Nutrition, active play, and caregiver psychoeducational guidance as predictors of early childhood stunting prevention: a rural–urban study in Indonesia

Introduction: Early childhood stunting prevention requires more than nutritional intervention; it also involves caregiver behavior, early childhood physical activity, psychoeducational guidance, and local caregiving knowledge. Objective: This study examined whether nutrition practices, active play practices, and caregiver psychoeducational guidance predicted early childhood stunting prevention behaviors in rural and urban/semi-urban communities in Indonesia. Methodology: A quantitative cross-sectional comparative-predictive design was employed involving 300 caregivers of children aged 24–59 months, including 150 participants from a rural area and 150 from an urban/semi-urban area in Jombang Regency, Indonesia. Data were collected using structured questionnaires and analyzed using descriptive statistics, reliability testing, rural–urban comparison, correlation analysis, and hierarchical multiple regression. Results: Urban/semi-urban caregivers reported higher psychoeducational guidance, nutrition practices, and stunting prevention behaviors than rural caregivers, while active play practices did not differ significantly. Nutrition practices were the strongest predictor, followed by caregiver psychoeducational guidance and active play practices, with the final model explaining 55% of the variance in stunting prevention behaviors. Discussion: The findings suggest that prevention behaviors are shaped by integrated caregiving practices involving nutrition, movement opportunities, caregiver guidance, and local context. Conclusion: Community-based prevention should combine adequate feeding, active play, caregiver guidance, and culturally grounded communication.