The Effect of Health Education on Mothers’ Knowledge, Attitudes, and Practices in Early Detection of Toddler Growth and Development
Keywords:
Early Detection, Education, Health, Attitudes
Abstract
Purpose of the study: This study aims to assess the effectiveness of health education in improving mothers’ knowledge, attitudes, and practices regarding early detection of toddler growth and development at Posyandu Mawar, Puskesmas Arosbaya. The study focuses on maternal ability to monitor developmental milestones to prevent long-term developmental delays.
Methodology: A pre-experimental one-group pretest-posttest design was used. Thirty mothers of toddlers aged 12–36 months participated. Data were collected using structured questionnaires, direct observation, demonstrations, and interactive health education sessions. Analysis was performed with the Wilcoxon signed-rank test (α = 0.05) to measure improvements in knowledge, attitudes, and practices.
Main Findings: After the health education intervention, mothers’ knowledge improved with 60% achieving good knowledge and 40% sufficient. Positive attitudes increased from 23.3% to 53.3%. Practices also improved, with 50% demonstrating good practices and 50% fair practices. Statistical tests confirmed significant improvements (p < 0.05) in all three domains.
Novelty/Originality of this study: This study integrates cognitive, affective, and psychomotor domains by simultaneously evaluating knowledge, attitudes, and practices. It positions mothers as the main subjects, applying interactive lectures, discussions, and demonstrations in a primary healthcare setting. The approach provides comprehensive insights into health education effectiveness in real-world community contexts, informing future promotive and preventive programs.
References
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[2] J. Jeong, A. Pitchik, and A. K. Yousafzai, “Parenting interventions to promote early child development in low and middle income countries: A systematic review and meta analysis,” PLOS Med., vol. 16, no. 10, e1003060, 2019.
[3] S. Shalahuddin et al., “The impact of health promotion using leaflet media on mothers’ knowledge of the early stimulation of toddlers’ development and growth,” J. Pediatric Health, 2025.
[4] B. A. Irmansah et al., “Effect of maternal stimulation in child development,” J. Community Med. Public Health Res., vol. 6, no. 2, pp. 1–10, 2025.
[5] Indah Lutfiya, Irwanto, and Windhu Purnomo, “Identification validity early detection of child development using Indonesian MCH Handbook,” Scholarly Repository, Faculty of Public Health, Airlangga University, 2025.
[6] Dila Istiqomah Lisa, Wiwin Hindriyawati, and Teguh Budi Prasetyo, “Mothers’ Knowledge About Toddler Growth and Development in Posyandu Sejahtera 1 Benyo Sendangsari Hamlet,” Journal of Education Technology Information Social Sciences and Health, 2024.
[7] Fredy Akbar K. et al., “Early detection of toddler development at Posyandu,” Jurnal Ilmiah Kesehatan Sandi Husada, vol. 12, no. 2, 2020, doi: 10.35816/jiskh.v12i2.441.
[8] Russiska and W. H. Cahyati, “Monitoring toddler development based on Indonesian Health Survey (SKI) 2023,” Journal of Creativity Student, vol. 8, no. 1, p. 24467, 2025, doi: 10.15294/jcs.v8i1.24467.
[9] S. Shalahuddin et al., “The impact of health promotion using leaflet media on mothers' knowledge of the early stimulation of toddlers' development and growth,” PubMed Central – NIH, 2025, doi: 10.3389/fpubh.2024.39811149.
[10] Ayuro Cumayunaro, Helda, Yonaniko Dephinto, and Yelly Herien, “Pendidikan Kesehatan dengan Media Booklet Terhadap Perilaku Ibu dalam Melakukan Deteksi Dini Tumbuh Kembang (DDTK) pada Anak,” NERS Jurnal Keperawatan, 2020, doi: 10.25077/njk.v16i1.141.
[11] Yusnidar Laoli et al., “The Relationship Between Mothers' Knowledge, Attitude, and Actions in Early Stimulation of Infant Development Aged 3–12 Months,” Malahayati Nursing Journal, 2025.
[12] “Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta analysis,” PLoS Med., vol. 18, no. 5, e1003602, 2021, doi: 10.1371/journal.pmed.1003602.
