Parental Involvement in Adolescents' Healthy Eating Through Karuni Application: A Community Study in Indonesia
Abstract
Background: Female adolescents in Indonesia frequently skip breakfast and have tea after meals, which leads to iron deficiency anemia. However, only a few interventions have successfully combined parental involvement and technology to promote healthy eating.
Objective: Our hypothesis was that parents' facilitation through the KARUNI mobile app would lead to healthy eating habits in adolescent girls.
Methods: The mixed-methods study recruited 108 female adolescents aged 12-15 years from Gunungkidul, Indonesia (58 intervention, 50 control). The intervention group was instructed to use KARUNI for 21 days with parental involvement, followed by focus group discussions and interviews.
Results: In the intervention group, the frequency of breakfast consumption significantly increased (p<0.001) and tea/coffee intake after meals was significantly reduced (p=0.001) with large effect sizes (r>0.48). KARUNI was instrumental in enhancing parental nutrition knowledge, increasing adolescents' self-efficacy, and facilitating better health communication within the family.
Conclusion: The engagement of parents through KARUNI resulted in a significant improvement in the adolescents' eating behaviors, indicating that family-centered and technology-enabled interventions can effectively tackle nutritional deficiencies in resource-poor environments.
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Al Shloul, T., Mazhar, T., Abbas, Q., Iqbal, M., Ghadi, Y. Y., Shahzad, T., Mallek, F., & Hamam, H. (2024). Role of activity-based learning and ChatGPT on students' performance in education. Computers and Education: Artificial Intelligence, 6, 100219. https://doi.org/10.1016/j.caeai.2024.100219
Benítez-Andrades, J. A., Arias, N., García-Ordás, M. T., Martínez-Martínez, M., & García-Rodríguez, I. (2020). Feasibility of social-network-based eHealth intervention on the improvement of healthy habits among children. Sensors, 20(5), 1404. https://doi.org/10.3390/s20051404
Bonnie, R. J., & Backes, E. P. (2019). The promise of adolescence: Realizing opportunity for all youth. National Academies Press. https://doi.org/10.17226/25388
Christofaro, D. G. D., Tebar, W. R., Silva, C. C. M. da, Saraiva, B. T. C., Santos, A. B., Antunes, E. P., Leite, E. G. F., Leoci, I. C., Beretta, V. S., Ferrari, G., Mota, J., Vanderlei, L. C. M., & Ritti-Dias, R. M. (2024). Association of parent-child health parameters and lifestyle habits—the "Epi-Family Health" longitudinal study protocol. Archives of Public Health, 82(1), 1–9. https://doi.org/10.1186/s13690-024-01311-7
Damara, C. D., & Muniroh, L. (2021). Breakfast habits and nutrient adequacy level of snacks is correlated with nutrition status among adolescent in SMPN 1 Tuban. Media Gizi Indonesia, 16(1), 10–16. https://doi.org/10.20473/mgi.v16i1.10-16
Feye, D., Gobena, T., Brewis, A., & Roba, K. T. (2023). Adolescent breakfast skipping is associated with poorer academic performance: A school-based study from Hidhabu Abote District, Ethiopia. Journal of Health, Population and Nutrition, 42(1), 1–9. https://doi.org/10.1186/s41043-023-00424-z
Gardner, B., Arden, M. A., Brown, D., Eves, F. F., Green, J., Hamilton, K., Hankonen, N., Inauen, J., Keller, J., Kwasnicka, D., Labudek, S., Marien, H., Masaryk, R., McCleary, N., Mullan, B. A., Neter, E., Orbell, S., Potthoff, S., & Lally, P. (2023). Developing habit-based health behaviour change interventions: Twenty-one questions to guide future research. Psychology and Health, 38(4), 518–540. https://doi.org/10.1080/08870446.2021.2003362
Gardner, B., Rebar, A. L., de Wit, S., & Lally, P. (2024). What is habit and how can it be used to change real-world behaviour? Narrowing the theory-reality gap. Social and Personality Psychology Compass, 18(6), e12975. https://doi.org/10.1111/spc3.12975
Giménez-Legarre, N., Santaliestra-Pasías, A. M., Cardon, G., Imre, R., Iotova, V., Kivelä, J., Liatis, S., Makrilakis, K., Mavrogianni, C., Milenkovic, T., Nánási, A., Tankova, T., Timpel, P., Willems, R., Manios, Y., & Moreno, L. A. (2021). Cross-sectional associations between mothers and children's breakfast routine—The Feel4Diabetes-study. Nutrients, 13(3), 720. https://doi.org/10.3390/nu13030720
He, Y., & Chen, J. (2024). Severe iron-deficiency anemia after short-term moderate consumption of green tea in woman: A rare case report. Heliyon, 10(17), e36666. https://doi.org/10.1016/j.heliyon.2024.e36666
Ho, Y. C. L., Mahirah, D., Ho, C. Z. H., & Thumboo, J. (2022). The role of the family in health promotion: A scoping review of models and mechanisms. Health Promotion International, 37(6), daac119. https://doi.org/10.1093/heapro/daac119
Jeong, S., & Lee, J. (2021). Effects of cultural background on consumer perception and acceptability of foods and drinks: A review of latest cross-cultural studies. Current Opinion in Food Science, 42, 248–256. https://doi.org/10.1016/j.cofs.2021.07.004
Karuniawati, B. (2025). Development of the "KARUNI" (young adolescents community) model to prevent stunting: A phenomenological study on adolescents in Gunungkidul regency, Yogyakarta, Indonesia. International Journal of Adolescent Medicine and Health, 37(1), 89–100. https://doi.org/10.1515/ijamh-2024-0171
Kieslinger, K., Wartha, O., Pollatos, O., Steinacker, J. M., & Kobel, S. (2021). Parental self-efficacy—A predictor of children's health behaviors? Its impact on children's physical activity and screen media use and potential interaction effect within a health promotion program. Frontiers in Psychology, 12, 712796. https://doi.org/10.3389/fpsyg.2021.712796
Kusumawati, A. D., Hayati, N., & Hardiyansyah, A. (2024). Hubungan antara asupan Fe, kebiasaan minum teh, dan pola menstruasi dengan kejadian anemia pada remaja putri [The relationship between Fe intake, tea drinking habits, and menstrual patterns with the incidence of anemia in adolescent girls]. Jurnal Ilmu Kesehatan, 13(2), 294–303.
