Haryanti Fitri, Madyaningrum Ema, Sitaresmi Mei Neni
Department of Mental and Community Health Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Department of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta, Indonesia.
Belitung Nurs J. 2021 Aug 27;7(4):311-319. doi: 10.33546/bnj.1521. eCollection 2021.
Stunting is a common malnutrition problem among children in the world. The Care for Children Development (CCD) intervention is a strategy to reduce stunting.
This study aimed to identify the effect of culturally modified CCD training on the knowledge, attitude, and efficacy (KAE) of cadres about stunting in the community.
We conducted a community-based study with a quasi-experimental research design using a comparison group. The study was conducted from March 2018 to February 2019 at three Public Health Centers in Yogyakarta, Indonesia. The total participants were 69 in the intervention group and 53 in the comparison group. Cadres in the intervention group received two days of training on a culturally modified CCD guideline. In contrast, cadres in the comparison group received a brief explanation (a one-day training) on that program. The nurses from three public health centers were facilitators in this training. Knowledge and self-efficacy were assessed using a modified Caregiver Knowledge of Child Development Inventory and General Self-efficacy Scale, respectively. Data were analyzed using Mann-Whitney U and Wilcoxon tests.
All 122 cadres completed the training. In the intervention group, CCD training significantly increased cadres' knowledge (median score 14 vs. 11), attitude (58 vs. 55), and efficacy (30 vs. 28), all with p <0.001. In the comparison group, the short explanation of CCD significantly improved cadres' knowledge (median score 12 vs. 10) and efficacy (29 vs. 27) but not their attitude. The delta or change in score before and after CCD training for cadres' attitude in the intervention group was significantly higher than that of the comparison group (3.78 vs. 0.72; = 0.050).
A culturally modified CCD training significantly improves cadres' KAE in the intervention group and cadres' knowledge in the comparison group. The learning delivery methods with demonstrations and role-plays significantly improved the cadres' attitudes as health educators for stunted mothers in the community. For sustainability, community health nurses should regularly collaborate with cadres to improve the nutritional status of children in their area.
发育迟缓是全球儿童中常见的营养不良问题。关爱儿童发展（CCD）干预措施是一项减少发育迟缓的策略。
本研究旨在确定文化适应性修改后的CCD培训对社区干部关于发育迟缓的知识、态度和效能（KAE）的影响。
我们采用准实验研究设计并设立对照组开展了一项基于社区的研究。该研究于2018年3月至2019年2月在印度尼西亚日惹的三个公共卫生中心进行。干预组共有69名参与者，对照组有53名。干预组的干部接受了为期两天的关于文化适应性修改后的CCD指南的培训。相比之下，对照组的干部接受了关于该项目的简要解释（为期一天的培训）。来自三个公共卫生中心的护士是此次培训的促进者。知识和自我效能分别使用修改后的《照顾者儿童发展知识量表》和《一般自我效能量表》进行评估。数据采用曼-惠特尼U检验和威尔科克森检验进行分析。
所有122名干部均完成了培训。在干预组中，CCD培训显著提高了干部的知识（中位数得分14对11）、态度（58对55）和效能（30对28），所有p值均<0.001。在对照组中，对CCD的简要解释显著提高了干部的知识（中位数得分12对10）和效能（29对27），但未提高他们的态度。干预组干部在CCD培训前后态度得分的差值或变化显著高于对照组（3.78对0.72；p = 0.050）。
文化适应性修改后的CCD培训显著提高了干预组干部的KAE以及对照组干部的知识。带有示范和角色扮演的学习交付方法显著改善了干部作为社区发育迟缓母亲的健康教育者的态度。为了实现可持续性，社区卫生护士应定期与干部合作，以改善其所在地区儿童的营养状况。