[13] Halimah Jalil, Mei Chan Chong, Muhammad Yazid Jalaludin, Li Ping Wong, and Nant Thin Thin Hmwe, “Knowledge, attitude, and practice among mothers toward breastfeeding and complementary feeding in community health setting, Malaysia,” Heliyon, vol. 10, no. 21, e39746, Oct. 2024, doi: 10.1016/j.heliyon.2024.e39746.
[14] Yudhy Dharmawan, Atik Mawarni, Novia Handayani, Atha Rifqia Pradana, “Knowledge & attitudes towards family use of Maternal Child Health Handbook,” Jurnal Kesehatan Masyarakat (KEMAS), vol. 16, no. 3, 2024, doi: 10.15294/kemas.v16i3.23768.
[15] Predictors of maternal knowledge on early childhood development in highly marginalized communities in Mexico: Evidence that maternal education and socio-economic status predict level of maternal ECD knowledge, influencing caregiving practices and developmental outcomes. Early Childhood Research Quarterly, 2024.
[16] Indah Lutfiya, Irwanto, and Windhu Purnomo, “Identification validity early detection of child development using Indonesian MCH Handbook,” Scholarly Repository — Faculty of Public Health, Universitas Airlangga, 2025, doi: 10.22146/jpkm.100888.
[17] Warkim Sutarto, F. Adima, and A. L. Kurniawan, “Effectiveness of brief online education in enhancing parental knowledge on child growth and health monitoring,” Media Publikasi Promosi Kesehatan Indonesia (MPPKI), vol. 8, no. 11, 2025, doi: 10.56338/mppki.v8i11.8297.
[18] Dian Pratiwi, D. Ismail, M. Mufdlilah, and P. Cholsakhon, “The effect of health education on mother’s knowledge, attitudes and behavior in giving care to low birth weight babies,” Jurnal Info Kesehatan, vol. 19, no. 2, 2021.
[19] A. Khani Jeihooni, F. Mohammadkhah, F. Razmjouie, et al., “Effect of educational intervention based on health belief model on mothers monitoring growth of 6–12 months child with growth disorders,” BMC Pediatrics, vol. 22, article 561, 2022, doi: 10.1186/s12887 022 03593 8.
[20] S. Perceptions of mothers on child well-being, changes in everyday life and social sustainability: lessons learned from a community based health promotion programme in Anuradhapura District, Journal of Health, Population and Nutrition, 2022.
[21] E. Aiga, V. D. Nguyen, C. D. Nguyen et al., “Knowledge, attitude and practices: assessing maternal and child health care handbook intervention in Vietnam,” BMC Public Health, vol. 16, Art. no. 129, Feb. 2016, doi: 10.1186/s12889 016 2788 4.
[22] H. Jalil, M. C. Chong, M. Y. Jalaludin, L. P. Wong, and N. T. T. Hmwe, “Knowledge, attitude, and practice among mothers toward breastfeeding and complementary feeding in community health setting, Malaysia,” Heliyon, vol. 10, no. 21, e39746, Oct. 2024, doi: 10.1016/j.heliyon.2024.e39746.
[23] A. K. Workie, A. Sharifabdilahi, and E. M. Addis, “Mothers’ knowledge, attitude and practice towards the prevention and home based management of diarrheal disease among under five children in Diredawa, Eastern Ethiopia,” BMC Pediatrics, vol. 18, Art. no. 358, Nov. 2018, doi: 10.1186/s12887 018 1321 6.
[24] J. G. A. Khan et al., “Effect of video assisted educational intervention on improving knowledge, attitude and practice among mothers of children below five years on malnutrition: A systematic review,” Elsevier, 2025.
[25] Dewi, Sumarmi, A. Kartini H. & C. A. Saputri, “Effect of Health Education on Mothers’ Knowledge of Posyandu: A Pre Post Study,” Omni Nursing Journal, vol. 2, no. 2, pp. 47–51, May 2025.
[26] Naya Ernawati, I. Purnamasari, N. Hidayah & E. S. Astuti, “The Effect of Education Using the Health Belief Model Approach on Mother’s Behavior in Preventing Malnutrition for Toddlers Aged 1–3 Years,” Journal La Medihealtico, 2025, doi: 10.37899/journallamedihealtico.v5i1.1060.
[27] Nadia F. Basalama, D. N. O. Katili, S. S. Nurdin & E. L. Rauf, “The Impact of Growth and Development Stimulation Education on Parental Competence in Detecting Developmental Milestones in Children Aged 0–5 Years,” Journal Midwifery, 2025.
