TUGAS MATRIKULASI

BIOSTATISTIKA
KRITISI ANALISA DATA JURNAL

Oleh:
Vina Firmanty Mustofa
NIM. 102114153023

PROGRAM MAGISTER KESEHATAN MASYARAKAT

FAKULTAS KESEHATAN MASYARAKAT
UNIVERSITAS AIRLANGGA
SURABAYA
2021
Jenis Penelitian
Design penelitian yang digunakan adalah design quasi eksperimen (quasi experiment)

Populasi dan sampel

Populasi yang digunakan pada penelitian ini adalah pasangan pranikah yang ada di Bangkalan
Madura. Jumlah sampel yang digunakan adalah 40 pasangan pranikah, dibagi menjadi
kelompok kontrol sejumlah 20 pasangan, dan kelompok yang diberikan perlakuan sebanyak 20
pasangan.

Pengambilan sampel
Pengambilan sampel pada penelitian ini menggunakan metode random sampling.

Kriteria
Spesifik kriteria yang digunakan pada penelitian ini adalah pasangan yang dapat membaca,
menulis, bersedia menjadi responden, dan merupakan etnis madura.

Alat ukur
Instrumen yang digunakan pada penelitian ini adalah kuesioner. Kuesioner dibagi menjadi 3
tipe yaitu pertama pengetahuan mengenai pencegahan stunting, nutrisi sebelum hamil, selama
hamil dan menyusui, serta ASI eksklusif dan MP-ASI (makanan pendamping ASI). Kedua
adalah kuesioner mengenai sikap terhadap pencegahan stunting. Ketiga adalah kuesioner
mengenai Tindakan pencegahan stunting.

Uji validitas
Dalam artikel tersebut penulis tidak menjelaskan uji validitas yang digunakan.

