Efektivitas edukasi gizi dengan MediFan StrokeAware dan WhatsApp dalam meningkatkan kepatuhan diet mediterania pada lansia

Author(s): Diana Mufarrokhah, Karina Muthia Shanti, Dwipajati Dwipajati
DOI: 10.30867/gikes.v7i1.3200

Abstract

Background: Stroke remains a leading cause of mortality and disability among older adults in Indonesia, with a prevalence of 8.3 per 1,000 population. The Mediterranean diet is effective in reducing cardiovascular risk; however, its implementation remains limited due to the lack of innovative and age-appropriate nutrition education media, as well as the absence of integrated approaches combining educational media with digital support.

Objectives:  To analyze changes in knowledge, adherence to the Mediterranean diet, and fat intake following nutrition education using MediFan StrokeAware and WhatsApp among older adults in Mulyorejo Village.

Methods: A pre-experimental one-group pretest–posttest study was conducted among 24 participants aged 45–70 years in Mulyorejo, Malang, selected through purposive sampling. Inclusion criteria included the ability to communicate and use WhatsApp, and no severe health conditions. The 2-month intervention utilized MediFan StrokeAware and WhatsApp (three times/week). Dietary adherence was measured using a validated questionnaire. Data were analyzed using Wilcoxon and paired t-tests (α=0.05).

Results: Knowledge increased significantly (68.06% vs 80.56%, p=0.044). Most participants (95.8%) achieved adherence to the Mediterranean diet after the intervention. MUFA intake increased (p=0.013), while SAFA intake also increased (p=0.001) as an unintended outcome. PUFA intake did not change significantly (p=0.141). Body fat percentage decreased significantly (p=0.002).

Conclusion: The nutrition education intervention using MediFan StrokeAware and WhatsApp was associated with improvements in knowledge and adherence to the Mediterranean diet among older adults. However, the increase in saturated fatty acid (SAFA) intake indicates that dietary behavior changes were not yet consistent, highlighting the need for more contextual and longer-duration interventions.

Keywords

Mediterranean Diet, Elderly, Nutrition Education, Stroke Prevention, Fat Intake, Educational Media

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References

Alpionira, V., Hapsari, A. I., Moviana, Y., Syarief, O., Saleky, Y. W., Fauziah, R. N., Gizi, J., Kesehatan, P., & Bandung, K. (2022). Asupan Lemak Jenuh dan Obesitas Sentral Pada Ibu Rumah Tangga Usia 30-49 Tahun. Jurnal Kesehatan Siliwangi, 2(3), 1020–1027. https://doi.org/10.34011/jks.v2i3.797

Appleton, K. M., McEvoy, C. T., Lloydwin, C., Moore, S., Salamanca-Gonzalez, P., Cupples, M. E., Hunter, S., Kee, F., McCance, D. R., Young, I. S., McKinley, M. C., & Woodside, J. V. (2023). A peer support dietary change intervention for encouraging adoption and maintenance of the Mediterranean diet in a non-Mediterranean population (TEAM-MED): lessons learned and suggested improvements. Journal of Nutritional Science, 12, 1–14. https://doi.org/10.1017/jns.2023.2

Bloom, I., Shand, C., Cooper, C., Robinson, S., & Baird, J. (2018). Diet Quality and Sarcopenia in Older Adults: A Systematic Review. Nutrients, 10(3). https://doi.org/10.3390/nu10030308

Chen, L., Huang, H., Jiang, S., Yao, H., Xu, L., Huang, Q., Xiao, M., & Zhao, Q. (2024). Facilitators and barriers to the implementation of dietary nutrition interventions for community-dwelling older adults with physical frailty and sarcopenia: A qualitative meta-synthesis. International Journal of Nursing Sciences, 11(1), 18–30. https://doi.org/https://doi.org/10.1016/j.ijnss.2023.12.007

Chou, C.-C., Li, Y.-J., Wang, C.-J., & Lyu, L.-C. (2022). A mini-flipped, game-based Mediterranean diet learning program on dietary behavior and cognitive function among community-dwelling older adults in Taiwan: A cluster-randomized controlled trial. Geriatric Nursing (New York, N.Y.), 45, 160–168. https://doi.org/10.1016/j.gerinurse.2022.03.009

Fadhilah, H., & Sari, V. Y. P. (2019). Beban ekonomi yang ditanggung pasien dan keluarga akibat penyakit stroke : Studi literatur. Journal of Community Medicine and Public Health, 35(6), 193–197.

Furbatto, M., Lelli, D., Antonelli Incalzi, R., & Pedone, C. (2024). Mediterranean Diet in Older Adults: Cardiovascular Outcomes and Mortality from Observational and Interventional Studies—A Systematic Review and Meta-Analysis. In Nutrients (Vol. 16, Issue 22, p. 3947). https://doi.org/10.3390/nu16223947 https://doi.org/10.18196/ijnp.v8i1.21431

Bertalina. (2015). Hubungan Asam Lemak Jenuh, Tak Jenuh Ganda dan Serat dengan Rasio LDL/HDL pada Penderita Jantung Koroner DI Poli Jantung RSUD Dr. HI. Abdul Moeloek. Jurnal Dunia Kesmas, 4(4), 233–241.

