THE HEALTH BELIEF MODEL COMBINED WITH EDUCATION ON HEALTHY FOOD PREPARATION TO IMPROVE DIETARY IRON INTAKE AMONG ADOLESCENT GIRLS

Lilik Hidayanti; M. Zen Rahfilludin; S.A. Nugraheni; Retno Murwani

Lilik Hidayanti Nutrition Program, Faculty of Health Science, Universitas Siliwangi, Tasikmalaya, 46115, Indonesia
M. Zen Rahfilludin Public Health Nutrition Departement, Faculty of Public Health, Universitas Diponegoro, Semarang, 50275, Indonesia
S.A. Nugraheni Public Health Nutrition Departement, Faculty of Public Health, Universitas Diponegoro, Semarang, 50275, Indonesia
Retno Murwani Faculty of Animal and Agricultural Sciences, Universitas Diponegoro, Semarang, 50275, Indonesia

Keywords: adolescent girls, iron intake, nutrition education, HBM, healthy food preparation

Abstract

Anemia is still a public health problem among adolescent girls in low and middle-income countries (LMICs), and nutrition education is needed to improve their iron intake. Therefore, this study aims to measure the effects of nutrition education based on HBM combined with training about healthy food preparation to improve dietary iron intake among adolescent girls in boarding schools. This research was a pre test post test control group design. The intervention group (IG) consists of two boarding schools, forty adolescent girls, and six cooks, while the control group (CG) contains four boarding schools, forty adolescent girls, and ten cooks. Nutrition education based on HBM combined with training about healthy food preparation was held for the IG with follows-ups 4 and 12 weeks after the intervention. After the process, data were collected from both groups and analyzed using an independent t-test and Mann Whitney. The dietary intake of energy, protein, and iron, namely 1421.1 kcal ±363.7-1543.4 kcal ±28.5, 32.3 g ±8.6-49.7 g ±6.7, and 7.8 mg-12.1 mg±2.0, respectively, increased at follow-up 1 in the IG. The results showed that there were differences in the dietary energy, protein, and iron intake both groups at follow-ups 1 and 2 (p<0.05). These findings indicate that HBM strategies combined with education about healthy food preparation can improve dietary iron intake among adolescent girls in boarding schools. Therefore, the authority can consider using this pattern to design and perform educational interventions to increase iron consumption.

References

WHO. Adolescent Health: The missing population in Universal Health Coverage. WwwWhoInt. Published online 2018:1-32. https://www.who.int/health-topics/adolescent-health#tab=tab_2

Haberland NA, McCarthy KJ, Brady M. A Systematic Review of Adolescent Girl Program Implementation in Low- and Middle-Income Countries: Evidence Gaps and Insights. J Adolesc Heal. 2018;63(1):18-31. doi:10.1016/j.jadohealth.2017.11.294

Mistry SK, Jhohura FT, Khanam F, Akter F, Khan S, Yunus F. An outline of anemia among adolescent girls in Bangladesh : findings from a cross- sectional study. Published online 2017:1-9. doi:10.1186/s12878-017-0084-x.

Kumari S, Garg N, Kumar A, et al. Maternal and severe anaemia in delivering women is associated with risk of preterm and low birth weight: A cross sectional study from Jharkhand, India. One Heal. 2019;8(July):100098. doi:10.1016/j.onehlt.2019.100098.

Thankachan P, Selvam S, Surendran D, et al. Efficacy of a multi micronutrient-fortified drink in improving iron and micronutrient status among schoolchildren with low iron stores in India: A randomised, double-masked placebo-controlled trial. Eur J Clin Nutr. 2013;67(1):36-41. doi:10.1038/ejcn.2012.188.

Mills S, White M, Wrieden W, Brown H, Stead M, Adams J. Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation. PLoS One. 2017;12(8):1-18. doi:10.1371/journal.pone.0182842.

Soliah LAL, Walter JM, Jones SA. Benefits and barriers to healthful eating: What are the consequences of decreased food preparation ability? Am J Lifestyle Med. 2012;6(2):152-158. doi:10.1177/1559827611426394.

Reicks M, Kocher M, Reeder J. Impact of Cooking and Home Food Preparation Interventions Among Adults: A Systematic Review (2011–2016). J Nutr Educ Behav. 2018;50(2):148-172.e1. doi:10.1016/j.jneb.2017.08.004.

