Development and evaluation of animated videos to promote healthy nutrition during pregnancy & exclusive breastfeeding for childhood stunting prevention

Abstract

Stunting has a negative impact on children under five years old in both short and long terms, where maternal nutrition status during pregnancy is determined to be a crucial causative factor. However, education tools are limited, particularly in the digital format called for by the World Health Organization (WHO) to enable rapid information dissemination. Therefore, this study aimed to develop and evaluate a nutrition education module in the form of an animated video series on healthy maternal nutrition during pregnancy and exclusive breastfeeding to prevent child stunting. This study utilised the design and developmental research (DDR) method, which has three stages: content analysis through a review of the literature and evidence-based practice guidelines or recommendations; evaluation of the storyboards and scripts by experts in relevant areas such as nutritionists, dietitians, and senior lecturers in nutrition and dietetics (N=6); and design and development of the videos by using a video animation software. The storyboards for the video were developed, and Bloom’s Taxonomy was used as a reference. Then, the script of the videos was constructed based on learning objectives and contents from the storyboards. Next, the videos were developed using a selected animation software, such as Powtoon. Once ompleted, the video iterations were evaluated by multimedia experts in terms of language and voice, visual enhancement, content and organisation. Finally, the videos were evaluated among a subgroup of the target viewers which comprised women of childbearing age from 18 to 49 years (N=50). The participants were given a link for the videos with questionnaires through WhatsApp and email. The evaluation of its suitability, understandability, and actionability was conducted using the Suitability Assessment Method and Patient Education Materials Assessment Tools for Audio-Visual (PEMATA/ V) questionnaires. Four short video animations were produced on total energy and nutrient requirements for pregnant and breastfeeding mothers to avoid childhood stunting. The titles included ‘Total energy and macronutrient requirements during pregnancy’, ‘Total energy and macronutrient requirements during exclusive breastfeeding’, ‘Vitamin requirements during pregnancy and exclusive breastfeeding’, and ‘Mineral requirements during pregnancy and exclusive breastfeeding’. The length of each video was between three and five minutes. The mean suitability score ± SD of the educational materials for video 1, video 2, video 3, and video 4 were 94 ± 6.6, 97 ±7.4, 98 ± 3.7 and 99 ± 3.1, respectively. The developed educational video was rated as “superior media” based on the SAM ratings. The understandability of videos 1, 2, 3 and 4 were found to average 96%, 98%, 99%, and 100%, respectively, whereas the overall actionability average was 95%, 99%, 99% and 99%, respectively. In conclusion, the study showed the developed educational videos were good in suitability, understandability and actionability. These videos can serve as valuable tools for educating pregnant and breastfeeding mothers about their nutritional needs to prevent childhood stunting. Further research could explore the impact of these videos on actual dietary practices and health outcomes in targeted populations.