity) diuji dengan Cronbach’s alpha dan, exploratory dan confirmatory factor analysis. Distribusi bobot pengetahuan, sikap dan keterampilan dan nilai titik potong kompetensi untuk tiap construct dan instrumen ditetapkan berdasarkan sensitivitas dan spesifisitas menggunakan ROC Curve. HASIL: Instrumen yang valid terdiri dari: 1) 28 item terkait pengetahuan BNS dengan tipe memilih benar atau salah suatu pertanyaan, pertanyaan dengan jawaban singkat, dan pilihan ganda; 2) 10 item terkait sikap BNS dengan Likert scale untuk menilai pandangan pribadi, sikap terhadap implementasi, dan hambatan yang dirasakan saat konseling IYCF; 3) 18 item menggunakan 5 skala frekuensi penilaian BNS dalam mendengarkan, memberikan support, dan praktik penilaian dan keterampilan; 4) 18 item dengan 4 skala nilai untuk atasan BNS menilai intensitas proses konseling, penilaian dan penggunaan materi IYCF; dan 5) 17 item berupa daftar tilik kegiatan untuk klien menilai pemberian support, penilaian, dan praktik keterampilan. Gabungan item masing-masing menjadi instrumen penilaian kompetensi KAS-WOR, KAS-SUP, KAS-MOM dan KAS-COM dengan nilai titik potong masing-masing yaitu 75%, 50%, 80% dan 65%. Berdasarkan pembobotan 20% untuk pengetahuan, 10% sikap, dan 70% keterampilan diperoleh 30% BNS yang kompeten dalam konseling IYCF. KESIMPULAN: Hasil pengembangan instrumen penilaian kompetensi BNS melakukan konseling IYCF memiliki konsistensi internal dan tingkat validitas yang sedang sampai tinggi.
Kata Kunci: konseling IYCF, Barangay Nutrition Scholar, pengembangan instrument, validasi, penilaian kompetensi.