Game-Based Education Improves Stunting Knowledge and Healthy Behaviors Among Primary Students

Hesteria Friska Armynia Subratha; Ida Ayu Diah Purnama Sari; Ni Kadek Diah Purnamayanti; Fajar Dwi Cahyoko; Neil Madulara Martin

doi:10.30787/gaster.v24i1.2403

Authors

Hesteria Friska Armynia Subratha Department of Midwifery, Faculty of Medicine, Universitas Pendidikan Ganesha, Singaraja
Ida Ayu Diah Purnama Sari Department of Medicine, Faculty of Medicine, Universitas Pendidikan Ganesha, Singaraja
Ni Kadek Diah Purnamayanti Department of Nursing, Faculty of Medicine, Universitas Pendidikan Ganesha, Singaraja
Fajar Dwi Cahyoko Demographic and Civil Registration Study Program, Universitas Sebelas Maret, Surakarta
Neil Madulara Martin Nursing Program, Mindanao State University – Iligan Institute of Technology, Iligan City, Mindanao

DOI:

https://doi.org/10.30787/gaster.v24i1.2403

Keywords:

stunting prevention, health promotion, nutrition education, game-based learning, School-based Intervention

Abstract

Introduction: Stunting remains a major public health challenge in Indonesia, particularly among school-age children, reflecting persistent gaps in nutrition knowledge and health-related behaviors. Conventional health education approaches often show limited effectiveness in engaging children, highlighting the need for more interactive and context-appropriate strategies. Gamification has emerged as a promising approach to enhance learning engagement, yet evidence on its application in nutrition education within local settings remains limited.

Objective: To examine the effectiveness of a game-based health education intervention in improving nutrition knowledge and attitudes related to stunting prevention among elementary school students.

Method: A quasi-experimental design with a pretest–posttest approach was conducted among elementary school students selected using purposive sampling. The intervention consisted of nutrition education delivered through a modified snakes and ladders game. Data on students’ knowledge and attitudes were collected using structured questionnaires before and after the intervention. Statistical analyses were performed to assess changes in outcomes following the intervention.

Result: The findings demonstrated a significant improvement in both nutrition knowledge and attitudes after the implementation of the game-based education intervention. Students showed higher engagement during learning sessions, indicating that interactive media facilitated better understanding of balanced nutrition and stunting prevention concepts.

Conclusion: Game-based nutrition education is an effective and feasible strategy to enhance students’ knowledge and attitudes related to stunting prevention. Despite limitations related to study design and sample size, these findings support the integration of gamified learning approaches into school health programs. Future studies are recommended to assess long-term behavioral outcomes within broader policy frameworks.

References

Dinas Kesehatan Kabupaten Badung. Data Jumlah Stunting Kabupaten Badung Tahun 2023. 2023. Available from: https://diskes.badungkab.go.id/storage/diskes/file/Data%20jumlah%20stunting%20dan%20rekomendasi%20Pengukuran%20dan%20publikasi%20tahun%202023.pdf [Last accessed: 4/1/2024].

Woldehanna T, Behrman JR, Araya MW. The effect of early childhood stunting on children’s cognitive achievements: Evidence from young lives Ethiopia. Ethiop J Health Dev 2017;31(2):75–84.

Kementerian Kesehatan RI. Mengenal Apa Itu Stunting. 2022. Available from: https://yankes.kemkes.go.id/view_artikel/1388/mengenal-apa-itu-stunting [Last accessed: 3/14/2023].

Direktorat Jendral Kesehatan Masyarakat Kementerian Kesehatan RI. Cegah Stunting Itu Penting. Warta Kesmas 2018;2(2).

Awaliyah S, Apriadi Siregar P, Sumatera Utara U, et al. PENGARUH PENYULUHAN GIZI MELALUI MEDIA PERMAINAN ULAR TANGGA DAN CERITA BERGAMBAR TERHADAP PENGETAHUAN DAN SIKAP TENTANG GIZI SEIMBANG PADA ANAK SEKOLAH USIA 7-12 TAHUN DI KELURAHAN INDRAKASIH MEDAN TEMBUNG. Jurnal Kesehatan Masyarakat Indonesia 2023;1(1):10–21.

Azizah M. Pengaruh Media Ular Tangga Terhadap Pengetahuan Dan Sikap Konsumsi Buah Dan Sayur Pada Anak Sekolah Dasar Di Wilayah Kerja Puskesmas Tanjung Enim. 2023.

Widiana W, Nyoman Jampel I, Prawini IP. The Effectiveness Of Traditional Game-Based Communication Learning Activity For Cognitive Process Dimension Learning Achievement. Cakrawala Pendidikan, Juni 2018 2018;2(2).

Fradianto I, Andriyanto A, Akbar N, et al. Improving Handwashing Behavior of School-Age Children Through a Game-Based Educational Program. ASEAN Journal of Community ASEAN Journal of Community Engagement Engagement 2022;6(2):324–334; doi: 10.7454/ajce.v6i2.1138.

Lagu AMHR, Thaha RM, Syafar M, et al. Using Games to Promote Healthy Behavior in Children: A Narrative Review. Open Access Maced J Med Sci 2022;10(E):1904–1910; doi: 10.3889/oamjms.2022.8851.

