Undergraduate Thesis Proposal

THE INFLUENCE OF ISLAMIC COMICS AND COMIC STRIP ABOUT

HEALTHY BREAKFAST ON THE KNOWLEDGE AND ATTITUDES OF
ISLAMIC ELEMENTARY SCHOOL TELUK LINGGA STUDENTS

Prepared By:
HAFIZHATUNNISA
NIM: 36.2015.7.2.1174

NUTRITION DEPARTEMENT OF HEALTH SCIENCE FACULTY

UNIVERSITY OF DARUSSALAM GONTOR
NGAWI
2018
 ii

STATEMENT OF ELIGIBILITY
FOR UNDERGRADUATE THESIS EXAMINATION

With this state that the Undergraduate Thesis entitle :

THE INFLUENCE OF ISLAMIC COMICS AND COMIC STRIP ABOUT

HEALTHY BREAKFAST ON THE KNOWLEDGE AND ATTITUDES OF
ISLAMIC ELEMENTARY SCHOOL TELUK LINGGA STUDENTS

Prepared by
Hafizhatunnisa
36.2015.7.2.1174

Has been read carefully and considered scientific meet the standars, either the
scope or quality.

Has been approved to be examined on: Desember 6th 2018

Major Advisor Co. Advisor

Joyeti Darni, S.Gz., M.Gizi Amilia Yuni Damayanti, S.Gz., M.Gizi

NIY.170584 NIY.160573

Head of Departement of Nutrition

Faculty of Health Science
University of Darussalam Gontor

Fathimah, S.Gz., MKM

NIY. 140368
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CONTENTS
COVER
STATEMENT OF ELIGIBILITY .......................................................................... ii
CONTENTS ........................................................................................................... iii
TABLE OF CONTENT .......................................................................................... v
TABLE OF FIGURE ............................................................................................ vii
TABLE OF APPENDIX ...................................................................................... viii
CHAPTER 1 INTRODUCTION ............................................................................ 1
1.1. Background of Reseach ............................................................................... 1
1.2. Formulation of the Research Problem ......................................................... 4
1.3. Obejectives Research ................................................................................... 4
1.3.1 General objectives .............................................................................. 4
1.3.2 Spesific objectives .............................................................................. 4
1.4. Benefits of Research .................................................................................... 5
1.4.1 For Respondents ................................................................................. 5
1.4.2 For Institution ..................................................................................... 5
1.4.2 For Islamic Elementary School Teluk Lingga ................................... 5
1.4.4 For researchers ................................................................................... 5
1.5. Authenticity and Formers Research ............................................................. 5
CHAPTHER 2 LITERATURE REVIEWS ............................................................ 7
2.1 Theoretical Basis ........................................................................................... 7
2.1.1. Healthy Breakfast ............................................................................... 7
2.1.2. Nutrition Knowledge.......................................................................... 8
2.1.3. Nutritional Attitude .......................................................................... 10
2.1.4. The Characteristics of Elementary School Children ........................ 12
2.1.5. Nutritional Media Promotion ........................................................... 13
2.1.6. Comics Media .................................................................................. 15
2.3. Theoritical framework................................................................................ 17
2.3. Conceptual framework ............................................................................... 17
2.4. Hypothesis .................................................................................................. 18
BAB 3 RESEARCH METHODS ......................................................................... 19
3.1 Reseach Design ........................................................................................... 19
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3.2 Time and Place of Implementation ............................................................. 19

3.3. Subject of Research .................................................................................... 19
3.3.1 Population......................................................................................... 19
3.2.2 Number of Samples ......................................................................... 20
3.4. Identification of Research Variables .......................................................... 20
3.5. Operational Definition ............................................................................... 21
3.6. Instruments and Data Measurement .......................................................... 22
3.6.1 Instruments of Research ................................................................... 22
3.6.2 Data Collection Method ................................................................... 22
3.7. Research Design Flow Chart ...................................................................... 23
3.8. The Test of Validity and Reliability .......................................................... 24
3.8.1 The Validity Test .............................................................................. 24
3.8.2 The Reliability Test .......................................................................... 24
3.9. Data Analysis Method ................................................................................ 25
3.9.1 Univariate Analisys .......................................................................... 25
3.9.2 Bivariate Analisys ............................................................................ 25
3.10. Research Ethics ........................................................................................ 25
3.11. Research Limitation ................................................................................. 26
3.12. Research Time Planning .......................................................................... 26
REFERENCES...................................................................................................... 27
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TABLE OF CONTENT

Table 1.1 Authenticity and Formers Research ........................................................ 5

Table 3.1 Research Design .................................................................................... 18
Table 3.2 Operasional Definition .......................................................................... 20
Table 3.3 Research time Plinning ......................................................................... 27
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TABLE OF FIGURE

Figure 1.1 Theoritical Framework ......................... Error! Bookmark not defined.

Figure 1.2 Conceptual Framework ........................................................................ 17
Figure 3.1 Research Design ................................... Error! Bookmark not defined.
Figure 3.2 Research Design Flow Chart ............................................................... 23
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TABLE OF APPENDIX

