A Study to Assess the Effectiveness of Informational Booklets on Knowledge regarding Iron Deficiency Anemia among Adolescent Girls in selected Higher Secondary School of Mehsana, Gujarat
Kajalben Chaudhari1, Pinal Chaudhari2, Viya Patel3
1Final Year B.Sc. Nursing Students, Mehsana District Bank College of Nursing, Mehsana, Gujarat, India.
2Assistant Professor, Mehsana District Bank College of Nursing, Mehsana, Gujarat, India.
*Corresponding Author E-mail: chaudharikajal78028@gmail.com
ABSTRACT:
Introduction: Iron deficiency anemia (IDA) remains highly prevalent among adolescent girls in India, impairing growth, cognition, and academic performance. Low-cost, scalable educational interventions may enhance awareness and foster preventive behaviors. Objective: To determine whether a focused informational booklet can significantly improve knowledge about IDA among adolescent girls in higher secondary schools of Mehsana city. Methods: A quasi‑experimental pretest–posttest design enrolled 60 girls (ages 16–17) selected via convenience sampling from two schools. Participants completed a 20‑item multiple‑choice questionnaire assessing IDA knowledge (score range: 0–20) before and 7 days after receiving a color booklet covering iron sources, symptoms, consequences, and prevention. Post‑intervention scores were compared using paired t-tests. Results: Baseline mean knowledge score was 6.25±2.16; post‑intervention, it rose to 12.77±2.23 (t(59) = 21.34, p<0.001). The proportion of students attaining “good” knowledge (≥14/20) increased from 3.3% to 43.3%, while those scoring poorly (<7/20) declined from 46.7% to 5.0%. No significant associations emerged between knowledge gains and demographic variables (family income, parental education, dietary pattern). Conclusion: A single-session booklet intervention produced a substantial, statistically significant uplift in IDA-related knowledge among adolescent girls. Incorporating similar materials into school health curricula may serve as an effective component of anemia control strategies.
KEYWORDS: Iron Deficiency Anemia, Adolescent Girls, Educational Booklet, Knowledge Assessment, School Health.
INTRODUCTION:
Background of the Study:
Iron deficiency anemia (IDA) is the most common nutritional disorder globally, affecting an estimated 30% of the world’s population, with adolescent girls disproportionately burdened due to rapid growth and menstrual losses1. In India, national surveys report anemia prevalence of 55% among females aged 15–49; adolescents represent a particularly vulnerable subgroup, with studies documenting rates up to 70% in some regions2. Anemic adolescents often exhibit fatigue, impaired cognitive function, and reduced school performance, underscoring the need for effective preventive measures3.
Iron is an important micronutrient which is essential for various functions in human body. It is essential for cellular growth and differentiation, oxygen binding, transport and storage, enzymatic reactions, immune function, cognitive function, mental and physical growth etc. So, deficiency of iron due to either physiological or pathological reason can affect mental and physical growth resulting in decreased learning capacity and work productivity. IDA is characterized by a defect in haemoglobin synthesis, resulting in hypochromic and microcytic red blood cells [1]. Iron deficiency can result either due to less nutritional supply, increased demand or blood loss due to any reason4.
Health education constitutes a cornerstone of anemia control programs, yet traditional didactic sessions may not sufficiently engage youth5. Printed educational materials—booklets or pamphlets—offer a low-cost, reusable medium to convey tailored messages on dietary sources of iron, enhancing absorption, recognizing symptoms, and seeking timely car6. However, evidence on their standalone effectiveness in improving IDA knowledge among Indian adolescents remains limited7.
This study aimed to evaluate the impact of a purpose‑designed informational booklet on knowledge regarding IDA among adolescent girls in selected higher secondary schools of Mehsana city, Gujarat.
Problem Statement:
“A Study to Assess the Effectiveness of Informational Booklets on Knowledge Regarding Iron Deficiency Anemia Among Adolescent Girls in Selected Higher Secondary School of Mehsana, Gujrat."
Objective:
1) To evaluate knowledge regarding iron deficiency anemia among adolescent girls.
2) To find out the association of knowledge with their selected demographic variables.
Hypothesies:
HO: There is a no significant difference in the level of iron deficiency anemia before and after nutritional intervention among adolescents.
H1: There will be significant association between pre – test knowledge scores of adolescent girls with their selected demographic variable.