Andriani R, Apriani F, Damayanti S, et al. Game Ular Tangga: Media Edukatif dan Persuasif Dalam Memilih Jajanan Sehat Bagi Anak Usia Sekolah Dasar. Prosiding Seminar Nasional Pengabdian Masyarakat 2023;1:2023; doi: 10.61142/PSNPM.V1.83.

Lellyawaty L, Mariani M, Nisa C. Education Prevent Stunting Through Snakes and Ladders Game. Jurnal Mandala Pengabdian Masyarakat 2022;3(2):135–140; doi: 10.35311/JMPM.V3I2.81.

Ratna Adiba T, Katmawanti S. EFEKTIVITAS PERMAINAN ULAR TANGGA SEBAGAI MEDIA PENYULUHAN TERHADAP PENGETAHUAN GIZI SEIMBANG SISWA DI SDN LANDUNGSARI 1 KABUPATEN MALANG. Preventia: Indonesian Journal of Public Health 2020;5(1):1–7.

Fadhilah D, Ninuk Sri Hartini T, Made Alit Gunawan I, et al. Efektifitas Penyuluhan tentang Sayuran Menggunakan Media “Kartu Sayuran” terhadap Peningkatan Pengetahuan Siswa Sekolah Dasar. JURNAL NUTRISIA 2017;19(2):100–105; doi: 10.29238/JNUTRI.V19I2.18.

Dewi SP, Kurniasari R. Literature Riview: Pengaruh Media Pembelajaran Edukatif Terhadap Pengetahuan, Sikap, Dan Perilaku Gizi Pada Siswa Sekolah Dasar: Difference in knowledge before and after giving program counseling I am proud to know (Abat) about HIV and AIDS in class X and Xi students At SMK Tunas Pariwisata Ungaran. JURNAL GIZI DAN KESEHATAN 2022;14(1):138–145; doi: 10.35473/JGK.V14I1.284.

Maksum E, Murtiningsih M, Inayah I. Systematic Riview: Permainan Ular Tangga tentang Protokol Kesehatan Covid-19 dan Edukasi Kesehatan Anak Sekolah. Jurnal Kesehatan Komunitas 2022;8(3):453–462; doi: 10.25311/KESKOM.VOL8.ISS3.1099.

Thaha RM, Farid JA, Rachmat M, et al. The Effect of Education Using Snakes and Ladders Board Game on Healthy Snacks Selection of Elementary School Students. Macedonian Journal of Medical Sciences 2022;10(E):465–470; doi: 10.3889/oamjms.2022.8327.

Novaria Pay M, Leu Obi A, Nubatonis MO, et al. THE EFFECTIVENESS OF COUNSELING USING PUZZLE AND SNAKE AND LADDER GAME MEDIA ON DENTAL CARIES KNOWLEDGE IN ELEMENTARY SCHOOL STUDENTS. JDHT Journal of Dental Hygiene and Therapy 2023;4(2):140–145; doi: 10.36082/JDHT.V4I2.1311.

Kementerian Kesehatan RI. BUKU SAKU Hasil Survei Status Gizi Indonesia (SSGI) 2022. 2023.

Kementerian Kesehatan RI. Ular Tangga Stunting. 2019.

Fatimah AS, Weni K, Th. Ninuk Sri H. EFEKTIVITAS PENYULUHAN GIZI MENGGUNAKAN MEDIA PGS CARDS DIBANDINGKAN LEAFLET TERHADAP PENINGKATAN PENGETAHUAN PEDOMAN GIZI SEIMBANG PADA SISWA SEKOLAH DASAR. 2019.

Widiasavitri PN, Agustini NMYA, Astiti DP, et al. TRADITIONAL GAMES AS ALTERNATIVE ACTIVITIES FOR CHILDREN STIMULATION. JPAI (Journal of Psychology and Instruction 2020;4:1–9.

Fitrizah MK, Raksanagara AS, Agoes R. THE EFFECT OF SNAKES AND LADDERS GAME TO IMPROVE KNOWLEDGE AND ATTITUDES OF ELEMENTARY SCHOOL STUDENTS TO STOP OPEN DEFICATION IN BANDUNG CITY. he Indonesian Journal of Public Health 2020;15(2):173–180; doi: 10.20473/ijph.vl15il.2020.173-180.

Miller CJ, Mcnear J, Metz MJ. A comparison of traditional and engaging lecture methods in a large, professional-level course. Adv Physiol Educ 2013;37:347–355; doi: 10.1152/advan.00050.2013.-In.

Alaagib NA, Musa OA, Saeed AM. Comparison of the effectiveness of lectures based on problems and traditional lectures in physiology teaching in Sudan. BMC Med Educ 2019;19(1); doi: 10.1186/S12909-019-1799-0.

Afrasiabifar A, Asadolah M. Effectiveness of shifting traditional lecture to interactive lecture to teach nursing students. Invest Educ Enferm 2019;37(1); doi: 10.17533/UDEA.IEE.V37N1A07.

van Gaalen AEJ, Brouwer J, Schönrock-Adema J, et al. Gamification of Health Professions Education: A Systematic Review. Advances in Health Sciences Education 2021;26(2):683–711; doi: 10.1007/s10459-020-10000-3.

Khoshnoodifar M, Ashouri A, Taheri M. Effectiveness of Gamification in Enhancing Learning and Attitudes: A Study of Statistics Education for Health School Students. J Adv Med Educ Prof 2023;11(4):230–239; doi: 10.30476/jamp.2023.98953.1817.