A Path Analysis of Environmental and Social Factors Affecting Feeding and Swallowing Abilities in Preschool Children
Main Article Content
Abstract
Background: Environmental and social factors influence the feeding and swallowing abilities of preschool children. However, understanding of how these factors interact to form eating and swallowing abilities is still limited. This study assesses the influence of environmental and social factors on children's feeding and swallowing abilities using various environmental and social indicators.
Methods: A cross-sectional study was conducted in Surakarta, Central Java (April–August 2025), with 81 purposively selected children. Feeding and swallowing ability was the dependent variable, while family, school, economic, social, and parenting factors served as predictors. Data were collected through interviews, observations, questionnaires, and the Dysphagia Disorder Survey, and analyzed using path analysis in Stata 13.
Results: Children’s feeding and swallowing abilities were significantly associated with economic conditions and food availability (b = 2.09; 95% CI: 0.08–2.58; p = 0.037), parental support and social factors (b = 3.16; 95% CI: 0.79–3.41; p = 0.002), as well as feeding practices (b = 3.27; 95% CI: 0.82–3.27; p = 0.001). Indirectly, children’s abilities were also influenced by social factors, parental support, appropriate feeding practices, school and peer environment, and social support.
Conclusion: Economic conditions, parental support, and feeding practices have a direct influence on children’s feeding and swallowing abilities. In contrast, social factors, parenting styles, educational environments, and social support exert indirect effects. The main implication for health practices is the need for integrated interventions involving family economic support, parental education, social systems, and learning environments to support the development of feeding and swallowing abilities in preschool children.
Article Details
How to Cite
References
A’yun, A. R. Q., Rahmawati, A., & Fitrianingtyas, A. (2024). Hubungan pola asuh orang tua dengan perilaku makan anak. Kumara Cendekia, 12(1), 32–43. https://doi.org/10.20961/kc.v12i1.72063
An, J., Zhu, X., Shi, Z., & An, J. (2024). A serial mediating effect of perceived family support on psychological well-being. BMC Public Health, 24(1), 1–10. https://doi.org/10.1186/s12889-024-18476-z
Assegap, F. F., Haq, F. A., Khumayah, S., & Erawati, D. (2025). Family communication as a foundation of mental health: Roles and responsibilities. Jurnal Syntax Admiration, 6(7), 1595–1605. https://doi.org/10.46799/jsa.v6i7.2435
Asshar, B., Khoirunnisa, D. U., Hardhana, E. W., Novitasari, I. K., Paramitha, K. P., Paramesti, L., Himawan, J., Ariyanti, N. K., Akbar, N. A., & Aulia, N. A. (2024). Hubungan konsumerisme makanan cepat saji terhadap kebiasaan makan mahasiswa Universitas Negeri Semarang Program Studi Gizi Angkatan 2023. Jurnal Angka, 1(2), 371–383.
Cahyaningsih, D. S. (2023). Hubungan variasi makanan dan tekanan makan terhadap kejadian picky eater pada anak usia prasekolah di TK As-Saadah Karawang. Jurnal Keperawatan Dan Kebidanan, 1(1).