Hareer, K., Abdullah, H., & Mahmood, S. (2024). Bridging the gap between nutrition evidence and community practice: Challenges in dietary behavior change. Public Health Nutrition, 27(4), 1035–1044.

Kalsum, U., Nugraha, A. T., Sulistyowati, Y., Azijah, I., Widayati, T., Erik, I., Yanuar, S., Afriliani, A. R., Saputra, R., & Ilham, H. U. (2024). Uning Mandimas : Upaya Peningkatan Kemandirian Keluarga dalam Mengelola Penyakit Diabetes Mellitus di Masyarakat. Jurnal Pelayanan Dan Pengabdian Masyarakat (Pamas), 8(4), 365–376.

Kosasih, R., Rayhan, N., Gaofman, B. A., Kurniawan, J., Nathaniel, F., & Santoso, A. H. (2024). Kegiatan Pengukuran Antropometri Pada Populasi Lanjut Usia Sebagai Deteksi Dini Obesitas Dan Komplikasi Terkait Obesitas Anthropometric Measurement Activities In The Elderly Population As Early Detection Of Obesity And Obesity-Related Complications. Sejahtera: Jurnal Inspirasi Mengabdi Untuk Negeri, 3(2), 76–82.

Kwan, R. Y. C., Law, Q. P. S., Tsang, J. T. Y., Lam, S. H., Wang, K. T., Sin, O. S. K., & Cheung, D. S. K. (2024). The Effect of the Mediterranean Diet-Integrated Gamified Home-Based Cognitive-Nutritional (GAHOCON) Training Programme for Older People With Cognitive Frailty: Pilot Randomized Controlled Trial. JMIR Rehabilitation and Assistive Technologies, 11(e60155), 1–18. https://doi.org/10.2196/60155

Mills, C. M., Keller, H. H., DePaul, V. G., & Donnelly, C. (2024). Factors Associated with the Development of High Nutrition Risk: Data from the Canadian Longitudinal Study on Aging. Canadian Journal on Aging = La Revue Canadienne Du Vieillissement, 43(1), 153–166. https://doi.org/10.1017/S0714980823000545

Nucci, D., Fatigoni, C., Amerio, A., & et al. (2024). Mediterranean diet adherence and risk of dementia: Updated systematic review and meta-analysis. Ageing Research Reviews, 94, 102198.

Nurati, O. E., Allenidekania, A., Waluyanti, F. T., & Rizany, I. (2024). Digital-Based and Direct Education to Enhance Complementary Feeding Knowledge and Practices: A Systematic Review. IJNP (Indonesian Journal of Nursing Practices), 8(1), 42–55. https://doi.org/10.18196/ijnp.v8i1.21431

Nurhasan, M., Ariesta, D. L., Utami, M. M. H., Fahim, M., Aprillyana, N., Maulana, A. M., & Ickowitz, A. (2024). Dietary transitions in Indonesia: the case of urban, rural, and forested areas. Food Security, 16(6), 1313–1331. https://doi.org/10.1007/s12571-024-01488-3

Nurrul Affanti, K. A., & K., A. C. (2015). Hubungan Indeks Massa Tubuh Dan Asupan Asam Lemak Jenuh Dengan Rasio Ldl/hdl Serum Lansia. Journal of Nutrition College, 4(2), 189–194.

Ohnishi, H., & Saitoh, S. (2019). Obesity and Diabetes Mellitus as Risk Factors for Cardiovascular Disease in the Elderly BT - Health Issues and Care System for the Elderly (M. Washio & C. Kiyohara (eds.); pp. 97–106). Springer Singapore. https://doi.org/10.1007/978-981-13-1762-0_7

Rose, D., Livingstone, K. M., & McNaughton, S. A. (2024). Measuring adherence to dietary patterns in community interventions: A methodological review. Nutrients, 16(2), 365.

Saleh, A., Al-Malki, M., & Hassan, R. (2024). WhatsApp-based health education and patient engagement: A scoping review. Journal of Medical Internet Research, 26, e54721.

Sakir, A., Pramono, A., & Hardinsyah. (2024). Konsumsi gula, garam, dan lemak serta asupan buah dan sayur pada masyarakat perkotaan Indonesia. Jurnal Gizi dan Pangan Indonesia, 19(1), 45–56.

Seid, M. A., Hussen, M. S., & Kassie, B. A. (2024). Mobile messaging interventions for improving health behaviors: A systematic review. Digital Health, 10, 1–15.

Shi, Z., Du, X., Li, J., Hou, R., Sun, J., & Marohabutr, T. (2024). Factors influencing digital health literacy among older adults: a scoping review. Frontiers in Public Health, 12(November), 1–14. https://doi.org/10.3389/fpubh.2024.1447747

Turner, J., Smith, K., & Wallace, L. (2024). Health education strategies for older adults: Barriers and opportunities for community-based interventions. BMC Public Health, 24, 1189.

UNESCO. (2010). Mediterranean diet. UNESCO Intangible Cultural Heritage. https://ich.unesco.org/en/RL/mediterranean-diet-00884

DOI: http://dx.doi.org/10.30867/gikes.v7i1.3200

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