The impact of e-booklets on knowledge and attitudes toward anemia awareness among adolescent girls
DOI:
https://doi.org/10.21927/ijnd.2025.13(5).352-364Keywords:
anemia, attitude, adolescent girls, e-booklet, knowledge, pengetahuan, remaja putri, sikapAbstract
ABSTRAK
Latar Belakang: Menurut Survei Kesehatan Indonesia tahun 2023, sebanyak 15,5% remaja putri menderita anemia, sehingga anemia sebagai suatu masalah kesehatan yang signifikan. Salah satu faktor yang berkaitan dengan anemia remaja adalah rendahnya pengetahuan dan kepatuhan konsumsi Fe.
Tujuan: Mengevaluasi efektivitas edukasi gizi menggunakan e-booklet dibandingkan dengan media slide dalam meningkatkan pengetahuan dan sikap terkait anemia.
Metode: Penelitian ini merupakan penelitian quasi eksperimental dengan desain pretest-posttest control group. Penelitian dilakukan pada bulan Maret-April 2024, melibatkan 85 siswi SMP di Yogyakarta, yang dibagi ke dalam kelompok intervensi (e-booklet dan media slide) dan kelompok kontrol (media slide). Data tentang pengetahuan dan sikap dikumpulkan menggunakan kuesioner terstruktur pada tiga tahap: pretest, posttest-1, dan posttest-2. Analisis statistik yang digunakan adalah paired t-test, uji wilcoxon, independent t-test, dan uji mann-whitney.
Hasil: Hasil penelitian menunjukkan peningkatan yang signifikan dalam skor pengetahuan pada kedua kelompok, dengan kelompok intervensi mencapai skor post-test yang lebih tinggi (89,1 vs 78,8; p<0,05). Meskipun kedua kelompok menunjukkan sedikit peningkatan dalam hal sikap, perubahan yang diamati tidak mencapai signifikansi secara statistik. Temuan ini menyoroti efektivitas e-booklet sebagai alat pembelajaran digital, yang menawarkan fleksibilitas dan konten mendalam yang mendukung pembelajaran mandiri.
Kesimpulan: Penelitian ini menggarisbawahi potensi e-booklet untuk mengatasi kesenjangan pengetahuan tentang anemia di kalangan remaja. Pembuat kebijakan sebaiknya mengintegrasikan e-booklet ke dalam program pendidikan kesehatan nasional dan menggabungkannya dengan metode offline yang interaktif untuk meningkatkan perubahan pengetahuan remaja.
KATA KUNCI: anemia; e-booklet; pengetahuan; remaja putri; sikap
ABSTRACT
Background: Based on Indonesia Health Survey 2023, 15,5% female adolescents suffer from anemia, as a significant health problem. This is due to lack of knowledge and low compliance of Fe consumption.
Objectives: To evaluate the effectiveness of nutrition education using e-booklets compared to slide media in improving anemia-related knowledge and attitudes.
Methods: This was a quasi-experimental design with a pretest-posttest control group, conducted in March–April 2024, involving 85 junior high school girls in Yogyakarta, divided into intervention (e-booklet and slide media) and control (slide media) groups. Data on knowledge and attitudes were collected using structured questionnaires at three points: pretest, posttest-1, and posttest-2. Statistical analyses included paired t-tests, Wilcoxon, independent t-tests, and Mann-Whitney tests.
Results: The results showed a significant improvement in knowledge scores in both groups, with the intervention group achieving higher post-test scores (89.1 vs. 78.8; p<0.05). Although both groups demonstrated a slight improvement in attitudes, the observed changes did not reach statistical significance. The findings highlight the effectiveness of e-booklets as a digital learning tool, offering flexibility and in-depth content that supports independent learning
Conclusions: This study underscores the potential of e-booklets to address knowledge gaps about anemia among adolescents. Policymakers should integrate e-booklets into national health education programs while combining them with interactive offline methods to enhance attitude changes.
KEYWORDS: anemia; attitude; adolescent girls; e-booklet; knowledge
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References
Kemenkes RI. Riset Kesehatan Dasar Nasional 2018. Jakarta, Indonesia; 2018.
Kemenkes RI. Laporan Provinsi DI Yogyakarta Riskesdas 2018. Jakarta, Indonesia; 2019.