METHODOLOGY:
The collected data was coded and analysed. This study is based on the conceptual framework of "Health Belief Model ", which aims at developing and evaluating the effect of intervention efficiently8. A quasi-experimental pretest–post-test study was conducted in June 2022 in two government‑aided higher secondary schools in Mehsana city. Ethical clearance was obtained from the institutional review board, and school authorities granted permission9. Participants Using convenience sampling, 60 female students aged 16–17 years were recruited after obtaining written informed assent and parental consent. Inclusion criteria comprised enrolment in grades 11–12 and willingness to participate; girls with known chronic illnesses or on iron therapy were excluded. Intervention An informational booklet was developed following a literature review and expert validation. It covered: Basic physiology of iron and haemoglobin, Common causes and symptoms of IDA, Dietary sources of iron and enhancers/inhibitors of absorption, Preventive strategies and the importance of menstrual hygiene. The 12-page, full-colour booklet used simple language and illustrations to appeal to adolescents. After the pretest, each participant received the booklet and was advised to review it over the next week. Data Collection A structured, self-administered questionnaire assessed IDA knowledge via 20 multiple-choice items (score range: 0–20). Sections addressed etiology, symptom recognition, dietary sources, and prevention. Scores were categorized as: Poor (0–6), Average (7–13), Good (14–20) Reliability of the tool (test–retest) was r = 0.90. The pretest was administered immediately before booklet distribution; the post-test occurred exactly 7 days later. Statistical Analysis Data were analyzed using SPSS v25. Continuous variables are presented as mean ± SD; categorical data as frequencies and percentages. Paired t-tests compared pre- and posttest mean scores. Associations between knowledge gains and demographic factors (parental education, family income, dietary pattern) were examined via chi-square tests. A p-value < 0.05 denoted statistical significance10.
RESULT:
Percentage Distribution of Sample Characteristics:
Among 60 participants, 53.3% were aged 16 years and 46.7% were 17 years old. The majority followed a vegetarian diet (76.7%), with the remainder reporting mixed diets. Fathers’ education was predominantly up to higher secondary level (65%), and 61.7% of families were joint. Nearly one-third (30%) had prior awareness of IDA.
Comparison between the pre-test and post-test knowledge score.
|
Level of knowledge |
Pre test |
Post test |
||
|
Frequency |
% |
Frequency |
% |
|
|
Poor |
28 |
46.66% |
03 |
5% |
|
Average |
30 |
50% |
31 |
51.66% |
|
Good |
02 |
3.33% |
26 |
43.33% |
|
Total |
60 |
100% |
60 |
100% |
|
Sr No |
Level of knowledge |
Mean |
Mean difference |
Standard deviation |
T test |
|
1 |
Pre - test |
6.25 |
6.5166 |
2.1573 |
465.3422 |
|
2 |
Post - test |
12.766 |
2.2304 |
Mean scores rose from 6.25±2.16 pre-intervention to 12.77±2.23 post-intervention, a highly significant increase (t (59) = 21.34, p < 0.001).
CONCLUSION:
A one-week, booklet-based educational intervention yielded a significant and meaningful improvement in adolescent girls’ knowledge of iron deficiency anemia in Mehsana city. Integrating similar materials into school health programs offers a feasible, scalable strategy to augment existing anemia control efforts.
CONFLICT OF INTEREST:
I have no conflicts of interest regarding this investigation.
ACKNOWLEDGMENTS:
I would like to thank you all the school faculty and student who participated to their kind support to conduct my research.
REFERENCES:
1. https://pmc.ncbi.nlm.nih.gov/articles/PMC8744124/.
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC10860231/.
3. https://www.researchgate.net/publication/333225201_Health_and_educational_achievement_of_school-aged_children_The_impact_of_anaemia_and_iron_status_on_learning.
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC5620749/.
5. https://www.who.int/publications/i/item/9789241564960, World Health Organization. The Global Prevalence of Anaemia in 2011. Geneva: WHO; 2015.
6. Ihttps://dhsprogram.com/pubs/pdf/fr339/fr339.pdf - International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4), 2015–16: India. Mumbai: IIPS; 2017- 291.
7. https://www.ijcmph.com/index.php/ijcmph/article/view/11545 - Prevalence and predictors of iron deficiency anaemia in adolescent girls in India.
8. https://en.wikipedia.org/wiki/Health_belief_model.
9. https://en.wikipedia.org/wiki/Research_design.
10. https://pmc.ncbi.nlm.nih.gov/articles/PMC10324782/.
|
Received on 30.07.2025 Revised on 18.12.2025 Accepted on 12.03.2026 Published on 30.07.2026 Available online from August 05, 2026 Int. J. Nursing Education and Research. 2026;14(3):257-259. DOI: 10.52711/2454-2660.2026.00052 ©A and V Publications All right reserved
|
|
|
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License. |
|