Pengembangan Metode Pendidikan Gizi pada Siswa dan Orangtua serta Pengaruhnya terhadap Perilaku Konsumsi Sayur, Buah dan Ikan
Date
2021Author
Sofianita, Nur Intania
Khomsan, Ali
Setiawan, Budi
Ekayanti, Ikeu
Metadata
Show full item recordAbstract
Perilaku konsumsi kurang sayur, buah dan ikan masih menjadi masalah gizi di
Indonesia. Sayur dan buah merupakan sumber vitamin, mineral dan serat yang
dibutuhkan tubuh dan ikan adalah salah satu sumber protein yang mengandung omega 3
yang baik untuk perkembangan otak anak. Salah satu upaya untuk meningkatkan
konsumsi secara langsung dengan menyediakan sayur, buah dan ikan di rumah dan
pemberian pendidikan gizi untuk meningkatkan pengetahuan, membangun sikap positif
dan perilaku konsumsi yang baik pada siswa, guru dan orangtua. Penelitian ini bertujuan
untuk mengembangkan dan menguji efektifitas metode pendidikan gizi pada siswa dan
orangtua serta pengaruhnya terhadap perilaku konsumsi sayur, buah dan ikan.
Penelitian dilaksanakan dalam tiga tahap. Tahap pertama adalah studi pendahuluan
dengan desain cross sectional menggunakan metode kualitatif dan kuantitatif. Tahap
pertama ini mengidentifikasi pengetahuan,sikap, perilaku konsumsi, ketersediaan pangan
dan status gizi pada 433 siswa sekolah dasar. Wawancara dan focus group discussion
(FGD) untuk mengkaji dukungan Dinas Kesehatan dan Dinas Pendidikan pada sekolah
dan keluarga. Tahap kedua mengembangkan metode pendidikan gizi, pembuatan modul,
modifikasi pesan, media dan metode pendidikan gizi sayur, buah dan ikan; dilanjutkan
uji kelayakan dan uji coba metode pada siswa, guru, dan orangtua. Hasil uji digunakan
untuk merevisi pesan dan metode pendidikan gizi. Tahap ketiga menganalisis intervensi
pendidikan gizi menggunakan desain pretest and postest control group design,
melibatkan lima kelompok studi.
Hasil studi pendahuluan menunjukkan tidak ditemukan kebijakan/program khusus
untuk meningkatkan konsumsi sayur, buah dan ikan untuk siswa sekolah dan masih
kurang lengkapnya kompetensi mengenai gizi seimbang di dalam kurikulum, sebagian
besar siswa memiliki pengetahuan gizi kurang, sikap gizi dengan kategori cukup, serta
tidak semua siswa terbiasa makan sayur, buah dan ikan. Sayur, buah dan ikan jarang
tersedia di rumah, masih terdapat siswa dengan status gizi sangat kurus dan kurus (8,7%),
gizi lebih dan obesitas (11,5%). Rata-rata konsumsi sayur, buah dan ikan siswa masih
rendah. Hasil identifikasi pada tahap pendahuluan menjadi dasar pengembangan dan
analisis kebutuhan pesan/materi metode pendidikan gizi pada tahap dua. Hasil uji
kelayakan menunjukkan bahwa metode ceramah dan video mempunyai desain yang
cukup menarik, pesan cukup jelas serta dapat dipahami dan bermanfaat bagi responden.
Hasil uji coba menunjukkan bahwa pendidikan gizi pada metode ceramah dan video
meningkatkan pengetahuan, sikap dan praktik responden sesudah intervensi. Hasil
evaluasi pelaksanaan intervensi pada siswa, orangtua, dan guru harus dilaksanakan di
ruangan yang terpisah, agar dapat fokus pada informasi gizi yang diberikan,
memperbanyak gambar, penjelasan yang singkat dan merevisi kata-kata sulit dalam
materi pendidikan gizi. Minimnya keikutsertaan guru karena faktor kesibukan sehingga
peneliti mempertimbangkan untuk tidak mengikutkan guru dalam tahap tiga. Tahap tiga
adalah intervensi pendidikan gizi menggunakan desain pretest and postest control group
design yang diikuti oleh 85 siswa dan 51 ibu. Intervensi ini bertujuan untuk mengetahui
efektifitas pendidikan gizi terhadap kelompok intervensi dan metode intervensi yang
efektif digunakan dalam pendidikan gizi. Terdapat lima kelompok studi; (A) kelompok
siswa;orangtua dengan metode video;permainan, (B) kelompok siswa dengan metode
video;permainan, (C) kelompok siswa dengan metode ceramah;praktik, (D) kelompok
siswa;orangtua dengan metode ceramah;praktik dan, (E) kelompok kontrol
siswa;orangtua. Pendidikan gizi melalui ceramah dan video diberikan sebanyak empat
kali dalam waktu empat minggu. Hasil uji N-gain score menunjukkan pendidikan gizi
cukup efektif dalam meningkatkan pengetahuan pada semua kelompok intervensi
pendidikan gizi, peningkatan sikap paling efektif pada kelompok (A), dan cukup efektif
meningkatkan praktik pada kelompok (D). Efektifitas pendidikan gizi terhadap
pengetahuan, sikap dan praktik ibu menunjukkan bahwa pendidikan gizi tidak efektif
meningkatkan pengetahuan dikarenakan pengetahuan ibu sudah cukup baik sebelum
intervensi, namun kedua metode efektif meningkatkan sikap ibu, dan metode
ceramah;praktik cukup efektif meningkatkan praktik ibu.
