Sociodemographic Factors and Parenting Patterns Related to Stunting in Children Under Five Years in Pekanbaru, Indonesia: A Structural Equation Modeling Analysis

Background: Stunting is a critical nutritional issue that affects children under five, significantly impacting their health and development. Pekanbaru has been identified as a priority area for stunting intervention, with the Lima Puluh Health Center reporting the highest prevalence of stunting in 2021. This study aimed to analyze the associations among sociodemographic factors, parenting patterns, and stunting in children under five in Pekanbaru, Indonesia. Methods: A case-control study was conducted with 108 children (54 cases of stunting and 54 controls). All children with stunting who met the criteria were considered case samples. Control samples were randomly selected from the same Integrated Health Posts as the cases. Data were collected via validated questionnaires and analyzed using structural equation modeling. Results: Sociodemographic factors, including maternal knowledge, attitudes, and family income, were indirectly associated with stunting through their influence on parenting patterns (β = 1.33; p < .001). Parenting patterns, encompassing feeding practices, hygiene practices, environmental sanitation, and health service use, directly impacted stunting (β = 0.09; p = .049). Notably, the structural equation model exhibited good fit indexes (goodness-of-fit index = 0.922; root mean square error of approximation = 0.073), confirming its validity. Conclusion: Parenting patterns were found to mediate the relationship between sociodemographic factors and stunting. Holistic interventions that address sociodemographic factors while supporting parental education and improved parenting practices are essential for reducing the prevalence of stunting.