Appendix 1. Explanation Sheet Before Approval for Students . Error! Bookmark

not defined.
Appendix 2. The Informed Consent for Student ... Error! Bookmark not defined.
Appendix 3. The Questionaire for Student ........... Error! Bookmark not defined.
Appendix 4. The Knowledge Assessment Questionnaire ... Error! Bookmark not
defined.
Appendix 5. The Attitude Assessment Questionnaire ........ Error! Bookmark not
defined.
 CHAPTER 1
INTRODUCTION
1.1. Background of Reseach
Breakfast in a few years has become one of the focuses on improving
the nutrition of school-age children in relation to their correlation with
nutritional status. In developing countries, the prevalence of obesity in
children is known to increase by 60% since 1980 (Gupta et al, 2015). Obesity
is associated with a healthy breakfast, where children who do not regularly
have breakfast are at a risk of 1.7 times more likely to suffer from obesity as
adults (Siong et al., 2018). In Indonesia, it is known that 69.6% of Indonesian
children have not had breakfast according to the recommended balanced
nutrition guidelines and 73.4% of breakfast with the low nutritional quality of
food consumption (Perdana, 2013). Though consumption of various foods is
very influential on nutritional status (Handayani, 2016).
Eating a variety of foods is a recommendation in the first pillar of
balanced nutrition (Kemenkes, 2014). In accordance with the command of the
Qur'an to pay attention to the type of intake consumed (QS Abasa; 80: 24).
Covers the quality and quantity of food (Surah al-Mu'minun; 23: 51). Namely
in the form of foods that are halal and thayyib, meaning healthy, safe,
nutritious and bring benefits (Afzaal et al., 2017) according to the verses of
Al-Qur'an as follows:

ِ ‫ض ﺣﻼﻻ ﻃَﻴﱢﺒﺎ وﻻ ﺗَـﺘﱠﺒِﻌﻮا ﺧﻄُﻮ‬

ِ َ‫ات اﻟﺸﱠﻴﻄ‬
‫ﺎن إِﻧﱠﻪُ ﻟَ ُﻜ ْﻢ‬ ِ
ْ َ ُ ُ َ ً ْ ‫ﱠﺎس ُﻛﻠُﻮا ﳑﱠﺎ ِﰲ‬
َ ِ ‫اﻷر‬ ُ ‫ﻳَﺎ أَﻳـﱡ َﻬﺎ اﻟﻨ‬
(١٦٨) ‫ﲔ‬ ٌ ِ‫َﻋ ُﺪ ﱞو ُﻣﺒ‬
“O mankind, eat from whatever is on earth (that is) lawful and
good and do not follow the footsteps of Satan. Indeed, he is to you a
clear enemy (QS Al-Baqarah:2; 168)”

Based on data from the 2018 Basic Health Research Results

(Riskesdas) in March, 95.5% of children aged ≥5 years in Indonesia
consumed fewer vegetables and fruits, with the highest prevalence in East
Kalimantan Province with 98.2%. This data is directly proportional to the
 2

third largest obesity proportion in Indonesia, where 28% of age >18 years in
East Kalimantan have central obesity, increasing 5,4% from prevalence in
2016 (Kemenkes, 2016). That is, there is a relationship between breakfast and
the incidence of obesity (Morales et al., 2011; Dorothea et al., 2017).
The habit of not having breakfast causes hypoglycemia, dizziness,
trembling, fatigue and difficulty concentrating in children (Huang et al.,
2010). In the long-term impact, it results in nutritional status, a decrease in
children's health, and inhibits the improvement of the nation's human
resources (Tin et al., 2011). Breakfast has a positive influence on cognitive
and academic outcomes (Babaeer et al., 2018) Breakfast is important for
elementary school age, where the period of brain productivity is high in
absorbing various lessons (Jefri, 2017). The habit of not having breakfast also
affects fiber content and micronutrients. Children who routinely have healthy
breakfasts with vegetables and fruits have higher levels (Coulthard et al.,
2017) while low consumption of fruits and vegetables can occur due to lack
of motivation (Albani et al., 2018).
Nutrition Communication, Information and Education for children can
shape children's eating habits from an early age to achieve better individual
conditions in the future (Damayanti et al., 2018). The role of nutrition
education by using media is to help the process of sending nutritional
messages and cause motivation to target themselves so that the message of
nutrition given can be well received (Cita, 2016). In order for the chosen
method to run effectively and efficiently, it needs to be supported by the right
media and tools (Kemenkes, 2014).
Media promotion that is not appropriate can result in the failure of the
messages contained in the media (Kostanjevec et al., 2011). Daryanto (2013)
states that elementary school students tend to dislike textbooks, especially
those that are not accompanied by interesting images and illustrations, and
empirically students tend to like picture books, full of colors and visualized in
realistic or cartoon forms. Cartoon media can increase the intake of fruit or
vegetable children (Kraak et al., 2015).
 3

Visual media such as leaflets, posters and pictorial stories (comics) are
interesting methods and liked by elementary school student (Widajanti et al.,
2009). The comic media increases the post-test knowledge score of the group
given an education. But, comic media does not have a significant effect on
changes in body weight in cases of childhood obesity. This is caused by the
time of the study which requires observation of more than 2 weeks (Nugroho,
2018). In addition to the knowledge score, there were significant changes in
the attitude of the comic media experimental group (Widajanti, 2009).
Increased knowledge scores also occur in groups given education through the
comic strip method (Jefri, 2017).
So far the media that are often intended for children put forward good
illustrations without regard to the planting of moral values (Yuliana, 2014),
whereas comic media is a medium of learning that is proven to be more
effective than the lecture method (Pratiwi et al., 2015). Learning media
should not only prioritize changes in knowledge but also provide moral
values in it (Albiruni, 2017). The cultivation of noble character through
comic characters also plays an important role, because children like to imitate
and abuse (Hafiz, 2017). Based on Pratiwi et al., (2015) research the age of
elementary school students that is suitable for nutrition education is a period
ranging from 6 to 14 years. At this age, children begin to mature sexually and
mature to learn. Among those ages, the most appropriate given nutrition
education is the age of 11 years (Hapsari & Suminar, 2016).
Among the many studies, no one has carried out Islamization of the
media used. According to Johan et al., (2018) audio-visual media are still
rarely used in health education related to health behaviour in school-age
children in the East Kalimantan. So from that, we need a study to determine
the differences in the influence of the islamic comic and comic strip about
healthy breakfast on the knowledge and attitudes of islamic elementary Teluk
Lingga students, East Kalimantan.
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1.2. Formulation of the Reasearch Problem

