Effectiveness of storytelling and roleplay in improving oral hygiene knowledge and supporting nutritional health among elementary school students: A quasy experimental study

Anses Warman* -  Department of Dental Nursing, Poltekkes Kemenkes Padang, Indonesia
Arnetty Arnetty -  Department of Dental Nursing, Poltekkes Kemenkes Padang, Indonesia
Ika Ifitri -  Department of Dental Nursing, Poltekkes Kemenkes Padang, Indonesia
Fadila Rahmat Dinanti -  Department of Dental Nursing, Poltekkes Kemenkes Padang, Indonesia
Amiruddin Amiruddin -  Department of Dental Nursing, Poltekkes Kemenkes Aceh, Indonesia
Renita Eka Zurianti -  Members of PDGI Bengkalis Branch, Riau, Indonesia
DOI : 10.30867/action.v10i3.2657

Poor oral hygiene among school-aged children can compromise food intake and contribute to nutritional problems including stunting, wasting, and underweight. However, few studies have explored active learning methods that integrate oral health education with its nutritional implications. This study evaluated the effectiveness of storytelling and roleplay in improving oral hygiene knowledge and their potential relevance to nutritional health promotion. A true experimental study with a pretest-posttest design on two intervention groups was conducted in December 2024 at State Elementary School 23, Kubang Putiah, Agam Regency, West Sumatra. Thirty-six students in grades III and IV were randomly assigned to either the storytelling or roleplay groups. Both groups received one week of structured counseling. Instrument validity and reliability were confirmed through expert review and Cronbach’s alpha testing (α > 0,80). Paired and independent t-tests were used at the 95% confidence level. Results indicated significant post-intervention knowledge gains in both groups (p < 0,001), with the roleplay group achieving a greater mean improvement (27,8 ± 1,77) than the storytelling group (19,5 ± 2,60; p < 0,001). Roleplay demonstrated superior effectiveness in enhancing children’s oral health literacy, which is essential for supporting school-based malnutrition prevention initiatives such as the School Health Unit (SHU) program and curriculum integration. Longitudinal studies are recommended to examine behavioral changes and their measurable impact on nutritional status.

