Disertasi

Development of Digital Complementary Feeding Monitoring System and Its Effect on Feeding Practice and Growth as Stunting Prevention in Children Aged 6 – 12 Months.

The most significant growth faltering in terms of height occurred during the complementary feeding period. Intake monitoring has been shown to be effective in enhancing complementary feeding practices and to have a significant effect on growth. Nutrition education and intake monitoring systems can use information technology such as smartphone applications. This study aimed to develop a digital complementary feeding monitoring system and analyze its effect on feeding practice and growth for stunting prevention in children aged 6 – 12 months. The first stage of this study was to develop a complementary feeding-monitoring system application using a research and development design with analyze, design, development, implementation, and evaluation (ADDIE) approach. The application development process consists of several stages: the analysis stage, which includes literature study and expert judgment phase I; the design stage, encompassing application prototype design and expert judgment phase II; the development stage, which involves application content creation and application coding; and the implementation and evaluation stage, comprising end user computing satisfaction test and expert judgment phase III. The second stage of this study was to implement a complementary feeding-monitoring system using an experimental design. The intervention conducted for 3 months in stunting loci villages Bandung Barat Regency West Java among children aged 6 – 12 months. The intervention stage involved 42 mothers in the intervention group and 58 mothers in the control group. The intervention group received monitoring of complementary feeding through an application, while the control group received educational materials via a WhatsApp group. The user satisfaction level with the application was 87.4 + 9,26, indicating very satisfied. The digital complementary feeding monitoring application is useful for monitoring, child’sْ ageْ specific complementary feeding recommendations, education through articles, videos, and recipes. There was an effect of the digital complementary feeding monitoring system on increasing maternal knowledge (p < 0.001), attitude (p < 0.001), complementary feeding practice (p= 0.003), energy (p= 0.008), carbohydrate (p= 0.043) and protein intake (p < 0.001) of children aged 6 – 12 months in Bandung Barat Regency. The weightfor-age z-score (WAZ) indicator showed an increase in z-scores in the intervention group, but it was not statistically significant. The length-for-age z-score (LAZ) indicator showed a reduction in linear growth faltering in the intervention group (p < 0.001). Based on the multivariate linear regression, it was found that the intervention had a significant impact on knowledge (p < 0.001), attitude (p < 0.001), complementary feeding practice (p < 0.001), protein intake (p=0.013), and the LAZ (p < 0.001). Digital complementary feeding monitoring application is beneficial for improving complementary feeding practices, enhancing nutrition intake, and potentially playing a role in preventing stunting in children aged 6 to 12 months.
Keywords : digital application, complementary feeding monitoring, maternal knowledge, attitude, practices, nutrition intake, children growth, stunting


Perlambatan pertumbuhan yang paling signifikan terjadi selama periode makanan pendamping ASI (MP-ASI). Monitoring asupan gizi terbukti efektif dalam meningkatkan praktik pemberian makan dan memengaruhi pertumbuhan. Edukasi gizi dan sistem pemantauan asupan gizi dapat memanfaatkan teknologi informasi, seperti penggunaan aplikasi smartphone. Penelitian ini bertujuan untuk mengembangkan sebuah sistem pemantauan MP-ASI digital dan menganalisis dampaknya terhadap praktik pemberian makan dan pertumbuhan pada anak usia 6 – 12 bulan sebagai upaya pencegahan stunting. Tahap pertama dari penelitian ini adalah pengembangan aplikasi sistem monitoring MPASI digital menggunakan metode research and development dengan pendekatan analyze, design, development, implementation, and evaluation (ADDIE). Pengembangan aplikasi terdiri dari beberapa tahap, tahap analisis yang terdiri dari studi literatur dan expert judgement phase I; tahap desain terdiri dari pembuatan prototype aplikasi dan expert judgment phase II; tahap development terdiri dari pembuatan konten dan coding aplikasi; tahap implementasi dan evaluasi terdiri dari end user computing satisfaction test dan expert judgment phase III. Tahap kedua dari penelitian ini adalah implementasi aplikasi sistem monitoring MP-ASI menggunakan metode eksperimental. Intervensi dilakukan selama 3 bulan di desa lokus stunting di Kabupaten Bandung Barat pada anak usia 6 – 12 bulan. Tahap ini menggunakan 42 orang ibu dan anak pada kelompok intervensi dan 58 ibu dan anak pada kelompok kontrol. Kelompok intervensi mendapat monitoring MPASI menggunakan aplikasi digital, sementara kelompok kontrol mendapatkan materi edukasi melalui Whatsapp group. Hasil penelitian menunjukkan tingkat kepuasan pengguna aplikasi adalah 87.4 + 9,26, yang mengindikasikan sangat puas. Aplikasi monitoring MP-ASI digital bermanfaat untuk monitoring pemberian MP-ASI, rekomendasi pemberian MP-ASI sesuai usia, media edukasi melalui artikel, video dan resep MP-ASI. Hasil uji statistik menunjukkan ada pengaruh monitoring MP-ASI digital terhadap pengetahuan ibu (p < 0.001), sikap (p < 0.001) dan praktik MP-ASI (p = 0.013), asupan energi (p = 0.008), karbohidrat (p = 0.043) dan protein (p < 0.001) pada anak usia 6 – 12 bulan di Kabupaten Bandung Barat. Indikator berat badan menurut umur (BB/U) menunjukkan perbaikan pada kelompok intervensi, namun belum bermakna secara statistik. Sedangkan indikator panjang badan menurut umur (PB/U) menunjukkan penurunan perlambatan pertumbuhan pada kelompok intervensi (p < 0.001). Berdasarkan analisis regresi linier multivariat, ditemukan bahwa intervensi memiliki dampak yang signifikan terhadap pengetahuan (p < 0.001), sikap (p < 0.001), praktik pemberian MP-ASI (p < 0.001), asupan protein (p=0.013), dan z-score PB/U (p < 0.001). Aplikasi monitoring MP-ASI digital bermanfaat untuk meningkatkan praktek pemberian MP-ASI, meningkatkan asupan gizi dan berpotensi dan pencegahan stunting pada anak usia 6 – 12 bulan.
Kata kunci : applikasi digital, monitoring MP-ASI, pengetahuan ibu, sikap, praktek pemberian MP-ASI, asupan gizi, pertumbuhan anak, stunting.