1.2.1 How does the infulence of islamic comics about healthy breakfast on
knowledge and attitudes of Islamic Elementary school Teluk Lingga
student?
1.2.2 How does the infulence of islamic comic strips about healthy breakfast
on knowledge and attitudes of islamic Elementary school Teluk Lingga
student ?
1.3. Obejectives Research
As for some of the research objectives were to:
1.3.1 General objectives
Knowing the influence of islamic comics and comic strips about
healthy breakfast on the knowledge and attitudes of Teluk Lingga
Islamic Elementary school student
1.3.2 Spesific objectives
a. Produce nutritional promotion media in the form of islamic comics
and comic strips.
b. Knowing an overview about healthy breakfast of islamic
Elementary school Teluk Lingga student.
c. Knowing the influence of islamic comics on the level of knowledge
about healthy breakfast of islamic Elementary school Teluk Lingga
student.
d. Knowing the influence of Islamization of comics on the attitude
about healthy breakfast of islamic Elementary school Teluk Lingga
student.
e. Knowing the influence of Islamization of comic strips on the level
of knowledge about healthy breakfast of islamic Elementary school
Teluk Lingga student.
f. Knowing the influence of Islamization of comic strips on the
attitude about healthy breakfast of islamic Elementary school Teluk
Lingga student.
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1.4. Benefits of Research

1.4.1 For Respondents
a. Gain knowledge about healthy breakfast with islamic nutrition
promotion media in the form of comics and comic strips.
b. Gain knowledge about the application of healthy breakfast
according to balanced nutrition guidelines values.
1.4.2 For Institution
Provide information about the influence of nutritional promotion media
in the form of islamic comics and comic strips on the knowledge and
attitudes of islamic elementary school Teluk Lingga student.
1.4.3 For Islamic Elementary School Teluk Lingga
This research is expected to be an input in selecting nutrition promotion
media for students.
1.4.4 For researchers
a. Increase knowledge about matters relating to healthy breakfast.
b. Improve ability in analyzing the manufacture of nutrition
promotion media.
1.5. Authenticity and Formers Research
Table 1.1 Authenticity and Formers Research
No Title Variables & Design Result Diference
1. Nutritional Education Variable The lecture group The sampling method
of Healthy Snack dependent: Nutrition pretest 10,44+4,66 in this study is total
Choices Between Education about increase from 13,62 sampling.
Lecture and Comic Choosing Healthy +5,07 and comic group
Methods Snacks 13,28+3,45 increase The dependent
Independent variable: 15,72+3,13 variable is the
(Nur Pratiwi Hartono, Lecture Method and There were significant knowledge of
Comic Method differences (p <0.05) choosing healthy
2015)
Design: Cross on both methods. snacks
Sectional
2. Development of Dependent variable: The poster group The design of the
Material and Nutritional 77,8+12,5 increase approach used in this
Acceptance of knowledge 86,5+12,1 and leaflet study is a non
Nutrition Education Independent variable: group increase equivalent control
Through Visual Visual Media 82,1+10,2 to be group design.
Media on Nutrition 84,2+11,8
Knowledge of Design: Cross Significant differences The media used are
Elementary School Sectional (p <0.05) on the two posters and leaflets.
Ages media acceptability of
the poster media
(Defika Annisa Cita, preference was higher
2014) than the leaflet.
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3. Effects of Health Dependent Variables: Good knowledge This study only uses
Education Using The Knowledge increased by 14.7% strip media.
Media Strip Comics about Hand Washing from 16.4% to 31.1% The sampling method
Against Knowledge between after and : stratified random
about Hand Washing Independent before education using sampling.
Variable: The comic comic strips with
(M. Jefri Wildan, strip significant differences
2017) (p value = 0,000)
Design:
Cross Sectional
4. Pengaruh Media Dependent Variables: There was a significant This study only uses
Pendidikan Gizi The Obesity Student effect on the level of one medium, namely
(Komik) Terhadap Knowledge and student knowledge (p comics.
Peningkatan Weight <0.05) but there was no The sampling
Pengetahuan dan Independent effect on student body technique : purposive
Perubahan Berat Variable: The comic weight (p> 0.05) sampling.
Badan pada Anak as nutrisional
Sekolah Dasar education student
dengan Obesitas
Design:
Anugrah Nugroho Cross Sectional
(2018)

5. Penerapan Komik Dependent Variables: The application of this research uses one
Strip Sebagai Media Learning Financial learning using comic media, namely comic
Pembelajaran Mata Management Courses strip media that is strip.
Kuliah Manajemen carried out has a This study only
Keuangan Mahasiswa Independent positive impact on provides an overview
Variable: The comic learning activities. of the application
Meyta Prihandhari strip media without measuring its
(2016) level of influence.
Design:
Case Study

6. The Effect of Healthy Dependent Variables: There was an increase This study only uses
and Nutritious Snack The Knowledge and in knowledge and one comis media
Food Comics to Attitudes of Students attitudes of food
Increase Knowledge sanitation (22.0%), and The sampling method
and Attitudes of Independent safety of snacks : Random
Elementary School Variable: The comic (12.6%). Increased Sampling
Children Ages media attitudes related to
Snack Food Sanitation
Widajanti L, Design: (21.0%), and Snack
Chriswardani S, Cross Sectional Food Safety (0.7%).
Anung S (2009)
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CHAPTHER 2
LITERATURE REVIEWS
2.1 Theoretical Basis
2.1.1 Healthy Breakfast
Breakfast is a meal and drink activity carried out before 9 am to
meet 15-30% of daily nutritional needs as part of balanced nutrition in
order to realize a healthy, fit, active and intelligent life (Hardinsyah,
2013). Breakfast is important for everyone to start activities throughout
the day. Breakfast is a food and drink activity that is carried out
between waking up to 9 o'clock to fulfill a portion (15-30%) of daily
nutritional needs in order to realize a healthy, active, and intelligent life
(Hardinsyah, 2012).
Breakfast aims to meet nutritional needs in the morning, as part of
fulfilling balanced nutrition and is beneficial in preventing
hypoglycemia, stabilizing blood glucose levels, and preventing
dehydration after fasting all night (Gibson & Gunn, 2011). Breakfast
for children is very important because it can have a positive impact on
good school attendance, academic performance, nutritional intake,
fitness, healthy weight diet quality, health level, appetite regulation, and
cognitive performance (Katie et al., 2017). In the long term, breakfast is
beneficial to prevent obesity because breakfast habits instil a good diet
(Kral et al., 2011). In addition, breakfast habits can also help regulate
body weight for obese sufferers (Schusdziarra et al., 2011).
Children who do not have breakfast will experience a lack of
energy and motivation to do activities other than that malnutrition and
lack of micronutrients can have an impact on physical, mental, health,
and reduce cognitive function (Mhurchu et al., 2010). The habit of not
having breakfast causes hypoglycemia, dizziness, trembling, fatigue
and difficulty concentrating (Huang et al., 2010). In the long-term
impact, it affects nutritional status, decreases the health and stamina of
children, and inhibits the improvement of the nation's human resources
(Tin et al., 2011). The habit of not having breakfast also risks increasing
 8