Analisis Data
Pada penelitian ini, penulis menjelaskan mengenai karakteristik demografi dari
responden, dimana peneliti mengelompokkan responden berdasarkan usia, Pendidikan, dan
profesi yang dimiliki. Pada table 1 penelitian ini, terlihat bahwa rata-rata responden ada pada
rentang usia 20-25 tahun dengan level edukasi terbanyak pada tingkat sekolah menengah
pertama, dan memiliki profesi sebagai pedagang. Pada table 2 dijelaskan mengenai
pengetahuan responden sebelum dan sesudah diberikan intervensi. Uji data pada penelitian ini
menggunakan uji Wilcoxon test, The Mann-Whitney test, dan delta test. Hasil uji data
berdasarkan variable tingkat Pendidikan sebelum dan sesudah intervensi menggunakan
Wilcoxon Signed Rank test pada grup kontrol dan grup memiliki hasil signifikan (p) = 0.0000
kurang dari α = 0.05 yang artinya terdapat hubungan antara edukasi kesehatan dengan tingkat
pengetahuan mengenai stunting pada pasangan pranikah. Hasil dari tes the Mann-Whitney U
test pada pre dan post test dari kedua grup menunjukkan hasil adanya perbedaan signifikan
diantara grup kontrol dan grup dengan intervensi.
Pada variable sikap pasangan pranikah grup kontrol maupun intervensi sebelum dan
sesudah intervensi secara statistic memiliki hasil signifikan (p) = 0.0000 kurang dari α = 0.05
yang artinya terdapat perbedaan data dari kedua grup, sedangkan untuk uji The Mann-Whitney
U test didapatkan hasil p = 0.096 pada pre-test kedua grup dan p = 1.0000 untuk post-test kedua
grup, sedangkan nilai delta pada kedua grup adalah 0.027, yang mana tidak terdapat efek
pemberian intervensi pada kedua grup. Pada variable asupan nutrisi (karbohidrat) sebelum dan
sesudah intervensi pada grup kontrol dan grup dengan perlakuan memiliki hasil p = 0.0000
pada uji Wilcoxon Signed Rank test, sedangkan pada uji Mann-Whitney U test nilai dari kedua
grup adalah 0.507 pada pre-test dan 1.0000 pada post test, yang menandakan bahwa tidak ada
pengaruh edukasi Kesehatan mengenai asupan karbohidrat pada kedua grup pre maupun post
test.
Hasil uji data responden berdasarkan asupan protein, pada uji Wilcoxon Signed Rank
test memiliki hasil signifikan p = 0.0000 , artinya terdapat perbedaan data diantara kedua grup
penelitian, sedangkan pada uji Mann-Whitney, p = 0.481 yang artinya tidak terdapat pengaruh
module intervention dan diskusi grup dari kedua grup pre dan post tes. Hasil signifikan pada
uji data berdasarkan tingkat Pendidikan pada tes Wilcoxon Signed Rank U test, sedangkan
pada Mann Whitney test tidak terdapat perbedaan signifikan dari kedua grup pre maupun post
grup. Uji data dengan hasil data signifikan pada aspek total energi sebelum dan sesudah
intervensi pada kedua grup. Hasil uji tidak signifikan atau hipotesis tidak diterima pada uji
Mann Whitney, dengan hasil p = 1.0000.
Hasil dari analisis data menggunakan analisis bivariat, terdapat pengaruh edukasi
Kesehatan terhadap pengetahuan pasangan pranikah, tetapi tidak terdapat hasil signifikan pada
intervensi yang diberikan. Hal tersebut menjelaskan bahwa pemberian modul dan diskusi group
dapat dilakukan untuk meningkatkan pengetahuan dan membentuk sikap sebagai pencegahan
dari stunting. Sehingga tenaga Kesehatan seharusnya melakukan pencegahan dengan
meningkatkan edukasi kesehatan sebagai tindakan nyata dari pencegahan stunting.
Journal Review
Analisis data yang digunakan pada penelitian ini sudah tepat, dengan tujuan untuk
mengetahui perbedaan data antar grup digunakan uji Wilcoxon, dan mengetahui ada tidaknya
pengaruh signifikan pre dan post test menggunakan uji Mann-Whitney, dimana data dependen
yang digunakan menggunakan skala ordinal, rasio, dan dengan distribusi data tidak normal.
Peneliti sudah tepat menggunakan uji Wilcoxon signed rank test denga tujuan menguji
perbedaan 2 kelompok berpasangan. Uji Wilcoxon digunakan untuk mencari perbedaan data
dengan tipe data rasio atau interval, dan menunjukkan selisih nilai antara kedua perlakuan. Uji
Mann-whitney, sangat sensitive pada perubahan median data.

Penelitian ini menggunakan kuesioner dan peneliti membaginya menjadi 3 jenis

kuesioner tentang pencegahan stunting, nutrisi sebelum hamil yaitu karbohidrat, protein,
lemak, dan total energi selama hamil dan ketika menyusui serta ASI eksklusif dan MP-ASI,
kuesioner tentang pencegahan stunting dan kuesioner tindakan yang dilakukan responden.
Pada artikel ini, peneliti tidak melampirkan contoh pertanyaan yang diajukan kepada
responden, tetapi peneliti memaparkan tabel distribusi frekuensi responden berdasarkan
pengetahuan sikap dan tindakan pencegahan stunting.

Kemungkinan hasil tidak signifikan pada data kuesioner action yang terdiri dari
karbohidrat, protein, lemak serta jumlah kalori karena tindakan intervensi yang terbatas dan
beberapa factor lain yang tidak dapat dikontrol dan terukur, seperti yang dijelaskan peneliti
bahwa responden menunjukkan sikap yang baik pada pre-test maupun post-test namun tidak
sesuai dengan kurangnya pengetahuan yang dimiliki dan sikap negative sebelum intervensi.
Sikap tidak sama dengan perilaku atau tindakan, dan perilaku padda satu waktu tidak
mencerminkan perilaku seseorang dikemudian hari, karena seseorang dapat menunjukkan
tindakan yang bertentangan dengan sikap dan pengetahuan yang dimiliki.
Referensi

