Postgraduate Study Program

Department of Nutrition Science

Faculty of Human Ecology

THE EFFECT OF INTERACTIVE MEDIA-BASED NUTRITION

EDUCATION ON CHANGES IN EATING BEHAVIOR AND PHYSICAL
ACTIVITY OF OBESITY ADOLESCENT’S
Irfan Said (I1604211004)
Supervised By:
Prof. Dr. Ir. Dodik Briawan, MCN
Dr. Ir. Cesilia Meti Dwiriani, MSc.
Dr. Annisa Utami Seminar, S.IP., M.Si.
Reviewed By:
Prof. Dr. Ir. Ali Khomsan, MS.
Prof. Dr. Ir. Budi Setiawan, MS.
Moderated By:
Dr. Zuraidah Nasution, S.TP., M.Sc.
Bogor, 4 July 2024

1. Background of Research
 WHO data for 2020 shows that the number
of obese adolescent aged 15-19 years has
increased tenfold over the last 20 years
(Reddy et al. 2021).
Obesity is influenced by:
(Septiani et al. 2017)
The prevalence of obesity in adolescents aged
13-15 years in Indonesia increased from 10.8%
in 2013, where 8.3% were fat and 2.5% were
very fat (obese), to 16% in 2018, where 11.2%
of them are obese and 4.8% are very obese (RI
Ministry of Health 2018).
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Globally, the prevalence of adolescent
obesity increased from 1.4% in 2006 to
6.8% in 2016. Indonesia, including the
country that ranks 10th (Weihe and
Weihrauch-Blüher 2019).
Each media has different effectiveness in
increasing health knowledge, attitudes and
behavior. Significant difference in intervention
results between education using media and
without using media on health knowledge in
adolescents (Sulistiyanti et al. 2022).
Focus research
Changes in the behavior of obese adolescents in
an effort to increase knowledge through
education on diet and physical activity by
applying the Health Believe Model (HBM)
approach.
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2 . Purposes, Benefits and Novelty Research
2. General Objective 3. Benefits of Research
Examining the effect of nutrition education
This research is an effort to determine and
on changes in food consumption behavior
and physical activity in obese adolescents. develop nutritional education media that can
be an effective medium in efforts to prevent
obesity in adolescents
Specific Objective
(1) Identifying factors (sociodemographics,
nutritional status, food intake, physical
activity, knowledge, attitudes, practices,
fat percentage, social and social media
exposure) that are associated with 4. Novelty
obesity in adolescents.
(2) Development of nutritional education (1) Creating contemporary nutritional education media that
media for obese adolescents. can be used as an intervention medium for obese
(3) Analyzing differences in knowledge, adolescents.
food intake, physical activity before and (2) Can complement previous educational media and is
after intervention expected to become an effective educational media in
(4) Analyzing differences in nutritional efforts to improve nutrition in obese adolescents.
status before and after intervention.

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 Nutrition Education Media 04

Education
Media
Material and Revision 1
media expert

Individual trials Revision 2

Small group trials Revision 3

Field trials Revision 4

Media ready

Procedural Model for Educational Media Development Media Testing Plan

ADDIE Model
Analysis, Design, Development, Implementation, Evaluation.
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Framework Research
Respondent
Demographic
variables
Media
Gender
Age Knowledge
Height
Weight Nutrition Education
BMI Impact of obesity
Diet to control obesity
Practice
Fat percent Food Intake ↓
Physical activity for obesity
Changes in sedentary Attitude Physical activity ↑
behavior Perceived
Parent’s Socioeconomic Designing a diet menu
Variables susceptibility
Foods at risk of obesity
Income Perceived severity
Work Perceived benefits BMI↓
Education Perceived barriers Fat percent ↓
Self-efficacy

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Research Stages
Research stages

Stage 3: Intervention study

Stage 2: Developing using a quasi-experimental
Stage 1: Preliminary studies
educational media design with a pre-post test
control group design

