Factors Influencing Toddler Nutritional and Developmental Outcomes at the Bangkalan Health Center, Madura Island, Indonesia: A PRECEDE–PROCEED Model Approach

Background: The nutritional and developmental status of toddlers in Indonesia remains a significant concern, requiring further analysis of influencing factors to enable more comprehensive interventions. Objectives: This study aimed to analyze the factors that influence the nutritional and developmental status of toddlers using the PRECEDE–PROCEED Model. Methods: This is a cross-sectional study that involved 472 mothers who had children aged 12-60 months, selected by cluster sampling through 88 Integrated Service Posts in the Bangkalan Health Center area. The dependent variables in this study were the nutritional status and developmental status of toddlers aged 12-60 months. While the independent variables in this study were predisposing factors, enabling factor, and reinforcing factor. Data collection was conducted using questionnaires, the child development pre-screening questionnaire, and the ‘Maternal and Child Health’ handbook. Logistic regression analysis was performed with a significance level of 0.05. Results: The results showed that the factors influencing toddlers’ nutritional status included predisposing factors such as maternal knowledge, maternal education level, and maternal participation in monthly Integrated Service post activities. Reinforcing factors such as husband's support, families, healthcare, and exposure to health information also affect toddler nutrition. In terms of toddler development, there are reinforcing factors in the form of husband and family support for mothers in providing developmental stimulation to their toddlers. Conclusion: The critical role of husband and family support in shaping the nutritional and developmental status of toddlers aged 12-60 months. Therefore, educational interventions should target not only mothers but also their families to optimize child health and development.