Increased Self Efficacy Fathers in Growth Stimulation and
Development Under Five Years (BALITA) with the Health Promotion
Model Approach
Heri Wibowo and Ririn Probowati
College of Health Sciences Pemkab Jombang, East Java, Indonesia
Keywords: Self-Efficacy, Father, Posyandu Father.
Abstract: Growth and development of infants influenced by self-efficacy of mother and providing stimulation from
mother that can be obtained from following activities like Posyandu father. The goal of health promotion
model application is to improve self effeciacy of father in stimulation Design quesi experiment with pre post
control group. This research carries out a health promotion development model in improving self efficacy
from the father's stimulus to the development and growth of children with modules. All the fathers who
have the children in POSYANDU father. The population of all fathers who had chidren (1-5years) of 102,
40 samples has taken with simple romdom sampling were divided into intervention group 20 and control
group 20. Variable of self efficacy father research and growth of development children analysis with t test α
= 0.05 The results show a change in self-efficacy of the father in the pre test and post test in the intervention
group with p = 0.000. Using a module as a guide in health promotion activities aims to improve the self
efficacy of the father. A simple module containing information and pictures will make it easier for fathers to
stimulate the growth and development of the children.
1 BACKGROUND
The interaction of mothers, fathers and toddlers is
largely determined by the quality of togetherness
that exists between the fathers, mothers and toddlers
because care is a shared responsibility between
mother and father.
Growth and development in toddlers requires
maximal stimulation by parents (father and mother)
for their children to grow and develop optimally
(Yusuf, 2005). Especially in the Golden period of
the 1000-day period of childhood is a very important
period for the growth and development of a baby to
get growth stimulation in the form of nutrition and
stimulation of development in order to achieve
optimal intelligence. Efforts to optimize the growth
and development of children have been done by the
government and the community to increase the role
of people around the mother, father and family in
order to have self-efficacy or confidence in the
ability to provide stimulant growth and
development.
POSYANDU activities consist of POSYANDU,
coaching family centre (BKB) and PAUD is an
activity organized by the community and for the
community so that the community is able to
independently stimulate growth and development
which in turn the children can grow and develop
optimally.
POSYANDU which has been run by female
cadres and who deliver children to POSYANDU
also mother, grandmother, aunt is a woman. But
children also need the stimulation of a father
activities can be obtained through the activities.
POSYANDU father The expectations of a father
also crave a close relationship with his children from
pregnancy and subsequently play an active role in
the lives of his children. But how can fathers do if
society promotes traditional gender roles where
women are considered primary caregivers.
As an effort to evaluate the self efficacy of the
father in providing stimulation of growth and
development on balita can be done through the
theory of Health Promotion Model by the pattern of
J.Pender (Bandura, 1997). Model of health
promotion concept is optimal health which in toddler
we can see from growth and optimal development.
Optimal growth and development one of them is
Wibowo, H. and Probowati, R.
Increased Self Efficacy Fathers in Growth Stimulation and Development Under Five Years (BALITA) with the Health Promotion Model Approach.
DOI: 10.5220/0008331106910695
In Proceedings of the 9th International Nursing Conference (INC 2018), pages 691-695
ISBN: 978-989-758-336-0
Copyright
c
 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
691

influenced by the stimulation provided by the father.
A father can provide good stimulation if the father
has knowledge of stimulation that can be obtained
through activities at POSYANDU father.
Model Theory Health promotion suggests the
importance of cognitive processes called social
cognitive theory including self-belief in behavioral
change. Social cognitive social learning theory
includes self efficacy that is influenced from aspects
of cognition and affection of specific behavior
(Bandura, 1977).
The concept of Barbara Resnick theory self
Efficacy is based on the behavior of a person is
something that is thought, believed, and will affect
one's feelings in the ability to perform an action. Self
Efficacy process in a person who plays a role is 1)
cognitive process is action a person begins with
something to think about first.2) The process of
motivation is self-impulse and directing action
through the previous stage of thought. 3) Affective
process is the process of regulating emotional states
and emotional reactions. 4) Selection process is the
ability of individuals to choose certain activities and
situations
6
. Through increased self efficacy a father
will have an increased confidence in the ability to
provide stimulation of growth and development. One
way to improve self efficacy is verbal persuasion:
Verbal is used extensively to persuade a person that
they have the ability to achieve goals through direct
education.
