THE EFFECT OF POCKET BOOKS AS NUTRITION COUNSELING MEDIA ON KNOWLEDGE AND ATTITUDES OF PROSPECTIVE BRIDE AND GROOM

The First Thousand Days of Life or 1000 HPK (Golden Period) is a critical period starting from conception until the child is 2 years old. Bride and groom are one of the target groups to improve health quality in 1000 HPK. Improving the quality of health can be done by providing pocket books as a medium for nutritional counseling. This research aims to determine the effect of pocket books as a medium for nutritional counseling on the knowledge and attitudes of prospective brides and grooms. This research uses the method true experiment research with randomized pre and posttest control group design. The number of respondents was 36 brides and grooms who registered at the Pedurungan Office of Religious Affairs (KUA) of Semarang City, which consisted of 19 interventions (given counseling and pocket books) and 17 controls (only counseled). Knowledge and attitude data were collected using a questionnaire. The test used to determine the effect between variables is the Paired Sample T-test. Results: There The Effect of Pocket Books as Nutrition Counseling Media on Knowledge and Attitudes of Prospective Bride and Groom provision of pocket books as a medium for nutritional counseling has an effect on increasing the knowledge and attitudes of the bride and groom.


INTRODUCTION
Nutritional problems in Indonesia are still dominated by malnutrition. The problem of undernutrition in women's groups, especially in the premarital period, can affect nutritional status in the next life cycle (intergenation impact) (Umisah & Puspitasari, 2017). This is because later women who will enter the period of pregnancy, breastfeeding, giving birth and dominating in taking care of children and can help realize quality HR (Human Resources) (Paratmanitya et al., 2012). Based on efforts to improve nutrition, Presidential Regulation no. 42 of 2013 concerning the National Movement for the Acceleration of Nutrition Improvement which focuses on the First 1000 Days of Life (HPK) or 1000 HPK (Nurarifah & Harjatmo, 2017).
The period of the first thousand days of life or 1000 HPK is a critical period starting from conception until the child is 2 years old. This period is also known as the "golden period" or the "Window of Opportunity" (Sulistyoningsih, 2011). Bride and groom are one of the target groups to improve health quality in 1000 HPK because they are a nutritionally vulnerable group (Supariasa, 2012). Efforts to increase knowledge and attitudes of prospective brides are one of them by being given nutritional counseling (Nurlaela et al., 2018).
Nutrition counseling media for prospective brides can be in the form of print media such as leaflets, booklets, posters and pocket books. Research conducted by Winda (2018) found that the use of pocket book media increased the knowledge of mothers of toddlers which was greater than leaflet and video media with a difference in knowledge increase of 5.3 for pocket books, 4.3 for leaflets and 4 for videos (Fahira, 2022).
Research conducted by (Nadira et al., 2017), shows that the level of knowledge of the bride and groom regarding 1000 HPK is quite sufficient as much as 57.1% and less as much as 42.9% (Kemenkes, 2015). Research conducted by (Febriani, 2016) found that the positive attitude of preconception women about nutrition and reproductive health was 18.5%, namely 5 people, while the negative attitude was 22 people (81.5%). Research conducted by (Lestari et al., 2018) regarding the level of knowledge of the bride and groom related to the First 1000 Days of Life shows that the level of knowledge of men in the less category tends to be higher than women, namely 44.1% and women, which is 35.5%.
Based on the results of a preliminary survey conducted at the Office of Religious Affairs (KUA) of Pedurungan District, there is an implementation of pre-wedding guidance for brides and grooms which is held every three months with the lecture or counseling method. The health material presented is about family reproductive health, therefore it is necessary to add counseling regarding 1000 HPK with pocket book media. Based on the description above, researchers are interested in conducting research on the effect of pocket books as a medium of nutrition counseling on the knowledge and attitudes of prospective brides and grooms at the Office of Religious Affairs (KUA) Pedurungan District, Semarang City.

RESEARCH METHOD
This research is included in the scope of community nutrition research, the type of research is true experiment with randomized pre-post test control group design. Respondents were divided into 2 groups, namely the intervention group and the control group. The total number of respondents is 42 with anticipated dropouts. Sampling was done by purposive sampling technique with accidental randomized according to the specified criteria.

Information: O1
: Initial measurement (pretest) in the intervention group O2 : Final measurement (posttest) in the intervention group Xab : Giving treatment (given nutrition counseling + pocket book for the first 1000 days of life) O3 : Initial measurement (pretest) in the control group O4 : Final measurement (posttest) in the control group (-) : Giving treatment (given nutrition counseling without pocket book the first 1000 days of life).
The independent variable in this study is the provision of pocket books as a medium for nutritional counseling, knowledge and attitudes of the prospective bride and groom as the dependent variable, while the confounding variable is the level of education of the prospective bride and groom.
The data collected are data on the characteristics of the respondents (name, age, education level, occupation and address) as well as data on knowledge and attitudes. Data was collected by direct interviews and filling out questionnaires by respondents. The results of bivariate analysis using Paired Sample T-test, Mann Whitney test, Independent T-test and ordinal regression test.