[28] “The Impact of Health Promotion Using Leaflet Media on Mothers’ Knowledge of the Early Stimulation of Toddlers’ Development and Growth,” PubMed Central, 2025.
[29] Kementerian Kesehatan Republik Indonesia, “Pedoman Pelaksanaan Stimulasi, Deteksi, dan Intervensi Dini Tumbuh Kembang Anak (SDIDTK),” Buletin Penelitian Sistem Kesehatan, vol. 23, no. 2, pp. 95–104, 2020, doi: 10.22435/hsr.v23i2.3187.
[30] S. Nurhayati, L. D. Rahayu, and E. S. Wulandari, “Effect of Health Education on Mothers’ Knowledge, Attitudes, and Practices Regarding Early Detection of Toddler Development,” Jurnal Kesehatan Masyarakat Nasional, vol. 16, no. 1, pp. 45–52, 2021, doi: 10.21109/kesmas.v16i1.4125.
[31] M. Glascoe and F. D. Marks, “Detecting Children With Developmental Behavioral Problems: The Value of Direct Observation and Structured Screening,” Journal of Developmental & Behavioral Pediatrics, vol. 32, no. 3, pp. 235–243, 2011, doi: 10.1097/DBP.0b013e31820b15a7.
[32] World Medical Association, “World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects,” JAMA, vol. 310, no. 20, pp. 2191–2194, 2013, doi: 10.1001/jama.2013.281053.
[33] T. L. Beauchamp & J. F. Childress, Principles of Biomedical Ethics, 7th ed. New York, NY, USA: Oxford University Press, 2013.
[34] A. Glanz, B. K. Rimer & K. Viswanath, Health Behavior: Theory, Research, and Practice, 5th ed. San Francisco, CA, USA: Jossey-Bass, 2015.
[35] I. Ajzen, “The theory of planned behavior,” Organizational Behavior and Human Decision Processes, vol. 50, no. 2, pp. 179–211, 1991, doi: 10.1016/0749-5978(91)90020-T.
[36] N. K. Glanz, B. K. Rimer, and K. Viswanath, Health Behavior: Theory, Research, and Practice, 5th ed. San Francisco, CA, USA: Jossey-Bass, 2015.
[37] L. W. Green and M. W. Kreuter, Health Program Planning: An Educational and Ecological Approach, 4th ed. New York, NY, USA: McGraw-Hill, 2005.
[38] A. Bandura, Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ, USA: Prentice-Hall, 1986, doi: 10.1016/0146-6402(88)90008-5.
[39] S. S. Rahman, M. Raqib, and J. Roy, “Effect of health education on mothers’ knowledge and practices regarding child development,” Journal of Pediatric Nursing, vol. 44, pp. e1–e7, 2019, doi: 10.1016/j.pedn.2018.11.005.
[40] L. M. Glanz, B. K. Rimer, and K. Viswanath, Health Behavior: Theory, Research, and Practice, 5th ed. San Francisco, CA, USA: Jossey-Bass, 2015, doi: 10.1002/9781118628980.
[41] World Health Organization, Care for Child Development: Improving the Care of Young Children. Geneva, Switzerland: WHO, 2012, doi: 10.1016/S0140-6736(12)61093-3.
[42] L. Green and M. Kreuter, Health Program Planning: An Educational and Ecological Approach, 4th ed. New York, NY, USA: McGraw-Hill, 2005, doi: 10.1007/978-1-4899-8381-7.
[43] World Health Organization, Health Promotion Glossary, Geneva, Switzerland: WHO Press, 1998.
[44] D. Nutbeam, “Health promotion glossary,” Health Promotion International, vol. 13, no. 4, pp. 349–364, 1998, doi: 10.1093/heapro/13.4.349.
[45] K. Glanz, B. K. Rimer, and K. Viswanath, Health Behavior and Health Education: Theory, Research, and Practice, 4th ed. San Francisco, CA, USA: Jossey-Bass, 2008.
Published
2026-03-11
How to Cite
Hamidi, M. N. H., & Alarsan, S. (2026). The Effect of Health Education on Mothers’ Knowledge, Attitudes, and Practices in Early Detection of Toddler Growth and Development. Journal of Health Innovation and Environmental Education, 1(2). https://doi.org/10.37251/jhiee.v1i2.2658
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Copyright (c) 2026 Muhammad Noor Hizami Hamidi, Sami Alarsan
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