From the research of Ririn et al, 2017 that the
development of health promotion model in
improving self efficacy of father stimulation of
growth and development of balita at posyandu of
Losari village father of Ploso sub-district of
Jombang Regency are all influential variable in
increasing self efficacy of father that is benefit
variable. obstacles variable, self-confidence variable,
influence variable caused by stimulation,
interpersonal influence variable, situational
influence variable giving stimulation of growth and
development of toddler, self efficasy variable of
father, father commitment variable, father behavior
variable, growth variable and infant development
with value t> 1.96. and improvement of self efficacy
of father in giving stimulation of growth and
development can be done through verbal persuation
by using a guidance in the form of learning module
(Ririn, n.d).
The purpose of this research is to apply health
promotion development model in improving self
efficacy of father stimulation of growth and
development of BALITA by using a module at
posyandu father of Jombang district.
2 METHODS
Research design using pre post-experiment with
control (Kuntoro, 2010). In this research will be
implementation of health promotion development
model in improving self efficacy of father
stimulation of growth and development of BALITA
by using a module at posyandu father of Jombang
district.
Implementation model is done to prove the
effectiveness of a model increase self-efficacy father
in stimulation growth and development of BALITA
which was in POSYANDU father.
In the intervention group use the media of a
module with verbal persuasion that contains 1)
identifies the types of games that can be used, how
to use games to stimulate, how to assess progress. 2)
practice how to weigh weight 3) how to read KMS
to assess the minimal weight change. In the control
group get education using media leaflet
(conventional method) done before going home in
the activity POSYANDU father. In the intervention
and control group At week 2. 3. 4 were assessed by
visiting home to see self efficacy of the father
stimulating growth and development of BALITA.
The population, sample and time9 All fathers
who have BALITA in POSYANDU Father of Losari
Village, Ploso sub-district jombang 2017 with a
sample of 20 respondents intevens and 20 groups of
with simple rondom sampling. Data September -
October 2017. The data analysis using paired T test
with α = 0.05.
3 RESULTS
In table 1 there was no significant change in self-
efficacy before and after intervention. In table 2
there was no significant change in self efficacy of
the father before and after intervention. In table 3
there was no significant growth in of the baby before
and after intervention. In table 4 there was
significant growth in of the baby before and after
intervention. In table 5 there was no significant
growth in of the baby before and after intervention.
Tabel 1: The level of self-efficacy of the father after and
before intervention in the intervention group.
Level
Category
Frequency
Before
Frequency
after
∑
%
∑
%
self
efficacy
Good
2
10
4
20
Enough
4
20
14
70
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
692

ayah
Less
14
70
2
10
amount
20
100
20
100
p = 0.000
Tabel 2: The level of self-efficacy of the father after and
before intervention in the control group.
Level
Category
Frequency
Before
Frequency
after
∑
%
∑
%
self efficacy
ayah
Good
3
15
3
15
Enough
6
30
7
35
Less
11
55
10
50
amount
20
100
20
100
p = 0.743
Tabel 3: Growth of BALITA in the intervention group and
Control Group.
Changes in weight
Intervention
Control
∑
%
∑
%
Weight
increased
10
50
4
20
Decreased
2
10
2
10
stable
8
40
14
70
Amount
20
100
20
100
p = 0.743
Tabel 4: Development of BALITA on a group of
interventions.
Characte-
ristic
Indicator
Frekuensi
Before
After
∑
%
∑
%
Gross
motor
Appropriate
17
85
19
95
doubtful
3
15
1
5
deviation
0
0
0
0
Fine
motor
Appropriate
17
85
19
95
doubtful
3
15
1
5
deviation
0
0
0
0
Sosiliasasi
Appropriate
16
70
19
95
doubtful
4
20
1
5
deviation
0
0
0
0
language
Appropriate
16
80
18
90
doubtful
2
10
2
10
deviation
2
10
0
0
p = 0.001
Tabel 5: Development of BALITA on a group of control.
