The Effect of Leaflet-Based Health Promotion on Mothers’ Knowledge and Handwashing Practices
https://doi.org/10.53770/medica.v8i8.1098
Keywords
Diarrhea Handwashing Health Promotion Leaflet ToddlerAbstract
Diarrhea remains an important public health problem among toddlers, and caregiver handwashing is an important preventive practice. This study aimed to assess changes in mothers’ knowledge and reported handwashing behavior regarding the prevention of toddler diarrhea following leaflet-based health promotion in Mamboro Barat Urban Village, Palu City. A quantitative quasi-experimental study with a one-group pretest-posttest design was conducted among 30 mothers of toddlers who completed the pretest, leaflet-based health promotion, and posttest. Data were collected using structured questionnaires covering knowledge and reported handwashing behavior, with scores converted to a 0–100 scale. Univariate analysis described respondent characteristics and outcome distributions, while paired-samples t-tests compared pretest and posttest mean scores at a 0.05 significance level. Before the intervention, 18 respondents (60.0%) had poor knowledge, and 21 (70.0%) had poor handwashing behavior. After the intervention, 22 respondents (73.3%) had good knowledge, and 26 (86.7%) had good handwashing behavior. The mean knowledge score increased from 56.33 to 82.50, while the mean behavior score increased from 58.10 to 85.20. Paired-samples t-tests indicated significant within-group differences in knowledge (t = -21.85, p = 0.001) and reported handwashing behavior (t = -20.84, p = 0.001). Leaflet-based health promotion was associated with short-term improvements in mothers’ knowledge and reported handwashing behavior. Because the study used a single group and an immediate posttest, the findings should be interpreted as short-term within-group changes rather than as evidence of sustained behavior change or reduced incidence of diarrhea.
Downloads
References
Achjar, K. A. H., Marni, N. K., Lestari, A. S., & Ribek, I. N. (2023). Health education with leaflet media on the level of knowledge of mother’s about toddler rearing partners in stunting prevention. Journal of Education Research and Evaluation, 7(2), 197–203. https://doi.org/10.23887/jere.v7i2.61560
Althubaiti, A. (2016). Information bias in health research: definition, pitfalls, and adjustment methods. Journal of Multidisciplinary Healthcare, 9(4), 211–217. https://doi.org/10.2147/JMDH.S104807
Andrade, C. (2021). The limitations of quasi-experimental studies, and methods for data analysis when a quasi-experimental research design is unavoidable. Indian Journal of Psychological Medicine, 43(5), 451–452. https://doi.org/10.1177/02537176211034707
Ariani, D., Septiani, H., & Srinayanti, Y. (2024). The effects of using e-leaflet and lecture methods on maternal knowledge regarding stunting prevention in toddlers. Genius Journal, 5(1). https://doi.org/10.56359/gj.v5i1.329
Azizi, S. A., Salianto, S., & Astuty, D. A. (2024). The influence of health promotion through leaflet media on students knowledge about handwashing with soap. Indonesian Journal of Global Health Research, 6(3), 1405–1414. https://doi.org/10.37287/ijghr.v6i3.3187
Badan Kebijakan Pembangunan Kesehatan. (2024). Survei Kesehatan Indonesia (SKI) 2023. Jakarta: Badan Kebijakan Pembangunan Kesehatan. https://www.badankebijakan.kemkes.go.id/hasil-ski-2023/
Boyle, C., Bear, G., van Winsen, M., & Nicholson, G. (2020). Patient information on benign colorectal disease: an assessment of the value and effectiveness of traditional methods. Journal of Patient Experience, 7(6), 1410–1416. https://doi.org/10.1177/2374373520957769
Cronin, A. A., Sebayang, S. K., Torlesse, H., & Nandy, R. (2016). Association of safe disposal of child feces and reported diarrhea in Indonesia: need for stronger focus on a neglected risk. International Journal of Environmental Research and Public Health, 13(3), 310. https://doi.org/10.3390/ijerph13030310
