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The Role of Mother Cares Applications (MOCA) towards
Knowledge and Parenting Skills in Stimulating Growth
1
Mega Dewi Lestari*,
2Dede Waslia
1,2
Department of Midwifery, School of Health Sciences Jenderal Achmad Yani
*Email: mega312209011@gmail.com
Abstract
Baby's brain experiences the fastest growth and development at the age of 0-6 months.
Developmental abnormalities due to lack of stimulation during this period would have caused long-term consequences. Mother's knowledge and skill in stimulating would determine the growth of baby. Fifty-three percent of adults have smart phones. Smartphone apps can be used to aid medical activities such as health promotion. Application mother cares (MOCA) is a guide in the Smartphone in the form of animation to allow parents to stimulate the growth of toddlers. The purpose of this study is to analyze the role of MOCA towards knowledge and skills of parents in stimulating the growth of infants aged 0-6 months.True experiment was used in the study design.
Furthermore, pre-posttest with control group design was conducted in June-July 2016 in the work area of Public Health Center (Puskesmas) Ibrahim Adjie, Bandung, with 60 respondents based on proportionate stratified of random sampling. Statistical analysis used was Mann-Whitney test and Wilcoxon test (p <0.05). There were significant differences of the scores of knowledge and parental skills in giving stimulation between intervention and control groups with p values for each of 0.003 and 0.008. The conclusion is MOCA application plays a role to increase knowledge and skills of parents to stimulate the growth of infants aged 0-6 months.
Keywords: Application of Mother Cares (MOCA), baby aged 0-6 months, knowledge, skill, growth stimulation.
Introduction
Research data of basic health in 2013 found that there was an increased prevalence of malnutrition of toddlers from 17.9% in 2010 to 19.6% in 2013. Moreover, the prevalence of stunting toddlers reached 37.2%, and 16% of toddlers in Indonesia experienced developmental disruption with the highest prevalence occurred in language disorder (13.8%) (Riskesdas, 2013;
Dewi, 2012).
The first thousand days of life greatly affect cognitive and physical development (Deisye, 2015). In this period, the development of brain is very fast up to 80% (Dewi, 2009). Growth and development of baby are interrelated and influenced by the environment, occur in a singular time, and cannot be repeated again (Niken, 2014; Depkes RI, 2013). Stimulation is an activity undertaken to arouse child's basic abilities. Aberration of growth and development might be caused by lack of stimulation (Ari, 2014; Depkes RI, 2013).
Permenkes RI number 66 year 2014 is currently a reference to optimize child growth through stimulation, detection, early intervention of child growth and development (SDIDTK) and also provision of KIA books (Kemenkes RI, 2014). Alas the use of SDIDTK still relies on health workers in local health post (posyandu) so that there was an increase in percentage of under-five children who have never been weighed from 23.8% in 2010 to 34.3% in 2013 (Riskesdas, 2013;
Siti dkk, 2012). Besides, outcome of Maritalia (2009) research indicated the implementation of SDIDTK still limited to early detection of growth aberrations caused by the lack of support from the heads of Public Health Center (Puskesmas), people in charge of SDIDTK who neither have been trained nor been socialized, and also inadequate of supporting facilities for stimulation and early detection of growth. Therefore, KIA books shared are never read by parents at home.
The role of parents in nurture is crucial to the growth of the child (Wina, 2012). Parental knowledge and skills can be improved through information delivery. Computer Technology Research (CTR) states that one can remember 80% of what is heard, viewed, and performed at once.
Animation is one of the media that can be used to increase knowledge and skills compared with other media (Danang, 2014). Research Center's Internet and American Life Project "Mobile Health" (2013) reports that 88% of 53% of Smartphone users use smart phones because it is easy to use, easy to carry, standalone, and more efficient (Maged, 2014). Application mother cares (MOCA) is a guide in the Smartphone in the form of animation to allow parents to stimulate the growth of toddlers.
Method
The design used in this study is true experiment and pre-posttest with control group design. The study was conducted in June-July 2016 in the working area of Public Health Center (Puskesmas) Ibrahim Adjie, Bandung. Respondents in this study were 60 respondents with 30 respondents as control group and 30 respondents as intervention group. The sampling technique used based on probability sampling is proportionate stratified random sampling. Statistical analysis used was Mann-Whitney test and Wilcoxon test (p <0.05).
