The impact of e-booklets on knowledge and attitudes toward anemia awareness among adolescent girls

Ismi Izaz Ainun Najmi, Muhammad Primiaji Rialihanto, Idi Setiyobroto, Agus Wijanarka, Jutharat Attawet, Agung Dwi Laksono, Heru Subaris kasjono, Waluyo Waluyo, Tri Siswati

Abstract


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


Keywords


anemia; attitude; adolescent girls; e-booklet; knowledge; pengetahuan; remaja putri; sikap

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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




DOI: http://dx.doi.org/10.21927/ijnd.2025.13(5).352-364

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