Edward, A., Jung, Y., Chhorvann, C., Ghee, A. E., & Chege, J. (2019). Association of mother’s handwashing practices and pediatric diarrhea: Evidence from a multi-country study on community oriented interventions. Journal of Preventive Medicine and Hygiene, 60(2), E93–E102. https://doi.org/10.15167/2421-4248/jpmh2019.60.2.1088
Ejemot-Nwadiaro, R. I., Ehiri, J. E., Arikpo, D., Meremikwu, M. M., & Critchley, J. A. (2021). Hand-washing promotion for preventing diarrhoea. The Cochrane Database of Systematic Reviews, 12(1), CD004265. https://doi.org/10.1002/14651858.CD004265.pub4
Ferasinta, F., & Dinata, E. Z. (2020). The effect of education with the leaflet media on motivation in caring baby with diarrhea. Jurnal Vokasi Keperawatan (JVK), 3(2), 165–172. https://doi.org/10.33369/jvk.v3i2.13558
Hendrastuti, C. B. (2019). Hubungan tindakan pencegahan ibu dengan kejadian diare pada balita. Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education, 7(2), 215–222. https://doi.org/10.20473/jpk.V7.I2.2019.215-222
Hutasoit, M., Widiyandana, & Soenarto, S. S. (2017). Pengaruh media edukasi booklet tentang pencegahan diare dan pneumonia secara terpadu terhadap pengetahuan ibu. Media Ilmu Kesehatan, 6(2), 101–111. https://doi.org/10.30989/mik.v6i2.185
Kementerian Kesehatan Republik Indonesia. (2024). Indonesia health profile 2023. Jakrta: Kementerian Kesehatan Republik Indonesia.. https://kemkes.go.id/eng/indonesia-health-profile-2023
Komala, S., & Pangestika, R. (2024). Hubungan higiene perorangan dan sanitasi lingkungan dengan kejadian diare pada balita di Kelurahan Mekarjaya, Kota Depok. Ruwa Jurai: Jurnal Kesehatan Lingkungan, 18(1), 26–32. https://doi.org/10.26630/rj.v18i1.4461
Kregting, L. M., van Ravesteyn, N. T., Spijker, W., Dierks, T., Aitken, C. A., Geuzinge, H. A., & Korfage, I. J. (2020). Effects of a leaflet on breast cancer screening knowledge, explicit attitudes, and implicit associations. Patient Education and Counseling, 103(12), 2499–2507. https://doi.org/10.1016/j.pec.2020.06.032
Krumpal, I. (2013). Determinants of social desirability bias in sensitive surveys: a literature review. Quality & Quantity, 47(4), 2025–2047. https://doi.org/10.1007/s11135-011-9640-9
Luby, S. P., Halder, A. K., Huda, T., Unicomb, L., & Johnston, R. B. (2011). The effect of handwashing at recommended times with water alone and with soap on child diarrhea in rural Bangladesh: An observational study. PLoS Medicine, 8(6), e1001052. https://doi.org/10.1371/journal.pmed.1001052
Mbakaya, B. C., Kalembo, F. W., & Zgambo, M. (2020). Use, adoption, and effectiveness of tippy-tap handwashing station in promoting hand hygiene practices in resource-limited settings: A systematic review. BMC Public Health, 20(1), 1005. https://doi.org/10.1186/s12889-020-09101-w
Mbanda, N., Dada, S., Bastable, K., Ingalill, G.-B., & Ralf W, S. (2021). A scoping review of the use of visual aids in health education materials for persons with low-literacy levels. Patient Education and Counseling, 104(5), 998–1017. https://doi.org/10.1016/j.pec.2020.11.034
Musdalifah, M., Oka, I. A., & Marwanty, M. (2021). Efektivitas Promosi Kesehatan Terhadap Pengetahuan Dan Sikap Tatalaksana Diare Pada Balita Di Kota Palopo. PREPOTIF : Jurnal Kesehatan Masyarakat, 5(1), 20–34. https://doi.org/10.31004/prepotif.v5i1.1281
Noguchi, Y., Nonaka, D., Kounnavong, S., & Kobayashi, J. (2021). Effects of hand-washing facilities with water and soap on diarrhea incidence among children under five years in Lao People’s Democratic Republic: a cross-sectional study. International Journal of Environmental Research and Public Health, 18(2), 687. https://doi.org/10.3390/ijerph18020687
Purnama, L., Armiatin, A., & Salim, N. A. (2024). The relationship of mother’s knowledge, attitude, and hand washing patterns with the incident of diarrhea in toddler in RSUD dr. Fauziah Bireuen. JOHAR (Journal of Hospital Administration Research), 1(01), 13–21. https://doi.org/10.35706/johar.v1i01.10994