Dicky Hastjarjo. (2008). Ringkasan buku Cook & Campbell. (1979). QuasiExperimentation:
Design & Analysis Issues for Field Settings.
Trimawartinah, MKM. 2020. Bahan Ajar Statistik Non Parametrik. UHAMKA
https://exponensial.wordpress.com/2010/05/13/uji-wilcoxon/

http://staffnew.uny.ac.id/upload/132232818/pendidikan/04+Teknik+Analisis+Data+2013.pdf
https://www.statistikian.com/2014/05/wilcoxon-table.html
 EurAsian Journal of BioSciences
Eurasia J Biosci 14, 2519-2525 (2020)

The effects of health education on increasing knowledge,

attitudes, and stunting prevention in pre-marriage
couples in bangkalan madura
Esti Yunitasari 1*, Wiwik Hidayatun Nadhifah 1, Retnayu Pradanie 1
1
Faculty of Nursing, Universitas Airlangga, Surabaya, INDONESIA
*Corresponding author: esti-y@fkp.unair.ac.id

Abstract
Early marriage has an impact on reproductive health, and the health of the baby later because of the
younger the age of marriage, the more time to produce. The impact caused by stunting can cause
children to become cognitive disorders, motor disorders, body growth, increased incidence of
morbidity, and death. Health education, especially about nutrition before pregnancy in several
Indonesian studies, influences the level of knowledge, attitudes, and practices. This study aimed to
explain the influence of modules and peer group discussions on stunting prevention at pre-marital
couples. This research was an experimental quasy design. Samples were taken as many as 40
respondents for two groups to be studied. The instrument used the independent variable
questionnaire was stunting prevention. The dependent variable in this research was knowledge,
attitude, and action to prevent stunting. Data were collected using a questionnaire and analyzed using
the Wilcoxon test, Mann Whitney-U, and delta tests with significance levels α <0.05. From the results
of the bivariate analysis, there is an effect of health education on knowledge (p = 0.000), but on
attitudes (1.000) and actions p> 0.05), there is no effect of the intervention. It can be concluded that
the module and peer group discussion can be used as a method of health education in increasing
knowledge and attitudes about stunting prevention. In action, there is no influence on the two groups
because good attitudes and knowledge do not always reflect conflicting actions. Health workers must
take preventive, stunting actions.

Keywords: health education, pre-marital couple, stunting

Yunitasari E, Nadhifah WH, Pradanie R (2020) The effects of health education on increasing
knowledge, attitudes, and stunting prevention in pre-marriage couples in bangkalan madura.
Eurasia J Biosci 14: 2519-2525.

© 2020 Yunitasari et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution License.

INTRODUCTION age of marriage and more time to produce (Berliana et

Failure to grow in the first 1000 days of life, in
addition to causing physical growth disorders, will also
cause metabolic disorders, especially disorders of
metabolism of fats, proteins and carbohydrates which
can ultimately trigger the emergence of non-
communicable diseases such as obesity, diabetes and
coronary heart disease in adulthood, and stunting
(Departemen Kesehatan, 2015). Stunting is a condition
where a toddler has a length or height that is less when
compared with the age of a toddler. This condition is
measured by length or height more than minus two
standard deviations from the median standard of child
growth from the World Health Organization (WHO,
2015). Toddler stunting includes chronic nutritional
problems caused by many factors such as
socioeconomic conditions, maternal nutrition during
pregnancy, morbidity in infants, early marriage, and lack
of nutrition in infants (Scheffler et al., 2019).
Early marriage has an impact on reproductive health,
and the baby’s health later because of the younger the
al., 2018; Yunitasari et al., 2016). The occurrence of
early marriage in Bangkalan Madura is influenced by
several factors, including cultural and social norms that
apply in the community, economic status, and level of
knowledge. Cultural and social norms include those
related to beliefs. The culture that developed in
Indonesian society environment such as negative
assumptions towards old maid if they did not get married
at around 14-16 years old is a factor that encourages the
high early marriage in Bangkalan, Madura (BPS,
BKKBN, Depkes, & International, 2013). The age of the
mother when she first got pregnant affects the course of
the pregnancy. A woman who gets pregnant in her teens
will get fewer early prenatal care (Suarayasa et al.,
2017). This factor can cause babies born with low weight
and infant death. Deaths of babies, premature babies,
Received: June 2019
Accepted: March 2020
Printed: July 2020

