HEALTH PROMOTION MODEL-BASED
ON SOCIAL INTERACTION AND FAMILY FOR ACCELERATING TODDLER DEVELOPMENT
SUMMARY
Early childhood development is critical for shaping the quality of future human resources. Optimal child development can be fostered through targeted developmental stimulation. Parents, especially mothers, play a crucial role in parenting within the family context. The practices of parenting within families are significantly influenced by the cultural environment in which the parents were raised and where the family currently resides. Indonesian cultural values that emphasize family greatly influence parenting practices. Families not only assist with parenting but also serve as sources of moral and material support. Enhancing healthy maternal behaviors to accelerate child development can be achieved through health promotion strategies that take into account the cultural influence of family. This research aims to develop a health promotion model based on social and family interactions by examining constructs from Social Cognitive Theory (SCT) and the Information-Motivation-Behavioral Skills (IMB) Model.
This research employs an analytical cross-sectional design conducted between July and October 2023 in the Special Region of Yogyakarta, specifically in Yogyakarta City and Bantul Regency. The study focuses on mother-child under five pairs with children aged 12-59 months. A total sample of 400 pairs was selected using a two-stage sampling technique. The first stage involved cluster random sampling to identify 20 districts, followed by purposive sampling to select the mother-child under five respondents. Variables in this study were constructs from SCT, IMB, and family supports. The dependent variables in this study were maternal behaviors aimed at enhancing child development and child development. Meanwhile, the independent variables were observational learning, outcome expectations, self-efficacy, information, motivation, family support, behavioral skills. The study used researcher-developed questionnaires and observation sheets, validity was confirmed through Pearson correlation tests, and reliability was assessed using Cronbach’s Alpha, both of which deemed the instruments appropriate for the study. Data were analyzed using univariate, bivariate, and multivariate. Multivariate analysis employed path analysis to elucidate direct and indirect effects using path diagrams. Effects were deemed significant if p < 0>
Characteristics of Mothers: A significant portion of the mothers were between 31-40 years old (49.25%). Most mothers had completed high school or its equivalent (50.50%). Over half of the mothers were housewives (55.00%). The majority had more than one child (65.25%). Family Characteristics: Most heads of households were employed as employees or workers (59.00%). The average household income ranged from 2 to 5 million rupiah (64.41%). Nearly half of the respondents lived with extended family (45.75%), A majority received family support in parenting (55.50%), and more than half provided toys suitable for their child’s age (52.50%). The number of boys and girls was approximately equal and the majority were first-born children (40.75%). Most children were under 3 years old (64.50%), had not yet participated in early childhood education programs (PAUD) (67.50%), and had a rapid development rate (61.50%).
Descriptive Statistics for Research Variables: 1) observational learning: Mean = 9.71 and SD = 2.34, Outcome Expectations: Mean = 7.67 and SD = 1.14, self-efficacy: Mean = 7.28 and SD = 1.36, information: Mean = 11.10 and SD = 2.26, motivation: Mean= 15.67 and SD= 3.02, behavioral skills: Mean= 7.88 and SD= 1.58, family support: Mean= 7.27 and SD= 1.78, and maternal behavior: Mean= 14.44 and SD= 3.21.
Bivariate Analysis Results on the effect of independent variables on maternal behavior are as follows: observational learning: Coefficient (b)= 0.67 and p< 0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>
Multivariate analysis was done using path analysis. The analysis revealed an ideal health promotion model for child development behavior with goodness of fit (p-value): 0.068; Root Mean Square Error of Approximation (RMSEA): 0.041; Comparative Fit Index (CFI): 0.997; Tucker-Lewis Index (TLI): 0.991; and Standardized Root Mean Square Residual (SRMR): 0.018. Based on the model, the influences of constructs from SCT, IMB model, and family support can be identified as follows:
Observational learning directly correlates with maternal behavior in child development (b= 0.06, p= 0.025). Observational learning has indirect effects through outcome expectations (b= 0.02), motivation (b= 0.04), behavioral skills (b= 0.08), information and behavioral skills (b= 0.08), and self-efficacy and behavioral skills (b= 0.03). Additionally, observational learning directly related to information (b= 0.51), outcome expectations (b = 0.23), self-efficacy (b= 0.32), motivation (b= 0.21), and behavioral skills (b= 0.14).
Family support exhibits a direct impact on maternal behavior in early childhood development (b= 0.08, p < 0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>
Outcome expectations and motivation directly correlate with maternal behavior in child development (b= 0.09 and b= 0.21). Self-efficacy has indirect relationships through motivation (b= 0.09) and through behavioral skills (b= 0.08), while outcome expectations have an indirect relationship through self-efficacy and behavioral skills (b= 0.02). Information indirectly affects outcome expectations (b= 0.04), motivation (b= 0.07), behavioral skills (b= 0.16), motivation through behavioral skills (b= 0.28), and through self-efficacy and behavioral skills (b= 0.01).
Behavioral skills strongly impact maternal behavior in early childhood development (b = 0.60). The development of children is influenced by maternal behavior in child development (b= 0.13, p = 0.017) and family support (b= 0.17, p= 0.001).
The conceptual framework of the dissertation on health promotion models for maternal behavior in early childhood development comprises three main factors: social, individual, and behavioral. The social factors include observational learning and family support. Individual factors encompass information, outcome expectations, self-efficacy, and motivation. Behavioral factors involve maternal behavioral skills and practices in child development. Healthy maternal behavior in child development and family support increase the likelihood of children achieving accelerated developmental potential.
There is a significant direct relationship between social factors, individual factors, and behavioral factors on maternal behavior in the development of children under five. Social factors and maternal behavior are directly and significantly related to the development of children under five. These findings of this study provide a novelty because they have integrated the SCT and IMB models in the context of modeling maternal behavior to improve the development of children. They show a direct relationship between social factors (family support and observational learning) and healthy maternal behavior to enhance child development. Social factors (family support) also directly relate to the development of children under five years of age. The social factors from the SCT construct (observational learning and family support) and individual factors from the SCT and IMB constructs (self-efficacy, information, and motivation) significantly improve maternal behavioral skills in stimulating child development. Behavioral skills, in turn, were identified as the strongest predictor of maternal behaviors that promote the development of children under five years of age. Therefore, it is recommended that policymakers through the health office in cross-sectoral collaboration with the women's empowerment and child protection office, and the education office continue and improve the performance of the children under five family development program and the family learning center program to improve the skills of parents and families in making efforts to improve child development. Organize training for families and health cadres to improve support in parenting that supports child development. Establish cross-sectoral collaboration with the education office to involve ECED educators in skills development activities for mothers, families, and health cadres to support efforts to improve child development. Furthermore, a serious and sustainable campaign must be carried out by the health office, the women's empowerment and child protection office, and the ECED education office about the importance of efforts to improve optimal child development to encourage improvements in the quality of human resources in the future and the progress of the Indonesian nation.