Keywords : Oral hygiene, knowledge, nutritional health, roleplay, storytelling

  1. Abdi, F., Karamoozian, A., Lotfilou, M., Gholami, F., Shaterian, N., Niasar, A. A., Aghapour, E., & Jandaghian-Bidgoli, M. (2025). Effect of play therapy and storytelling on the anxiety level of hospitalized children: a randomized controlled trial. BMC Complementary Medicine and Therapies, 25(1), 23. https://doi.org/10.1186/s12906-025-04767-4
  2. Abigayl, I., & Putri, A. N. (2024). Assessing dental health knowledge and care behavior among school children in Banjar City, Indonesia. Journal of Syiah Kuala Dentistry Society, 9(2), 186–194. https://doi.org/10.24815/jds.v9i2.39258
  3. Aboalshamat, K., Alsharif, F. S., Alsanei, B. S., Aljohani, A., Aljabri, S., Salawati, R., & Nassar, A. A. (2023). Storytelling as innovative method to improve the recognition of teledentistry among adults: A randomized controlled trial. International Journal of Dentistry, 2023, 1–7. https://doi.org/10.1155/2023/8814905
  4. Ayten, B. K., & Polater, C. (2021). Values education using the digital storytelling method in fourth grade primary school students. International Journal of Education and Literacy Studies, 9(2), 66. https://doi.org/10.7575/aiac.ijels.v.9n.2p.66
  5. Belda-Medina, J., & Goddard, M. B. (2024). The effect of digital storytelling on english vocabulary learning in inclusive and diverse education. International Journal of English Language Studies, 6(1), 110–118. https://doi.org/10.32996/ijels.2024.6.1.11
  6. BKPK. (2023). Survei Kesehatan Indonesia (SKI) 2023. https://www.badankebijakan.kemkes.go.id/ski-2023-dalam-angka/
  7. Cohen, L., Manion, L., & Morrison, K. (2017). The ethics of educational and social research. In Research Methods in Education (8th editio, p. 33). Routledge. https://doi.org/10.4324/9781315456539
  8. Cronin-Gilmore, J., & Hammond, H. G. (2024). Storytelling in videos: A novel way to teach qualitative research. Advances in Online Education: A Peer-Reviewed Journal, 3(1), 85–98. https://doi.org/10.69554/LAIY8682
  9. Cuffee, Y., Burse, N. R., Jaffe, R., & Hargraves, J. L. (2022). Developing a storytelling study for African Americans with hypertension: A study protocol. Delaware Journal of Public Health, 8(4), 48–53. https://doi.org/10.32481/djph.2022.10.010
  10. Ernawati, F., Efriwati, Nurjanah, N., Aji, G. K., Hapsari Tjandrarini, D., Widodo, Y., Retiaty, F., Prihatini, M., Arifin, A. Y., Sundari, D., Rachmalina, R., Salimar, Julianti, E. D., Aidi, M. N., & Syauqy, A. (2023). Micronutrients and Nutrition Status of School-Aged Children in Indonesia. Journal of Nutrition and Metabolism, 2023(1), 4610038. https://doi.org/https://doi.org/10.1155/2023/4610038
  11. Fadhilah, N. (2025). Efektivitas penyuluh kesehatan gigi dengan metode storytelling dan ceramah terhadap pengetahuan kesehatan gigi pada siswa SDN. 101921 Beringin. Future Academia: The Journal of Multidisciplinary Research on Scientific and Advanced, 3(1), 486–495. https://doi.org/10.61579/future.v3i1.440
  12. FAO. (2021). The State of Food Security and Nutrition in the World 2021. https://openknowledge.fao.org/server/api/core/bitstreams/1c38676f-f5f7-47cf-81b3-f4c9794eba8a/content
  13. Haznedaroglu, E., & Polat, E. (2023). Dental Caries, Dental Erosion and Periodontal Disease in Children with Inflammatory Bowel Disease. International Journal of Medical Sciences, 20(5), 682–688. https://doi.org/10.7150/ijms.83075
  14. Heaton, B., Gebel, C., Crawford, A. J., Barker, J. C., Henshaw, M., García, R. I., Riedy, C. A., & Wimsatt, M. A. (2018). Using storytelling to address oral health knowledge in American Indian and Alaska native communities. Preventing Chronic Disease, 15(E63), 170305. https://doi.org/10.5888/pcd15.170305
  15. Jun, J., Siegrist, K., & Weinshenker, D. (2022). Evaluation of nurses’ experiences with digital storytelling workshop: new way to engage, connect, and empower. Journal of Nursing Management, 30(5), 1317–1323. https://doi.org/10.1111/jonm.13619
  16. Kenefick, M. A., & June, M. R. (2020). Video storytelling in the classroom: The role of narrative transportation. Journal of Nursing Education, 59(8), 470–474. https://doi.org/10.3928/01484834-20200723-10
  17. Kim, S. W., Chen, A. C.-C., Ou, L., Larkey, L., Todd, M., & Han, Y. (2023). Developing a culturally and linguistically congruent digital storytelling intervention in Vietnamese and Korean American mothers of human papillomavirus–vaccinated children: Feasibility and acceptability study. JMIR Rormative Research, 7, e45696. https://doi.org/10.2196/45696
  18. Kusumo, M. P. (2021). Health Behavior Education to Prevent Coronavirus Disease-19 in Orphanages: Roleplay Strategies. Open Access Macedonian Journal of Medical Sciences, 9(E), 1480–1484. https://doi.org/10.3889/oamjms.2021.6870
  19. Mayangsari, R., & Rasmiati, K. (2020). Effect of supplementation of F100 biscuits modified with moringa oleifera flour substitution on nutritional status of under-five children with malnutrition in Kendari City Indonesia. Public Health of Indonesia, 6(1), 28–34. https://doi.org/10.36685/phi.v6i1.318
  20. Mazengia, A. L., & Biks, G. A. (2018). Predictors of stunting among school‐age children in northwestern Ethiopia. Journal of Nutrition and Metabolism, 2018(1), 752175. https://doi.org/10.1155/2018/7521751
  21. Merbawani, G. W., Setiawan, S., & Anam, S. (2023). “In Storytelling, we see the performance more from the personality”: The goals and self-regulation on storytellers of other-language. EDUKASIA Jurnal Pendidikan Dan Pembelajaran, 4(2), 2109–2120. https://doi.org/10.62775/edukasia.v4i2.555
  22. Moradi, H., & He-fang, C. (2019). Digital storytelling in language education. Behavioral Sciences, 9(12), 147. https://doi.org/10.3390/bs9120147