Kemenkes RI. Survei Kesehatan Indonesia (SKI) tahun 2023. Jakarta, Indonesia; 2023.
Silitonga HTH, Salim LA, Nurmala I, Wartiningsih M. Compliance of Iron Supplementation and Determinants among Adolescent Girls: A Systematic Review. Iran J Public Health. 2023 Jan;52(1):37–48. https://doi.org/10.18502/ijph.v52i1.11664
Pareek P, Kuwari S, Thakur H. Determinants of Anemia Among Adolescents Girls. Curr Dev Nutr. 2022;6:154. https://doi.org/10.1093/cdn/nzac051.070
Wiafe MA, Ayenu J, Eli-Cophie D. A Review of the Risk Factors for Iron Deficiency Anaemia among Adolescents in Developing Countries. Anemia. 2023;2023:6406286. https:// doi:10.1155/2023/6406286
van Zutphen KG, Kraemer K, Melse-Boonstra A. Knowledge Gaps in Understanding the Etiology of Anemia in Indonesian Adolescents. Food Nutr Bull. 2021;42(1_suppl):S39–58. https://doi.org/10.1177/0379572120979241
Agustina R, Wirawan F, Sadariskar AA, Setianingsing AA, Nadiya K, Prafiantini E, et al. Associations of Knowledge, Attitude, and Practices toward Anemia with Anemia Prevalence and Height-for-Age Z-Score among Indonesian Adolescent Girls. Food Nutr Bull. 2021;42(1_suppl):S92–108. https://doi.org/10.1177/03795721211011136
Rachmi CN. Hidup Sehat Sejak Sekarang Untuk Remaja Kekinian [Internet]. 2019. 1–224 p. Available from: https://ayosehat.kemkes.go.id/buku-modul-pendidikan-gizi downloaded at 25 January 2025.
Wijaya LR, Utami SB, Rialihanto MP, Siswati T. Implementation of an e-pocket book to improve knowledge and perceive anemia in adolescents. J Gizi dan Diet Indones.2024;12(1):10–8. https://dx.doi.org/10.21927/ijnd.2024.12(1).10-18
WHO. Anemia. 2024; Available from: https://www.who.int/health-topics/anaemia#tab=tab_1 downloaded at 05 January 2025.
Norris SA, Frongillo EA, Black MM, Dong Y, Fall C, Lampl M, et al. Nutrition in adolescent growth and development. Lancet. 2022 Jan 8;399(10320):172–84. https://doi.org/10.1016/S0140-6736(21)01590-7
Deivita Y, Syafruddin S, Andi Nilawati U, Aminuddin A, Burhanuddin B, Zahir Z. Overview of Anemia; risk factors and solution offering. Gac Sanit. 2021;35 Suppl 2:S235-S241. doi:10.1016/j.gaceta.2021.07.034
Siswati T, Olfah Y, Kasjono HS, Paramashanti BA. Improving Adolescent Knowledge and Attitude toward the Intergenerational Cycle of Undernutrition through Audiovisual Education: Findings from RESEPIN Study in Yogyakarta, Indonesia. Indian J Community Med. 2022;47(2):196-201. https://doi:10.4103/ijcm.ijcm_1229_21
Hargreaves D, Mates E, Menon P, Alderman H, Devakumar D, Fawzi W, et al. Strategies and interventions for healthy adolescent growth, nutrition, and development. Lancet. 2022 Jan 8;399(10320):198–210. https://doi.org/10.1016/S0140-6736(21)01593-2
Ghadam OS, Sohrabi Z, Mehrabi M, et al. Evaluating the effect of digital game-based nutrition education on anemia indicators in adolescent girls: A randomized clinical trial. Food Sci Nutr. 2022;11(2):863-871. https://doi:10.1002/fsn3.3120
Khizar M, Ruel-Bergeron J, Zavala E, et al. Delivery platforms for reaching adolescents with nutrition interventions in low- and middle-income countries. Ann N Y Acad Sci. 2024;1538(1):71-84. https://doi:10.1111/nyas.15196
Ruiz LD, Radtke MD, Scherr RE. Development and Pilot Testing of a Food Literacy Curriculum for High School-Aged Adolescents. Nutrients. 2021;13(5):1532. https://doi:10.3390/nu13051532
Omar Amahmid Youssef El Guamri YRMYBRKKRSEBOI, Belghyti D. Nutrition education in school curriculum: impact on adolescents’ attitudes and dietary behaviours. Int J Heal Promot Educ. 2020;58(5):242–58. https://doi.org/10.1080/14635240.2019.1685399
