Immediate Changes in ANC K6 Knowledge and Attitudes Following Blended e-CINTA BUNDA Digital Education: A One-Group Pretest-Posttest Study
DOI:
https://doi.org/10.21070/midwiferia.v12i2.1908Keywords:
pregnant women, knowledge and attitude, e-CINTA BUNDA, digital education, antenatal careAbstract
Introduction Incomplete attendance of the sixth antenatal care visit (ANC K6), remains a challenge in maternal health care. Limited knowledge and negative attitudes among pregnant women can contribute to incomplete use of ANC services. Digital health education can provide accessible strategies to strengthen maternal health literacy. The study aimed to assess immediate changes in knowledge and attitudes regarding ANC K6 following a blended education intervention using e-CINTA BUNDA among pregnant women.
Methods A pre-experimental one-group pretest-posttest design was conducted among 72 pregnant women at Puskesmas Banjarsengon, using attendance-based convenience sampling. The 45-minutes blended intervention combined face - to face education and the e-CINTA BUNDA, a Google Sites-based digital platform containing information about ANC K6, pregnancy nutrition, warning signs, pregnancy complications, and childbirth preparation. Knowledge and attitudes were measured using questionnaires before and immediately after the intervention within the same session. Data were analyzed using the Wilcoxon signed-rank test.
Results The mean knowledge score increased from 5.86 to 10.03 (Z = −7.117; p < 0.001;r = 0.84), and the mean attitude score increased from 38.32 to 43.47 (Z = −6.918; p < 0.001; r = 0.82) both with large effect sizes.
Discussion Blended education using e-CINTA BUNDA was associated with immediate improvements in ANC K6 knowledge and attitudes among pregnant women. This platform can support maternal health education in primary care settings. However, the absence of a control group limits causal interpretation, and further controlled studies are needed to evaluate its sustained impact.
References
[1] Kementerian Kesehatan Republik Indonesia, “Profil Kesehatan Indonesia 2025,” Kementerian Kesehatan Republik Indonesia, Jakarta, 2026. [Online]. Available: Https://Setjen.Kemkes.Go.Id/Uploads/Topics/Profil-Kesehatan-Indonesia-2025-Oudg5.Pdf
[2]I. P. Sari Et Al., “Faktor Penyebab Angka Kematian Ibu Dan Angka Kematian Bayi Serta Strategi Penurunan Kasus (Studi Kasus Di Negara Berkembang),” Vol. 7, 2023.
[3] Peraturan Menteri Kesehatan Republik Indonesia Nomor 21 Tahun 2021 Tentang Penyelenggaraan Pelayanan Kesehatan Masa Sebelum Hamil, Masa Hamil, Persalinan, Dan Masa Sesudah Melahirkan, Pelayanan Kontrasepsi, Dan Pelayanan Kesehatan Seksual. 2021.
[4]Dinas Kesehatan Provinsi Jawa Timur, “Profil Kesehatan Jawa Timur 2025,” Dinas Kesehatan Provinsi Jawa Timur, Surabaya, 2026.
[5]P. Ndruru, J. Harahap, And R. B. Suroyo, “Faktor-Faktor Yang Berhubungan Dengan Kunjungan K6 Pada Ibu Hamil Trimester Iii Di Puskesmas Hilimegai Kabupaten Nias Selatan | Vitalitas Medis : Jurnal Kesehatan Dan Kedokteran,” Sep. 2026, Accessed: Oct. 07, 2026. [Online]. Available: Https://Journal.Lpkd.Or.Id/Index.Php/Vimed/Article/View/3508