Czarniecka-Skubina, E., Gutkowska, K., & Hamulka, J. (2023). The family environment as a source for creating the dietary attitudes of primary school students—a focus group interview: The Junior-Edu-Żywienie (JEŻ) Project. Nutrients, 15(23), 1–23. https://doi.org/10.3390/nu15234930
da Fonseca, P. G., Raposo, A., Alqarawi, N., Alasqah, I., Pinto, M. F., Martins, T. M. M., Gonçalves, V. D., Pereira, S. C. L., Albaridi, N. A., BinMowyna, M. N., Saraiva, A., & Guimarães, N. S. (2025). The influence of family in children’s feeding difficulties: An integrative review. Frontiers in Pediatrics, 13. https://doi.org/10.3389/fped.2025.1609714
Duh-Leong, C., Yin, H. S., Salcedo, V., Mui, A., Perrin, E. M., Yi, S. S., Zhao, Q., & Gross, R. S. (2023). Infant feeding practices and social support networks among immigrant chinese american mothers with economic disadvantage in New York City. Journal of Human Lactation, 39(1), 168–177. https://doi.org/10.1177/08903344221121571
Fierloos, I. N., Windhorst, D. A., Fang, Y., Hosman, C. M. H., Jonkman, H., Crone, M. R., Jansen, W., & Raat, H. (2023). The association between perceived social support and parenting self-efficacy among parents of children aged 0–8 years. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16710-8
Fitri, U., & Rusdiani, N. I. (2024). Analisis kemampuan interaksi sosial anak usia dini di tempat penitipan anak (Pocenter). BUHUTS AL ATHFAL: Jurnal Pendidikan Dan Anak Usia Dini, 4(1), 16–27. https://doi.org/10.24952/alathfal.v4i1.10584
Handayani, L. (2018). Contributions of Social Support, Knowledge, Attitude, and Self-Efficacy on Breastfeeding Practice in Indonesia. Thesis Faculty of Education Universiti Teknologi Malaysia. Retrieved 04 December 2025 from https://1library.net/document/yro83lvy-contributions-support-knowledge-attitude-efficacy-breastfeeding-practice-indonesia.html
Heselo, A., Indasah, & Prasetyo, J. (2025). Analysis of environmental factors, children’s eating patterns and access to health services on the incidence of malnutrition. STRADA : Jurnal Ilmiah Kesehatan, 14(1), 141–151. https://doi.org/10.30994/sjik.v14i1.1164
Hosokawa, R., & Katsura, T. (2024). Association between parents’ perceived social support and children’s psychological adjustment: A cross-sectional study. BMC Pediatrics, 24(756), 1–7.
Ibrahim, A. F., Elsebahy, S. Y., Aldhahi, M. I., Khalaf, M. M., Torad, A. A., Mohamed Taha, M., & El-Sheikh, A. F. (2025). Influence of oromotor functions on motor development and feeding outcomes in children with cerebral palsy. Annals of Medicine, 57(1). https://doi.org/10.1080/07853890.2025.2479587
Khasanah, N. N., Mutiara, & Syifauzakia. (2024). Analisis pandangan guru dalam menghadapi perilaku picky eater berdasarkan latar belakang sosial ekonomi. Infantia: Jurnal Pendidikan Anak Usia Dini, 2(2), 38–46.
Khotimah, K., Hasibuan, R., Susilowati, E., Bunnayah, S., & Zumara, N. I. (2025). Peran Orang Tua Dalam Meningkatkan Kesehatan Serta Nutrisi Anak Pada Pendidikan Anak Usia Dini. JURNAL MADINASIKA Manajemen Pendidikan Dan Keguruan, 6(2), 166–174. https://doi.org/10.31949/madinasika.v6i2.13997
Kumala, A. M., Margawati, A., & Rahadiyanti, A. (2019). Hubungan antara durasi penggunaan alat elektronik (gadget), aktivitas fisik dan pola makan dengan status gizi pada remaja usia 13-15 tahun. Journal of Nutrition College, 8(2), 73–80. https://doi.org/10.14710/jnc.v8i2.23816
Lefton-Greif, M. A., Okelo, S. O., Wright, J. M., Collaco, J. M., McGrath-Morrow, S. A., & Eakin, M. N. (2014). Impact of children’s feeding/swallowing problems: Validation of a new caregiver instrument. Dysphagia, 29(6), 671–677. https://doi.org/10.1007/s00455-014-9560-7
Lin, M. H., Vijayalakshmi, A., & Laczniak, R. (2019). Toward an understanding of parental views and actions on social media influencers targeted at adolescents: the roles of parents’ social media use and empowerment. Frontiers in Psychology, 10(2664), 1–16. https://doi.org/10.3389/fpsyg.2019.02664
Maharani, E. A., & Soeyono, R. D. (2024). Gambaran pengetahuan gizi orang tua, pola asuh pemberian makan, dan status gizi siswa neurodevelopmental disorders. Journal Health and Nutritions, 10(2), 58–71. https://doi.org/10.52365/jhn.v10i2.1144
Melinda, A. E., & Izzati, I. (2021). Perkembangan sosial anak usia dini melalui teman sebaya. Jurnal Pendidikan Anak Usia Dini Undiksha, 9(1), 127. https://doi.org/10.23887/paud.v9i1.34533
Nababan, T., Wati, A. R., Mely, C., Nagan, C. S., & Lindawati, C. A. (2024). Hubungan pemberian MP ASI terhadap gangguan sistem pencernaan pada bayi usia 0-6 bulan. Jurnal Penelitian Perawat Profesional, 6(3), 1303–1308.
