Extending the Theory of Planned Behaviour: A Structural Model of Toddler Health Cadre Performance in Growth Monitoring Driven by Motivation, Empowerment, and Perception

Background: Stunting remains a critical public health issue in Indonesia, particularly among children under two years, with long-term effects on growth, cognition, and health. Toddler health cadres, as community volunteers in Posyandu, play a vital role in growth monitoring, yet their performance is shaped by psychological and structural factors requiring empirical study. Objective: This study aimed to develop and test a structural model of toddler health cadre performance in growth monitoring based on the Theory of Planned Behaviour (TPB), examining the roles of motivation, empowerment, and perception. Methodology: A cross-sectional survey of 200 cadres from eight community health centres in Sleman Regency, Indonesia, was conducted using validated Likert-scale questionnaire copies. Data were analysed with Structural Equation Modelling (SEM) via LISREL, testing direct, indirect, and mediation pathways. Results: Cadres demonstrated high motivation (M=94.29), empowerment (M=64.05), perception (M=65.96), and performance (M=100.68). SEM revealed significant effects of motivation on empowerment (β=0.255, p