Miracle Get Journal
Vol 3 No 3 (2026): August, 2026

The Effectiveness of School-Based Nutrition Education Programs in Improving Adherence to Iron Supplementation Among Adolescent Girls

Telvie Kasenda (Universitas Klabat, Indonesia)
Rafika Aini (STIKES Dharma Landbouw, Indonesia)



Article Info

Publish Date
30 Sep 2026

Abstract

Background: Weekly iron and folic acid supplementation (WIFAS) is a key school-based strategy for preventing iron deficiency among adolescent girls, yet adherence remains suboptimal. Nutrition education may improve knowledge, attitudes, and adherence by addressing behavioral barriers. Purpose: This study evaluated the effectiveness of an eight-week school-based nutrition education program in improving nutrition knowledge, attitudes toward iron supplementation, and adherence to weekly iron tablet consumption among adolescent girls. Methods: A quasi-experimental pretest–posttest control group study involved 180 female students aged 15–18 years from two public senior high schools in Padang City, West Sumatra, Indonesia. Ninety students received the intervention; 90 received routine school health services. The intervention comprised weekly interactive education, audiovisual materials, peer-group discussions, educational booklets, and teacher-supported monitoring. Knowledge and attitudes were assessed via questionnaires; adherence was evaluated using weekly monitoring records, supervised supplementation, and teacher-verified consumption. Adherence was defined as consuming ≥80% of prescribed weekly tablets. Results: Nutrition knowledge increased significantly in the intervention group from 61.8±10.5 to 86.7±8.4 (p<.001), versus 62.4±9.8 to 67.2±9.1 in controls (p=.061). Attitude scores rose from 52.6±6.7 to 66.9±5.3 in the intervention group (p<.001), versus 53.1±6.5 to 55.0±6.1 in controls (p=.087). Adherence increased from 46.7% to 84.4% in the intervention group and from 48.9% to 58.9% in controls. Logistic regression indicated intervention participation was associated with higher adherence (adjusted OR=4.73; 95% CI: 2.41–9.28; p<.001). Conclusion: The school-based nutrition education program was associated with improved knowledge, attitudes, and adherence to weekly iron supplementation among adolescent girls.

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Journal Info

Abbrev

miracle

Publisher

Subject

Public Health

Description

Miracle Get Journal is an open access and peer-reviewed journal. It refers to the word "MIRACLE" which stands for Manager, Innovator, Researcher, Apprenticer, Communitarian, Leader, and Educator. These components have important roles and functions required in the field of Public Health. Through ...