Dataset Information

Process evaluation of a national school-based iron supplementation program for adolescent girls in Iran.

ABSTRACT:

Background

Iron deficiency anemia remains as one of the most common nutritional problems in Iran, especially in women and girls. A process evaluation study of the national iron supplementation program targeting girls attending high schools was conducted to examine degree of exposure and satisfaction of the targets with the intervention components, and to assess the delivery (quantity), fidelity (quality), and environmental mediators of the intervention.

Methods

Three assessment tools were developed and used for the process evaluation. A total of 8 schools were selected using a simple randomization method. Data were collected from students (n = 658 of 661 participants), teachers (n = 80), and school principals (n = 7 of 8). For the qualitative measures semi-structured interviews were conducted with the three study groups.

Results

Mean continuous compliance was 62.3%. Intolerance to pills and no water supply in classrooms accounted for 47.72% and 36.21% of the refusals, respectively. The refusal rate was significantly correlated (p < 0.001) with the absence of a classroom water supply, and with each student's knowledge of iron deficiency issues (p < 0.05). The odds of refusal in the absence of a classroom water supply were 2.02 (95% CI 1 · 044 to 3 · 900) times greater than for those classrooms with a water supply. Student exposure to the program's goal was satisfactory; however, delivery and fidelity of educational materials and training sessions were inadequate.

Conclusions

The findings suggest that the methods of delivery and the fidelity of the program components, education materials and training sessions were insufficient and need to be improved. Additionally, specific attention has to be given to contextual factors to ensure the success of the program.

SUBMITTER: Kheirouri S

PROVIDER: S-EPMC4247064 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Process evaluation of a national school-based iron supplementation program for adolescent girls in Iran.

Kheirouri Sorayya S Alizadeh Mohammad M

BMC public health 20140916

<h4>Background</h4>Iron deficiency anemia remains as one of the most common nutritional problems in Iran, especially in women and girls. A process evaluation study of the national iron supplementation program targeting girls attending high schools was conducted to examine degree of exposure and satisfaction of the targets with the intervention components, and to assess the delivery (quantity), fidelity (quality), and environmental mediators of the intervention.<h4>Methods</h4>Three assessment to ...[more]

PMID: 25228096

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Project description:BackgroundGirls Active is a physical activity programme, delivered in UK secondary schools, with the aim of increasing moderate-to-vigorous physical activity (MVPA) in girls aged 11-14 years. This study presents the process evaluation as part of a 14-month cluster randomised controlled trial designed to evaluate the effectiveness of the Girls Active programme and which showed no difference in the primary outcome (MVPA at 14 months) between intervention and control arms.MethodsQuantitative and qualitative data were collected from intervention schools over the course of the 14 month trial. Feedback forms and attendance records were completed at the end of all teacher and peer leader training and review days. At 7- and 14-months, semi-structured interviews were conducted with the lead Girls Active teacher in all intervention schools (n = 10) and staff from the intervention provider (n = 4) and hub school (n = 1). At 14 months, separate focus groups with peer leaders (n = 8 schools), girls who participated in the evaluation component of the trial (n = 8 schools), and a sample of boys (n = 6 schools) were conducted. All participants in the intervention schools were asked to complete an exit survey at 14 months. Teachers (intervention and control) completed a school environment questionnaire at baseline, 7- and 14-months.ResultsThe Girls Active programme, i.e., the training and resources, appeared to be well received by teachers and pupils. Factors that may have contributed to the lack of effectiveness include: some initial uncertainty by teachers as to what to do following the initial training, a predominant focus on support activities (e.g., gathering opinions) rather than actual physical activity provision, and school-level constraints that impeded implementation.ConclusionsGirls Active and what it was trying to achieve was valued by schools. The programme could be improved by providing greater guidance to teachers throughout, the setting of timelines, and providing formal training to peer leaders.Trial registrationISRCTN, ISRCTN10688342 . Registered 12 January 2015.