waist circumference, total blood cholesterol levels, and bad cholesterol

or LDL levels (Smith et al., 2010).
Breakfast is also influential in appetite control, satiety, and energy
expenditure and weight management (Jess et al., 2018). The results of
the study by Siong et al., (2018) state that there is a relationship
between the consumption of regular food and breakfast to the risk of
obesity. Morales et al., (2011) agree that obesity can be avoided by
reducing energy intake from breakfast and keeping eating regularly
with normal energy and nutrient intake. Factors that correlate
significantly with breakfast skip habits are high consumption of soft
drinks, and high levels of physical activity on the one hand, and more or
less static socio-economic factors, single parenting, and education level
high family, gender factors, and body fat percentage at or above 95%
(Dorothea et al., 2017).
2.1.2 Nutrition Knowledge
Knowledge is a variety of things that humans acquire through the
five senses. Knowledge arises when someone uses his senses to explore
certain objects or events that have never been seen or felt before
(Wijayanti, 2009). Knowledge is the result of "knowing" and this
happens after people have sensed certain objects. Sensing can occur
through the five human senses, namely the sense of taste, touch. vision,
hearing and smell, for the most part, one's knowledge comes from the
eyes and ears (Notoatmodjo, 2011). The level of knowledge of a
person's nutrition influences attitudes and behaviours in the selection of
food which will ultimately affect the nutritional condition of the
individual concerned.
Measurement of knowledge can be done by interview or
questionnaire that asks about the material to be measured from the
research subjects or respondents. According to Notoadmodjo (2014)
measurement of knowledge can be done directly or indirectly. Direct
attitude measurement can be done by asking questions about the object
 9

in question. A person's knowledge can be categorized and interpreted

with the following scale (Arikunto, 2006) :
1) Good : Percentage range 76% - 100%
2) Enough : Percentage range 56% - 75%
3) Less : Percentage range < 56%
The score used in measuring knowledge is the Guttman scale
on multiple choice questions or multiple choices (a, b, c, d) with "true"
and "wrong" assessment criteria. Each correct answer gets a score of 1
and the wrong answer gets a score of 0 (Swarjana, 2015). Someone
who has good knowledge about nutrition will be able to apply his
ability to choose and process food so that he can fulfil his nutritional
needs, and there are several factors that affect knowledge, such as the
following :
1) Education
Education is a process of changing attitudes and behaviour of a
person or group through teaching and training efforts (Rahayu,
2010). A person's education influences the knowledge he has, the
higher one's education should the more knowledge he has (Emilia,
2015).
2) Age
Age is the age of the individual starting from birth. Increasing
age, will add maturity and strength of someone in terms of
thinking and work. In terms of public trust, a more mature person
will be more trusted than someone who is not sufficiently mature.
This can be due to the results of experience and maturity in his
soul (Nursalam, 2011).
3) Interest
Interest is something that is a tendency or high desire for
something. The existence of high knowledge supported by
sufficient interest is very likely someone will be in accordance
with what is expected (Notoadmodjo, 2007).
 10

4) Residence
A Residence is a place to settle someone in their daily lives. A
person's knowledge becomes better and better when in urban
areas than those in rural areas because in urban areas they have
the opportunity to involve themselves in all kinds of social
activities, social insights are stronger and in cities, it is very easy
to get information (Emilia, 2015)
5) Exposure to information
Information defines as a technique for collecting, preparing, and
storing, manipulating, announcing, analyzing, and disseminating
information with specific purposes and objectives that can be
obtained through electronic and printed media (Rahayu, 2010).
Information obtained from various sources will affect the level of
one's knowledge. If someone gets a lot of information, he tends to
have wider knowledge (Notoadmojo, 2007).
6) Media
Media is one of the determinants of knowledge. Examples of
media specifically designed to reach the wider community such as
television, radio, newspapers, magazines, books and the internet
(Rahayu, 2010). The media that can be used in nutrition
communication, information and education activities are:
a) Electronic media such as radio, television, cinema,
telephone and video.
b) Printed media such as newspapers, magazines, brochures,
leaflets, booklets, calendars, flipcharts and pocket books.
c) Online media like web, facebook, twitter and youtube
d) Audio media such as songs, jingles and yells (Kemenkes,
2014)
2.1.3. Nutritional Attitude
Attitudes are positive and negative tendencies in relation to
psychological objects (Sarkim et al., 2010). Attitude is a certain
regularity in terms of feelings (affection), cognitive , and predisposing
 11