Assess the effect (influence) of an

Educational media uses the
intervention carried out on research
Determining intervention ADDIE (Analysis, Design,
respondents, without randomization
media Develop, Implementation,
in determining the intervention group
Evaluation) model
and control group

Assessment and identification of factors that can

influence the incidence of obesity: Age, height, weight,
physical activity, BMI, behavior (knowledge, attitudes,
practices), food intake in research participants in the
obese adolescent group

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STAGE 1: Preliminary Studies, Survey, Determining Intervention Media
July 2024
Muhammadiyah High School 8 and 14
Kebayoran Baru, South Jakarta
Simple random sampling
220 respondents (Lameshow, 1997)
First Phase Respondent Withdrawal Scheme
Muhammadiyah High School 8 and 14
Kebayoran Baru, South Jakarta
Purposive
N= 481 students (2 schools)
Randomization
n= 220 students
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Data Collection Techniques and Methods
Quantitative data to be collected are:
Socio-economic characteristics
Gender, Parents education, Parents occupation, Parents income.
Physical activity data
International Physical Activity Questionnaire-Short Form (IPAQ-SF) for
the last 7 days.
Knowledge, attitudes and practices
Interviews using questionnaires.
Food intake
2 x 24 hours recall questionnare
Nutritional status and percent body fat
Anthropometric measurements, Bioelectrical Impedance Analysis (BIA)
Tanita brand
Analysis data
Characteristic data are analyzed using descriptive tests.
Variable data are analyzed using the Chi-Square test.

STAGE 2: Determining and Developing Educational Media
The ADDIE development model for producing educational media
is designed stage by stage.
This model is used because it has advantages in its systematic work
stages. Each phase carries out evaluation and revision of the stages
passed, so that the resulting product becomes a valid product
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Stages of Educational Media Development
1. Analysis
Identify topics/materials about nutrition based on interview results
regarding knowledge, attitudes, practices, media and content that are
popular with respondents obtained from the results of survey research
in phase 1 of the research.
2. Design
Prepare a framework in the form of a storyboard containing
information that will appear in educational media including opening,
title, main menu, sub menu (introduction) and sub material.
3. Development
Create educational media based on analysis results and storyboards.
After that, researchers produce educational media which will then be
validated by media experts, namely material experts and media
experts, using a media validation test form.
4. Implementation
Trial of educational media that has been developed and validated in
small groups.
5. Evaluation
Evaluation of the test results on 10 respondents from Hang Tuah 1 High
School students, South Jakarta, both in terms of content, visual and
audio.
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STAGE 3: Educational Media Intervention
Planning a Nutrition Education Model
August – October 2024
Nutrition Education Information
Muhammadiyah High School 8 and 14
1. Obesity
Kebayoran Baru, South Jakarta 2. Diet
3. Physical Activity
Topic 4. Diet Behavior and Eating Habits
= 26 people/grup 5. Behavior Change
= 52 people 6. Design a healthy menu
7. Risk foods
Pre-posttest control group design
Delivery of material (lectures) using selected
Method media.
Criteria inclusion
Muhammadiyah High School students 8 and 14 Kebayoran Baru, Media Media selected according to survey results.
classes X and XI, are willing to participate in the research and
Frequency of For 3 months
sign informed consent. meetings
Criteria exclusion Behavior change
theory HBM, KAP (Knowledge, Attitude, Practice).
Respondents who are sick, Respondent on weight loss diet
Analysis Data: Demographic characteristics of intervention and control by percentage were
compared using the χ2 test. The research variable data was tested for normality using Kolmogorov–
Smirnov statistics to determine the distribution of the data. Continuous variable data was compared
between the control and intervention groups using the independent t-test

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 Two selected schools 10
(Muhammadiyah High School 8 and 14
Purposive

Control Group Intervention Group

(Muhammadiyah High School 14) (Muhammadiyah High School 8)
Screening

Control group Intervention group

n=26 n=26
Receive media in the form of Receive nutritional education in the
leaflets for 12 weeks form of selected media for 12 weeks

