Tesis

Home Food Environment as Mediator Between Health Concern and Diet Quality Among Mothers of Young Children in Urban Slum in North Jakarta.

Diet quality among women remains a major issue. Having health concern may be related to diet. As mothers with young children usually had their meals at home, food environment at home could also play a role in shaping eating habit and foodrelated behavior. This study aims to examine the association between health concern and diet quality, and whether home food environment mediates this relationship. This cross-sectional study was conducted in an urban slum area in North Jakarta, involving 229 mothers of young children through consecutive sampling. Data was collected through interview using structured questionnaire, including 2x24-hour dietary recall to calculate diet quality using Diet Quality Index-International (DQI-I). Health concern was assessed using General Health Interest (GHIS). Home food environment was assessed using Consumer Behavior Questionnaire (CBQ). Statistical analysis was performed using SPSS Version 20 for Spearman correlation and multiple linear regression, and SPSS Amos Version 23 for path analysis. Majority of the mothers had poor diet quality, with mean DQII total score of 41.44 out of 100. The diet of mothers was characterized by low consumption of vegetables and fruits, high consumption of empty calorie food, and excessive fat intake. Home food environment showed vegetables, sweet snack, and sugar-sweetened beverages were available at home most of the time. The mothers usually cooked at home, yet having take-out food was commonly done at least once a week. One-third of the mothers had moderate health concern, with median GHIS score of 32 out of 48. There was no significant correlation between health concern and diet quality (r=0.092, P-value=0.166). Nonetheless, significant correlations were found between fruits and vegetables availability (r=0.206, P-value=0.002 for fruits; r=0.205, P-value=0.002 for vegetables) with diet quality. Health concern was also correlated with fruits availability (r=0.196, P-value=0.002), cooking frequency (r=0.238, P-value < 0.001), and take-out food frequency (r=-0.187, P-value=0.003). After adjusted with age, home food environment was not significant mediator between health concern and diet quality (IE=0.012, P-value=0.096). Multiple linear regression also showed age as a significant predictor of diet quality (B=0.196, Pvalue=0.024). Promoting health concern and healthier food choice when eating out or purchasing take-out food would be beneficial to improve diet quality among mothers of young children. Future study is also recommended to explore how age group differs in viewing health as importance, which could lead to dietary practices.
Keywords: diet quality, health concern, home food environment, mothers, urban slum


Kualitas diet pada wanita dewasa masih menjadi masalah. Memiliki perhatian khusus terhadap kesehatan (health concern) dapat berkaitan dengan pola makan. Wanita, khususnya ibu yang memiliki anak usia balita dan pra-sekolah umumnya makan di rumah. Sehingga lingkungan pangan rumah juga berkontribusi terhadap perilaku makan. Studi ini bertujuan untuk mengetahui hubungan antara health concern dan kualitas diet, serta mengetahui apakah lingkungan pangan rumah memediasi untuk hubungan ini. Studi potong lintang ini berlokasi di Jakarta Utara, dengan sampel sebanyak 229 subjek dengan metode penarikan sampel consecutive. Pengumpulan data dilakukan dengan menggunakan kuesioner. Health concern diukur dengan General Health Interest Scale (GHIS). Lingkungan pangan rumah diukur dengan Consumer Behavior Questionnaire (CBQ). Data kualitas diet dinilai dari 2x24-hour dietary recall dan skor Diet Quality Index-International (DQI-I). Analisis statistik menggunakan SPSS Versi 20 untuk analisis korelasi dan regresi linier berganda, dan SPSS Amos Versi 23 untuk analisis jalur. Sebagian besar subjek memiliki kualitas diet yang rendah (nilai mean skor DQI-I: 41.44). Konsumsi buah dan sayur masih rendah, sementara konsumsi makanan empty calorie dan asupan lemak berlebih. Sayur, cemilan manis, dan minuman manis adalah jenis makanan yang sering tersedia di rumah. Subjek biasanya memasak di rumah, namun membungkus makanan biasa dilakukan setidaknya sekali seminggu. Sepertiga subjek memiliki health concern tingkat sedang (nilai median GHIS: 32). Tidak terdapat korelasi bermakna antara health concern dan kualitas diet (r=0.092, P-value=0.166). Namun terdapat korelasi antara ketersediaan buah (r=0.206, Pvalue=0.002) dan sayur (r=0.205, P-value=0.002) dengan kualitas diet. Health concern juga berkorelasi dengan ketersediaan buah (r=0.196, P-value=0.002), frekuensi memasak (r=0.238, P-value < 0.001), dan frekuensi membungkus makanan (r=-0.187, P-value=0.003). Setelah di-adjust dengan usia, lingkungan pangan rumah khususnya ketersediaan sayur tidak memediasi hubungan antara health concern dan kualitas diet (IE=0.012, P-value=0.096). Hasil regresi linier berganda juga menunjukkan usia sebagai prediktor kualitas diet (β=0.196, Pvalue=0.024). Diperlukan upaya kolaboratif untuk memperbaiki kualitas diet pada ibu, dengan meningkatkan health concern serta pemahaman tentang pemilihan jenis makanan berdasarkan kualitas gizi saat membeli makanan. Rekomendasi untuk studi lanjutan dapat meneliti perbedaan health concern menurut usia, serta kaitannya dengan perilaku makan dan kualitas diet.
Kata kunci: kualitas diet, health concern, lingkungan pangan rumah, ibu, daerah kumuh perkotaan