ArticlePDF Available

The Effect of Nutrition Education on Knowledge, Attitudes, and Iron Intake in Adolescent Girls

Authors:

Abstract and Figures

Anemia in adolescent girls is still a health emergency in developing countries, including Indonesia. This is still a priority scale for health management in various countries because it will harm the generation to be born. The education movement is considered very effective and efficient in preventing problems early. This study aimed to determine the influence of education on the knowledge, attitudes, and iron intake of adolescent girls at Public high schools 1 Tanjung Redeb. The research method is an experimental Quasy with a design of two groups Pre-test and Post-test conducted in May-June 2023. 50 research samples were selected in total sampling. Nutritional status is measured using anthropometric tools, and knowledge, attitudes, and food recalls are obtained using questionnaires that have been validated by tests. Independent sample T-test and Paired T-test and Wilcoxson test. The results showed that there was an effect of nutrition education in the intervention group on increasing knowledge (p 0.000) while the control group did not (p 0.100), while attitude did not affect the intervention and control groups respectively (p 0.876) and (p 0.410). Nutrient intake in the intervention and control groups (p 0.709) and (0.143) respectively. There were differences in knowledge after education in the control and intervention groups (p 0.013). Meanwhile, attitudes and iron intake were no different (p 0.722) and (p 0.100) after intervention and control education.
Content may be subject to copyright.
131
Original Research

The Effect of Nutrition Education on Knowledge, Attitudes, and Iron Intake
in Adolescent Girls



Abstract


       



          
             
    


               

               

Keywords:
Key Messages:
          



               



Copyright (c) 2023 Authors.



This work is licensed under
a Creative Commons Attribution-
NonCommercial-ShareAlike 4.0
International License
1. Introduction
                
     

132

 

                 
                 







             





 



              





     

                

2. Methods



  





  

133


    
                


               




3. Results
                 

             
       
  


Characteristics of Adolescent Girls
Control (n 25)
Intervention (n 25)
n
%
n
%
Nutritional Status













Upper Arm Circumference









Duration of Menstruation


Total





25
100
25
100

   
          
 


p-valuesp


134


pp
Table 2 Influence between variables
Variable
Intervention Group
Control Group
Mean
Before
Mean
After
p
Mean
Before
Mean
After
p























   
  p-value              
 

p-value


p-value



Table 3 Value differences between variables
Variable
Mean Post-Test
InterventionGroup
Mean Post-Test
ControlGroup
p












4. Discussion
Nutrition education on Adolescent Girls 's knowledge



              
p-
value                


                  
             



135









p-value

           


                 




       p    
              


                   
         



            
                
              

             
             

     
             

            


Nutrition education on Adolescent Girls 's attitudes
Attitudes are influenced byif adolescent knowledge increases then adolescent
also increase, this is following the theory put forward by Notoatmodjo (2007) that good knowledge will encourage

136
someone to display attitudes that are by the knowledge they have gained. Based on the existing theory that
knowledge can influence the attitude of a person with good knowledge, good will be realized, and vice
versa. The results showed a
 

      




 
 
        

A systematic review observed that adolescents with better knowledge had better attitudes, but
improved attitudes did not necessarily result in better practices.    

 p
     



The observation that nutrition education has no significant effect on the attitudes of adolescent girls raises
important questions about the underlying factors at play. Several reasons may contribute to this phenomenon.
Firstly, it's essential to consider that attitudes are shaped by a complex interplay of various influences, including
cultural, social, and familial factors. Nutrition education programs often focus primarily on imparting knowledge
and fail to address the broader socio-cultural context in which food choices are made. Additionally, attitudes are
not easily changed through information alone; they are deeply ingrained over time and influenced by personal
beliefs and past experiences. Therefore, nutrition education programs may need to incorporate more
comprehensive strategies, such as behavioral interventions and psychological support, to address the emotional
and social aspects that underpin attitudes towards food and nutrition. Moreover, the impact of nutrition
education may be influenced by the duration and intensity of the program, with longer and more immersive
interventions potentially having a more profound effect on attitudes. Overall, while nutrition education can
effectively enhance knowledge, a more nuanced and holistic approach may be necessary to achieve significant
changes in the attitudes of adolescent girls towards nutrition
Nutrition education on Fe intake adolescent girls
 

  


 
p
                 

137
                 
   



                  
   
                 
                    



 


  

              
            


               

   

 
                


         
               


       
   


Research Limitations
                  


               


138
5. Conclusion
       
           
                 
             


              

             
              