RESULT AND DISCUSSION
This research was conducted at the Office of Religious Affairs (KUA) Pedurungan District, Semarang City. There were 6 respondents who experienced drop out in both groups, so the total research respondents were 36 respondents consisting of 19 intervention groups and 17 control groups).  Paired T-Test Control Table 2 shows that the knowledge of respondents in the intervention group has a greater score increase than the control group. Based on the results of statistical tests showed that there was a significant difference in increasing knowledge between the control group and the intervention group p = 0.000 (p <0.005).

Paired T-Test Intervention (c)
Independent T-Test Table 3 shows that there was an increase in the intervention group. Based on the results of statistical tests showed that there was a significant difference in the improvement of respondents' attitudes between the control group and the intervention group p = 0.001 (p <0.05).

Characteristics of Respondents
The results of the analysis of the characteristics of the respondents can be seen in table 1. The average age of the respondents is 21 -30 years. The minimum age for women to marry is 21 years, because at that age women's reproduction is ready and does not pose a risk of anemia and chronic energy deficiency (KEK). According to the Ministry of Health (2015) there are "4 too" that can cause high-risk pregnancies, namely too young to get pregnant (less than 20 years), too old to get pregnant (less than 35 years old), too often pregnant (children more than 3), and too close or closely spaced pregnancy (less than 2 years (Kemenkes, 2015).
Characteristics of respondents based on education level, namely high school/MA in the control group, and diploma/bachelor degrees in the intervention group. Education is an effort to develop personality and abilities inside and outside school and lasts a lifetime. Education affects the learning process, the higher a person's education, the easier it is for that person to get information either from other people or from the mass media. The more information that comes in, the more knowledge will be gained about health (Pendidikan, 2013). Characteristics of respondents in the control group and the intervention group based on work, namely employees.

The Effect of Pocket Books as a Media for Nutrition Counseling on Knowledge Before and After between the Control Group and the Intervention Group
The results showed that there was a significant difference. The knowledge of respondents who were given a pocket book as a medium for nutritional counseling had better knowledge than respondents who were only given counseling. The influence on both groups was due to the measuring instrument used to assess the level of knowledge using closed-ended questions in the form of True and False (True and False). This true-false type is included in the objective test because this test has provided a number of answers making it easier for respondents to choose one correct answer (Pendidikan, 2013). It is different when using open-ended questions in the form of essays because this type of question requires broad and free answers so that it can measure the broad insight of the respondents (Azwar, 1919).
The increase in knowledge scores more in the intervention group showed that the provision of pocket books in nutrition counseling was an appropriate medium to increase knowledge, compared to the control group which was only given counseling. Because counseling is done orally without media/props so that respondents may not digest and are less interested if there is no media/props, by giving a pocket book, respondents can read independently and can ask the researcher for things that are not clear to the researcher just before filling out the posttest.
The results of this study are in line with research conducted by Dian, et al (2018) which states that there is an increase in knowledge after being given health education, so it can be concluded that there is a significant difference in knowledge between before and after being given health education (Nurlaela et al., 2018). As well as research conducted by Winda (2018) found that the use of pocket book media increases the knowledge of mothers of toddlers which is greater than leaflet and video media.

The Effect of Pocket Books as a Media for Nutrition Counseling on Attitudes Before and After between the Control Group and the Intervention Group
The results of this study are in line with research conducted by (Syah et al., 2020), namely there are differences in the attitudes of respondents before and after in the intervention group, but there is no difference in attitudes of respondents before and after in the control group. And research conducted by (Margaretha, 2015) showed that there were differences in attitudes in the treatment group and no differences in attitudes in the control group.

Influence of Education Level with Knowledge Level and Attitude of Prospective Bride and Groom in Control Group and Intervention Group
The results showed that changes in attitude occurred in respondents who were given a pocket book as a medium for nutrition counseling, while respondents who were not given a pocket book had no change in attitude. This shows that the attitude of respondents who are given a pocket book as a medium for nutritional counseling will be better than respondents who do not receive a pocket book and only receive counseling. Through a pocket book that is coherent, clear and in easy-to-understand language (adequate explanations), the respondent's erroneous attitudes can be corrected. The higher attitude scores in the intervention group showed that the provision of pocket books as a counseling medium was an appropriate method for changing attitudes, compared to the control group, which was only given counseling.
Based on table 4 shows the effect of education level with the level of knowledge and attitudes of the bride and groom in the control group and the control group intervention calculated using ordinal regression analysis. In the control group, p = 0.587 on knowledge, The p value of knowledge and attitudes in both groups > 0.05 which means Ha is rejected, so it can be concluded that the level of education does not affect the level of knowledge and attitudes in both the control group and the intervention group. knowledge and attitude scores in both the control group and the intervention group, as well as proving that the increase that occurred was not influenced by the respondent's education level.

CONCLUSION
The provision of pocket books as a medium for nutritional counseling can increase the score of knowledge and attitudes regarding the First 1000 Days of Life. There was a significant difference in the increase in knowledge and attitudes between the control group who was only given counseling and the intervention group who was given counseling along with a pocket book. There is no effect of providing nutrition counseling alone on attitude change.
For other researchers, a similar study can be conducted with the provision of 2x interventions (in the first and third weeks) and posttest evaluation (in the second and fourth weeks) to determine the effectiveness of the intervention if it is carried out more than 1x intervention. As well as being able to use knowledge measuring instruments/tools in the form of open-ended questions in order to measure the broad insight of the respondents.