Simpulan hasil penelitian sebagai berikut: (1) tidak ditemukan dukungan kebijakan
pemerintah dalam meningkatkan konsumsi sayur, buah dan ikan pada siswa sekolah
dasar, (2) tidak ditemukan dukungan sekolah, kurangnya dukungan keluarga dan masih
kurang lengkapnya kompetensi dalam kurikulum sekolah dasar dalam upaya
meningkatkan konsumsi sayur, buah dan ikan pada siswa, (3) masih terdapat siswa
dengan status gizi sangat kurus dan kurus (8,7%) dan gizi lebih dan obesitas sebesar
(11,5%), siswa dengan ISPA sebesar (66%), diare (18%) dan tifus (16%). (4) terdapat
hubungan yang signifikan antara perilaku konsumsi sayur dan buah dengan karakteristik
siswa (jenis kelamin dan umur), ketersediaan pangan, dan sikap siswa (5) uji kelayakan
materi pada metode ceramah dan video dinilai mempunyai desain yang cukup menarik,
pesan yang cukup jelas, dapat dipahami dan bermanfaat, (6) pendidikan gizi cukup efektif
dalam meningkatkan pengetahuan pada semua kelompok studi yang diberikan intervensi
dibandingkan kelompok kontrol. Namun untuk peningkatan praktik cukup efektif hanya
pada kelompok intervensi siswa;orangtua metode ceramah;praktik. Hasil food record
menunjukkan bahwa terdapat pengaruh intervensi pada kelompok siswa dengan
keterlibatan orangtua pada metode video;permainan. (7) pendidikan gizi yang melibatkan
orangtua berpengaruh secara signifikan terhadap peningkatan pengetahuan, sikap dan
praktik ibu pada kelompok intervensi dibandingkan kelompok kontrol. Hasil uji N-gain
score menunjukkan pendidikan gizi tidak efektif meningkatkan pengetahuan ibu
dikarenakan pengetahuan ibu sudah cukup baik sebelum intervensi, namun efektif
meningkatkan sikap dan praktik ibu.
Rekomendasi dari penelitian ini: (1) merumuskan kebijakan tertulis oleh
kementerian terkait untuk mendukung peningkatan konsumsi sayur, buah dan ikan siswa
sekolah dasar, (2) mempertimbangkan untuk melengkapi kurikulum sekolah dengan
materi gizi seimbang, (3) melibatkan orangtua siswa dalam pendidikan gizi agar dapat
meningkatkan ketersediaan dan keterampilan orangtua untuk variasi menu, mengolah
sayur, buah dan ikan secara kreatif, sehat, bergizi dan disukai oleh anak-anak. The behaviour of inadequate consumption of vegetables, fruit and fish remains as
one nutritional problem in Indonesia. Vegetables and fruits are sources of vitamin,
minerals, and fiber that the body needs, and fish becomes the protein source with omega
3 content that good for the children’s brain development. One of the effort to increase the
direct consumption of these food sources is providing vegetables, fruit and fish at home
and giving a nutritition education to add the knowledge, build positive attitudes and create
a good consumption behaviour in students, teachers and parents. This study aims to
develop and to test the effectiveness of nutrition education method on students and parents
also its effect on the consumption behaviour of vegetables, fruits and fish.
The study was carried out in three stages. First stage is a preliminary study with a
cross sectional design by employing qualitative and quantitative research methods. The
first stage identifies the level of knowledge, attitudes, consumption behaviour, food
availability and nutritional status of 433 students in elementary grade. There were
interview sessions and focus group discussion (FGD) held to assess the Health
Department and Local Education Department support in the particular schools and the
families. The second stage is a stage to develop nutrition education methods, making
research modules and modifying messages, media, and method for delivering the
nutrition education about the nutrients of vegetables, fruits and fish; which will be
followed by a feasibility test and a method trial on students, teachers, and parents. The
test results will be used to revise the messages and methods from the nutrition education.
