How to cite:
Arvina Dian Wahyu Permatasari, Astidio Noviardhi, Meirina Dwi
Larasati, J. Supadi, Yuwono Setiadi. (2022). The Effect of Pocket
Books as Nutrition Counseling Media on Knowledge and Attitudes of
Prospective Bride and Groom.Journal Eduvest. Vol 2(8): 1.487-1.494
E-ISSN:
2775-3727
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https://greenpublisher.id/
Eduvest –Journal of Universal Studies
Volume 2 Number 8, August, 2022
p-ISSN 2775-3735-e-ISSN 2775-3727
THE EFFECT OF POCKET BOOKS AS NUTRITION
COUNSELING MEDIA ON KNOWLEDGE AND ATTITUDES
OF PROSPECTIVE BRIDE AND GROOM
Arvina Dian Wahyu Permatasari, Astidio Noviardhi, Meirina Dwi Larasati,
J. Supadi, Yuwono Setiadi
Poltekkes Kemenkes Semarang, Indonesia
Email: [email protected], [email protected],
meirinadwilarasati@yahoo.co.id, j.su[email protected],
ABSTRACT
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 was an
effect of pocket books as a medium of nutrition counseling on
knowledge in the intervention group (p=0.000) and control
(p=0.000) and intervention attitude (p=0.000), but there was
no effect on control attitudes (p=0.438). Knowledge of
respondents in the intervention group increased by 10.26 while
attitudes increased by 11.32. This study concludes that the
Arvina Dian Wahyu Permatasari, Astidio Noviardhi, Meirina Dwi Larasati, J. Supadi,
Yuwono Setiadi
The Effect of Pocket Books as Nutrition Counseling Media on Knowledge and Attitudes
of Prospective Bride and Groom 1.488
provision of pocket books as a medium for nutritional
counseling has an effect on increasing the knowledge and
attitudes of the bride and groom.
KEYWORDS
Pocket Book, Nutrition Counseling, Knowledge, Attitude of
Bride and Groom
This work is licensed under a Creative Commons
Attribution-ShareAlike 4.0 International
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.
Eduvest –Journal of Universal Studies
Volume 2 Number 8, August 2022
1.489 http://eduvest.greenvest.co.id
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).
1. Characteristics of Respondents
Table 1. Frequency Distribution of Respondents' Characteristics in the Control
Group and Intervention Group
Variable
Control
Intervention
Total
(n)
(%)
(n)
(%)
(n)
(%)
Age
< 20
2
11.8
1
5.3
3
8.3
21 - 30
10
58.8
13
68.4
23
63.9
> 30
5
17.6
5
26.3
10
27.8
Arvina Dian Wahyu Permatasari, Astidio Noviardhi, Meirina Dwi Larasati, J. Supadi,
Yuwono Setiadi
The Effect of Pocket Books as Nutrition Counseling Media on Knowledge and Attitudes
of Prospective Bride and Groom 1.490
Education
Graduated Middle
School/MTS
1
5.9
0
0
1
2.8
Graduated high school /
MA
10
58.8
9
47.7
19
52.8
Graduated
Diploma/Bachelor
6
35.5
10
52.6
16
44.4
Type of work
Doesn't work
3
17.6
3
15.8
6
16.7
Employee
7
41.2
9
47.4
16
44.4
Self-employed
6
35.3
5
26.3
11
30.6
Farmer/fisherman/labor
0
0
1
5.3
1
2.8
Other
1
5.9
1
5.3
2
5.6
1. The Effect of Pocket Books as a Media for Nutrition Counseling on Knowledge
Before and After between the Control Group and the Intervention Group
Table 2. Effects and Differences in Pretest and Posttest Knowledge Scores in the Control
Group and the Intervention Group
Knowledge
Attitude
Group
Control (n=17)
Intervention (n=19)
p
value
n
%
Mean±SD
n
%
Mean±SD
Pretest
55.29±8.19
56.84±12.38
Good > 80%
0
0
0
0
0.000
(a)
Enough 60 - 80%
6
35.3
7
36.8
Not Enough <
60%
11
64.7
12
63.2
Posttest
64.71±9.43
81.05±9.94
Good > 80%
1
5.9
8
42.1
0.000
(b)
Enough 60 - 80%
12
70.6
11
57.9
Not Enough <
60%
4
23.5
0
0
Difference
10.26
25.87
0.000
(c)
(a)
Paired T-Test Control
(b)
Paired T-Test Intervention
(c)
Mann-Whitney Test
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).
2. The Effect of Pocket Books as a Media for Nutrition Counseling on Attitudes Before
and After between the Control Group and the Intervention Group
Table 3. Effects and Differences in Pretest and Posttest Attitude Scores in the
Control Group and the Intervention Group
Group
Eduvest –Journal of Universal Studies
Volume 2 Number 8, August 2022
1.491 http://eduvest.greenvest.co.id
Attitude
Category
Control (n=17)
Intervention (n=19)
p
value
n
%
Mean±SD
n
%
Mean±SD
Pretest
49.14±8.47
44.06±7.64
Support
(Score T > 50%)
8
47.1
4
21.1
0.438
(a)
No Support
(Score T < 50%)
9
52.9
15
75.0
Posttest
50.86±11.53
55.94±8.52
Support
(Score T > 50%)
9
52.9
15
75.0
0.000
(b)
No Support
(Score T < 50%)
8
47.1
4
21.1
Difference
-12±10.851
11.32±7.071
0.001
(c)
(a)
Paired T-Test Control
(b)
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).
3. The Effect of Education Level with Knowledge Level and Attitude of Prospective
Bride and Groom in the Control Group and the Intervention Group
Table 4. The Effect of Education Level with Knowledge Level and Attitude
Group
P
Knowledge
Attitude
Control
0.587
0.772
Intervention
0.465
0.906
Discussion
1. 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.
Arvina Dian Wahyu Permatasari, Astidio Noviardhi, Meirina Dwi Larasati, J. Supadi,
Yuwono Setiadi
The Effect of Pocket Books as Nutrition Counseling Media on Knowledge and Attitudes
of Prospective Bride and Groom 1.492
2. 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.
3. 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.
4. 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,
Eduvest –Journal of Universal Studies
Volume 2 Number 8, August 2022
1.493 http://eduvest.greenvest.co.id
and p = 0.772 on attitude. While in the intervention group, p = 0.465 on knowledge and p
= 0.906 on attitude.
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.
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