Project description:Iron and folic acid (IFA) supplementation to reduce anemia is key for improving substantial lost disability adjusted life years (DALYs) for adolescent girls. This study assessed the impact of weekly IFA supplementation (WIFAS) on cognitive ability among adolescent girls in the Simiyu Region in northernwestern Tanzania. This cross-sectional comparative evaluation study of 770 adolescent girls (396 -WIFAS supplemented; 374 -not supplemented) evaluated the association between WIFAS and cognitive ability through a face-to-face survey and cognitive ability assessment using standardized tests (Span-forward Test, Span-backward Test and Maze Test). Using a modified Poisson regression, we controlled for the geographic setting (urban vs rural), availability of potable water and feeding programs in schools, age and school level of adolescent girls, parental status, main parental economic activities, and the number of teachers. Participants were between the ages of 11 and 19 years, with more than half (57%) between 12-15 years of age. Those with WIFAS had higher cognitive ability (Span-forward scores, χ2 = 46.34% p <0.001; Span-forward, χ2 = 46.34% p <0.001; and Global Composite Cognitive Performance (GCCP), χ2 = 32.52% p<0.001). Among the IFA supplemented adolescent girls, secondary school level had a significantly higher score with respect to Span-backward (aPR = 1.43, 95% CI = 1.06-1.62); Span-forward ability (aPR = 1.26, 95% CI = 1.04-1.53) and Maze Test ability (aPR = 1.12, 95% CI = 1.01-1.25) as compared to their counterpart in primary school level. Individual adolescent girls with WIFAS and living with both parents performed much better on the Span-backward Test (aPR = 1.22, 95% CI = 1.07-1.68) as compared to those living with relatives and/or orphans. The presence of potable water program among the WIFAS schools resulted in a higher Span-backward ability (aPR = 1.34, 95% CI = 1.03-1.89); and GCCP (aPR = 1.27, 95% CI = 1.03-1.75). Adolescent girls from WIFAS schools with feeding program had higher Span-forward (aPR = 1.38, 95% CI = 1.03-1.63) ability as well as a higher Maze Test (aPR = 1.15, 95% CI = 1.07-1.26) score. The present study provides compelling evidence that WIFAS is positively associated with higher cognitive ability among adolescent girls. Nevertheless, IFA interventions are still rare in communities across Tanzania.

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Project description:BackgroundThe rapid growth and changes that occur in adolescents increase the demand for macro and micronutrients and addressing their needs particularly in females would be an important step to break the vicious cycle of intergenerational malnutrition. Thus we evaluated the status of anemia and its anthropometric, dietary and socio demographic determinants in female adolescents, west Ethiopia.MethodsA school based cross-sectional study was conducted among school going adolescent girls of Wayu Tuqa district, south west Ethiopia and a 3-stage random sampling technique was used to select study participants. Data were entered into EpiData version 3.1 and analyzed using STATA version12. Haemoglobin was measured by HemoCue 301+ photometer and WHO Anthro-plus software Version 1.0.4 was used to calculate BMI for age z-score. Both bivariate and multivariate analyses were performed to check associations and control confounding. A p-value <0.05 was considered statistically.ResultThe overall prevalence of anemia was 27% (95% CI: 22.9-31%) of which 23, and 4% had mild and moderate anemia respectively. The proportion of thinness and overweight girls based on the BMI for age z-score was 33 and 3.6%, respectively. The odds of developing anemia were almost four times more likely among late adolescents as compared to early adolescents (AOR?=?3.8 95%CI?=?2.3 to 8.5).Adolescents from rural areas were 3.4 times more likely to have anemia as compared to their urban counterparts (AOR?=?3.4 95%CI?=?1.9 to7) and adolescents those who attained menarche were two times more likely to develop anemia compared to those who did not attained menarche (AOR?=?2.3 95%CI?=?1.34 to 4.2).ConclusionThe prevalence of anemia among adolescent girls was a moderate public health problem. To improve the prevailing nutritional problem, there must be inter-sectorial collaboration among health sectors and education sectors in providing nutritional education and counseling based on age and menarche status.

Dataset Information

Process evaluation of a national school-based iron supplementation program for adolescent girls in Iran.

Background

Methods

Results

Conclusions

Publications

Process evaluation of a national school-based iron supplementation program for adolescent girls in Iran.

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