Meanwhile, the third stage will analyze the intervention of the nutrition education by
applying a pretest and postest control group designs which involving five study groups.
The result of the preliminary study showed no specific policy/program for
increasing the consumption of vegetables, fruits and fish in students and because of the
lackness competency about a balanced nutrition in the school curriculum make most
students have a poor nutritional knowledge but adequate nutritional attitude, however, not
all students are accostumed in eating vegetables, fruits and fish. These food types are
rarely available at their homes and yet there are some students found with severe wasting
and wasting nutrititional status by 8.7 %, while students in overweight and obesity
nutritional status were 11.5 %. The students’ average consumption of vegetables, fruits
and fish still consider low. Then, the identification result at the preliminary stage will
become the basis to develop and analyze the needs for constructing messages/materials
for the second stage of the nutrition education method. The feasibility test result showed
that the video and explanation (lectures) method have a quite attractive design with quite
clear messages to be easily understood and useful for the respondents. Whereas the trial
results showed that nutrition education which delivered by lectures and video methods
able to improve the knowledge, attitudes, and practices from the respondents after the
intervention. The evaluation results from the implementation of intervention for students,
parents, and teachers must be held in separate rooms to make respondents focus on the
provided nutritional information, to give more pictures, more brief explanations and
revise some difficult words in nutrition education materials. The minimum contribution
from teachers due to their busy activities make the reseachers must consider not to include
teachers in the third stage of nutrition education program. The third stage is a nutrition
education intervention by employing a pretest and postest control group design which
attended by 85 students at elementary grade and 51 mothers. The intervention aims to
find out the efectiveness of a nutrition education on the intervention group also to find
out the effective intervention method to employ for nutrition education. There are five
study groups involved in this stage: (A) group of students ; parents using video ; game
method, (B) group of students using video ; game method, (C) group of students using
lecture ; practice method, (D) group of students ; parents using lecture ; practice method
and, ( E) group of students ; parents as the control group. The nutrition education method
through lecture and video is given four times within four weeks. The N-gain score test
result showed that the nutrition education is quite effective in increasing knowledge in all
intervention groups where the most effective result found in group A, and quite effective
to improve practices which found in group D. The effectiveness of nutrition education to
mother’s knowledge, attitudes and practices is ineffective to increase knowledge in
mothers because their initial knowledge are quite sufficient even before the intervention,
however, both methods are effective for improving the mother’s attitudes and the lecture ;
practice method is quite effective in improving the mother’s nutrition education practice.
The conclution of this research are as follow: (1) there is no support in a form of
government policies to increase the consumption of vegetables, fruits and fish in students
at elementary grade, (2) there is no support from school, lack of family support, and
incomplete competency about nutrition knowledge inside school’s curriculum in an effort
to increase the vegetables, fruits and fish consumption among their students, (3) there still
found students with severe wasting and wasting nutritional status (8.7%), students with
overweight and obesity nutritional status (11.5 %), students with ARI (66 %), students
with diarrhea (18 %) and students with typhus (16 %), (4) there is a significant
relationship between vegetables and fruit consumption behaviour with student
characteristics (gender and age), the food availability, and students’ attitude, (5) the
feasibility test of the lecture material and video methods is considered to have quite an
attractive design, quite clear messages, understandable and useful, (6) nutrition education
is quite effective for increasing knowledge in all study groups which given the
intervention activity when compared to the control group. However, for improving
practice, it was quite effective only in the group students with parents involvement that
treated by the video; game method. (7) the nutrition education which involving parents
have significantly increased the knowledge, attitudes and practices of mothers in the
intervention groups when compared to the control group. The results of the N-gain score
test showed that nutrition education was not effective for increasing mother's knowledge
because mother's knowledge were quite sufficient even before the intervention process,
however it was still effective to improve mothers' attitudes and practices about nutrition
education. The recommendation of this research are: (1) to formulate written policy issued
by local government to support the better (increase) consumption of vegetables, fruits and
fish for students in elementary grade, (2) consider for completing the school curriculum
with balanced nutritition materials, (3) to involve parents/mothers of related students in
the nutrition education to increase the availability and skills of the parents in preparing
menu variety, processing the vegetables, fruits and fish in creative-healthy-nutritive ways
which likeable by the children.
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- DT - Human Ecology [537]