Results
Table 1
Characteristics of Respondents both in Intervention Group and Control Group
Characteristics Group
Value
Table 2
Comparison of Knowledge Score Before and After Given Intervention Group
Knowledge Score Intervention
(n=30) Control (n=30) Value p*)
- Pretest 0.263
Average (Elementary) 72.5 (8.1) 69.5 (11.2)
Median 70 70
Range 55-85 50-85
- Posttest 0.003
Average (Elementary) 83 (9.2) 75.8 (8.7)
Median 85 75
Range 65–100 60–100
Comparison
Pretest vs Posttest **) p< 0.001 p < 0.001
Intervention Control
(n = 30) (n = 30) p*)
1. Age (years old) 0.437
<20 9 (30%) 5 (16.7%)
20–35 17 (56.7%) 19 (63.3%)
>35 4 (13.3%) 6 (20%)
2. Education 0.563
Low (elementary, junior high) 13 (43.3%) 17 (56.7%)
Medium (high school) 15 (50%) 11 (36.7%)
College 2 (6.7%) 2 (6.7%)
3. Employment
Not working 20 (66.7%) 24 (80%)
0.243
Working 10 (33.3%) 6 (20%)
4. Parity
Primipara 14 (46.7%) 10 (33.3%)
0.292
Multipara 16 (53.3%) 20 (66.7%)
Information:
*) Based on Chi Square Test
75
*) Mann-Whitney Test **) Wilcoxon Test
Table 3
Comparison of Skill Scores Before and After Given Intervention Group
Knowledge Score Intervention
Control (n=30) Value p*)
Comparison
Pretest vs Posttest **) Information:
p< 0.001 P<0.001
*) Mann-Whitney Test **) Wilcoxon Test
Discussion
According to table 1, it can be seen that most respondents are aged 20-35 years, with low education (elementary, junior high), not working, and multipart. In addition, it can be seen that there is no significant difference from the characteristics of respondents which includes age, education, occupation, and parity between the two groups with the value of p respectively: 0.437;
0.563; 0.243; and 0.292 (p> 0.05). Thus it can be concluded that the intervention group and the control group have homogeneous and feasible characteristics to be analyzed in this study.
Age is associated with experience in parenting, other than that it is also associated with the ability to grasp and the mindset of a person (Baiq, 2011; Fatimah dkk, 2013). In addition to age, there is a significant relationship between maternal education with the implementation of stimulation, early detection and early intervention of child development. The higher the level of formal education the wider the amount of insight thinking, so that more information obtained (Baiq, 2011; Fatimah, 2013). Employment and socioeconomic status will also affect a person in providing the necessary facilities for carrying out an activity (Fatimah, 2013). The stimulation done by parents is based on what they have done to the previous child, so in the stimulation, the parents‘ parity also affects (Stevens, 1984).
Based on table 2 it can be seen that the knowledge score during pretest in the intervention group and control group has p value = 0.263 which means the initial knowledge about growth stimulation between the two groups is not different. While at posttest obtained p value = 0,003 which indicates that after posttest there is significant difference of knowledge score between both group. The intervention group had median and range values higher than the control group. Both groups experienced an increase in knowledge score, but the percentage increase in the intervention group was greater than the control group (14.8% VS 7.4%). This shows that the MOCA application plays a role in increasing the knowledge of parents.
Increased knowledge is able to occur after a person makes sense to a particular object (Dohah, 2014). To obtain optimal results/effective in the delivery of messages required health education media. The use of media is meant to exert as many senses as possible to a message (Notoatmodjo, 2010). The knowledge gained will become clearer as more and more senses are used. A person can remember 50% of the views, 30% of the hearing, and 80% in total if both are simultaneous (Danang, 2014).
(n=30) - Pretest
Average (Elementary) 63.9 (11.8) 57 (13.3)
0.07
Median 63.6 62.5
Range 41-82 29-76
- Posttest
Average (Elementary) 81.1 (9.2) 74.7 (10.7)
<0.008
Median 82.3 78.9
Range 53-94 52-94
Audio visual media is better education than words in the delivery of information (Notoatmodjo, 2010; Vicky, 2012). The use of multimedia will be more interesting and effective in messaging, because of the combination of views, sound and movement (Notoatmodjo, 2010;
Richard dkk, 2014). Animation is proven to significantly increase knowledge about long-term health information and effectively provide health information compared to pamphlets.