actions someone to an aspect in the surrounding environment (Azwar,

2012), People who have a positive attitude towards an object of
psychology when he likes or have a favourable attitude, on the contrary,
the person who is said to have a negative attitude towards the object of
psychology if dislike or his attitude is unfavourable towards his
psychological object (Ahmad, 2013).
Someone who has good nutrition knowledge tends to have
appropriate nutritional attitudes (Aminudin, 2016). Attitudes can only
be interpreted in visible behaviour. Attitude is a readiness to react to an
object in a certain way, the form of a reaction with good and bad things,
attitude includes feeling like and disliking, approaching and avoiding
situations, things, someone, group, and social wisdom (Kholid, 2012).
According to Aminudin (2016) attitude is a tendency to act from
individuals, in the form of a closed response to a stimulus or a
particular object. Attitudes can be categorized into several levels, the
higher the influence of the media on the attitude of the respondents it
will be as good (Pratiwi et al., 2015). Among these levels are:
a. Receiving means that the subject wants and pay attention to the
stimulus given.
b. Respond, which can be in the form of giving an answer if
asked, working on and completing the assignment given.
c. Valuating, which can be in the form of inviting other people to
work on or discuss a problem.
d. Responsible for everything he has chosen (Notoatmodjo,
2005).
According to (Azwar, 2012) factors that influence the formation of
attitudes are:
1) Personal experience is what already exists that we are
experiencing will shape and influence the appreciation of
children in choosing food. Experience can affect nutritional
attitudes due to the amount of information a person has about
the body's need for nutrition for a number of times in its life.
 12

The ability of a person to apply nutrition knowledge to

choosing food and developing appropriate ways of using food
(Aminudin, 2016 )
2) The influence of important people in life or around
Among people who are usually considered important by
individuals are parents, people with higher social status, peers,
close friends, and teachers. In general, children tend to have an
attitude in line with the attitude of people who are considered
important or people who are close to him (Azwar, 2012)
3) The influence of culture
The culture of a society has a strength will affect the attitude or
consideration in buying food to be consumed. The social aspect
of food culture is the function of food in the community that
develops according to the circumstances of the environment,
religion, customs, habits and education of the community
(Azwar, 2012).
Attitude is a reaction or response that is still closed from someone
to a stimulus or object, so that it can be measured by giving an opinion
(Nursalam, 2011). Questions that are of a direct nature can be formed
by giving opinions by using the words "agree" and "disagree" with
certain object statements, using the Lickert scale (Swarjana, 2015).
From this Lickert scale attitudes can be categorized (Arikunto, 2013) as
follows:
1) 25% -50% = Less
2) 51-75% = Enough
3) 76-100% = Good
2.1.4 The Characteristics of Elementary School Children
Elementary school children are in the age range of 6-12 years.
This age is a time when children enter a new world, where relationships
with people outside their families and get acquainted with the
atmosphere of a new environment in their lives (Hapsari & Suminar,
2016). Some characteristics are happy to play, love to move, and love to
 13

work in groups and also like to feel something directly. This can affect
their eating habits and cause changes that deviate from the habits
planted in the family (Aminudin, 2016).
Based on research by Pratiwi et al., (2015) Elementary school
children age appropriate for nutrition education is given a period of 6 to
14-year range. At this age, children begin to mature sexually and
mature to learn. Among those ages, the most appropriate given nutrition
education is the age of 11 years. Because at that age a child is able to
think abstractly, reason logically, and draw conclusions from available
information (Hapsari & Suminar, 2016). Elementary school children
love to move and can sit quietly with a period of ± 30 minutes
(Aminudin, 2016). So, it is important to provide education with a short
time and solid information to them.
In the aspect of his education, is very important for a child to
socialize. Like learning to meet the Group's rules, a loyal friend of
learning, learning to accept responsibility, learn to compete with others
in a healthy and sportive (Notoadmojo, 2011). With socialization
activities, school children are usually a lot of activity playing a draining
so an imbalance between energy that goes with the energy out.
Especially if not offset by the consumption of nutritious foods
(Aminudin, 2016).
2.1.5. Nutritional Media Promotion
Media promotion is a tool used in health promotion such as health
education, health education, communication, information and education
(IEC) in community empowerment to maintain and improve their health
(Kemenkes, 2014). Promotion media classification according to its use
there are three types of media used, they are auditive media, visual
media, and audio-visual media (Prihandari, 2016). The use of teaching
media in the teaching and learning process can generate new desires
and interests, arouse motivation and stimulation of learning activities,
and even bring psychological influences to students in learning
(Rusman, 2013). According to Kemenkes (2014) media that can be
 14

used in nutrition communication, information and education activities

are:
1) Electronic media such as radio, television, cinema,
telephone and video.
2) Print media such as newspapers, magazines, brochures,
leaflets, booklets, calendars, flipcharts and pocket books.
3) Online media such as the web, facebook, twitter and
youtube.
4) Audio media such as songs, jingles and yells
There are two main functions of learning media that need to be
known. The first function of the media is as a learning aid and the
second function is as a medium of learning resources (Gunawan, 2016).
Besides that, according to Ajizah et al., (2016) several other functions
of visual media, are:
a) Attention function, visual media is the core media, namely
attracting and directing the attention of students to concentrate
on the contents of the lesson relating to the visual meaning
displayed or accompanying the text of the subject matter. Thus,
the possibility of obtaining and remembering the contents of the
lesson is getting bigger.
b) Affective function, visual media can be seen from the level of
enjoyment of students when learning (or reading) pictorial text.
Visual images or symbols can arouse students' emotions and
attitudes, for example information that concerns social or racial
issues.
c) Cognitive function, visual media can be seen from research
findings that reveal that visual or image symbols facilitate the
achievement of goals to understand and remember information
or messages contained in images.
d) Compensatory function, teaching media can be seen from the
results of research that visual media that provide context to
understand text helps students who are weak in reading to
 15

