Effectiveness of a mobile app-based intervention using local foods on maternal knowledge, attitude, practice, and toddlers’ growth: A quasy experimental study

Abstract

Background: Stunting remains a major public health concern in Indonesia. Mothers frequently face barriers in meeting children’s nutritional needs due to lack of knowledge, insufficient support, and a non-enabling environment. Strengthening maternal behaviour through targeted education, access to local nutritious foods, and mobile-based interventions is essential. This study evaluated the effectiveness of a mobile application–based nutrition intervention on maternal knowledge, attitudes, and practices (KAP) and toddler growth outcomes.

Methods: Guided by the PRECEDE–PROCEED model, this quasi-experimental study involved 138 dyads of mother-toddler who were purposively selected and divided equally into intervention and control groups through simple random sampling within clusters. Primary outcomes included maternal KAP related to stunting, nutritional monitoring, and meal preparation using Nile tilapia fish. Data were collected through pre- and post-tests using the set of knowledge, attitude and behavior questionnaire and Developmental Pre-Screening Questionnaire. The data analyzed using descriptive statistics and non-parametric tests (Wilcoxon, Mann–Whitney).

Results: Baseline characteristics were comparable between groups. After the intervention, the intervention group showed significantly higher maternal knowledge (mean±SD: 18.72±1.87 and 17.20±1.08), attitudes (85.97±5.47 and 75.09±3.72), and practices (77.06±3.55 and 70.13±2.16) than the control group (all p < 0.001). Height-for-age (HFA) scores also improved (0.70±0.91 and −1.06±0.78; p < 0.001), whereas no significant changes were observed in child development (9.54±0.65 and 8.94±0.82).

Conclusions: Enhanced knowledge and attitudes, combined with access to local food sources and simple recipes, facilitated behavior adoption, while the mobile module helped sustain these improvements. Cross-sector collaboration may support standardized maternal education and strengthen integration of this intervention within national stunting prevention programs.