Illustrations in animation help improve users‘ memory, material understanding, and satisfaction, as they are more interesting and use multiple senses when it is being used (Sheba dkk, 2013; Mark dkk, 2010). Mother cares application (MOCA) is a guide in the smartphone in the form of animation so as to improve knowledge better than with other methods.
Based on table 3, it can be seen that the pretest skill score in the intervention group and the control group has a p value of 0.07, which means the initial skill about the growth stimulation between the two groups is no different. At the posttest it can be seen that both groups experienced an increase in skill score (p <0.001), but the intervention group had median and range values higher than the control group. Obtained p value = 0.008 indicating that after posttest there is significant difference of skill score between intervention group and control group.
Increased individual skills begins by providing insights (Notoatmodjo, 2010).
Information will be prominent if the intensity is high, and repeated (Notoatmodjo, 2012). Mother can become skilled in parenting for her child by utilizing the app on a Smartphone. The use of online-based applications to move the role of parents in parenting for their babies can improve baby's growth and development (Sanders dkk, 2016). The mother cares application (MOCA) is a stimulation guide for infant and toddler growth in a Smartphone packaged in an exciting animated form, it comes with reminders that can improve the mother's skill.
Conclusion
Mother Cares Applications (MOCA) has a role on improving knowledge and skills of parents in stimulating the growth of infants aged 0-6 months. The MOCA application can be used as an alternative guide for parents to stimulate the growth of infants aged 0-6 months independently in addition on using MCH books which can assist the implementation of SDITDK program at the Public Health Center (Puskesmas). This application can also be used for early detection of delay or developmental disorders of infants aged 0-6 months at the family level.
Further research is needed to look at other factors that influence parents' knowledge and skills in stimulating growth.
Acknowledgment
Thanks to MOCA team and IT team from CV, particularly to Artama Selfira who had helped on the making of MOCA applications in this research. Moreover, the researcher also thank the whole range of health workers and cadres in the working area of Public Health Center (Puskesmas) Ibrahim Adjie, Bandung and the respondents who had cooperated in this study.
Reference
Danang Wahyu, Kusrini, Eko B. 2014. Perancangan Sistem Pakar Deteksi Dini Tumbuh Kembang Anak Berbasis Multimedia. Jurnal Ilmiah SISFOTENIKA Vol. 2 No.2, Juli 2014
Dirjen Bina Kesehatan Anak, Dirjen Bina Kesehatan Masyarakat, Depkes RI. 2013. Pedoman Pelaksanaan Stimulasi Deteksi Dan Intervensi Dini Tumbuh Kembang Anak Di Tingkat Pelayanan Kesehatan Dasar. Jakarta : Depkes RI
Fatima, Rahji, Chizoma. 2013. Factors Influencing Compliance With Immunization Regimen Among Mother In Ibadan Nigeria. IOSR Journal Of Nursing And Health Science (IOSR- JNHS) E-ISSN: 2320–1959.P- ISSN: 2320–1940 Volume 2, Issue 2 (Sep. – Oct. 2013), PP 01-09
Fitraza, Vicky. 2012. Intervensi Pelatihan Dan Pendampingan Coaching Untuk Menigkatkan Perceived Organizational Support Dan Komitmen Organisasi Karyawan Di PT XYZ.
Depok : Fakultas Psikologi Profesi
77 Kementrian Kesehatan RI. 2014. Peraturan Mentri Kesehatan RI Nomor 66 Tahun 2014 Tentang Pemantauan Pertumbuhan, Perkembangan, Dan Gangguan Tumbuh Kembang Anak.