organize information in the text and remember it again and

understand the contents of the lesson presented with text or
presented verbally.
2.1.6. Comics Media
Comics are one of five distributors of non-verbal graphic visual
messages (Jefri, 2017). Comics are a form of visual communication
media that has the power to convey information popularly and easily
understood. Comics are continuous drawings or paintings which are
stories. In short, comics can also be called illustrated stories. Comics
are generally in the form of a series of images, each in a box, all of
which are a series of one story. The images are usually equipped with
speech balloons and there are times when they are still accompanied by
narration as an explanation (Maharsi, 2010). Based on the shape, the
comic is divided into five types, they are:
i. Comic Strips
These comics refer to comics consisting of only a few panels
and usually appear in newspapers or magazines (Wildan, 2017)
Comic learning media strips contain images or series of images
that make up a story. Stories made based on the material
studied. The media is made with interesting stories and views
to attract students to read it. When students read directly they
learn the learning material that is taught (Pritandhari, 2016).
According to Jefri (2017) Strip comics are a picture or series of
images that contain stories. Usually, comic strips consist of
three to six panels or around it. The presentation of the contents
of the story can also be in the form of humour or a serious story
and it is also interesting to listen to in each period until the
story is finished (Maharsi, 2010). The effectiveness of comic
strips as learning media proved to be positive with a significant
increase in the level of knowledge in the experimental group
(Pritandhari, 2016). Significant improvement also occurred in
the attitude of the experimental group (Jefri, 2017).
 16

ii. Comic books

Comic books or commonly called comics are types of comics
that are presented in book form that are not part of other print
media. This comic book packaging is more like a magazine and
published regularly (Handayani, 2010). Comics are cartoons
that express a character and portray stories in a tight sequence,
linked to images and designed to provide entertainment to
readers. The main role of comics in instructional is their ability
to create interest in students (Pritandhari, 2016). Students'
interest in audio-visual learning media illustrates good
acceptance (Johan et al., 2018). Whereas in comic media,
besides being preferred by students, it also proved effective in
increasing students' knowledge (Nugroho, 2018).
iii. Graphic Novel
This type has more serious themes with a story length that is
almost the same as the novel and is intended for readers who
are not children (Maharsi, 2010)
iv. Compilation Comic
Compilation comis Is a collection of several different titles of
comics and comics. The story contained in this compilation
comic is not related at all, but sometimes there are also
publishers who give the same theme even with different stories
(Maharsi, 2010).
v. Web Comic (Online Comic)
As the name, this comic uses internet media for its publication.
By using a website, this type of comic only costs money which
is relatively cheaper than print media and has a very wide range
of unlimited (Maharsi, 2010).
 17

2.3. Theoritical framework

Education Ages Interest Residance Information expossure Media

Personal Cultural The Influence of

Knowledge Important people
Experience Influence

Snacking Parenting Obesity Sex/ Sosio-

Attitude
Habits Status Gender Economic

Breakfast Habits

Energy Concentration Cognitive Nutritional Health

Level
Intake Function Status Lavel

Figure 1.2 Theoritical framework

A Modification Framework by:

Babaeer et al., 2018; Katie et al., 2017; Dorothea et al.,2017;
Aminudin, 2016; Azwar, 2012; Emilia, 2015; Nursalam, 2011; Rahayu,
2010; Kemenkes, 2014

2.3. Conceptual framework

Knowledge

Media
Attitude

Figure 2.2 Conceptual framework

 18

2.4. Hypothesis
1. Ha 1 : The islamic comic about healthy breakfast have an influences to
increase the knowledge and attitudes of Islamic Elementary School Teluk
Lingga student
2. Ha 2 : The islamic comic strip about healthy breakfast have an influences
to increase the knowledge and attitudes of Islamic Elementary School
Teluk Lingga student
 19

BAB 3
RESEARCH METHODS
3.1 Reseach Design
In this study, the quasi-experimental research method used with the
pretest-posttest control group design. Illustrated in Figure 3.1, Sugiyono
(2012) stated that the design of this study can be seen in the figure below:

Figure 3. 1 Research Design

Explanation :
O1 & O3 : Knowledge and attitude before getting the intervention
O2 & O4 : Knowledge and attitude after getting the intervention

This study aims to determine the differences in the increase in

knowledge and attitudes in groups given education through comic media,
comic strips and without media (control group).
3.2 Time and Place of Implementation
The location of this study is Islamic Elementary School Teluk Lingga,
East Kutai Regency, East Kalimantan. The time of the study was conducted
in December 2018 until February 2019 which was adjusted to the active
schedule of students from Islamic Elementary School Teluk Lingga. The
school criteria taken are : Islamic based (Islamic Elementary School/
Integrated Islamic Elementary School), accredited A by the BANSM and
have never received counseling or nutrition education. Islamic Elementary
School Teluk Lingga is a school that meets all above criteria with the highest
student population.
3.3. Subject of Research
3.3.1 Population
The population in this study were all students of Islamic Elementary
School Teluk Lingga, about 537 students. Consisting of 17 classes with
various levels.
 20

3.2.2 Number of Samples

The method of sampling is the simple random sampling with
inclusion criteria, aged 10-12 years, has never received nutritional
counseling regarding healthy breakfast and is willing to take part in the
study until completion. The exclusion criteria were not sick when the
study took place. Sampling uses the Slovin formula because the number
of population is known, by the following equation:

Sample Formula
n= N
(1 + N x (e)2 )
Explaination :
N = Number of Population
e = Considered significant 90% or Error limits 10%

n =
( ( , ) )

=
,

=
,

= 99,8 = 100
= +10% n = 10
= 100 + 10 = 110

3.4. Identification of Research Variables

1. Independent
The independent variables in this research are the islamic comics and
strip comics about healthy breakfast.
2. Dependent
The dependent variables in this research are the students’ knowledge
and attitude of islamic elementary school Teluk Lingga.
 21

