Empowering cadres: the impact of KEPITING, a web-based application on stunting knowledge and attitudes
Downloads
Introduction: Stunting, an indicator of chronic malnutrition, affects children under five. Cadres hold strategic positions to enhance this. Despite the launch of digital applications designed to address stunting by enhancing knowledge and attitudes, their lasting impacts and usability have not been thoroughly evaluated, especially among cadres.
Methods: We conducted a longitudinal study to evaluate the long-term impact and usability of our web-based app KEPITING (Kader Peduli Stunting) to enhance knowledge and attitudes towards stunting detection among cadres covering two Districts in Jambi. We obtained 152 cadres as participants using purposive sampling, separated into two groups based on their respective districts—one using KEPITING and the other traditional training materials. Data were collected at pre-intervention, post-intervention, and nine months post- intervention using validated questionnaires to assess knowledge and attitude changes. A generalized Linear Model with Repeated Measures ANOVA and Mann-Whitney U tests was employed to examine the effects and interactions.
Results: KEPITING significantly improved knowledge of practical procedures (p <0.001) and nutritional interventions (p <0.001). Overall attitude improved significantly (p = 0.008, η = 0.033). Knowledge retention showed no significant time effect, whereas attitudes improved over time and were better retained in the intervention group. The System Usability Scale scored below an average of 58.7, indicating that usability improvements were needed.
Conclusions: KEPITING enhances cadre knowledge and attitudes but requires usability enhancements for optimal impact. This study highlights the importance of digital tools in stunting interventions and suggests areas for future research focusing on usability and long-term efficacy.
Ahmad, H., Alwi, F. and Hadi, A.J. (2023) ‘Contribution of the Role of Health Cadres in the Prevention of Stunting in Toddlers’, Jurnal Aisyah : Jurnal Ilmu Kesehatan, 8(3). Available at: https://doi.org/10.30604/jika.v8i3.2483.
Balaman, F. and ATAMAN>, Ü. (2022) ‘Teacher Opinions on the Usability of Digital Stories in Pre- School Values Education’, Disiplinlerarası Eğitim Araştırmaları Dergisi, 6(13), pp. 353–362. Available at: https://doi.org/10.57135/jier.1160170.
Begantsova, I.S., Акутина, С.П. and Щелина, Т.Т. (2020) ‘The Question of Students’ Preparedness for Studying in the Digital Educational Environment’. Available at: https://doi.org/10.3897/ap.2.e0207.
Brown, M. et al. (2016) ‘Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review’, Jmir Mental Health, 3(3), p. e39. Available at: https://doi.org/10.2196/mental.5710.
Côté, J. et al. (2020) ‘Effectiveness of a Web-Based Intervention to Support Medication Adherence Among People Living With HIV: Web-Based Randomized Controlled Trial’, Jmir Public Health and Surveillance, 6(2), p. e17733. Available at: https://doi.org/10.2196/17733.
Eysenbach, G. (2011) ‘CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-Based and Mobile Health Interventions’, Journal of Medical Internet Research, 13(4), p. e126. Available at: https://doi.org/10.2196/jmir.1923.
Fary, R. et al. (2015) ‘Policy‐Into‐Practice for Rheumatoid Arthritis: Randomized Controlled Trial and Cohort Study of E‐Learning Targeting Improved Physiotherapy Management’, Arthritis Care & Research, 67(7), pp. 913–922. Available at: https://doi.org/10.1002/acr.22535.
Fazrina, G. and Cahyaningrum, H. (2022) ‘Meta-Analysis: Effectiveness of Web-Based Intervention to Increase Physical Activity in Older People’, Journal of Health Promotion and Behavior, 7(1), pp. 55–66. Available at: https://doi.org/10.26911/thejhpb.2021.07.01.06.
Hyzy, M. et al. (2022) ‘System Usability Scale Benchmarking for Digital Health Apps: Meta-analysis’, JMIR mHealth and uHealth, 10(8), p. e37290. Available at: https://doi.org/10.2196/37290.