Smits M, Kim CM, van Goor H, Ludden GDS. From Digital Health to Digital Well-being: Systematic Scoping Review. J Med Internet Res. 2022;24(4):e33787. https:// doi:10.2196/33787
Nikmah A, Supadi J, Setiadi Y. The Effect of Nutrition Education with E-Booklet Media on Knowledge and Attitude About Anemia in Adolescent Girls at SMP N 1 Gemuh, Kendal Regency. Journal of NutritionVol. 3, No. 1, May, 2022 doi: https://doi.org/10.35308/jns.v3i1.5242
Pardosi M. The Effectiveness of Booklet of Anemia on the Behaviors of Adolescent. Glob J Health Sci. 2019;Vol. 11(10). https://doi.org/10.5539/gjhs.v11n10p111
Alves SAA, Silva KND, Machado MFAS, et al. Digital booklet on sustainable practices for promoting adolescent health. Cartilha digital sobre práticas sustentáveis para a promoção da saúde do adolescente. Cien Saude Colet. 2023;28(8):2215-2226. https://doi:10.1590/1413-81232023288.07222023
Lewis CC, Taba M, Allen TB, Caldwell PHY, Skinner SR, Kang M, et al. Developing an Educational Resource Aimed at Improving Adolescent Digital Health Literacy: Using Co-Design as Research Methodology. J Med Internet Res. 2024 Aug;26:e49453. https://doi.org/10.2196/49453
Caillaud C, Ledger S, Diaz C, Clerc G, Galy O, Yacef K. iEngage: A digital health education program designed to enhance physical activity in young adolescents. PLoS One. 2022;17(10):1–18. https://doi.org/10.1371/journal.pone.0274644
Tang Y, Diao H, Jin F, Pu Y, Wang H. The effect of peer education based on adolescent health education on the resilience of children and adolescents: A cluster randomized controlled trial. PLoS One. 2022;17(2):e0263012. https:// doi:10.1371/journal.pone.0263012
Diao H, Pu Y, Yang L, Li T, Jin F, Wang H. The impacts of peer education based on adolescent health education on the quality of life in adolescents: a randomized controlled trial. Qual Life Res. 2020;29(1):153–61. https://doi.org/10.1007/s11136-019-02309-3
Jansen BJ, Jung S, Salminen J, Guan KW, Nielsen L. Strengths and Weaknesses of Persona Creation Methods: Guidelines and Opportunities for Digital Innovations. Conference: Proceedings of the 54th Hawaii International Conference on System Sciences. January 2021. DOI: 10.24251/HICSS.2021.604
Siswati T, Iskandar S, Pramestuti N, et al. Effect of a Short Course on Improving the Cadres' Knowledge in the Context of Reducing Stunting through Home Visits in Yogyakarta, Indonesia. Int J Environ Res Public Health. 2022;19(16):9843. Published 2022 Aug 10. doi:10.3390/ijerph19169843
Jiang Y, Chen Y, Lu J, Wang Y. The Effect of the Online and Offline Blended Teaching Mode on English as a Foreign Language Learners' Listening Performance in a Chinese Context. Front Psychol. 2021;12:742742. doi:10.3389/fpsyg.2021.742742
Ruzek EA, Hafen CA, Allen JP, Gregory A, Mikami AY, Pianta RC. How teacher emotional support motivates students: The mediating roles of perceived peer relatedness, autonomy support, and competence. Learn Instr. 2016;42:95-103. doi:10.1016/j.learninstruc.2016.01.004
Tang Y, Diao H, Jin F, Pu Y, Wang H. The effect of peer education based on adolescent health education on the resilience of children and adolescents: A cluster randomized controlled trial. PLoS One. 2022;17(2 February):1–18. http://dx.doi.org/10.1371/journal.pone.0263012
Ragelienė T, Grønhøj A. The influence of peers' and siblings' on children's and adolescents' healthy eating behavior. A systematic literature review. Appetite. 2020;148:104592. doi:10.1016/j.appet.2020.104592
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