  23. Mosses, A., Ngadaya, E., Leyna, G., Solomon, D., Msola, H., Said, F. A., Masanja, H., Kagaruki, G., Mwiru, R. S., Salmin, A., Isangula, K., Kiyungai, M., Kombo, K. M., Mchau, G., Ngegba, J., & Codjia, P. (2025). Prevalence and Determinants of Double and Triple Burden of Malnutrition Among School Going Children and Adolescents in Zanzibar, 2022. MedRxiv, 12(3), 1–24. https://doi.org/10.1101/2025.02.28.25323109
  24. Özdemir, K., & Tuna, Y. E. (2023). A history lesson designed with the digital storytelling method: Kara Fatma example. International Journal of Education and Literacy Studies, 11(4), 362–371. https://doi.org/10.7575/aiac.ijels.v.11n.4p.362
  25. Özel, İ. Ç., Erbaş Ünverdi, G., Serdar Eymirli, P., & Yabancı Ayhan, N. (2024). The relationship between dental caries, dietary intake and body composition in school-age children. Egyptian Pediatric Association Gazette, 72(1), 14. https://doi.org/10.1186/s43054-024-00255-5
  26. Pakpahan, F., Sadira, L., Syifah, N., Jodi, S., Panjaitan, E., & Meisuri, W. (2025). The effectiveness of storytelling in improving speaking skills of junior high school students. KIRANA: Social Science Journal, 2(2), 48–55. https://doi.org/10.61579/kirana.v2i2.474
  27. Pulimeno, M., Piscitelli, P., & Colazzo, S. (2020). Children’s literature to promote students’ global development and wellbeing. Health Promotion Perspectives, 10(1), 13–23. https://doi.org/10.15171/hpp.2020.05
  28. Puteri, A. D., & Emini, E. (2023). Storytelling as increasing knowledge of dental health in kindergarten. Journal Center of Excellent: Health Assistive Technology, 1(2), 71–75. https://doi.org/10.36082/jchat.v1i2.1257
  29. Putriningtyas, I. F., Sulasri, N. A., & Mnsen, R. E. (2023). Support for the comprehensive school health model to increase reproductive health knowledge of elementary school children as a primary prevention effort. Journal of Health Sciences, 16(03), 258–266. https://doi.org/10.33086/jhs.v16i03.5110
  30. Rahayu, A. S., Eryansyah, E., & Sitinjak, M. D. (2022). Four Strategies in Teaching Speaking During Covid -19 Pandemic at SMA N 04 Palembang. English Review Journal of English Education, 10(3), 843–854. https://doi.org/10.25134/erjee.v10i3.6342
  31. Saavedra, J. M., & Prentice, A. M. (2023). Nutrition in school-age children: a rationale for revisiting priorities. Nutrition Reviews, 81(7), 823–843. https://doi.org/10.1093/nutrit/nuac089
  32. Santoso, M., Agrawal, R., Tiwari, K., Manjanatha, D., Austin, S. B., McAdams-Mahmoud, A., Craddock, N., & Raffoul, A. (2023). Tackling Colourism Through Storytelling in an Online Course for Public Health Professionals. Health Education Journal, 82(4), 430–443. https://doi.org/10.1177/00178969231164039
  33. Shofiyyah, N. A., Muharam, A., Susanti, I., & Nurdiana, A. (2024). Exploring the power of storytelling: Enhancing engagement and learning outcomes among adolescents. Indo-Mathedu Intellectuals Journal, 5(1), 990–1006. https://doi.org/10.54373/imeij.v5i1.847
  34. Siddaiah, S. B., Ramachandra, J. A., Mehta, D. V, & Gopinath, G. (2021). Assessment of oral health awareness among residential and day school-going children in south bengaluru: A questionnaire-based survey. World Journal of Dentistry, 12(3), 234–240. https://doi.org/10.5005/jp-journals-10015-1815
  35. Sihombing, K. P., & Syafriani, I. (2023). Effectiveness of interactive audiovisual media on the level of knowledge, attitude of children and dental oral health. Proceeding International Conference on Health Research and Science, 1(1), 133–138.
  36. Staley, B., & Freeman, L. (2017). Digital storytelling as student-centred pedagogy: empowering high school students to frame their futures. Research and Practice in Technology Enhanced Learning, 12(1), 21. https://doi.org/10.1186/s41039-017-0061-9
  37. Supady, A., Nguyen, K., Aziz, M., Überreiter, C., Bärnighausen, T., & Adam, M. (2023). A short, animated storytelling video about sodium intake as a major cardiovascular risk factor and recommendations for a healthy diet: an online, randomized, controlled trial. Trials, 24(1), 390. https://doi.org/10.1186/s13063-023-07418-6
  38. Thwin, K. M., Zaitsu, T., Ueno, M., & Kawaguchi, Y. (2018). Effects of oral health education in Myanmar preschool children and guardians. Journal of Investigative and Clinical Dentistry, 9(3), e12346. https://doi.org/10.1111/jicd.12346
  39. UNICEF. (2021). The State of the World’s Children 2021: On My Mind – Promoting, Protecting, and Caring for Children’s Mental Health. In https://www.unicef.org/reports. https://www.unicef.org/reports/state-worlds-children-2021
  40. WHO. (2021). Levels and trends in child malnutrition: Key findings of the 2021 edition of the joint child malnutrition estimates. https://www.who.int/data/gho/data/themes/topics/joint-child-malnutrition-estimates-unicef-who-wb.
  41. Yang, H., Gao, X.-B., Li, M., Ye, Q., Sun, Y., & Huang, Y. (2020). The use of mind mapping in health education in extended care for children with caries. Journal of International Medical Research, 48(5), 0300060519898053. https://doi.org/10.1177/0300060519898053

Open Access Copyright (c) 2025 Anses Warman, Arnetty, Ika ifitri, Fadila Rahmat Dinanti, Amiruddin, Renita Eka Zurianti
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
Soekarno-Hatta Street, No. 168. Health Polytechnic of Aceh, Aceh Besar, 23352. Telp/Fax: 0651 46126 / 0651 46121.
Website: https://gizipoltekkesaceh.ac.id/
E-mail: jurnal6121@gmail.com

e-issn: 2548-5741, p-issn: 2527-3310

All content is licensed under a: Creative Commons Attribution ShareAlike 4.0 International License

View My Stats

Get a feed by atom here, RRS2 here and OAI Links here