Julianti, E. and Elni, E. (2023) ‘The Intervention Package Increases the Readiness of Health Post Cadres to Preventing Stunting in Children’, Jurnal Aisyah : Jurnal Ilmu Kesehatan, 8(1). Available at: https://doi.org/10.30604/jika.v8i1.1409.
Kharaman-nia, F. et al. (2023) ‘Comparing the Effects of Self- Care Education by Lecture and Smartphone Application on Self-Efficacy of Patients With Thalassemia’, BMC Medical Informatics and Decision Making [Preprint]. Available at: https://doi.org/10.1186/s12911-023-02097-4.
Klímová, B. and Pikhart, M. (2023) ‘Cognitive Gain in Digital Foreign Language Learning’, Brain Sciences, 13(7), p. 1074. Available at: https://doi.org/10.3390/brainsci13071074.
Korkmaz, G. and Toraman, Ç. (2021) ‘Exploring Medical Students’ Readiness for E-Learning and Knowledge Sharing Behaviors in Emergency Remote Learning Environments During Covid-19’, Journal of Education in Science Environment and Health [Preprint]. Available at: https://doi.org/10.21891/jeseh.960141.
Lestari, E. et al. (2024) ‘Stunting and its association with education and cognitive outcomes in adulthood: A longitudinal study in Indonesia’, PLOS ONE, 19(5), p. e0295380. Available at: https://doi.org/10.1371/journal.pone.0295380.
McDonough, D.J., Liu, W. and Gao, Z. (2020) ‘Effects of Physical Activity on Children’s Motor Skill Development: A Systematic Review of Randomized Controlled Trials’, Biomed Research International, 2020, pp. 1–14. Available at: https://doi.org/10.1155/2020/8160756.
Mutapi, F. et al. (2021) ‘Assessing early child development and its association with stunting and schistosome infections in rural Zimbabwean children using the Griffiths Scales of Child Development’, PLOS Neglected Tropical Diseases, 15(8), p. e0009660. Available at: https://doi.org/10.1371/journal.pntd.0009660.
Ristkari, T. et al. (2019) ‘Web-Based Parent Training Intervention With Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real-World Practice: Implementation Study’, Journal of Medical Internet Research, 21(4), p. e11446. Available at: https://doi.org/10.2196/11446.
Tampake, R. et al. (2021) ‘The Effectiveness of Training on Improving the Ability of Health Cadres in Early Detection of Stunting in Toddlers’, Open Access Macedonian Journal of Medical Sciences, 9(E), pp. 373–377. Available at: https://doi.org/10.3889/oamjms.2021.6067.
WHO (2024) Prevalence of stunting in children under 5 (%). Retrieved from WHO Data, WHO Data.
Wysocki, T. et al. (2018) ‘A Web-Based Coping Intervention by and for Parents of Very Young Children With Type 1 Diabetes: User-Centered Design’, Jmir Diabetes, 3(4), p. e16. Available at: https://doi.org/10.2196/diabetes.9926.
Zanden, R. v. d. et al. (2014) ‘Web-Based Depression Treatment: Associations of Clients׳ Word Use With Adherence and Outcome’, Journal of Affective Disorders, 160, pp. 10–13. Available at: https://doi.org/10.1016/j.jad.2014.01.005.
Copyright (c) 2025 Jurnal Ners
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Jurnal Ners agree to the following terms:
- Authors transfer the Copyright and grant Jurnal Ners the right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to remix, adapt and build upon the work with an acknowledgment of the work's authorship and of the initial publication in Jurnal Ners.
- Authors are permitted to copy and redistribute the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Jurnal Ners.
Jurnal Ners requires a formal written declaration and transfer of copyright from the author(s) for each article published. We, therefore, ask you to complete and return this form, retaining a copy for your own records. Your cooperation is essential and appreciated. Any delay will result in a delay in publication. The form can be downloaded HERE.
