Assessment of a school-based, nursing-lead program to combat iron deficiency anemia among Saudi female adolescents: a pilot exploratory study

Abstract

Background/objectives: Iron-deficiency anemia (IDA) is a significant public health concern among female adolescents. This study aimed to assess the prevalence of IDA, evaluate the impact of a low-intensity educational intervention on the knowledge, attitudes, and practices (KAP) of students with IDA, and develop a logic model to guide future school health programs. Methods: Utilizing secondary data, a pre-post design was employed to evaluate a two-session educational intervention (45 min each) delivered by community health nurses in a public secondary school. The intervention focused on increasing knowledge of IDA, promoting healthy dietary practices, and addressing misconceptions identified during a needs assessment. Baseline assessments measured IDA prevalence, KAP levels, and relevant demographic factors. Post-intervention evaluations analyzed changes in KAP levels using linear mixed-effects regression models. Results: Of the 153 participants included (mean age = 16.29 years), 29.4% (45/153) self-reported a diagnosis of IDA. The intervention significantly improved knowledge (mean difference = 1.14, p <0.001) and practices (mean difference = 0.62, p < 0.001) among students with IDA. However, no significant changes were observed in attitudes (p = 0.976). Additionally, the study developed a logic model to guide future school-based IDA health programs. Conclusions: The educational intervention successfully improved knowledge and practices related to IDA, although attitudes remained unchanged. These findings highlight the potential of targeted, evidence-based school health programs to address gaps in adolescent nutrition knowledge and practices. Future work should consider more intensive interventions to achieve comprehensive improvements in all dimensions of KAP.