1. Socialization of research activities

2. Interviews and recording data on the subject's demographic and socio-economic
Baselines characteristics
(Week 0) 3. Anthropometric measurements and recording
4. Measurement and recording of consumption and physical activity
5. Measuring and recording knowledge, attitudes and behavior
Intervention period
(for 12 weeks)
1. Anthropometric measurements and recording
Endline 2. Measurement and recording of consumption and physical activity
(Week 12) 3. Measuring and recording knowledge, attitudes and behavior

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 Variabel Encoding
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Gender Male or Female.

1) sufficient (≥ DKI Jakarta UMR)
Parental Income 2) Less ( ≤ UMR DKI Jakarta)
(Ministry of Health 2018).

1= not working, 2= PNS/TNI/Polri/BUMN/BUMD, 3= private employees, 4= self-employed, 5=

farmers, 6= fishermen, 7= laborers/drivers/household helpers, 8=others (Republican Government
Parents' job Regulation Indonesia 2023).

1= no/never been to school, 2= not finished elementary school/MI, 3= finished elementary

Parental Education school/MI, 4= finished middle school/MTS, 5= finished high school/MA, 6= finished D1/D2/D3/PT
(Ministry of Health 2018 ).

1.Mild <600 MET minutes/week

Physical activity 2.Moderate ≥600-1500 MET minutes/week
3.High: >1500 MET minutes/week (Lee et al. 2011).

Knowledge 1) Good ( > 80%), 2) Average (60-80%), 3) Poor (< 60%) (Briawan, 2016).

Attitudes and practices 1) Good ( > 80%), 2) Average (60-80%), 3) Poor (< 60%) (Ahmad et al. 2019).
Food intake 1) Good (≥ 100% AKG), Moderate (80-99% AKG), insufficient (< 80%AKG) (Supariasa et al.2017)

Malnutrition < -3 SD; Malnutrition < -3 SD to -2 SD; Good nutrition -2 SD to +1 SD; Over nutrition
Nutritional status
+1 SD to +2 SD; Obesity +2 SD (RI Ministry of Health, 2020).

Women: normal= ≤ 31%, more= > 31%

%Body fat Men: normal= ≤ 25 %, more= > 25 %
(Hoeger & Hoeger, 2011).

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References
Briawan D. 2016. Perubahan pengetahuan, sikap, dan praktik jajanan anak sekolah dasar peserta program edukasi pangan
jajanan. J gizi dan pangan. 11(3):201–210

Indonesian Ministry of Health. 2018. Basic Health Research Results 2018. Volume 53. Jakarta.
Reddy P, Dukhi N, Sewpaul R, Ellahebokus MAA, Kambaran NS, Jobe W. 2021. Mobile Health Interventions Addressing
Childhood and Adolescent Obesity in SubSaharan Africa and Europe: Current Landscape and Potential for Future Research.
Front Public Heal. 9(604439):1–9. doi:10.3389/fpubh.2021.604439.
Septiani, Riswanti and Raharjo, Bambang Budi. 2018. Fast Food Consumption Patterns, Physical Activity and Hereditary
Factors on the Occurrence of Obesity (Case Study of Students at SD Negeri 01 Tonjong, Tonjong District, Brebes Regency).
Public Health Perspective Journal.2(3):262–269.
Sulistiyanti A, Ayu SM, Widiastuti YP, and Costa Nunes CF. 2022. Effectiveness Of Nutrition Education On Anemia On The
Level Of Knowledge In Adolescent Girls. In: Proceedings of the International Conference on Nursing and Health Sciences.
3rd volume. pp. 131–138.
Weihe P, Weihrauch-Blüher S. 2019. Metabolic Syndrome in Children and Adolescents: Diagnostic Criteria, Therapeutic
Options and Perspectives. Curr Obes Rep. 8(4):472–479. doi:10.1007/s13679-019-00357-x.

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…..Thank You….