Changes in knowledge and attitudes toward balanced nutrition following peer education among female vocational college students: A one-group pretest-posttest study

Background: Stunting remains a major public health concern in Indonesia. Adolescence is a critical period for nutrition interventions; however, inadequate knowledge and unfavorable attitudes toward balanced nutrition remain common among young people. Peer education has been proposed as a strategy to improve nutrition-related literacy through socially relevant learning approaches.Objective: To assess changes in balanced nutrition knowledge and attitudes among female vocational college students following participation in a peer education intervention.Methods: This quasi-experimental study employed an uncontrolled one-group pretest-posttest design. Conducted at Politeknik Negeri Madura, Indonesia, from October to November 2025, the study included 100 female students aged 18-21 years who completed both assessments. The GENZING (Gen Z Prevents Stunting) intervention consisted of four 60-minute peer-led educational sessions delivered by 10 trained peer educators who completed 12 hours of training. The posttest was administered one week after the final session. Knowledge and attitudes were measured using validated questionnaires and analyzed using the Wilcoxon signed-rank test.Results: Complete paired data were available for all participants. Knowledge scores increased from a median of 30.0 (IQR: 28.0-32.0) to 41.0 (IQR: 40.0-43.0) (Z = -8.52, p < 0.001; r = 0.60, 95% CI: 0.48-0.72). Attitude scores increased from a median of 33.0 (IQR: 31.0-35.0) to 40.0 (IQR: 38.0-41.0) (Z = -7.94, p < 0.001; r = 0.56, 95% CI: 0.43-0.69).Conclusion: Participation in the GENZING peer education program was associated with short-term increases in balanced nutrition knowledge and attitude scores among female vocational college students. Controlled multisite studies with longer follow-up periods and behavior-related outcomes are needed to strengthen the evidence base.