Latar Belakang Pabrik X, sebuah pabrik tekstil dimana sebagian besar karyawannya adalah perempuan, dalam operasional kerjanya mengharuskan mereka untuk menjalani sistem kerja gilir. Adanya perubahan pada pola makan, serta perubahan pada profil metabolik pekerja gilir, meningkatkan risiko terjadinya anemia gizi, sehingga diperlukan rekomendasi gizi tambahan bagi populasi ini. Pendekatan Linear Programming (LP) merumuskan Pedoman Gizi Seimbang berbasis Pangan Lokal (PGS-PL) menggunakan konteks makanan lokal (mempertimbangkan budaya dan harga) yang disesuaikan dengan pola makan dan mengoptimalkan kandungan nutrisi spesifik sesuai permasalahan gizi pada populasi tertentu. Sehingga rekomendasi PGS-PL yang dihasilkan dapat dijadikan sebagai kebijakan bagi pemerintah dan industri manufaktur yang mempekerjakan pekerja perempuan dengan kerja gilir. Sejauh ini pendekatan LP belum pernah diterapkan pada populasi pekerja.
Obyektif Untuk merumuskan PGS-PL dan menilai efektifitasnya dalam meningkatkan kadar Hb pekerja perempuan dengan kerja gilir..
Metode Penelitian ini dilakukan melalui dua fase. Fase pertama merupakan penelitian deskriptif analitik cross sectional untuk menyusun PGS-PL yang optimal dari 106 orang pekerja perempuan dengan kerja gilir. Data diet diperoleh dari data penimbangan makanan (weighed food) yang diberikan perusahaan pada shift malam, dikombinasi dengan 24 hours food recall serta 5dFFQ (5-days food-frequency questionnaire). Kadar Hb diperiksa dengan menggunakan HemoCue. Analisis LP menggunakan sistem Optifood. Fase kedua adalah penelitian eksperimental two group pretest and postest experiment design dengan 51 orang kelompok kontrol dan 49 orang kelompok intervensi. Intervensi PGS-PL dilakukan selama 24 minggu.
Hasil Hasil analisis Optifood menunjukkan bahwa yang merupakan permasalahan gizi adalah zat besi (Fe) dan kalsium. PGS-PL menghasilkan rekomendasi berupa pesan mingguan dan menu makanan pabrik yang digunakan untuk mengisi nutrient gap yang ada. Dengan intervensi PGS-PL responden yang mengalami kenaikan kadar Hb sebanyak 63.3% dengan peningkatan rerata Hb sebesar 0,6 mg/dL (p=0,000).
Kesimpulan Intervensi PGS-PL efektif dalam meningkatkan kadar Hb.
Kata Kunci : Formula makanan, Hemoglobin, linear programming, manufaktur, pekerja
Background Factory X, a textile factory where most of its employees are women, in their operational requires these female workers to undergo a shift work. Changes in diet, as well as changes in the metabolic profile of shift workers, increase the risk of nutritional anemia. In order to meet adequate nutrition, a nutrient based recommendation is necessary. The Linear Programming (LP) approach formulates Food Based Recommendation (FBR) to meet nutrient requirements given local food availability, food patterns, food portions, and cost based on problem nutrients in certain populations. LP approach has never been applied to the working population. A set of FBR produced is valuable for nutrition promotion, as well as nutrition program planning and advocacy.
Objectives To formulate a set of FBR and assess its effectiveness in increasing Hb levels.
Methods The first phase of this research was cross-sectional study to develop an optimal FBR of 106 female shift workers. Dietary data obtained from 1-day weighed diet record combined with repeated 24-hour recall and 5-day food intake tally. LP analysis was performed using Optifood software. Hb levels were examined using HemoCue. The second phase was an intervention study which was carried out for 16 weeks.
Results Iron and calcium were the problem nutrients. FBR produced recommendations in the form of weekly messages and factory food menu to fill the existing nutrient gap. With FBR intervention, 63.3% respondents experienced an increase in Hb levels with an increase in mean Hb of 0.6 mg/dL (p = 0,000).
Conclusions FBR intervention is effective in increasing Hb levels.
Keywords Food formula, Hemoglobin, linear programming, manufacture, workers
Anemia is a significant public health problem in female adolescents although intervention program has been established until present. One of the intervention programs, education on anemia is delivered by paper-based module. A scientific evidence is needed to evaluate the effectiveness of android application to prevent anemia through improvement in food and nutrient intake among female adolescents. The design studies used in this research, i.e. exploration, development (prototyping approach) and open label non-randomized trial. The location of this study was at six Muhammadiyah junior high schools in Depok since October 2015 to June 2016 with the phases of formative, pre-intervention, implementation for five months, post-intervention and follow-up for one month. Sample size calculation in this study was based on estimation means difference between two groups (228 subjects in android application group & 250 subjects in paper-based module group) with statistical analysis using General Linear model to evaluate the effectiveness of android application versus paper-based module on food & nutrient consumption and hemoglobin (Hb). This study showed that after controlling pre-intervention factors, there was significant different on the change in vitamin B12 intake. Other nutrients and Hb level between android application group and paper-based module group were not statistically different because of the influence factors from controlling factors, i.e. environment constraint & pre-intervention Hb. In addition to that, there was no statistically different in intention change after post-intervention and follow-up. This study revealed that adolescents using android application was better in determinant of behaviors, food & nutrient intake and Hb because they were more engaged in implementation intervention and more satisfied in experiencing the intervention. While paper-based module seemed to experience lower satisfaction. This can be interpreted that android application can be used for further intervention. Android application can be used as an education tool to prevent anemia among female adolescents. This effectiveness should optimize social media feature that female adolescents can have more interactive experience.