Jakarta : Kemenkes RI
Kemenkes RI. 2013. Riset Kesehatan Dasar. Jakarta : Badan Penelitian Dan Pengembangan Kesehatan Kementrian Kesehatan RI
Kumala, Dewi F. 2012. Efektifitas SDIDTK Terhadap Peningkatan Angka Penemuan Dini Gangguan Tumbuh Kembang Pada Anak Usia Balita Di Posyandu Teluk Wilayah Kerja Puskesmas Purwokerto Selatan. Purwokerto : STIKES Harapan Bangsa
Magdalena, Deisye. 2015. Seribu Hari Pertama Kehidupan Dalam Pertumbuhan Dan Perkembangan Anak. Buku Proceeding Prodi Magister Kebidanan Pascasarjana Fakultas Kedokteran UNPAD; 2015; 2. ISSN : 2406 – 8934. Bandung : UNPAD Maged Niken. Kamel Boulos, Ann C. Brewer, Chante Karimkhani, David B. Buller, Robert P,
Dellavalle5. 2014. Mobile Medical And Health Apps: State Of The Art, Concerns, Regulatory Control And Certification. Online Journal Of Public Health Informatics * ISSN 1947-2579 * Http://Ojphi.Org * 5(3):E229,
Maritalia, Dewi. 2009. Analisis Pelaksanaan Program Stimulasi Deteksi Dan Intervensi Dini Tumbuh Kembang (SDIDTK) Balita Dan Anak Pra Seolah Di Puskesms Kota Semarang. Semarang: Program Pascasarjana Universitas Dipenogoro
Mark Scnellinger MF, Megan V Thygeson, Heidi Vander Velden, Anna Karpas, Manu Madhak.
2010. Animated Video Vs Pamphlet: Comparing The Success Of Educating Parents Abaout Proper Antibiotic Use. Pubmed.
Notoatmodjo S. 2010. Promosi Kesehatan Teori Dan Aplikasi. Edisi Revisi. Jakarta: Rineka Cipta
Notoatmodjo S. 2012. Promosi Kesehatan Dan Perilaku Kesehatan.Edisi Revisi. Jakarta : Rineka Cipta
Palasari Wina, Ika Dewi. 2012. Keterampilan Ibu Dalam Deteksi Dini Tumbuh Kembang Terhadap Tumbuh Kembang Bayi. Jurnal STIKES Volume 5, No. 1
Rahayu Siti, Setyo I, Satino. 2012. Karakteristik Ibu Balita Kaitannya Dengan Pelaksanaan Stimulasi, Deteksi Dan Intervensi Dini Tumbuh Kembang Anak Balita. Surakarta : Kementrian Kesehatan Politeknik Kesehatan Surakarta Jurusan Keperawatan
Richard, Steven, John Torus, Ladson Hinton, And Peter Yellowlees. 2014. Mobile Tele-Mental Health: Increasing Applications And A Move To Hybrid Models Of Care. Healthcare 2014, 2, 220-233; Doi:10.3390/Healthcare2020220
Sanders MR, Love SM, Turner KM, Maurange M, Knott T, Prinz R, Metzler C, Ainsworth AT.
2016. Social Media And Gamification : Engaging Vulnerable Parents In An Online Evidance-Based Parenting Program. Child Abused & Neglect. Mar 31;53: 95-107. 2016 Septiana, Baiq. 2011. Hubungan Kepatuhan Konsumsi Biskuit Yang Diperkaya Protein Tepung Ikan Lele Dumbo (Clarias Gariepinus) Dengan Status Gizi Dan Morbiditas Balita Di Warungkiara, Bantargadung, Kabupaten Sukabumi. Bogor : Institut Pertanian Bogor Services Dohah. 2014. Using Health Text Messages To Improve Consumer Health Knowledge,
Behaviors, And Outcomes. In: Services Dohah, Amerika
Sheba George EM, Nelida Duran, Robert A Jenders. 2013. Using Animation As An Information Tool To Advance Health Research Literacy Among Minority Participants. NCBI. 2013.
Pubmed Central PMCID: PMC39000192. Epub 2013 Nov 16.
Stevens, Jr, J.H. 1984. Child Development Knowleadge And Paenting Skills. Family Relations, Pp.237-244.
Sukesi Niken, Rina D, Puspitasari F. 2014. Manajemen Penatalaksanaan Deteksi Dini Tumbuh Kembang Anak Di Posyandu Kelurahan Manyaran. Semarang : STIKES Widya Husada Sulistyawati, Ari. 2014. Deteksi Tumbuh Kembang Anak. Jakarta: Salemba Medika.