Hamulka J, Wadolowska L, Hoffmann M, Kowalkowska J, Gutkowska K. Effect of an education program on nutrition knowledge, attitudes toward nutrition, diet quality, lifestyle, and body composition in polish teenagers. The ABC of healthy eating project: Design, protocol, and methodology. Nutrients. 2018;10(10). doi:10.3390/nu10101439.

Fonseca LG, Bertolin MNT, Gubert MB, da Silva EF. Effects of a nutritional intervention using pictorial representations for promoting knowledge and practices of healthy eating among Brazilian adolescents. PLoS One. 2019;14(3):1-12. doi:10.1371/journal.pone.0213277.

Kalaian SA, Kasim RM. Effectiveness of various innovative learning methods in health science classrooms: a meta-analysis. Adv Heal Sci Educ. 2017;22(5):1151-1167. doi:10.1007/s10459-017-9753-6.

Ceber E, Turk M, Ciceklioglu M. The effects of an educational program on knowledge of breast cancer, early detection practices and health beliefs of nurses and midwives. J Clin Nurs. 2010;19(15-16):2363-2371. doi:10.1111/j.1365-2702.2009.03150.x.

Vahedian-shahroodi M. Predic ti on of Osteoporosis Preven ti ve Behaviors using the Health Belief Model. 2014;2(3):199-207.

Ghaderi N, Ahmadpour M, Saniee N, Karimi F, Ghaderi C, Mirzaei H. Effect of education based on the Health Belief Model (HBM) on anemia preventive behaviors among iranian girl students. Int J Pediatr. 2017;5(6):5043-5052. doi:10.22038/ijp.2017.22051.1844.

Nicholaus C, Martin HD, Kassim N, Matemu AO, Kimiywe J. Dietary Practices, Nutrient Adequacy, and Nutrition Status among Adolescents in Boarding High Schools in the Kilimanjaro Region, Tanzania. J Nutr Metab. 2020;2020(7):1-14. doi:10.1155/2020/3592813.

Anwar DF. Foreign Policy, Islam and Democracy in Indonesia. J Indones Soc Sci Humanit. 2010;3(1):37-54. doi:10.14203/jissh.v3i1.45.

Guilmoto CZ. Ananta, A., E. N. Arifin, M. S. Hasbullah, N. B. Handayani and A. Pramono, Demography of Indonesia’s ethnicity . Asian Ethn. 2017;18(3):424-427. doi:10.1080/14631369.2016.1249653.

Agustina R, Nadiya K, El Andini A, et al. Associations of meal patterning, dietary quality and diversity with anemia and overweight-obesity among Indonesian schoolgoing adolescent girls in West Java. PLoS One. 2020;15(4):1-19. doi:10.1371/journal.pone.0231519.

Keshani P, Hossein Kaveh M, Faghih S, Salehi M. Improving diet quality among adolescents, using health belief model in a collaborative learning context: a randomized field trial study. Health Educ Res. 2019;34(3):279-288. doi:10.1093/her/cyz009.

FAO. Dietary Assessment.; 2018. https://www.fao.org/3/i9940en/I9940EN.pdf.

Carpenter CJ. A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun. 2010;25(8):661-669. doi:10.1080/10410236.2010.521906.

Mohebi S, Shahnazi H, Shahsiah M, Sharifirad G, Tol A, Matlabi M. The effectiveness of nutrition education program based on health belief model compared with traditional training. J Educ Health Promot. 2013;2(1):15. doi:10.4103/2277-9531.112684.

Naghashpour M, Shakerinejad G, Lourizadeh MR, Hajinajaf S, Jarvandi F. Nutrition education based on health belief model improves dietary calcium intake among female students of junior high schools. J Heal Popul Nutr. 2014;32(3):420-429.

Tavakoli HR, Dini-Talatappeh H, Rahmati-Najarkolaei F, Gholami Fesharaki M. Efficacy of HBM-Based Dietary Education Intervention on Knowledge, Attitude, and Behavior in Medical Students. Iran Red Crescent Med J. 2016;18(11). doi:10.5812/ircmj.23584.

Reicks M, Trofholz AC, Stang JS, Laska MN. Impact of Cooking and Home Food Preparation Interventions Among Adults: Outcomes and Implications forFuture Programs. J Nutr Educ Behav. 2014;46(4):259-276. doi:10.1016/j.jneb.2014.02.001.

Chu YL, Storey KE, Veugelers PJ. Involvement in Meal Preparation at Home Is Associated With Better Diet Quality Among Canadian Children. J Nutr Educ Behav. 2014;46(4):304-308. doi:10.1016/j.jneb.2013.10.003