Funding: 
Acknowledgments:
                


Conflicts of Interest
Ethical Clearance
           

References
               
          

             


          

 

139
               

                

  

 
              

             


 

                 
           

                 


               
      

 
           

 

              
           

 
            

 
              

 

 
   󰨠  

 


 
      

... Hasil pemeriksaan kadar hemoglobin Zakiah et al (2023) pada 48 siswi di SMA Negeri 1 Tanjung Redeb Kabupaten Berau menunjukkan 14,58% anemia sedang, 77,0% anemia berat dan 8,3% anemia ringan. Laporan ini menjadi bukti bahwa anemia remaja merupakan darurat kesehatan yang memerlukan segera tindak lanjut. ...
Article
Full-text available
Latar Belakang: Anemia termasuk dalam sepuluh masalah kesehatan utama di dunia, terutama di Indonesia. Salah satu kota di Jawa Barat yang memiliki angka kejadian anemia pada remaja yang tinggi yaitu Kota Sukabumi, dan anemia pada remaja sering ditemukan di sekolah salah satunya di SMK PGRI 1 Kota Sukabumi. Tujuan dari penelitian ini untuk mengetahui apakah terdapat hubungan antara pengetahuan dan siklus menstruasi dengan kejadian anemia pada remaja.Metode: Jenis penelitian adalah korelasional. Populasi adalah seluruh siswa SMK PGRI 1 Kota Sukabumi dengan jumlah sampel 73 orang. Metode pengumpulan data dengan kuesioner untuk variable pengetahuan dan observasi untuk kejadian anemia. Teknik pengambilan sampel menggunakan total sampling. Analisa data dilakukan dengan menggunakan uji Chi-square.Hasil: Terdapat hubungan pengetahuan tentang anemia dengan kejadian anemia (p-value 0,000). Terdapat hubungan siklus menstruasi dengan kejadian anemia (p-value 0,040).Kesimpulan: Terdapat hubungan pengetahuan tentang anemia dan siklus menstruasi dengan kejadian anemia.
Article
Full-text available
Abstract Background Iron deficiency (ID) and anaemia of inflammation (AI) coexist where infections and nutritional deficiencies are common. The aim of this study was to determine burden of ID, anaemia, inflammation and AI in children in malaria endemic Limbe, Mount Cameroon as well as decipher the contribution of some inflammatory cytokines on the concentration of haemoglobin and ferritin. Methods A total of 520 children aged ≤ 15 years old from the Limbe Health District (LHD) were randomly selected and examined in a cross-sectional study for iron deficiency, anaemia, inflammation and inflammation anaemia. Collected blood samples were used for full blood count and inflammatory marker analyses with the aid of a haemoanalyzer and ELISA machine, respectively. Spearman’s rank correlation analysis was used to determine the correlation between cytokines and haemoglobin while multiple linear regression analysis was used to evaluate the effects of inflammatory cytokines on haemoglobin and ferritin concentrations. Results The overall prevalence of anaemia, ID, IDA, inflammation and AI were respectively, 67.5%, 34.6%, 12.9%, 63.1% and 30.2%. Children aged 12‒15 years (P = 0.001), enrolled from the community (P
Article
Full-text available
Background. The government established an iron supplementation program as a solution to overcome anemia in adolescent girls in Indonesia. Research shows that various factors influence the compliance of adolescent girls in consuming iron supplements, including knowledge, attitude, intention, and program implementation. Objective. This study aims to determine adolescent girls’ knowledge, attitudes, and intentions and explore the program implementation of iron supplementation in high school adolescent girls in Sidoarjo, Indonesia. Materials and Methods. This was mixed-method research. Quantitative data was collected on 202 girls students from 3 high schools in Sidoarjo using a questionnaire.Qualitative data was collected by interviewing 13 high school girls from 3 schools in Sidoarjo and Focus Group Discussion with the health office and primary health center representatives in Sidoarjo. Results. Most adolescent girls’ knowledge about anemia was still poor (59.9%), but knowledge about iron supplements was mostly good (59.9%). The attitudes towards anemia and iron supplements and intentions to consume iron supplements in adolescent girls were mostly low (51.0% and 51.5%). The focus group discussion found that the program was already referred to national guidelines, but the pandemic affected the implementation. Findings from the interview with adolescent girls show that the distribution of iron supplements in schools was carried out in 3 ways: distributed with explanations, distributed without explanation, and distributed only to students who request it or feel anemic. Conclusion. There is a need to improve the knowledge, attitudes, and intentions of adolescent girls and improve the implementation of iron supplementation programs in schools in Sidoarjo, Indonesia.
Article
Full-text available