Lazrak, M., El Kari, K., Stoffel, N. U., Elammari, L., Al-Jawaldeh, A., Loechl, C. U., Yahyane, A., Barkat, A., Zimmermann, M. B., & Aguenaou, H. (2021). Tea consumption reduces iron bioavailability from NaFeEDTA in nonanemic women and women with iron deficiency anemia: Stable iron isotope studies in Morocco. Journal of Nutrition, 151(9), 2714–2720. https://doi.org/10.1093/jn/nxab159
López-Gil, J. F., Tully, M. A., Cristi-Montero, C., Brazo-Sayavera, J., Gaya, A. R., Calatayud, J., López-Bueno, R., & Smith, L. (2024). Is the frequency of breakfast consumption associated with life satisfaction in children and adolescents? A cross-sectional study with 154,151 participants from 42 countries. Nutrition Journal, 23(1), 79. https://doi.org/10.1186/s12937-024-00979-5
Marashi, S. Z., Hidarnia, A., Kazemi, S. S., & Shakerinejad, G. (2024). The effect of educational intervention based on self-efficacy theory on promoting adolescent oral health behaviors through mobile application: A randomized controlled trial study. BMC Oral Health, 24(1), 870. https://doi.org/10.1186/s12903-024-04970-8
Marques, A., Loureiro, N., Avelar-Rosa, B., Naia, A., & Matos, M. G. de. (2020). Adolescents' healthy lifestyle. Jornal de Pediatria, 96(2), 217–224. https://doi.org/10.1016/j.jped.2018.09.002
Ministry of Health of the Republic of Indonesia. (2018). Hasil riset kesehatan dasar tahun 2018 [Results of the 2018 basic health research]. Kementerian Kesehatan RI.
Moore Heslin, A., & McNulty, B. (2023). Adolescent nutrition and health—Characteristics, risk factors, and opportunities of an overlooked life stage. Proceedings of the Nutrition Society, 82(2), 142–156. https://doi.org/10.1017/S0029665123002689
Said, A. M., Latersia, Y., & Muniroh, L. (2024). Relationship between breakfast habits and nutritional status with learning achievement in Strada Nawar Bekasi Junior High School students. Media Gizi Indonesia, 19(2), 148–157. https://doi.org/10.20473/mgi.v19i2.148-157
Scott, N., Delport, D., Hainsworth, S., Pearson, R., Morgan, C., Huang, S., Akuoku, J. K., Piwoz, E., Shekar, M., Levin, C., Toole, M., & Homer, C. S. (2020). Ending malnutrition in all its forms requires scaling up proven nutrition interventions and much more: A 129-country analysis. BMC Medicine, 18(1), 356. https://doi.org/10.1186/s12916-020-01786-5
Sincovich, A., Moller, H., Smithers, L., Brushe, M., Lassi, Z. S., Brinkman, S. A., & Gregory, T. (2022). Prevalence of breakfast skipping among children and adolescents: A cross-sectional population level study. BMC Pediatrics, 22(1), 478. https://doi.org/10.1186/s12887-022-03284-4
Singh, B., Murphy, A., Maher, C., & Smith, A. E. (2024). Time to form a habit: A systematic review and meta-analysis of health behaviour habit formation and its determinants. Healthcare, 12(23), 2488. https://doi.org/10.3390/healthcare12232488
UNICEF Indonesia. (2025). Indonesia adolescent health profile 2024. UNICEF Indonesia. https://www.unicef.org/indonesia/reports/indonesia-adolescent-health-profile-2024
World Health Organization. (2025). Adolescent health. WHO. https://www.who.int/health-topics/adolescent-health
Zhu, Y., Long, Y., Wang, H., Lee, K. P., Zhang, L., & Wang, S. J. (2024). Digital behavior change intervention designs for habit formation: Systematic review. Journal of Medical Internet Research, 26, e54375. https://doi.org/10.2196/54375
DOI: http://dx.doi.org/10.33757/jik.v9i2.1502
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