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EurAsian Journal of BioSciences 14: 2519-2525 (2020)
and low weight babies will be high in couples who have
early marriages (Lumbanraja, 2016). Most teenage girls
who get pregnant have a Body Mass Index (BMI) under
the category of underweight (Haseeb & Azam, 2020).
This is due to a lack of nutrition due to concerns in body
shape during adolescence and a lack of nutrition
education. These two things then cause low weight gain
during pregnancy (Syahrul et al., 2016).
The occurrence of short toddlers or stunting is one of
the nutritional problems experienced by toddlers in the
world today. In 2017, more than half of stunting toddlers
in the world came from Asia as much as 55%, while 83.6
million were stunting toddlers in Asia, the largest
proportion of which came from South Asia 58.7% and
the fewest proportion in Central Asia (WHO, 2015). In
2018, two regions in East Java Province had toddlers
with inadequate nutrition, namely in Bangkalan as many
as 26.39% and 25% in Pamekasan, Madura. In 2019 in
Bangkalan Madura, 578 people experienced stunting
from a total of 6771 children under five in Bangkalan
Madura. Based on National Social Economic Survey
(Susenas) data (2016), the average age of marriage of
rural residents is 34.74%, aged 22-24 years in rural
areas 21.16%, age 25-30 years in rural areas 21.16%
(Statistik, 2016). According to data from the Office of
Religious Affairs, 80 couples will get married in
December 2019.
Stunting can be prevented by fulfilling proper
nutrition before marriage (Surani & Susilowati, 2020).
Maternal nutrition and health status in pre-pregnancy,
during pregnancy, and while breastfeeding is a very
critical period for the growth and development of
children. The first 1000 days of life are sensitive periods
or windows of opportunity (Shah et al., 2016). If the child
is experiencing nutritional problems at this time, the
consequences will be permanent and cannot be
corrected (Senbanjo et al., 2013). According to the
results of Yinila’s research in 2016, pregnant women
who have anemia are at risk of having babies with
underweight nutritional status at risk of stunted fetal
growth and babies born having low birth weight (Yusuf
et al., 2020). In the next life, the child will be at risk of
experiencing malnutrition problems, decreased
development of motor and mental function, and reduced
physical capacity (Yinila Prabandari, 2016).
The cause of nutritional problems is influenced by
two factors, namely direct and indirect factors. The direct
causes are food factors and infectious diseases. Indirect
factors include food security in the family, parenting,
health care, inadequate sanitation. The four indirect
factors are interrelated with the mother’s education,
knowledge, income, and skills (Bhutta et al., 2008). The
impact caused by stunting can cause children to become
cognitive, motor impaired, posture growth, increased
incidence of morbidity, and death (Darlan et al., 2017;
Assefa, et al, 2016).
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Yunitasari et al.
Health education, especially about nutrition before
pregnancy in several Indonesian studies, influences the
level of knowledge, attitudes, and practices. This was
mentioned in research by Nikmawati et al. in 2009, which
revealed that nutrition education interventions could
improve the knowledge, attitudes, and nutritional
practices of toddler mothers (Nikmawati et al., 2009).
Based on research from Hariska et al. in 2017, there is
an influence of health education with media modules in
the form of increased knowledge and attitudes of
mothers in preventing stunting in infants (Pratiwi &
Bahar, 2017; Tel et al. 2018). Prevention of stunting can
also be influenced by information in group discussions
(peer group discussions). In several studies on peer
group discussions, it was found that health education
increased knowledge, attitudes, and stunting prevention
measures (Eide et al., 2016).
Health behavior, in this case, stunting prevention
efforts are influenced by several factors such as
knowledge, attitudes, and actions. This is in accordance
with the theory of Precede Proceed by Lawrence Green.
He explains that it examines the problem of human
behavior and the factors that influence it, as well as how
to follow it up by changing, maintaining, or improving the
behavior towards a more positive direction. The
assessment is the process or precedes stage and the
follow-up process at the procedural stage (Green &
Kreuter, 1991). Thus a program to improve health
behavior is the application of the four processes in
general to the assessment and follow-up model. So
there is a link between stunting prevention behavior that
is influenced by knowledge, attitudes, and actions. This
study aims to explain the effect of modules and peer
group discussions on the prevention of stunting in pre-
marital couples at the Office of Religious Affairs in
Bangkalan, Madura.
MATERIALS AND METHODS
This study used a quasi-experimental design or
quasi-experiment design with a pre-test and post-test
with a control group approach. This type of research
used modules and peer group discussions to determine
the effect of health education interventions. The design
of the study compared the knowledge before and after
the provision of educational interventions between the
intervention group and the non-intervention group.
The population in this study were 40 pre-marital
couples with a control group of 20 pre-marital couples
and a treatment group of 20 pre-marital couples. The
sampling technique used in this study is random
sampling. The research subjects were taken by
considering specific criteria that researchers
determined, that is, being able to read and write, being
willing to be respondents, with Madurese ethnicity. The
independent variable in this study was health education,
while dependent variables in this study were knowledge,
EurAsian Journal of BioSciences 14: 2519-2525 (2020) Yunitasari et al.

