DOI: https://doi.org/10.14710/nmjn.v14i3.73812

Determinants of Maternal Adherence to Complementary Feeding Guidelines in Padang City, Indonesia: An Application of The Integrated Change Model

*Hermalinda Herman scopus  -  Department of Maternity and Pediatric Nursing, Faculty of Nursing, Universitas Andalas, Indonesia
Ying-Ju Chang scopus  -  Professor, Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
Open Access Copyright (c) 2025 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Maternal adherence to complementary feeding guidelines is crucial in preventing childhood malnutrition, yet adherence remains low. Although previous studies have identified several influencing factors, evidence from Indonesia is limited and lacks a theory-based explanation of how cognitive and behavioral determinants influence maternal feeding practices.

Purpose: This study applies the Integrated Change Model (I-Change Model) to examine the determinants of maternal adherence to complementary feeding guidelines.

Methods: A cross-sectional design was used, involving 579 mothers of children aged 6–23 months, selected through cluster-stratified random sampling. Maternal adherence to complementary feeding guidelines was assessed using the Infant and Young Child Feeding (IYCF) indicators, while a self-developed questionnaire, along with several modified questionnaires, was used to evaluate associated factors. Multiple logistic regression analysis was applied to identify the determinants of maternal adherence to these guidelines.

Results: Only 40.1% of mothers adhered to complementary feeding guidelines. Maternal adherence was significantly associated with higher education (AOR = 1.984; 95% CI: 1.053–3.739), positive attitudes (AOR = 5.752; 95% CI: 1.283–25.794), high self-efficacy in providing complementary feeding (AOR = 2.695; 95% CI: 1.426–5.091), and non-provision of formula milk (AOR = 0.568; 95% CI: 0.395–0.806).

Conclusion: Maternal education, attitudes, self-efficacy, and non-provision of formula milk were identified as key determinants of adherence. These findings highlight the need for interventions focusing on enhancing maternal education, promoting positive attitudes, and improving self-efficacy. Future research should examine social support and sociocultural or economic factors through longitudinal studies to better understand their impact on adherence behaviors.

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Keywords: Complementary feeding; infants; malnutrition; maternal adherence and young children

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