SINTA

0.0

Impact

Scholar

6

H-Index

Journal of Health Innovation and Environmental Education

an Open Access Journal

Transforming Children's Attitudes and Knowledge towards Vegetable Consumption through Think Pair Share-Based Health Education

Sri Puastiningsih
Airlangga University ROR
Indonesia
srpstiningsiih@gmail.com
Sahlan Sahlan
Sekolah Dasar KHM Noer
Indonesia
Share

  • Purpose of the study: The aim of this study was to analyze the effect of implementing health education with the think pair share learning model on the knowledge and attitudes of school-age children regarding vegetable consumption.

    Methodology: This study used a pre-experimental design with a one-group pre-post test approach. A sample of 40 fourth-grade students was drawn using a total sampling technique. The independent variable was health education using the Think Pair Share model, while the dependent variables were knowledge and attitudes. Data analysis used the Wilcoxon Sign Rank Test with α≤0.05.

    Main Findings: The results of the Wilcoxon Sign Rank Test statistical test show that health education with the think pair share learning model can influence children's knowledge (p=0.000) and attitudes (p=0.000).

    Novelty/Originality of this study: The novelty of this research lies in the application of the Think Pair Share learning model in health education to improve school-age children's knowledge and attitudes toward vegetable consumption. This approach has not been widely used in the context of child nutrition, thus providing an innovative contribution to effective and participatory health education methods.

  • How to cite

    Transforming Children’s Attitudes and Knowledge towards Vegetable Consumption through Think Pair Share-Based Health Education. (2025). Journal of Health Innovation and Environmental Education, 2(1), 85-93. https://doi.org/10.37251/jhiee.v2i1.2004