Table 1. Demographic characteristics of respondents the effect of health education on increasing knowledge, attitudes and
preventive measures for stunting in pre-marital women
Control group Intervention Group
Characteristics of Respondents
n % n %
20-25 12 60 12 60
Age 26-30 8 40 8 40
Total 20 100 20 100
Elementary school 1 5 2 10
Middle School 4 20 4 20
Level of education High school 10 50 9 45
College 5 25 5 25
Total 20 100 20 100
Private 5 25 5 25
Teacher 1 5 1 5
Profession
Trader 14 70 14 70
Total 20 100 20 100

attitude, and stunting prevention measures. The
instrument in this study was a questionnaire. There were
three types of questionnaires, namely the knowledge
questionnaire about prevention of stunting, nutrition
before pregnancy, during pregnancy and while
breastfeeding, and exclusive breastfeeding and MP-ASI
(Complementary food); questionnaire about stunting
prevention attitude; and action questionnaire.
The tests used are the Wilcoxon test, the Mann-
Whitney test, and the delta test. Wilcoxon test was used
to analyze the results of paired observations from two
data, whether different or not. The Mann Whitney test
was used to determine the difference in the median of
the two independent groups if the scale of the dependent
variable data was ordinal, interval/ratio, but not normally
distributed. The statistical test was used to see the
average difference in the effect of health education on
increasing knowledge, attitudes, and stunting prevention
measures. Researchers have conducted an ethical test
at the Ethics Commission of the Faculty of Nursing,
Airlangga University, which was issued on December 5,
2019, with No. 1845-KEPK.
RESULTS
Based on Table 1 about the characteristics of
respondents. Judging from the age category, most
respondents were aged 20-25 in both groups. A total
was 12 people (60%) in the control group and 12 people
(60%) in the treatment group. The last education of the
respondent showed four junior high school graduates
(20%) in the control group and four people (20%) in the
intervention group, ten high school graduates (50%) in
the control group and nine people (45%) in the
intervention group Meanwhile, the most recent tertiary
education was five people (25%) in the control group and
five people (25%) in the intervention group. The types of
work of private respondents were five people (25%) in
the control group, and five in the intervention group. The
type of work of civil servant respondents was one person
in the control group and one person in the intervention
group.
Table 2 shows the number and percentage of
respondents based on the level of knowledge before and
after the intervention in the control group and treatment
group. Statistical test results with the Wilcoxon Signed
Rank Test in the control group obtained a significant
value (p) = 0.000 less than α = 0.05 so that the
hypothesis was accepted, while in the treatment group
obtained significantly (p) = 0.000 less than α = 0.05, so
the hypothesis was accepted. The results of the Mann
Whitney U test in the pre and post-test of the two groups
showed that there were significant differences in the
control group and the treatment group with a
significance value (p) = 0.000.
The number and percentage of respondents based
on attitude before and after intervention in the control
and treatment group. Statistical test results with the
Wilcoxon Signed Rank Test in the control group