Indicator
Indicator
Frekuensi
Before
After
∑
%
∑
%
Gross
motor
Appropriate
16
70
17
75
doubtful
3
15
2
10
deviation
1
5
1
5
Fine
motor
Appropriate
15
75
15
75
doubtful
5
25
5
25
deviation
0
0
0
0
Sosiliasasi
Appropriate
16
70
17
75
doubtful
4
20
3
15
deviation
0
0
0
0
language
Appropriate
16
80
16
80
doubtful
2
10
2
10
deviation
2
10
0
0
p = 0.732
Tabel 6 : Analysis of health education on self efficacy of
fathers in control and intervention groups.
Indicator Self
efficacy
Mean ± SD
p
Significant
Intervensi
8.90±0.894
0.000
Significant
Control
12.70±1.594
7.143
Not significant
4 DISCUSSIONS
Most (70%) self-efficacy fathers before being given
an education on how to stimulate growth and
development of BALITA using a module is less and
after being given self efficacy education most fathers
(70%) enough in table 3 appears to change after
intervention using a book modules used to provide
growth stimulation and development of the Balinese.
In Table 4 Self-efficacy of the father in the control
group before and after does not appear to change. In
the control group intervention was given as usual
using a leaflet during a visit to POSYANDU father.
Bandura (1997) defines self-efficacy as a
person's belief in his ability to organize and execute
actions to achieve defined goals and seek to assess
levels and strengths across activities and contexts
(Bandura, 1997). Myers (1996) also says that self-
efficacy is how one feels able to do a thing. Self-
efficacy in the father is a belief that has to provide
stimulation of growth and development of the
Balinese in order to achieve growth and
development of optimal BALITA. Bandura 1997
Self-efficacy is influenced by age, experience, work
most of the father's age between 20-40 years. Age is
the length of a person experiencing life, in a life of a
father will experience the learning process in setting
up a child-generating home as the next generation of
the family. A father has a role as head of the family
who is the head in educating children other than the
main role is as the main breadwinner in the family.
Self-efficacy is formed through a social learning
process that can last for life. Older individuals tend
to have more time and experience in coping with
what happens when compared to younger
individuals, who may still have little experience and
events in their lives. The older individual will be
Increased Self Efficacy Fathers in Growth Stimulation and Development Under Five Years (BALITA) with the Health Promotion Model
Approach
693

better able to overcome the obstacles in his life
compared to the younger individual, it is also related
to the experience that individuals have throughout
their life span. The higher the age of the father is
expected to have experience in educating children in
the form of stimulation of growth and development
of BALITA.
One of the factors affecting self-effecacy is
father's level of education. Bandura (1997) Self-
efficacy education level is formed through an
acceptable learning process of individuals at the
level of formal education. Individuals who have
higher levels usually have higher self-efficacy,
because basically they learn more and receive more
formal education, other than that individuals who
have higher education will have more chance to
learn in overcoming the problem - the problems in
his life. Medium father education will affect self
efficacy in stimulating growth and development.
Stimulation is an activity performed by the father to
stimulate growth and development.
Activity stimulation is a father's behavior that
can be observed by others in providing stimulation
to the Balinese. Secondary education in conducting
an activity required clear guidance. In the
intervention group with a module that is easily
understood by the father for guidelines in providing
stimulation of growth and development (Depkes,
2007).
Module is a book to facilitate one in giving
stimulation. In a module that contains a picture of
the way stimulation makes it easy for a father to do
the stimulation, the intermediate educator will easily
use a module containing the images.
Most of my father's work still works when my
father gets a regular salary every month and every
day routine leaves home to work for a living.
Permanent work affects the father's self efficacy in
stimulating the growth and development of the
Balinese.
A father who has a steady job will have a good
self efficacy because by working a father earns a
salary that can be used to support his wife and
children. A portion of the father's salary can be
bought to buy tools used for stimulation. A father if
able to meet the needs of his child will affect the
good self efficacy. On the other hand to work time
gathering with children and wives will decrease,
especially the time in giving stimulation to BALITA
will decrease therefore a father will try to improve
self efficacy in giving stimulation by seeking
information about stimulation of growth and
development.