    More Citation Formats

  • 124
    Abstract views
    130
    Downloads

    Metrics — Badges

    1. R. Osae, D. Nukpezah, D. A. Darko, S. S. Koranteng, and A. Mensah, “Accumulation of heavy metals and human health risk assessment of vegetable consumption from a farm within the Korle lagoon catchment,” Heliyon, vol. 9, no. 5, p. e16005, 2023, doi: 10.1016/j.heliyon.2023.e16005. DOI: https://doi.org/10.1016/j.heliyon.2023.e16005
    2. N. Küçük, F. Urak, A. Bilgic, W. J. Florkowski, A. K. Kiani, and F. N. Özdemir, “Fruit and vegetable consumption across population segments: evidence from a national household survey,” J. Heal. Popul. Nutr., vol. 42, no. 1, pp. 1–20, 2023, doi: 10.1186/s41043-023-00382-6. DOI: https://doi.org/10.1186/s41043-023-00382-6
    3. L. Fischer et al., “Feasibility of a Home-Delivery Produce Prescription Program to Address Food Insecurity and Diet Quality in Adults and Children,” Nutrients, vol. 14, no. 10, pp. 1–21, 2022, doi: 10.3390/nu14102006. DOI: https://doi.org/10.3390/nu14102006
    4. S. R. Chowdhury and S. Ray, “Micronutrient Deficiency in Indian Diet,” Interantional J. Sci. Res. Eng. Manag., vol. 08, no. 05, pp. 1–11, 2024, doi: 10.55041/ijsrem33586. DOI: https://doi.org/10.55041/IJSREM33586
    5. J. P. Almandoz et al., “Nutritional considerations with antiobesity medications,” Obesity, vol. 32, no. 9, pp. 1613–1631, 2024, doi: 10.1002/oby.24067. DOI: https://doi.org/10.1002/oby.24067
    6. N. Akhter et al., “A Comprehensive Review on Formulation of Baby Foods: Nutraceutical potential of Fruits, Vegetables, Cereals and Probiotics in Baby Food Preparation,” Curr. Food Sci. Technol. Reports, vol. 2, no. 3, pp. 255–270, May 2024, doi: 10.1007/s43555-024-00034-8. DOI: https://doi.org/10.1007/s43555-024-00034-8
    7. M. Amoadu, S. A. Abraham, A. K. Adams, W. Akoto-Buabeng, P. Obeng, and J. E. Hagan, “Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review,” Children, vol. 11, no. 4, pp. 1–19, 2024, doi: 10.3390/children11040476. DOI: https://doi.org/10.3390/children11040476
    8. E. Asgari, M. Askari, N. Bellissimo, and L. Azadbakht, “Association between Ultraprocessed Food Intake and Overweight, Obesity, and Malnutrition among Children in Tehran, Iran,” Int. J. Clin. Pract., vol. 2022, pp. 1–7, 2022, doi: 10.1155/2022/8310260. DOI: https://doi.org/10.1155/2022/8310260
    9. L. Mahmood, P. Flores-Barrantes, L. A. Moreno, Y. Manios, and E. M. Gonzalez-Gil, “The Influence of Parental Dietary Behaviors and Practices on Children’s Eating Habits,” Nutrients, vol. 13, no. 4, pp. 1–13, 2021. DOI: https://doi.org/10.3390/nu13041138
    10. L. Dubois, B. Bédard, D. Goulet, D. Prud’homme, R. E. Tremblay, and M. Boivin, “Eating behaviors, dietary patterns and weight status in emerging adulthood and longitudinal associations with eating behaviors in early childhood,” Int. J. Behav. Nutr. Phys. Act., vol. 19, no. 1, pp. 1–11, 2022, doi: 10.1186/s12966-022-01376-z. DOI: https://doi.org/10.1186/s12966-022-01376-z
    11. K. C. Igbokwe, S. I. Ejoh, and G. O. Iheme, “Vegetable consumption and promotion among school-age children and adolescents in West Africa: A systematic review and narrative synthesis,” Br. J. Nutr., vol. 133, no. 3, pp. 408–421, 2025, doi: 10.1017/S0007114524003301. DOI: https://doi.org/10.1017/S0007114524003301
    12. D. L. Sufyan and U. Wahyuningsih, “Adequate fruit and vegetable consumption and its association with overnutrition among primary school-aged children,” AcTion Aceh Nutr. J., vol. 8, no. 3, p. 331, 2023, doi: 10.30867/action.v8i3.965. DOI: https://doi.org/10.30867/action.v8i3.965
    13. M. Mustikawati and W. E. Hikma, “Knowledge and Attitudes of School-Age Children Towards Vegetable and Fruit Consumption At Sd Negeri 9 Pekanbaru,” Int. J. Heal. Sci. Med. Res., vol. 1, no. 2, pp. 102–110, 2022, doi: 10.37905/ijhsmr.v1i2.15493. DOI: https://doi.org/10.37905/ijhsmr.v1i2.15493
