Research in Community and Public Health Nursing

Original Articles

[English] Modelling of Family Functioning, Dietary Diversity, Family Environmental Sanitation, Household Food Insecurity Access, and Stunting: A Cross-Sectional Study in Rural Areas of Indonesia: Tantut Susanto, Hanny Rasni, Emi Wuri Wuryaningsih, Eka Afdi Septiyono, Vigo Agustilano Salim; Res Community Public Health Nurs. 2026;37(2):125-135. Published online June 30, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01305

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Abstract PDF Supplementary Material: Purpose
Risk factors associated with stunting are often studied individually, while their combined effect within a single framework is poorly understood. This study aimed to model the interrelationships between family function, dietary diversity, family environmental sanitation, and household food insecurity access as predictors of stunting in rural areas of Indonesia.
Methods
A descriptive-analytic, cross-sectional approach was conducted on 339 mothers with stunted children under five years of age in a rural area of Indonesia from June to August 2025. Data were collected using questionnaires and measurements of stunting. Data analysis utilised Structural Equation Modelling (SEM) based on Partial Least Squares (PLS) to examine the relationships among mothers' factors, child factors, family functioning (as measured by the Family Assessment Device - FAD), dietary diversity, family environmental sanitation (FES), household food insecurity access (HFIA), and stunting.
Results
The final structural model demonstrated that dietary diversity (p=.001; β=.16) and family functioning (p=.003; β=.20) were the most significant direct predictors of stunting. Notably, 'child factors' (e.g., medical history) also had a direct effect on stunting (p=.029; β=0.14), but more importantly, exerted a powerful indirect influence by significantly shaping family functioning, FES, and HFIA. While 'mother factors' (e.g. education) influenced household food and hygiene, they did not have a direct statistical effect on stunting in the final model.
Conclusion
Alongside dietary diversity, family functioning is a key predictor of stunting. To be effective, community nursing interventions must integrate strategies that support family dynamics with traditional nutritional guidance.

[English] How Many Older Koreans Are at Risk? National Estimates of Food Insecurity and Sarcopenia Risk Based on ESPEN Guidelines: Dasom Kim; Res Community Public Health Nurs. 2026;37(1):61-70. Published online February 26, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01270

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Abstract PDF: Purpose
Food insecurity and inadequate nutrient intake are major public health concerns in aging populations. Sarcopenia is influenced by nutrition and socioeconomic status. This study aimed to estimate the prevalence of food insecurity and sarcopenia risk among Korean older adults and examine associations with socioeconomic and lifestyle factors.
Methods
A cross-sectional analysis of the 2019 Korea National Health and Nutrition Examination Survey (KNHANES) was conducted using a complex sample design. A total of 1,365 adults aged ≥65 years were included. Food insecurity, nutrient adequacy per European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines, and sarcopenia risk (defined by low handgrip strength) were assessed. Logistic regression determined associations with socioeconomic status, diet, and exercise.
Results
Food insecurity affected 15.7% of older adults (weighted percentage). An estimated 40.9% had inadequate nutrient intake, and 24.6% were at risk of sarcopenia. Lower income was significantly associated with sarcopenia risk; compared to the lowest quintile, those in the second quintile had lower odds (OR = 0.61, 95% CI: 0.43–0.87). Lower education also increased risk, with high school graduates showing lower odds (OR = 0.45, 95% CI: 0.26–0.78) compared to those with elementary education or less. Notably, nutrient adequacy based on ESPEN guidelines was not significantly associated with sarcopenia risk. Resistance exercise ≥3 days/week was protective (OR = 0.48, 95% CI: 0.28–0.82).
Conclusions
Socioeconomic disadvantage and physical inactivity are primary determinants of sarcopenia risk in Korean older adults. The lack of association between ESPEN-based nutrient adequacy and sarcopenia risk highlights the need to address structural socioeconomic determinants beyond simple nutrient supplementation.

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