Mostly middle and late child positions. a child's
position may affect a father's experience in
stimulating the growth and development of the
Balinese. Banduru (1997) One's experience affects
self-efficacy. Previous experiences that have had a
good impact on stimulating growth and development
in previous children will be used by fathers in
stimulating children now that will improve the self
efficacy of father for the better by before. Direct
experience as a result of the experience of doing a
task in the past had done the task in the past
In table 3 In the intervention group before and
after being given a health education on how to
stimulate growth and development using the module
there is an increase in self efficacy of the father.
Table 5.4 in the control group given health education
using the standard on the POSYANDU service
father using the leaflet did not experience self-
efficacy change father.
Health education is a process to improve people's
ability to maintain their capabilities and improve
their health. Notoatmojo (2010) self-efficacy owned
by someone is also filled with information (Bandura,
1977). The more often a person gets information
from sharing media sources increasing his self-
efficacy.
Bandura in Hambawany (2007) one way that one
can increase self-efficacy is Verbal persuasion is a
way to influence a person using verbal that they
have the ability to achieve their desired goals
(Bandura, 1977). A person who gets verbal
persuasion will have the ability to complete the task
at his disposal with the maximum possible effort
than someone who does not get persuasion verbally.
Persuasion verbally is always in use by health
personnel to influence a person to be able to act in
accordance with the expected behaviour. In the
intervention group got a verbal persuasion about
how to stimulate growth and development on
BALITA by using a module or book that can be
used by the father as a guide in providing
stimulation. Inside the module there are various
ways of stimulating and loading interesting pictures
so that the father can easily do the stimulation. A
module that includes things that interest the father
will make it easier for the father to receive the
information contained in the module that will
ultimately be easy for father to stimulate the
Balinese. In the control group POSYANDU father
on table 4 health education provided by a cadre with
a leaflet. The leaflet is a simple medium containing
information that can also be used as a guide to the
father in providing stimulation. Inside the
information leaflet is limited to allow the father to
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
694

understand precisely what should be done to
stimulate his Baldness. Modul is a handbook created
for the father's guidance in providing the stimulation
already considered with the father's ability to
provide stimulation.
Table 8 The t-test results in the intervention and
control groups showed that there was a significant
difference in self-efficacy in the stimulation of
growth and development of BALITA. The accepted
research hypothesis is that there is a difference
between the father's self effecacy before being given
intervention and after being given intervention using
the guideline of a stimulation module of growth and
development of BALITA by leaflet method.
The theory of the health promotion model
suggests that manuasia has basic skills such as the
symbolization of the process and the transformation
of experience as a guide to stimulation appropriately
and correctly to achieve optimal growth and
development on Balinese.
5 CONCLUSIONS
Health education can increase the self efficacy of the
father and with increased self efficacy the increased
father can also increase infant growth and
development, we suggest that For Health Officers
Increasing health education to POSYANDU cadres
with a variety of methods and media that make it
easy for fathers to receive information on
stimulation of growth and development. For the
father It is expected that the father actively seek
information from sharing media sources how to
stimulasi growth and development of Balinese. For
POSYANDU's father cadres. It is expected to be
more active following activities aimed at improving
understanding of growth and developmental
stimulation.
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Bandura, A., 1977. Self-efficacy: Toward a unifying
theory of behavioral change. Psychological Review,
84, pp.191–215.
DEPKES, 2007 Stimulasi , Deteksi dan Intervensi Dini
Tumbuh kembang Anak di Tingkat Pelayanan
kesehatan Dasar
Kuntoro, 2010.Metodologi Sampling dan Besar Sampling
Pustaka Melat, Surabayai
Nursalam. 2016. Konsep dan Penerapan Metodologi Ilmu
Keperawatan, Salemba. Jakarta
Syamsu Yusuf 2005, Psikologi Perkembangan Anak dan
Remaja, Bandung, PT Remaja Rosdakarya
Wong et al ,2008 Buku Ajar Keperawatan Pediatric, Edisi
4 EGC
Increased Self Efficacy Fathers in Growth Stimulation and Development Under Five Years (BALITA) with the Health Promotion Model
Approach
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