    14. F. Morales, S. Montserrat-de la Paz, M. J. Leon, and F. Rivero-Pino, “Effects of Malnutrition on the Immune System and Infection and the Role of Nutritional Strategies Regarding Improvements in Children’s Health Status: A Literature Review,” Nutrients, vol. 16, no. 1, pp. 1–16, 2024, doi: 10.3390/nu16010001. DOI: https://doi.org/10.3390/nu16010001
    15. R. Cordeiro, A. Souza, and C. De Paulo, “Impacts of technology on children ’ s health : a systematic review Impactos da tecnologia na saúde infantil : revisão sistemática,” Soc. Pediatr. São Paulo, vol. 41, pp. 1–8, 2023. DOI: https://doi.org/10.1590/1984-0462/2023/41/2020504
    16. S. N. Halimah, Y. Yuliastati, and M. Fadilah, “Knowledge, levels of consumption of vegetables and fruits in adolescents at SMPN 1 CIOMAS Bogor Regency,” Int. J. Health Sci. (Qassim)., vol. 6, no. March, pp. 6653–6663, 2022, doi: 10.53730/ijhs.v6ns1.6419. DOI: https://doi.org/10.53730/ijhs.v6nS1.6419
    17. Y. B. Prasetyo, S. Sunaringsih, and F. A. Farera, “Determinant Factors Affecting Adolescent Fruit and Vegetable Consumption in Indonesia,” Ankara Med. J., vol. 24, no. 1, pp. 14–27, 2024, doi: 10.5505/amj.2024.82609. DOI: https://doi.org/10.5505/amj.2024.82609
    18. C. L. Chan, P. Y. Tan, and Y. Y. Gong, “Evaluating the impacts of school garden-based programmes on diet and nutrition-related knowledge, attitudes and practices among the school children: a systematic review,” BMC Public Health, vol. 22, no. 1, pp. 1–33, 2022, doi: 10.1186/s12889-022-13587-x. DOI: https://doi.org/10.1186/s12889-022-13587-x
    19. K. Wolnicka, A. M. Taraszewska, and J. Jaczewska-Schuetz, “Can the school fruit and vegetable scheme be an effective strategy leading to positive changes in children’s eating behaviours? Polish evaluation results,” Int. J. Environ. Res. Public Health, vol. 18, no. 23, 2021, doi: 10.3390/ijerph182312331. DOI: https://doi.org/10.3390/ijerph182312331
    20. S. S. Salam et al., “Impact of a school-based nutrition educational intervention on knowledge related to iron deficiency anaemia in rural Karnataka, India: A mixed methods pre–post interventional study,” BJOG An Int. J. Obstet. Gynaecol., vol. 130, no. S3, pp. 113–123, 2023, doi: 10.1111/1471-0528.17619. DOI: https://doi.org/10.1111/1471-0528.17619
    21. R. Poličnik et al., “Dietary Intake of Adolescents and Alignment with Recommendations for Healthy and Sustainable Diets: Results of the SI.Menu Study,” Nutrients, vol. 16, no. 12, pp. 1–26, 2024, doi: 10.3390/nu16121912. DOI: https://doi.org/10.3390/nu16121912
    22. J. H. Nel and N. P. Steyn, “The Nutrition Transition and the Double Burden of Malnutrition in Sub-Saharan African Countries: How Do These Countries Compare with the Recommended LANCET COMMISSION Global Diet?,” Int. J. Environ. Res. Public Health, vol. 19, no. 24, 2022, doi: 10.3390/ijerph192416791. DOI: https://doi.org/10.3390/ijerph192416791
    23. R. Yekti, P. D. Kusumo, Y. Prilia, and R. J. Silitonga, “The Relationship of Micronutrient Intake with the Incidence of Anemia in Adolescents,” Int. J. Recent Res. Life Sci., vol. 9, no. 9, pp. 9–13, 2022, [Online]. Available: https://doi.org/10.5281/zenodo.6979674
    24. J. Mellawati and E. Nurtjahya, “Natural radionuclide content in horticulture plants from former tin mining land and health risk assessment: A case study on Bangka Belitung Island, Indonesia,” IOP Conf. Ser. Earth Environ. Sci., vol. 1297, no. 1, pp. 1–10, 2024, doi: 10.1088/1755-1315/1297/1/012097. DOI: https://doi.org/10.1088/1755-1315/1297/1/012097
    25. M. M. A. Ayed, A. abd E. Mohamed, and H. H. A. El-Monem, “Effect of Iron Deficiency Anemia on Academic Performance among Primary School Children,” Egypt. J. Heal. Care, vol. 12, no. 1, pp. 418–432, 2021, doi: 10.21608/ejhc.2021.141885. DOI: https://doi.org/10.21608/ejhc.2021.141885