Ningning, W., & Wenguang, C. (2023). Influence of family parenting style on the formation of eating behaviors and habits in preschool children: The mediating role of quality of life and nutritional knowledge. PLoS ONE, 18(7), 1–16. https://doi.org/10.1371/journal.pone.0288878
Nurlianawati, L., Nurjanah, A., & Program, A. (2023). Pola asuh ibu berhubungan dengan perilaku sulit makan pada anak usia prasekolah (3-6 Tahun). Jurnal Penelitian Perawat Profesional, 5(1), 93–102.
Nyanyi, M. F. A., Wahyuni, T. D., & Swaidatul, M. A. (2019). Pola asuh ibu yang mempengaruhi perilaku sulit makan pada anak prasekolah (4-6 tahun). Ilmiah Keperawatan, 4(1), 1–10.
Pebruanti, P., & Rokhaidah. (2022). Hubungan picky eating dengan kejadian stunting pada anak prasekolah di Tka Nurul Huda Tumaritis Kabupaten Bogor. Jurnal Keperawatan Widya Gantari Indonesia, 6(1), 1–11.
Pereira, B., Rosário, P., Núñez, J. carlos, & Magalhães, P. (2025). The role of child-family-peer relationships on children’s healthy eating behavior: A Path Model Study. Revista Iberoamericana de Psicologia y Salud, 16(1), 24–35. https://doi.org/10.70478/rips.2025.16.04
Ragelienė, T., & Grønhøj, A. (2020). The influence of peers′ and siblings′ on children’s and adolescents′ healthy eating behavior. A systematic literature review. Appetite, 148. https://doi.org/10.1016/j.appet.2020.104592
Rikandi, M., & Sari, N. U. (2018). Analisis hubungan pengetahuan dan pola asuh orang tua dengan kesulitan makan pada anak usia prasekolah di TK Negeri 1 Padang Tahun 2016. Jurnal Ilmu Kesehatan (JIK), 2(1), 107–113.