[6]A. Sari And H. Kusumajaya, “Faktor – Faktor Yang Berhubungan Dengan Rendahnya Cakupan Anc K6 Di Wilayah Kerja Puskesmas Mentok,” Vol. 6, 2025. DOI: https://doi.org/10.31004/jkt.v6i4.52121
[7]S. S. Gesese, E. A. Mersha, And W. F. Balcha, “Knowledge Of Danger Signs Of Pregnancy And Health-Seeking Action Among Pregnant Women: A Health Facility-Based Cross-Sectional Study,” Ann Med Surg (Lond), Vol. 85, No. 5, Pp. 1722–1730, May 2023, Doi: 10.1097/Ms9.0000000000000610. DOI: https://doi.org/10.1097/MS9.0000000000000610
[8]R. Winda, S. Yarah, And N. H. Novita, “Faktor-Faktor Yang Mempengaruhi Rendahnya Cakupan Kunjungan Antenatal Care (Anc) Di Wilayah Kerja Uptd Puskesmas Simeulue Barat,” J Ris Sains Kes Ind, Vol. 2, No. 1, Pp. 21–28, Jan. 2025, Doi: 10.69930/Jrski.V2i1.239. DOI: https://doi.org/10.69930/jrski.v2i1.239
[9]D. Novianti, D. Wildayani, And E. Aprianti, “Faktor Faktor Yang Berhubungan Dengan Kepatuhan Kunjungan K6 Pada Ibu Hamil Di Puskesmas Pauh Kota Padang,” Menara Ilmu : Jurnal Penelitian Dan Kajian Ilmiah, Vol. 19, No. 1, Pp. 647–656, Jul. 2025, Doi: 10.31869/Mi.V19i1.6836. DOI: https://doi.org/10.31869/mi.v19i1.6836
[10] M. C. Akayuni, Y. Puspitasari, And A. Fitriani, “Kelas Edukasi Dan Konseling Aktif Ibu Hamil Sebagai Upaya Peningkatan Kepatuhan Kunjungan Antenatal Care (Anc)Di Puskesmas Sepaku I,” Jurnal Lentera Kesehatan Masyarakat, Vol. 5, No. 2, Pp. 115–123, Aug. 2026, Doi: 10.69883/Kr753h76. DOI: https://doi.org/10.69883/kr753h76
[11] D. Tahir And N. Anjarwati, “Program Edukasi Dan Pendampingan Kesehatan Terhadap Perilaku Ibu Hamil Dalam Melakukan Pemeriksaan Antenatal Care,” Mega Buana Journal Of Innovation And Community Service, Vol. 3, Pp. 66–74, Jun. 2025, Doi: 10.59183/Ej33sn78. DOI: https://doi.org/10.59183/ej33sn78
[12] A. D. Treasa, S. N. Intang, A. Vitariani, F. Astuti, N. L. G. S. Wahyudianti, And A. E. R. S. Yusuf, “Efektivitas Mobile Health (Mhealth) Dalam Mendukung Continuity Of Care Kebidanan Pada Ibu Hamil Trimester Iii,” Journal Of Innovative And Creativity (Joecy), Vol. 6, No. 1, Pp. 3071–3080, Jan. 2026, Doi: 10.31004/Joecy.V6i1.7244. DOI: https://doi.org/10.31004/joecy.v6i1.7244
[13] T. Srimulyawati, Y. Septina, And N. W. Setiati, “Peningkatan Pengetahuan Ibu Hamil Tentang Tanda Bahaya Kehamilan Melalui Edukasi Digital Whatsapp Group,” Jurnal Pemberdayaan Dan Pendidikan Kesehatan, Vol. 5, No. 02, Pp. 116–122, Jun. 2026, Doi: 10.34305/H5n05m25. DOI: https://doi.org/10.34305/h5n05m25
[14] E. Rahmaniah, “Gambaran Kepatuhan Kunjungan K6 Antenatal Care Di Wilayah Kerja Puskesmas Menteng Kota Palangka Raya.,” Doctoral Dissertation, 2024.
[15] R. Sakinah, A. Asriwati, And M. Wulan, “Analisis Perilaku Yang Memengaruhi Pemeriksaan Anc Di Wilayah Kerja Puskesmas Mamas Kecamatan Darul Hasanah Kabupaten Aceh Tenggara Provinsi Aceh Tahun 2022,” Jurnal Keperawatan Priority, Vol. 6, No. 2, Pp. 144–153, Aug. 2023, Doi: 10.34012/Jukep.V6i2.4063.