obtained a significant value (p) = 0.000 less than α =
0.05 so that the hypothesis was accepted, while in the
treatment group obtained significantly (p) = 0.000 less
than α = 0.05, so the hypothesis was accepted. The
results of the Mann Whitney U test statistic in the pre-
test of the two groups are 0.096, and in the post-test that
is 1.000 and the delta value of the two groups is 0.027,
there is no intervention effect in both groups because of
α> 0.05.
The number and percentage of respondents based
on carbohydrate consumption before and after the
intervention in the control group and the treatment
group. Statistical test results with the Wilcoxon Signed
Rank Test in the control group obtained a significant
value (p) = 0.000 less than α = 0.05 so that the
hypothesis was accepted, while in the treatment group
obtained significantly (p) = 0.000 less than α = 0.05. The
results of the Mann Whitney U test statistic in the pre-
test of the two groups are 0.507, and the post-test in both
groups is 1.000, meaning that α> 0.005 hypotheses are
rejected, no influence from both groups both pre and
post.
The number and percentage of respondents based
on protein consumption before and after the intervention
in the control group and the treatment group. Statistical
test results with the Wilcoxon Signed Rank Test in the
control group obtained a significant value (p) = 0.000
less than α = 0.05 so that the hypothesis was accepted,

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EurAsian Journal of BioSciences 14: 2519-2525 (2020) Yunitasari et al.

Table 2. Frequency distribution of respondents based on the knowledge, attitudes, and actions of pre-marital women about
preventing stunting in the Religious Affairs Office
Control group Treatment group
Knowledge level Pretest Post-test Pretest Post-test
n % n % n % n %
Good 0 0 6 30 2 10 16 80
Enough 3 15 14 70 3 15 4 20
Less 17 85 0 0 15 75 0 0
Total 20 100 20 100 20 100 20 100
The mean 36 78 46 86
Elementary school 13.1917 5.231 15.355 8.208
Pair Sample Test 0.000
Wilcoxon signed rank test 0.000 0.000
Mann Whitney UcTest Pre Post Test 0.000
Delta value 0.000
Attitude
Positive 4 20 19 95 9 45 20 100
Negative 16 70 5 5 11 55 0 0
Total 20 100 20 100 20 100 20 100
Mean 22.70 28.35 26.65 35.25
Elementary school 2.577 2.346 2.560 4.435
Pair Sample Test 0.000
Wilcoxon signed rank test 0.000 0.000
Mann Whiney U Test Pre Test 0.096
Mann Whitney U Test Post Test 1.000
Delta value 0.027
Action
Carbohydrate
Enough 20 100 20 100 20 100 20 100
Less 0
Total 20
Mean 904.62 1094.33 890.08 1012.53
Elementary school 84.7 189.22 88.3 49.35
Wilcoxon 0.000 0.000
Mann Whitney U Test Pre 0.588
Mann Whitney U Test Post 0.645
Delta value 0.640
Protein
Enough 20 100 20 100 20 100 20 100
Less 0
Total 20
Mean 296.1 300.61 263.96 302.9
Elementary school 27.87 18.04 27.87 18.04
Wilcoxon 0.000 0.000
Mann Whitney U Test Pre 0.481
Mann Whitney U Test Post 0.818
Delta value 0.126
Fat
Enough 20 100 20 100 20 100 20 100
Less 0
Total 20
Mean 514.89 596.08 513.09 605.8
Elementary school 83.56 40.14 71.85 30.51
Wilcoxon 0.001 0.000
Mann Whitney U Test Pre 0.786
Mann Whitney U Test Post 0.533
Delta value 0.327
Total Energy
Enough 20 100 20 100 20 100 20 100
Less 0
Total 20
Mean 1760.3 2018.9 1760.3 1012.53
Elementary school 158.14 2018.99 158.14 2018.99
Wilcoxon 0.000 0.000
Mann Whitney U Test Pre 0.507
Mann Whitney U Test Post 1.000
Delta value 1.000