3.5. Operational Definition

Table 3. 2 Operational Definition

No Variable Operational Measuring Scale Criteria Analyis

Definition instrument
1. Knowledge Student Questionna Ordinal Test 1.Good, with range
Knowledge of ire 76%-100%
healty breakfast 2.Enough, with range
56%-75%
3.Less, with range
<55%
(Nursalam, 2011)
2 Attitude Student attitude Questionna Ordinal Test 1. Good, with range
in the form of ire 76%-100%
positive and 2. Enough, with
negative range 51%-76%
thingking about 3. Less, with range
healthy breakfast 25-50%
(Arikunto, 2013)
3 The islamic A collection of - Nominal Usage status Evaluation and
comics about pictures or (can / cannot identification by five
healthy continuous be used) expert teams from
breakfast paintings which University of
are stories about Darussalam nutrition
healthy breakfast science lecturers.
according to
eating habits
(adab) in Islam.
4 The islamic The comic strip is - Nominal Usage status Evaluation and
comic strips a collection of (can / cannot identification by five
about healthy pictures of a be used) expert teams from
breakfast descending panel University of
that contains Darussalam nutrition
stories about science lecturers.
healthy breakfast
according to
eating habits
(adab) in Islam.
 22

3.6. Instruments and Data Measurement

3.6.1 Instruments of Research
1. Questionnaire sheets
2. Knowledge questionnaires in the form of multiple choices, and
attitudes as opinion questions.
3. Nutrition education media in the form of comics and comic strips.

3.6.2 Data Collection Method

1. Primary Data
a. Responden Characteristics
Questionnaire questions in the table of respondent
characteristics include gender, age, class level, and absent
numbers.
b. Knowledge Characteristics
The attitude level of knowledge is measured using the Guttman
scale, the results of this measurement will get a firm answer,
between "right" and "wrong", with obstacle scores 1 and 0,
score 0 if the answer is wrong, and score 1 if the answer is
correct. This answer is obtained from the results of the
question in the form of multiple choices (a, b, c, d). The value
of knowledge obtained is then categorized.
c. Attitude Characteristics
Attitude variables were measured using a Likert scale. This
method is a method of scaling opinion statements. The attitude
questionnaire includes statements of positive and negative
statements about eating and healthy breakfast. The scale used is
a Likert scale that is quantitative in value, as positive statements
are given quantitative values 1, 2, 3, and 4 while negative
statements are given quantitative values 4, 3, 2, and 1.
2. Secondary Data
Secondary data used are general data obtained from the school
database of students of Islamic Elementary School Teluk Lingga,
Sangata, East Kutai.
 23

3.7. Research Design Flow Chart

Preparation of Research Proposal

Instrument preparation and testing

Research Implamentation

Pre-Test

(A Group) (B Group) (C Group)

The islamic comics The islamic comic strips Control

Intervention

First Post Test

Intervention

Second Post Test

Data Analysis

Result and Conclution Research

Figure 3.1 Research Design Flow Chart

 24

This research was conducted in five stages which were carried out
for five consecutive days. The first stage of pre-test data collection for the
three groups was carried out on the first day. The second stage was
conducted nutrition education intervention in group A using comic media
and in group B using comic strip media which was done on the second
day. The third stage was post-test data collection from the three groups
with the same questions in the three groups conducted on the third day.
Stage four is the repetition of the second stage, while the fifth stage is the
repetition of the third stage.
The nutrition education interventions through comics and comic
strips is about ± 35 minutes. The pretest was carried out for ± 25 minutes
with ± 10 minutes explanation of the instructions for filling out the
questionnaire. Posttest was carried out for ± 25 minutes with discussion of
answers for ± 10 minutes. This adjusts to the duration of one meeting in
the school hours about ± 35 minutes.
3.8. The Test of Validity and Reliability
3.8.1 The Validity Test
Validity is a measure that shows the level of validity or validity of
an instrument. Can be said to be valid if the instrument can be used to
measure what should be measured (Notoatmodjo, 2010). If all the
statements have a meaningful correlation (construct validity), it means
that all items (statements) in the questionnaire measure the concept
being measured (Arikunto, 2013). Then, the statements in the
questionnaire are given a suspension or the answer value of each "0" for
the wrong answer, while "1" for the correct answer. (Notoatmodjo,
2010)
3.8.2 The Reliability Test
Reliability is an index that shows how far a reliable or reliable
measuring device is. The reliability test in this study was carried out by
looking at r in the "Cronbach's Alpha" column, if the calculated r value
is greater than r on r table (r count> r table) then it can be said that the
instrument is reliable. (Dahlan, 2014).
 25

3.9. Data Analysis Method

Data that has been obtained from the field will be analyzed to test the
hypothesis. There are 2 methods of analysis used to process the data,
including:
3.9.1 Univariate Analysis
Univariate analysis in this study was used for variables according
to the characteristics of the research data.
3.9.2 Bivariate Analysis
Bivariate analysis is used to test the dependent and independent
variables that are the priority of the problem, using statistical tests.
Paired sample T test with significant level (P = 0.05) for normal data
and Wilcoxon test for data is not normal to see differences in
knowledge and attitudes before and after the provision of media comics,
comic strips, and without media giving, in each group treatment.
ANOVA test (P = 0.05) for normal data and Kruskall Wallis for
abnormal data to see differences in knowledge and attitudes between
treatment groups.
The provisions that apply to ANOVA test are if F count <F table
then Ho is accepted or there is no significant difference between comic
media groups, comic strips, and control groups to increase knowledge
of healthy breakfast. Conversely if F count> t table then H0 is rejected
or there is a significant average difference between all groups.
3.10. Research Ethics
Research ethics is a very important problem in research, considering
that this research is directly related to humans, so the aspect of research ethics
must be considered as follows (Sugiyono, 2012):
1. Informed Consent
It is a form of agreement between researchers and research respondents
by giving an approval sheet. The goal is that the subject understands the
purpose and objectives of the research and knows the impact.
 26

2. Confidentiality
It is an ethic in guaranteeing the confidentiality of research results, good
information on other problems. All information that has been collected is
guaranteed by the researcher, only certain data groups will be reported on
the results of research research.
3.11. Research Limitation
This research has been attempted and implemented in accordance with
scientific procedures, but still have limitations :
1. This study only examined the improvement in attitudes about
healthy breakfast after intervention without being able to proceed
with changes in breakfast habits. It is better for research with long-
term attitude variables to include a behavioral history list or called
by anecdotal record. That can be made by parents or student teachers
in schools regarding healthy breakfast behavior.
2. In this study there was no assessment of the acceptability of nutrition
education media. So that the level of the subject's preference for the
media is not yet known.