Reiner, R. C., Wiens, K. E., Deshpande, A., Baumann, M. M., Lindstedt, P. A., Blacker, B. F., Troeger, C. E., Earl, L., Munro, S. B., Abate, D., Abbastabar, H., Abd-Allah, F., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, G., Abegaz, K. H., Abreu, L. G., Abrigo, M. R. M., … Hay, S. I. (2020). Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: Analysis for the Global Burden of Disease Study 2017. The Lancet, 395(10239), 1779–1801. https://doi.org/10.1016/S0140-6736(20)30114-8
Rianti, R., Apriliawati, A., & Sulaiman, S. (2020). Pengaruh edukasi menggunakan leaflet, audio visual, leaflet dan audio visual terhadap pengetahuan, sikap dan perilaku orangtua dalam pencegahan diare di Puskesmas Rawat Inap Manis Jaya Tangerang. Journal of Islamic Nursing, 5(1), 60–67. https://doi.org/10.24252/join.v5i1.10396
Sari, R. A., Wardani, D. W. S. R., & Sari, R. D. P. (2019). Perilaku ibu rumah tangga yang mempunyai balita dan sanitasi dasar rumah dengan kejadian diare pada balita. Holistik Jurnal Kesehatan, 13(4), 402–415. https://doi.org/10.33024/hjk.v13i4.2301
Schubbe, D., Scalia, P., Yen, R. W., Saunders, C. H., Cohen, S., Elwyn, G., van den Muijsenbergh, M., & Durand, M.-A. (2020). Using pictures to convey health information: A systematic review and meta-analysis of the effects on patient and consumer health behaviors and outcomes. Patient Education and Counseling, 103(10), 1935–1960. https://doi.org/10.1016/j.pec.2020.04.010
Setyobudi, I., Pribadiani, F., & Listyarini, A. D. (2020). Analisis perilaku ibu tentang cuci tangan dengan kejadian diare pada balita di Rumah Sakit Mardi Rahayu Kudus. Jurnal Keperawatan Dan Kesehatan Masyarakat Cendekia Utama, 9(3), 214–222. https://doi.org/10.31596/jcu.v9i3.624
Staniford, L. J., & Schmidtke, K. A. (2020). A systematic review of hand-hygiene and environmental-disinfection interventions in settings with children. BMC Public Health, 20(1), 195. https://doi.org/10.1186/s12889-020-8301-0
Umboh, E. M., Engkeng, S., & Munayan, H. (2020). Pengaruh penyuluhan kesehatan tentang cuci tangan pakai sabun terhadap pengetahuan dan sikap pada peserta didik di SD GMIM 14 Manado. KESMAS: Jurnal Kesehatan Masyarakat Universitas Sam Ratulangi, 9(1). https://ejournal.unsrat.ac.id/v3/index.php/kesmas/article/view/28646
UNICEF & World Health Organization. (2020, June 26). Hand hygiene for all: A call to action for all of society to achieve universal access to hand hygiene. UNICEF. https://www.unicef.org/reports/hand-hygiene-for-all-2020
Wolf, J., Hubbard, S., Brauer, M., Ambelu, A., Arnold, B. F., Bain, R., Bauza, V., Brown, J., Caruso, B. A., Clasen, T., Colford, J. M., Freeman, M. C., Gordon, B., Johnston, R. B., Mertens, A., Prüss-Ustün, A., Ross, I., Stanaway, J., Zhao, J. T., … Boisson, S. (2022). Effectiveness of interventions to improve drinking water, sanitation, and handwashing with soap on risk of diarrhoeal disease in children in low-income and middle-income settings: A systematic review and meta-analysis. Lancet, 400(10345), 48–59. https://doi.org/10.1016/S0140-6736(22)00937-0
World Health Organization. (2024a). Diarrhoeal disease. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
World Health Organization. (2024b). Water, sanitation and hygiene and infection prevention and control measures for infectious diarrhoea in health-care settings: Operational guide. World Health Organization. https://www.who.int/publications/i/item/9789240098985
World Medical Association. (2024). World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. https://www.wma.net/policies-post/wma-declaration-of-helsinki/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 MEDICA (International Medical Scientific Journal)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.




