Ida Nursanti
Department of Nursing, Faculty of Health Sciences, Universitas Jenderal Achmad Yani Yogyakarta, Indonesia

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Gaps in Maternal Behavior, Family Support, and Early Childhood Education Participation in the Development of Children Under Five Years: A Stratified Analysis of Urban vs. Rural Settings Ida Nursanti; Bhisma Murti; Sri Mulyani
Journal of Health Promotion and Behavior Vol. 11 No. 2 (2026)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2026.11.02.01

Abstract

Background: The intensity and quality of developmental stimulation provided by mothers, families, and the early childhood education environment determine the developmental outcomes of children under five years of age. Place of residence influences the cultural practices surrounding child-rearing, access to healthcare services, and the availability of facilities that support child development. This study aims to examine maternal stimulation behaviors, family support, and participation in early childhood education on child development based on place of residence (urban vs. rural). Subjects and Method: A cross-sectional study was conducted involving 200 respondents in urban areas and 200 in rural areas. Respondents consisted of mother-child pairs with children under five years of age, selected according to predetermined criteria. Data were measured using questionnaires and observation sheets (DDST II). Stratified tests were performed using STATA 13 software. Results: In the rural group, positive maternal behavior and family support were significantly associated with improved developmental outcomes for children under five years of age (RR 1.94; 95%CI 1.31 to 2.87; p = 0.001 and RR 1.47; 95%CI 1.17 to 1.867; p = 0.001), while non-significant associations were found in the urban group (p = 0.256 and p = 0.069). In the urban group, children's participation in early childhood education programs was significantly associated with more optimal developmental outcomes (RR 1.59; 95%CI 1.04 to 2.43; p = 0.033), whereas a non-significant association was observed in the rural group (p = 0.546). Conclusion: The factor of place of residence determines differences in maternal behavior, family support, and participation in early childhood education regarding child development. Health promotion intervention research aimed at enhancing maternal behavior and family support for child development needs to be designed with different methodologies based on the residential area.
Effect of Health Education Based on the Information–Motivation–Behavioral Skills Model on Maternal Knowledge, Motivation, Skills, and Behavior in Stimulating Child Speech Development Ida Nursanti; Bhisma Murti; Anna Kusumawati Sugiharti; Muhammad Erwan Syah
Journal of Health Promotion and Behavior Vol. 11 No. 3 (2026)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpb.2026.11.03.02

Abstract

Background: The primary education of children under the age of three is provided by caregivers, and mothers are the principal caregivers within the family. The key to optimizing child development lies in enhancing mothers’ ability to provide developmental stimulation. This study aimed to examine the effectiveness of health education based on IMB theory in improving mothers’ health behaviors related to speech development stimulation. Subjects and Method: The study employed a quasi-experimental pretest-posttest control group design. The intervention group received health education in stages over four weeks, whereas the control group received health education through standard health services provided by health personnel. Each group comprised 30 mother–child dyads with children aged 2–3 years, selected according to the inclusion criteria. Data analysis compared pre- and post-intervention score differences using Wilcoxon test with Stata 13. Results: The pretest–posttest score comparisons in the intervention group showed statistically significant results and medium effect sizes for information (r= 0.32; p= 0.014), motivation (r= 0.35; p= 0.007), skills (r= 0.37; p= 0.005), and maternal behavior (r= 0.34; p= 0.008). In the control group, the mean differences in pretest-posttest scores for all variables were not statistically significant: information (r= 0.22; p= 0.083), motivation (r= 0.10; p= 0.465), skills (r=0.08; p= 0.564), and maternal behavior (r= 0.05; p= 0.706).  Conclusion: Structured and integrated interventions addressing informational, motivational, and behavioral skills components have been shown to be more effective in enhancing speech development stimulation in toddlers. Future research should emphasize the use of behavior-theory-based approaches in the development of early childhood health programs.