[16] C. O. Fritz, P. E. Morris, And J. J. Richler, “Effect Size Estimates: Current Use, Calculations, And Interpretation,” J Exp Psychol Gen, Vol. 141, No. 1, Pp. 2–18, Feb. 2012, Doi: 10.1037/A0024338. DOI: https://doi.org/10.1037/a0024338
[17] S. Bashir, A. H. Ansari, And A. Sultana, “Knowledge, Attitude, And Practice On Antenatal Care Among Pregnant Women And Its Association With Sociodemographic Factors: A Hospital-Based Study,” J Patient Exp, Vol. 10, P. 23743735231183578, Jun. 2023, Doi: 10.1177/23743735231183578. DOI: https://doi.org/10.1177/23743735231183578
[18] M. Mishra Et Al., “Effectiveness Of Mhealth Interventions For Monitoring Antenatal Care Among Pregnant Women In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis,” Healthcare (Basel), Vol. 11, No. 19, P. 2635, Sep. 2023, Doi: 10.3390/Healthcare11192635. DOI: https://doi.org/10.3390/healthcare11192635
[19]M. O. Rahman, N. Yamaji, Y. Nagamatsu, And E. Ota, “Effects Of Mhealth Interventions On Improving Antenatal Care Visits And Skilled Delivery Care In Low- And Middle-Income Countries: Systematic Review And Meta-Analysis,” J Med Internet Res, Vol. 24, No. 4, P. E34061, Apr. 2022, Doi: 10.2196/34061. DOI: https://doi.org/10.2196/34061
[20] J. Persis, S. Kathirvel, S. Chopra, And A. Singh, “Effectiveness Of Mhealth-Based Educational Interventions To Improve Self-Care During Pregnancy: A Pragmatic Randomized Controlled Trial From Northern India,” International Journal Of Gynecology & Obstetrics, Vol. 163, No. 1, Pp. 177–185, 2023, Doi: 10.1002/Ijgo.14792. DOI: https://doi.org/10.1002/ijgo.14792
[21] P. F. Karamolahi, Z. Bostani Khalesi, And M. Niknami, “Efficacy Of Mobile App-Based Training On Health Literacy Among Pregnant Women: A Randomized Controlled Trial Study,” European Journal Of Obstetrics & Gynecology And Reproductive Biology: X, Vol. 12, P. 100133, Oct. 2021, Doi: 10.1016/J.Eurox.2021.100133. DOI: https://doi.org/10.1016/j.eurox.2021.100133
[22] H. Mohamed, A. Ismail, R. Sutan, R. A. Rahman, And K. Juval, “A Scoping Review Of Digital Technologies In Antenatal Care: Recent Progress And Applications Of Digital Technologies,” Bmc Pregnancy Childbirth, Vol. 25, No. 1, P. 153, Feb. 2025, Doi: 10.1186/S12884-025-07209-8. DOI: https://doi.org/10.1186/s12884-025-07209-8
[23] B. F. Endehabtu, K. A. Gelaye, S. A. Mengiste, And B. Tilahun, “Mapping The Role Of Digital Health Interventions To Enhance Effective Coverage Of Antenatal Care: A Scoping Review,” Jmdh, Vol. 17, Pp. 71–82, Jan. 2024, Doi: 10.2147/Jmdh.S438097. DOI: https://doi.org/10.2147/JMDH.S438097
[24] S. T. Ali, S. A. Rizvi, M. Talat, S. Abuzar, M. Azhar, And M. Rehman, “Barriers To Timely And Adequate Antenatal Care: A Systematic Review Of Socioeconomic, Cultural, Psychosocial, And Health-System Factors Across High And Low Resource Settings,” Bmc Pregnancy Childbirth, Vol. 26, No. 1, P. 96, Dec. 2025, Doi: 10.1186/S12884-025-08565-1. DOI: https://doi.org/10.1186/s12884-025-08565-1
[25] H. Mehrtash, K. Stein, M. Barreix, M. Bonet, M. A. Bohren, And Ö. Tunçalp, “Measuring Women’s Experiences During Antenatal Care (Anc): Scoping Review Of Measurement Tools,” Reprod Health, Vol. 20, No. 1, P. 150, Oct. 2023, Doi: 10.1186/S12978-023-01653-5. DOI: https://doi.org/10.1186/s12978-023-01653-5
[26] M. B. Tungaraza And A. A. Joho, “The Health Belief Model And Self-Determination Theory In Explaining The Use Of Antenatal Care Services: A Cross-Sectional Study,” African Journal Of Midwifery And Women’s Health, Vol. 16, No. 2, Pp. 1–11, Apr. 2022, Doi: 10.12968/Ajmw.2021.0012. DOI: https://doi.org/10.12968/ajmw.2021.0012
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Copyright (c) 2026 Ayu Candra Seto, Noza Loviana, Aurina Dwi Febriani, Septia Kusuma Lestari, Isnawiyah Madaningrum, Wafa Aulia Maharany, Dr. Yuseva Sariati, SST., M.Keb, Driana Desy P, Amalia Dwi Shinta
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