Indonesians face serious health issues that arise from malnutrition, particularly in children who are under unfavorable dietary environments. The present study established a school meal program consisting of dietary and educational interventions and evaluated its impact on promoting continuous improvement in dietary behavior among junior and senior high school students in Indonesia. A total of 319 students belonging to an Islamic Boarding School participated in the pre-post intervention study for 9 months. All participants were assessed based on their Knowledge, Attitude, and Practice (KAP). A subgroup of 115 participants who were anemic and underweight was examined for dietary intake, nutrition status, and hemoglobin level. The KAP test scores for both nutrition and hygiene showed a significant increase for all students and the undernutrition group post-intervention. Protein, iron, and vitamin C intake significantly improved. Although there were no significant improvements in nutrition status, there was a significant increase in the hemoglobin level and a reduction in the prevalence of anemia from 42.6% to 21.7%. Thus, school meal program that combines dietary and educational interventions may effectively improve anemia in undernourished students as well as enhance the knowledge, attitudes, and practices related to health, nutrition, and hygiene in junior and senior high school students.
Article
Full-text available
Background: Anemia is a condition with lower hemoglobin and hematocrit levels. The number of iron deficiency in Indonesia among children aged 5 to 14 years is still quite high at 26.4%. Less knowledge in adolescent caused by the consumption of unhealthy food or light snacks.Purpose: To describe the relationship of Iron deficiency anemia and current state of knowledge among adolescent girls in 1st Mesuji Junior High School.Methods: The type of this research is an observational study with a cross-sectional method. The population of this study was members of all adolescent girls in class VIII and IX at 1st Mesuji Junior High School with the total is 87 respondents. Data collected by a questionnaire and analyzed used chi-square.Results: The most of the respondents 47 (54%) had poor knowledge about Iron deficiency anemia and experienced of Iron deficiency anemia 44 (50.6%) with p-value = 0.001. Conclusion: There is a relationship between Iron deficiency anemia and current state of knowledge among adolescent girls, Mesuji Junior High School in 2018. It is recommended for school management to further improve health promotion or counseling about Iron deficiency anemia in adolescent girls, especially in prevention.
Preprint
Full-text available
Background Iron deficiency (ID) and anaemia of inflammation (AI) coexist where infections and nutritional deficiencies are common. The aim of this study was to determine burden of ID, anaemia, inflammation and AI in children in malaria endemic Limbe, Mount Cameroon as well as decipher the contribution of some inflammatory cytokines on the concentration of haemoglobin and ferritin. Methods A total of 520 children aged ≤ 15 years old from the Limbe Health District (LHD) were randomly selected and examined in a cross-sectional study for iron deficiency, anaemia, inflammation and inflammation anaemia. Collected blood samples were used for full blood count and inflammatory marker analyses with the aid of a haemoanalyzer and ELISA machine, respectively. Spearman’s rank correlation analysis was used to determine the correlation between cytokines and haemoglobin while multiple linear regression analysis was used to evaluate the effects of inflammatory cytokines on haemoglobin and ferritin concentrations. Results The overall prevalence of anaemia, ID, IDA, inflammation and AI were respectively, 67.5%, 34.6%, 12.9%, 63.1% and 30.2%. Children aged 12‒15 years (P = 0.001), enrolled from the community (P < 0.001), whose parents are civil servants (P < 0.001), living in a home with 6‒10 occupants (P = 0.016), afebrile (P < 0.001) and malaria negative (P = 0.007) had the highest prevalence of ID while, children ≤ 5 years old (P = 0.001), with a family size of 1‒5 occupants (P = 0.033) had the highest prevalence of AI. Haemoglobin concentration positively correlated with concentrations of IFN-γ (P = < 0.001), TNF-α (0.045) and ferritin (P = < 0.001) while a negative correlation was observed with IL-10 (P = 0.003). In the multiple linear regression analysis only IL-6 significantly (P = 0.030) influenced haemoglobin concentration. Conclusions While IL-6 is of significance in the pathology of anaemia, iron deficiency and anaemia of inflammation are of moderate public health concerns in the Mount Cameroon area. Hence, appropriate intervention against anaemia, ID and AI should be directed at children ≤ 5 years and counterparts > 10 years old that bear the highest burden.
Article
Full-text available
