Simulation-Based Education and Caregiving Ability Among Families of Stunted Children

Simulation-Based Education and Caregiving Ability Among Families of Stunted Children: A Nonrandomized Quasi-Experimental Study

Stunting can affect children's growth and development and requires not only nutritional management but also appropriate stimulation and responsive caregiving. This study evaluated whether adding simulation-based growth and development education to a standard educational module could improve the caregiving ability of families with stunted children. Caregivers received either a standardized take-home module alone or the same module combined with simulation-based education. The study assessed changes in caregivers' knowledge and self-reported ability to perform developmental stimulation activities.

This study was a nonrandomized quasi-experimental study using a pretest-posttest control group design. The study was conducted among family caregivers of children with stunting aged 1-3 years in the working area of Tamansari Public Health Center, Tasikmalaya, Indonesia.

Participants were allocated based on geographical areas. The control group received a standardized growth and development education module to use at home. The intervention group received the same module plus simulation-based education. The simulation session included explanation of child growth and development concepts, demonstration of developmental stimulation activities, guided caregiver practice, and corrective feedback from the facilitator.

The study included 55 caregivers in the final analysis, consisting of 31 caregivers in the intervention group and 24 caregivers in the control group. Caregiving ability was assessed in two domains: cognitive ability measured using a 32-item instrument and self-reported psychomotor ability measured using a 20-item questionnaire.

The primary purpose of this study was to determine whether simulation-based education provides additional benefits compared with module-only education in improving caregiver knowledge and perceived ability to perform developmental stimulation activities for children with stunting.

The study received ethical approval from the Health Research Ethics Committee, Faculty of Nursing and Health Sciences, Universitas Muhammadiyah Semarang (Ethical Clearance No. 001/KE/05/2026). Participation was voluntary, and all participants provided written informed consent before joining the study.

Inclusion Criteria:

1. Family caregivers of children aged 1-3 years diagnosed with stunting.
2. The caregiver is the primary person responsible for daily child care.
3. The caregiver lives with the child during the study period.
4. The caregiver is willing to participate and provide written informed consent.
5. The caregiver is able to communicate and complete the study questionnaire.

Exclusion Criteria:

1. Caregivers who cannot participate in the educational sessions.
2. Caregivers who have communication barriers that prevent completion of the assessment.
3. Participants who withdraw consent during the study period.