while in the treatment group obtained significant (p) =
0.000 less than α = 0.05. The results of the Mann
Whitney U test statistic before the module intervention
and intervention (p) = 0.481. After the module
intervention and peer group discussion showed the
results (p) = 0.818, the α> 0.05 hypothesis was rejected,
and there was no influence from both pre and post
groups.
The number and percentage of respondents based
on protein consumption before and after the intervention
in the control group and the treatment group. Statistical
test results with the Wilcoxon Signed Rank Test in the

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EurAsian Journal of BioSciences 14: 2519-2525 (2020)
control group obtained a significant value (p) = 0.000
less than α = 0.05 so that the hypothesis was accepted,
while in the treatment group obtained significant (p) =
0.000 less than α = 0.05. The results of the Mann
Whitney U test statistic before the module intervention
and intervention (p) = 0.786. After the module
intervention and peer group discussion showed the
results (p) = 0.533 means that α> 0.005 hypothesis was
rejected, there was no influence from both pre and post
groups.
The number and percentage of respondents based
on the total energy before and after the intervention in
the control group and the treatment group. Statistical
test results with the Wilcoxon Signed Rank Test in the
control group obtained a significant value (p) = 0.000
less than α = 0.05 so that the hypothesis was accepted,
while in the treatment group obtained significant (p) =
0.000 less than α = 0.05. The results of the Mann
Whitney U test statistic before and after the module
intervention and peer group discussion showed that the
results (p) = 1.000 mean α> 0.005 hypothesis was
rejected, there was no influence from both pre and post
groups.
DISCUSSION
Health education with the module media and peer
group discussion has an influence on pre-marital
women’s knowledge, the results of changes in the
treatment group before health education are carried out
with the module media, and the peer group discussion is
in the control group. After conducting statistical analysis
based on the level of knowledge of respondents before
and after health education with media modules and peer
group discussions, most have sufficient and less
knowledge when pre-tested. Most respondents lack
knowledge related to the prevention of editing, the
impact of stunting, and the causes of stunting. In the
control group, when pre-tested, the majority of
respondents were dominated by enough and fewer
categories. The knowledge that is dominated by enough
in both groups is due to the existence of previous health
information from various sources such as mass media,
internet, health workers, and other friends so that
respondents have knowledge related to stunting
prevention, the impact of stunting, and causes of
stunting. Lack of knowledge in the pre-test of the two
groups is due to the lack of experience on how to prevent
stunting.
This research is in line with research conducted by
Sri Handayani et al. in 2009. It states that peer group
discussions are more effective in increasing knowledge
about pre-marital sexual behavior compared to
discussion methods (Handayani, Emilia, & Wahyuni,
2009). The importance of attitude is in line with
Abdurahman’s research in 2012 regarding the effect of
the group discussion method on the mother’s knowledge
Yunitasari et al.
of toddlers’ development concludes that the group
discussion method can have a functional influence can
positively affect the mother’s knowledge (Mohammed,
Woldeyohannes, Feleke, & Megabiaw, 2014). According
to Notoarmodjo, in 2007, one’s exposure to information
sources will affect the level of knowledge. Sources of
information obtained affect one’s knowledge, for
example, from print media, electronic media, and from
health workers. Someone who has many sources of
information will provide clearer knowledge about
stunting prevention (Notoatmodjo, 2014).
Modules and peer group discussions influence the
attitudes of brides-to-be. The results showed a
significant effect after a health education intervention
with modules and peer group discussions on improving
the attitude of brides-to-be about stunting prevention. In
the pre-test results obtained, almost all respondents