    26. S. Gedfie, S. Getawa, and M. Melku, “Prevalence and Associated Factors of Iron Deficiency and Iron Deficiency Anemia Among Under-5 Children: A Systematic Review and Meta-Analysis,” Glob. Pediatr. Heal., vol. 9, pp. 1–13, 2022, doi: 10.1177/2333794X221110860. DOI: https://doi.org/10.1177/2333794X221110860
    27. A. A. Zerga, S. E. Tadesse, F. Y. Ayele, and S. Z. Ayele, “Impact of malnutrition on the academic performance of school children in Ethiopia: A systematic review and meta-analysis,” SAGE Open Med., vol. 10, pp. 1–10, Jan. 2022, doi: 10.1177/20503121221122398. DOI: https://doi.org/10.1177/20503121221122398
    28. E. Greene and C. Murrin, “Parental influences on children’s dairy products consumption: A narrative review,” Public Health Nutr., vol. 26, no. 5, pp. 976–993, 2023, doi: 10.1017/S1368980022002555. DOI: https://doi.org/10.1017/S1368980022002555
    29. S. Zuarub, L. Stojanovska, and H. I. Ali, “Barriers and Facilitators of Weight Management among School Children with Obesity: A Qualitative Investigation of Parents’ Perceptions,” Nutrients, vol. 14, no. 23, p. 5117, Dec. 2022, doi: 10.3390/nu14235117. DOI: https://doi.org/10.3390/nu14235117
    30. A. Verdonschot, B. M. Follong, C. E. Collins, E. De Vet, A. Haveman-Nies, and T. Bucher, “Effectiveness of school-based nutrition intervention components on fruit and vegetable intake and nutrition knowledge in children aged 4-12 years old: an umbrella review,” Nutr. Rev., vol. 81, no. 3, pp. 304–321, 2023, doi: 10.1093/nutrit/nuac057. DOI: https://doi.org/10.1093/nutrit/nuac057
    31. J. N. Davis et al., “School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial,” Int. J. Behav. Nutr. Phys. Act., vol. 18, no. 1, pp. 1–14, 2021, doi: 10.1186/s12966-021-01087-x. DOI: https://doi.org/10.1186/s12966-021-01087-x
    32. B. O. Akangbe, M. Abacheng, and G. Stephen-kings, “Evaluating The Role Of School-Based Health Education Programs In Improving Nutrition Knowledge, Dietary Habits, And Preventable Disease Outcomes Among Children In Underserved Communities,” Int. J. Eng. Technol. Res. Manag., vol. 7, no. 12, pp. 514–531, 2023.
    33. V. Fransisca, “Effectiveness of the Nutrition Education Program in Increasing Awareness of Balanced Eating Patterns in Elementary Schools,” Al Makki Heal. Informatics J., vol. 2, no. 6, pp. 353–358, 2025, doi: 10.57185/hij.v2i6.47. DOI: https://doi.org/10.57185/hij.v2i6.47
    34. M. A. Alsmadi, A. A. S. Tabieh, R. M. Alsaifi, and S. J. Al-Nawaiseh, “The Effect of the Collaborative Discussion Strategy Think-Pair-Share on Developing Students’ Skills in solving Engineering Mathematical Problems,” Eur. J. Educ. Res., vol. 12, no. 2, pp. 1123–1135, 2023, doi: 10.12973/eu-jer.12.2.1123. DOI: https://doi.org/10.12973/eu-jer.12.2.1123
    35. Y. R. R. Darmawan and F. E. Lestariningsih, “Students’ Views toward the use of Think-Pair-Share Strategy on students’ oral communication skill in an EFL context,” J. Lang. Lang. Teach., vol. 11, no. 4, p. 798, 2023, doi: 10.33394/jollt.v11i4.8694. DOI: https://doi.org/10.33394/jollt.v11i4.8694
    36. M. A. Sudrajat, S. Sarbaini, and ..., “Development of Think and Share Model Based on Traditional Games to Improve Mutual Cooperation Attitude,” Proceeding …, no. Ice, pp. 148–156, 2024, doi: 10.37640/ice.03.1187.
    37. G. K. W. Wong, S. Jian, and H. Y. Cheung, Engaging children in developing algorithmic thinking and debugging skills in primary schools: A mixed-methods multiple case study, vol. 29, no. 13. Springer US, 2024. doi: 10.1007/s10639-024-12448-x. DOI: https://doi.org/10.1007/s10639-024-12448-x