Pada usia remaja, gizi merupakan salah satu masalah yang masih terjadi. Tingkat kejadian di Indonesia sebesar 7,5 juta dan memasuki angka 8 dari 11 negara di Asia. Kejadian ini lebih sering terjadi pada remaja putri karena mempunya siklus menstruasi. Status anemia pada remaja diduga dipengaruhi oleh beberapa faktor yaitu pengetahuan gizi serta kepatuhan konsumsi tablet tambah darah. Tujuan adanya penelitian ini untuk menganalisis hubungan antara kepatuhan konsumsi tablet tambah darah dengan kejadian anemia pada remaja putri. Penelitian ini menggunakan desain systematic review yang diperoleh dari Google Scholar dan disaring sesuai dengan kriteria inklusi. Artikel dipilih berdasarkan publikasi yang diterbitkan antara tahun 2017-2021 (5 Tahun). Hasil penelitian ini yaitu terdapat hubungan yang berarti antara kepatuhan konsumsi tablet tambah darah dengan kejadian anemia pada remaja putri di Indonesia. Artinya bahwa semakin patuh dalam mengkonsumsi TTD maka kadar Hb remaja putri akan meningkat.
Article
Full-text available
The childhood years represent a period of increased nutrient requirements during which a balanced diet is important to ensure optimal growth and development. The aim of this study was to examine food and nutrient intakes and compliance with recommendations in school-aged children in Ireland and to examine changes over time. Analyses were based on two National Children’s Food Surveys; NCFS (2003-04) ( n 594) and NCFS II (2017-18) ( n 600) which estimated food and nutrient intakes in nationally representative samples of children (5-12y) using weighed food records (NCFS: 7-d; NCFS II: 4-d). This study found that nutrient intakes among school-aged children in Ireland are generally in compliance with recommendations; however this population group have higher intakes of saturated fat, free sugars and salt, and lower intakes of dietary fibre than recommended. Furthermore, significant proportions have inadequate intakes of vitamin D, calcium, iron and folate. Some of the key dietary changes that have occurred since the NCFS (2003-04) include decreased intakes of sugar-sweetened beverages, fruit juice, milk and potatoes, and increased intakes of wholemeal/brown bread, high fibre ready-to-eat breakfast cereals, porridge, pasta and whole fruit. Future strategies to address the nutrient gaps identified among this population group could include the continued promotion of healthy food choices (including education around ‘healthy’ lifestyles and food marketing restrictions); improvements of the food supply through reformulation (fat, sugar, salt, dietary fibre); food fortification for micronutrients of concern (voluntary or mandatory) and/or nutritional supplement recommendations (for nutrients unlikely to be sufficient from food intake alone).
Article
Full-text available
Despite the availability of iron supplements during pregnancy for all pregnant women receiving antenatal care in Saudi Arabia, anemia remains to be a global public health concern leading to adverse maternal, fetal, and neonatal effects. We aimed to evaluate the effectiveness of the Health Information Package Program on the knowledge anemic pregnant women had about anemia, their compliance with iron and folic acid supplementation, and their hemoglobin levels. A single-blind randomized controlled trial was carried out in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines between January and May 2021. Pregnant women (n = 196) aged 18–45 years old and diagnosed with anemia during the first trimester of their pregnancy were randomly assigned into two groups: the intervention group (Health Information Package Program plus routine care, n = 98) and the control group (routine care only, n = 98). Knowledge, the ability to select appropriate food, and hemoglobin levels were assessed at baseline and after three months, while compliance with iron and folic acid supplementation was also measured at the end of three months. This study indicated that the post-education mean knowledge score, food selection ability score, compliance rate, and hemoglobin level were significantly higher for the intervention group than for the control group. The Health Information Package Program with regular follow-ups using the WhatsApp platform was an effective educational intervention for anemic pregnant women.
Article
p class="16bIsiAbstrak">Pengetahuan gizi seimbang pada anak di Indonesia masih terbilang rendah. Pengetahuan gizi seimbang yang rendah mengakibatkan sampai saat ini Indonesia masih menghadapi permasalahan gizi seperti kekurangan gizi, stunting, kelebihan gizi dan obesitas. Karenanya edukasi gizi harus diberikan sedini mungkin. Dalam memberikan pendidikan gizi media menjadi komponen penting untuk membantu menyampaikan pesan kepada sasaran. Media yang tepat dapat menimbulkan semangat belajar sehingga meningkatkan keaftikan siswa dalam proses pembelajaran. Media yang digunakan antara lain media bergambar dan permainan seperti komik, edutainment card dan teka-teki silang.</p