have a negative attitude, and all respondents do not
know about stunting prevention. The increase in a
positive attitude in this study is due to the information
when providing health education that carries a
suggestive message that prevention of stunting is
important and must be performed by pre-marital women.
This study is not in line with the results of the study
Retnayu in 2014, which states that the Buzz group is an
effective health education method in increasing
knowledge and attitudes towards adolescents (Salim et
al., 2014). Attitudes are formed through the willingness
to accept one’s words, respond to messages with active
participation, provide judgment to readiness to act
(Potter & Perry, 2010). Attitude is an assessment, and it
can be a person’s opinion of a stimulus or object. In
giving his judgment, someone responds to a closed
attitude towards a particular stimulus or object that
already involves one’s emotions. Attitudes involve
thoughts, feelings, concerns, and symptoms of a
person’s intelligence. The attitude function is not yet an
action or activity, but it is a predisposing behavior or a
closed reaction.
Modules and peer group discussions influence the
attitudes of pre-marital women in the control and
treatment groups. This study is not in line with research
conducted by Richards et al. in 2006, who examined the
effects of nutritional education on women of childbearing
age 18-24 years in Dakota, America, also concluded that
health education was effective in increasing the
consumption of healthy foods and vegetables in the
intervention group (Richards, Kattelmann, & Ren, 2006).
Cena et al. in 2008 also found a correct increase in the
intervention group who received pre-conception nutrition
education in consuming folic acid compared to the
control group (Cena et al., 2008).
In action, variable respondents have shown good
actions at the pre-test and post-test. However, these
actions are not in accordance with the lack of knowledge
and negative attitudes before the intervention, but if
seen in the action variables show a good category.
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Attitude is not the same as behavior or action, and
behavior does not always reflect someone’s behavior
because it often happens that someone can show
actions that are contrary to the attitude and the
knowledge he has (Kholid, 2018).
According to Notoatmodjo, in 2012, the behavior is a
person’s psychological reaction to the environment. The
reaction has various forms that are basically classified
into two names in the form of passive without real action
and inactive form with real action. Forms of behavior can
be observed through attitudes and actions only, and
behavior can also be potential in the form of knowledge,
motivation, and perception (Notoatmodjo, 2012). In this
study, they were using the theory of Lawrence Green in
1991. The health of a person or community is influenced
by behavioral factors and factors outside the behavior of
one of them, namely knowledge and attitudes. What
influences the respondent’s actions before and after
health education to have actions in good food
consumption. There are supporting factors that are
manifested in the physical environment, the availability
or unavailability of health facilities or facilities, and the
driving factors manifested in the attitudes and behaviors
of officers’ health in providing health promotion for
stunting prevention (Green & Kreuter, 1991).
CONCLUSION
There is an influence of health education on the level
of knowledge. Health workers are advised to provide
more health education to prospective bride and groom
on how to prevent stunting by utilizing Integrated
Healthcare Center (center for pre and postnatal health
care and information). Public health services are
advised to optimize the CATIN (Bride to be) and Nutrition
Program, which focuses on stunting prevention
behavior. The candidate’s training is needed to assist
brides who lack knowledge about stunting prevention
behavior. This result can be used to design interventions
to add information and improve stunting prevention
behaviors for the community. Future researchers are
also expected to investigate further about effective
health education in preventing stunting.

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