    38. N. Putri, L. Wati, M. Nirnasari, and S. Khoriroh, “Pengaruh Pendidikan Kesehatan Model Think Pair Share Terhadap Pengetahuan Konsumsi Sayur dan Buah Pada Anak Usia Sekolah di SDN 005 Tanjungpinang Kota,” J. Imliah Cereb. Med., vol. 6, no. 1, pp. 1–6, 2024, [Online]. Available: http://jurnal.akperkesdam-padang.ac.id/index.php/JICM/article/view/124/95
    39. H. Silva, J. Lopes, C. Dominguez, and E. Morais, “Think-Pair-Share and Roundtable: Two Cooperative Learning Structures to Enhance Critical Thinking Skills of 4th Graders,” Int. Electron. J. Elem. Educ., vol. 15, no. 1, pp. 11–21, 2022, doi: 10.26822/iejee.2022.274. DOI: https://doi.org/10.26822/iejee.2022.274
    40. G. Prasetya and A. Khomsan, “The Knowledge, Attitude and Practice of Mothers and Children on the Indonesian Dietary Guidelines and the Relationship with Children’s Nutritional Status,” J. Gizi Pangan, vol. 16, no. 28, pp. 55–64, 2021.
    41. F. Paramita et al., “Anthropometry Measurement Video Improve Knowledge of Cadres in Nganjuk City : A Single Group Pre-Post Test Design Study,” Prev. Indones. J. Public Heal., vol. 10, no. 1, pp. 1–6, 2025, doi: 10.17977/um044v10i12025p1-6. DOI: https://doi.org/10.17977/um044v10i12025p1-6
    42. Z. N. Yuhbaba, N. Khoirunnisa, and W. S. Suswati, “Enhancing Adolescents’ Knowledge of Bullying Through Educational Videos: A Pre-Experimental Study in a Junior High School,” Blambangan J. Nurs. Heal. Sci., vol. 3, no. 1, pp. 1–7, 2025, doi: https://doi.org/10.61666/bjnhs.v3i1.66. DOI: https://doi.org/10.20473/dc.V7.I1.2025.61-66
    43. K. R. Subedi, “Determining the Sample in Qualitative Research,” Sch. J., vol. 4, no. December, pp. 1–13, 2021, doi: 10.3126/scholars.v4i1.42457. DOI: https://doi.org/10.3126/scholars.v4i1.42457
    44. H. S. Mediani, S. Hendrawati, T. Pahria, A. S. Mediawati, M. Suryani, and H. S. Mediani, “Factors Affecting the Knowledge and Motivation of Health Cadres in Stunting Prevention Among Children in Indonesia Factors Affecting the Knowledge,” J. Multidiscip. Healthc., vol. 15, pp. 1069–1082, 2022, doi: 10.2147/JMDH.S356736. DOI: https://doi.org/10.2147/JMDH.S356736
    45. K. A. A. Gamage, D. M. S. C. P. K. Dehideniya, and S. Y. Ekanayake, “The role of personal values in learning approaches and student achievements,” Behav. Sci. (Basel)., vol. 11, no. 7, pp. 1–23, 2021, doi: 10.3390/bs11070102. DOI: https://doi.org/10.3390/bs11070102
    46. M.-M. L. And and C.-C. Tu, “Developing a Project-Based Learning Course Model Combined with the Think–Pair–Share Strategy to Enhance Creative Thinking Skills in Education Students,” Educ. Sci., vol. 14, no. 233, pp. 1–18, 2024, doi: https://doi.org/10.3390/educsci14030233. DOI: https://doi.org/10.3390/educsci14030233
    47. F. A. Ismail, J. Bungsu, and M. Shahrill, “Improving Students’ Participation and Performance in Building Quantities through Think-Pair-Share Cooperative Learning,” Indones. J. Educ. Res. Technol., vol. 3, no. 3, pp. 203–216, 2023. DOI: https://doi.org/10.17509/ijert.v3i3.50348
    48. E. Sunarya and A. Atmazaki, “The Impact of the Think Pair Share Learning Model Assisted by Audiovisual Media on High School Learners’ Indonesian Speaking Skills,” J. Lang. Lang. Teach., vol. 12, no. 4, pp. 2040–2051, 2024, doi: https://doi.org/10.33394/jollt.v12i4.12638. DOI: https://doi.org/10.33394/jollt.v12i4.12638
    49. F. Nurlaika, S. Sahade, and A. Rijal, “The Effect of Cooperative Learning Model Type Think Pair Share (TPS) on Student Learning Outcomes,” Golden Ratio Data Summ., vol. 4, no. 2, pp. 641–653, 2024. DOI: https://doi.org/10.52970/grdis.v4i2.648
    50. R. Dau, S. Suciati, and J. Juhana, “The Effect of the Cooperative Learning Model Type Think Pair Share ( TPS ) on Communication Skills , Self-Efficacy , and Learning Outcomes of Students in Indonesian Language Subject,” Electron. J. Educ. Soc. Econ. Technol., vol. 6, no. 2, pp. 1–11, 2025.