3.12. Research Time Planning

Table 3. 3 Research Time Planning

Schedule of activities
No Activities
Nov Des Jan Feb

1. Preparation of thesis
proposal
2. Proposal seminary
3. Instrument preparation and
testing
4. Research implemantation
5. Data analysing
6. Obtain the research results
and conclusions
 27

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 33

Appendix 1. Explanation Sheet Before Approval To Students (Given to

student guardians)

PENJELASAN SEBELUM PERSETUJUAN (PSP)

KEPADA CALON RESPONDEN PENELITIAN

Nama : Hafizhatunnisa (Mahasiswa)

Institusi : Fakultas Ilmu Kesehatan Universitas Darussalam Gontor
Judul Penelitian
Pengaruh Media Komik dan Komik Strip Islami Tentang Sarapan Sehat Terhadap
Pengetahuan dan Sikap Siswa MIN 1 Teluk Lingga.

Tujuan umum
Mengetahui pengaruh komik dan komik strip islami mengenai sarapan sehat
terhadap pengetahuan dan sikap siswa MIN 1 Teluk Lingga.

Perlakuan
Perlakuan akan diberikan kepada siswa-siswi sebagai responden untuk
mendapatkan informasi dan tata cara mengenai pengisian kuesioner pengetahuan,
dan sikap selama 10 menit kemudian diberikan waktu untuk mengisi kuesioner
tersebut selama 25 menit. Kemudian akan diberikan intervensi pendidikan gizi
mengenai sarapan sehat selama 35 menit dengan 2x pengulangan.

Manfaat
Responden akan dikenalkan kepada media promosi gizi mengenai sarapan sehat
dengan media berupa komik dan komik strip islami.

Bahaya Potensial
Tidak terdapat bahaya potensial yang akan dirasakan sebagai akibat pengumpulan
data karena proses pengumpulan data tersebut hanya melalui pengisian kuesioner.

Kerahasiaan data
Baik identitas maupun hasil jawaban dari kuesioner akan dijaga
kerahasiaannya dan hanya digunakan untuk kepentingan penelitian semata.
 34

Hak untuk Undur Diri

Keikutsertaan siswa(i) dalam penelitian ini bersifat sukarela dan tidak
memaksa. Siswa berhak untuk mengundurkan diri kapanpun, tanpa menimbulkan
konsekuensi yang merugikan.

Adanya Insentif untuk Subyek

Sebagai ucapan terima kasih maka siswa-siswi akan mendapatkan insentif
souvenir berupa gantungan kunci dan stiker.

Contact Person (CP) : Hafizhatunnisa (0812 2663 9718)

Demikian penjelasan yang perlu saya sampaikan dan harus dipahami

sebelum bersedia menjadi responden penelitian. Atas perhatian Anda saya
ucapkan terima kasih.

Kalimantan Timur, Januari 2019

Peneliti,
Hafizhatunnisa
NIM. 362015721174
 35

Appendix 2. Informed Consent for Student (Given to student guardians)

INFORMED CONSENT
PERNYATAAN PERSETUJUAN IKUT PENELITIAN
Saya yang bertanda tangan dibawah ini, sebagai wali dari:
Nama : ……………………………………………………………..
Jenis Kelamin : ……………………………………………………………..
Umur : ……………………………………………………………..
Kelas : ……………………………………………………………..
Telah mendapatkan keterangan secara rinci dan jelas mengenai:
1. Penelitian yang berjudul: “Pengaruh Komik Dan Komik Strip Islami
Tentang Sarapan Sehat Terhadap Pengetahuan dan Sikap Siswa MIN 1
Teluk Lingga”
2. Perlakuan yang dilakukan kepada responden.
3. Tidak ada perlakuan dan tidak ada bahaya yang akan ditimbulkan
jika menjadi responden.
4. Manfaat ikut sebagai subyek penelitian.
5. Waktu yang digunakan adalah maksimal 35 menit.
6. Hak untuk mengundurkan diri sebagai subyek penelitian.
7. Kerahasiaan informasi yang diberikan.

Dan setelah mendapatkan kesempatan untuk bertanya dan waktu berpikir yang
cukup, maka dengan ini secara sukarela dan dengan penuh kesadaran serta tanpa
keterpaksaan menyatakan mengijinkan/tidak mengijinkan* putra/putri* kami
untuk ikut dalam penelitian.
Demikian pernyataan ini saya buat dengan sebenarnya tanpa tekanan dari
pihak manapun.
Sangata,……… Januari 2019
Peneliti Wali Murid

(Hafizhatunnisa) (…………………)

Saksi**

(………………………)
*Coret yang tidak diperlukan
**Kepala Sekolah MIN 1 Teluk Lingga
 36

Appendix 3. The Questionnaire for Students

KUESIONER PENELITIAN
PENGARUH KOMIK DAN KOMIK STRIP ISLAMI TENTANG
SARAPAN SEHAT TERHADAP PENGETAHUAN DAN SIKAP
SISWA MIN 1 TELUK LINGGA

IDENTITAS RESPONDEN
1. NAMA : _____________________________________________
2. KELAS : _____________________________________________
3. NOMER ABSEN : _____________________________________________
4. UMUR : _____________________________________________
5. JENIS KELAMIN: _____________________________________________

Peneliti
Hafizhatunnisa
NIM. 362015721174
Mahasiswa S1 Fakultas Ilmu Kesehatan Program Studi Gizi
Universitas Darussalam Gontor