Scaglioni, S., De Cosmi, V., Ciappolino, V., Parazzini, F., Brambilla, P., & Agostoni, C. (2018). Factors influencing children’s eating behaviours. Nutrients, 10(6). https://doi.org/10.3390/nu10060706
Sindri, Handayani, T. S., & Sari, L. Y. (2024). Hubungan dukungan keluarga dengan perilaku ibu dalam memenuhi nutrisi balita Di Wilayah Kerja Puskesmas Sp Iii, Pumu Lahat Tahun 2023. Journal Of Midwifery, 12(1), 40–48. https://doi.org/10.37676/jm.v12i1.6188
Street, S., Simoncini, K., & Byrne, R. (2024). Peer influence on eating behaviour in early childhood: A scoping review. Appetite, 203(107708), 1–24. https://doi.org/10.1016/j.appet.2024.107708
Suparmi, S., Sasman, M. F., Ratnawati, R., & Rustanti, N. (2025). Hygiene and food safety practices among mothers as predictors of diarrhea risk in toddlers in Purwawinangun Village, West Java, Indonesia. Frontiers in Public Health, 13. https://doi.org/10.3389/fpubh.2025.1530828
Swanson, W. S., Ross, E. S., Matiz, L. A., Czerkies, L., Huss, L. R., Smith-Simpson, S., Bettler, J., & Pac, S. (2025). Essential elements for learning to eat: guidance to support families with infants and young children. Frontiers in Pediatrics, 13, 1–9. https://doi.org/10.3389/fped.2025.1493780
Toga, E., Laili, R. N., & Nashir, M. (2024). Hubungan pola asuh dengan tingkat stres menjelang ujian pada anak kelas 6 di SDN 2 Sumber Kencono Wongsorejo. NAJ : Nursing Applied Journal, 2(3), 01–11. https://doi.org/10.57213/naj.v2i3.278
Tournier, C., & Forde, C. G. (2024). Food oral processing and eating behavior from infancy to childhood: evidence on the role of food texture in the development of healthy eating behavior. Critical Reviews in Food Science and Nutrition, 64(26), 9554–9567. https://doi.org/10.1080/10408398.2023.2214227
Wahyuni, N. S., Wahyuningrum, E., & Gayatina, A. K. (2024). Pengalaman ibu dalam memberi makan pada anak cerebral palsy. Jurnal Ilmiah Keperawatan Stikes Hang Tuah Surabaya, 19(2), 153–158.
Wang, Y., Wang, L., Yang, L., & Wang, W. (2024). Influence of perceived social support and academic self-efficacy on teacher-student relationships and learning engagement for enhanced didactical outcomes. Scientific Reports, 14(1), 1–10. https://doi.org/10.1038/s41598-024-78402-6
Weir, S., Arstein-Kerslake, A., Eadie, T., & McVilly, K. (2023). Realising economic and social rights for children with communication and swallowing disability: Sustainable Development Goals 1, 8 and 10. International Journal of Speech-Language Pathology, 25(1), 37–41. https://doi.org/10.1080/17549507.2022.2153166
Wijaya, K. (2019). Hubungan intensitas penggunaan smartphone dengan perilaku makan pada emerging adults. Calyptra: Jurnal Ilmiah Mahasiswa Universitas Surabaya, 8(1), 1606–1616.
Winarni, S. S., & Purnama, N. L. A. (2017). Perilaku orang tua dalam pemberian makandan perilaku makan anak usia 2-5 tahun. Jurnal Penelitian Kesehatan, 7(2), 43–51.
Winarsih, B. D., & Zumrotun. (2012). Hubungan Pemberian Makanan Tambahan Usia Dini Dengan Kejadian Gangguan Sistem Pencernaan Pada Bayi Usia 0-6 Bulan Di Puskesmas Bangsri I Kecamatan Bangsri Kabupaten Jepara. Jurnal Keperawatan Dan Kesehatan Masyarakat STIKIES Cendekia Utama Kudus, 1(1), 26–1111.
Yasya, W. (2019). Association between online social support on Facebook and breastfeeding self efficacy. Proceeding International Conference On Social Sciences: The 2nd International Conference on Social Science 2019, November, 5–6.
Yavanoglu Atay, F. (2023). Evaluation of the effect of oral motor stimulation exercises on feeding skills in premature infants. SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 57(2), 189–194. https://doi.org/10.14744/semb.2022.96562
Yu, L., Wu, X., Zhang, Q., & Sun, B. (2024). Social Support and Social Adjustment Among Chinese Secondary School Students: The Mediating Roles of Subjective Well-Being and Psychological Resilience. Psychology Research and Behavior Management, 17, 3455–3471. https://doi.org/10.2147/PRBM.S477608
Zhang, J., Zhang, Q., Xiao, B., Cao, Y., Chen, Y., & Li, Y. (2025). Parental Technoference and Child Problematic Media Use: Meta-Analysis. Journal of Medical Internet Research, 27(e57636), 1–16. https://doi.org/10.2196/57636