A Behavior Model for Students and Parents in Iodine Deficiency Prevention in Nong Song Hong District, Khon Kaen Province

Abstract

 The purpose of this study is to develop a model for behavior modification among students and parents in the prevention of iodine deficiency disorders. A participatory action research project was applied in three Royal Project schools and four public school areas in Nong Song Hong village, Khon Kaen Province, during January 2021–January 2022. The participants in the model development sample consisted of: 1) 27 teachers who involved in health and nutrition, village health volunteers, community leaders, and public health officials, 2) 248 students grades 1–3 and 131 of their parents. Data were collected using an interview form, focus group discussions, and the urinary iodine content of students. The statistics used were frequency, percentage, and median. Qualitative data were analyzed by content analysis. The study found that before the intervention, students and parents had inaccurate perceptions about iodine deficiency disorders. Most students and parents believe that a lack of iodine causes an enlarged neck, unattractiveness, and difficulty breathing. The student was improperly taking of iodized water at school, taking foods within below iodine level. The school did not organize the drinking of iodine-fortified water, and there was a lack of communication in the village. Parents also used less than 90 percent salt and iodized products. The development model implemented by the focus groups with stakeholders as follows: 1) To review the knowledge on iodine deficiency prevention for student leaders and their parents, 2) Transmission the knowledge to parents to focus on taking food with iodine consumption by the community leaders through information broadcasting tower twice a week. Village Health Volunteers (VHVs) provided knowledge at home. Survey the use of salt and iodized products in households/restaurants in the village. Selling salt at the local shop with attaching a sticker of the ministry of Public Health, the restaurants used iodized salt, health officials provided the audio clips of iodine deficiency prevention to community leaders. 3) Efficiently manage the salt fund by providing public health officials with iodized salt and manipulation for salt fund. 4) The school provides iodine-fortified drinking water and makes an agreement on iodine-fortified water drinking with students, the student leaders educated and controlled iodine-fortified drinking water. 5) Student’s parents used salt with Iodine supplements for cooking, after the intervention indicated that the students increased the knowledge level from 75.5 percent to 95.1 percent. Students believed that iodine deficiency can affect all age groups, affecting health beyond just an unattractive neck, and fears that they will get sick with goiter increased from 37.9% to 72.8%. They also increased having the breakfast from 41.1 percent to 50.5 percent, taking more iodine-containing foods such as eating 4-7 eggs/week, which increased from 49.9 percent to 60.8 percent. It also found that within a day, students increased drinking a box of milk from 38.7% to 94.8%, increased taking the seafood 2-3 days per week from 32.5% to 65.6%. Additionally, the parents’ knowledge of iodine deficiency increased from 75.6 percent to 95.0 percent, acknowledging that iodized salt and seafood help prevent iodine deficiency disease. All household has iodized salt 72.2% more regular distribution of iodized salt in the community and found that after intervention the median iodine levels in the students’ urine were sufficient standard level. (Median = 240.3, and 207 mcg/l respectively)