The Effects of a Health Literacy Promotion Program on Prevention Behaviors of Iron-deficiency Anemia in Pregnant Women

Authors

  • Wipa Suwannarat Faculty of Nursing, Thaksin University, Phatthalung Campus
  • อฑิภา อมรปิยภากร Faculty of Nursing, Thaksin University, Phatthalung Campus
  • Malee Kumkong Faculty of Nursing, Thaksin University, Phatthalung Campus
  • Patomporn Photaworn Boromarajonani College of Nursing, Songkhla, Faculty of Nursing, Praboromarajchanok Institute

Keywords:

Health Literacy, Iron Deficiency Anemia, Pregnant Women

Abstract

This two-group quasi-experimental research aimed to examine the effects of a health literacy   promotion program on iron deficiency anemia prevention behavior among pregnant women. The sample consisted of 68 pregnant women attending antenatal care at Phattalung Hospital who were   randomly assigned to an experimental and control group with 34 persons per group. Research instruments were: 1) a new health literacy promotion program to prevent iron deficiency anemia among pregnant women, including 6 activities, lasting 8 weeks, with group meetings at week 1st and week 8th, dividing experimental group into 3 groups with 10-12 persons per group with individual follow-up at week 4th and follow-up on application at week 7th; 2) a health literacy assessment questionnaire; and 3)a questionnaire on iron deficiency anemia prevention behavior during   pregnancy. All instruments were tested for content validity with CVI of .97, .91, and .91, respectively. The questionnaires yielded Cronbach alpha coefficients of .95 and .80, respectively. Data were analyzed using descriptive statistics, Chi-square test, Mann-Whitney U test, paired t-tests, independent t-tests, and Wilcoxon signed–rank test. Research results were as follows.

1. Pregnant women who received the health literacy promotion program had a significantly higher mean score for health literacy and iron deficiency anemia prevention behavior (p-value = .001). Hematocrit levels were significantly lower (p-value = .001).

2. Pregnant women who received the health literacy promotion program had significantly higher mean scores for health literacy and iron deficiency anemia prevention behavior compared to those who did not receive the program (p-value = .05 and p-value = .001, respectively). However, Hematocrit levels of both groups were not different.

Therefore, the health literacy promotion program could enable pregnant women to gain better health literacy and adopt proper iron deficiency anemia prevention behaviors.

References

Anusornteerakul, S., Ounkaew, A., & Chaiwan, W. (2024). Nurse's role in caring for pregnant women with iron deficiency anemia. Udonthani Hospital Medical Journal, 32(3), 453-463. (in Thai)

Beckert, R. H., Baer, R. J., Anderson, J. G., Jelliffe-Pawlowski, L. L., & Rogers, E. E. (2019). Maternal anemia and pregnancy outcomes: a population-basedstudy. Thai Journal of Obstetrics and Gynaecology, 39(9), 11-19.

Boonyaprapapan, T., Sangin, S., & Siriarunrat, S. (2018). Effects of the educative supportive program on self-care behavior and hematocrit level among pregnant women with iron deficiency anemia. The Journal of Faculty of Nursing Burapha University, 26(4), 40-48. (in Thai)

Cohen, J. (1977). Statistical Power Analysis for the Behavioral Sciences. (rev. ed.). Hillsdale, NJ: Erlbaum.

Cho, Y. I., Lee, S. Y., Arozullah, A. M., & Crittenden, K. S. (2008). Effects of health literacy on health status and health service utilization among the elderly. Social Science & Medicine, 66(8), 1809-1816.

Department of Health Ministry of Public Health. (2025). Health and Environmental Health Promotion Surveillance Data List 2025. Retrieved April 20th, 2025 from https://planning.anamai.moph.go.th/th/surveillance handbook/5113#wow-book/

Department of Health Ministry of Public Health. (2025). Action Plan 2025. Retrieved April 20th, 2025 from https://planning.anamai.moph.go.th/th/government-action-plan/download?id=124471&mid=35347 &mkey=m_document&lang=th&did=28679

Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191.

Health Education Division, Ministry of Public Health. (2019). Health Education Program to Promote Health Literacy Concerning the Prevention of Tuberculosis in the Community. Retrieved November 7, 2025 from http://hed.go.th/linkHed/396

Ingkaprasert, M., & Neelasamith, S. (2024). The effects of an online anemia education program with family support on anemic perception, food and iron supplement consumption behaviors among adolescent pregnancy in the community hospital. Nursing, Health, and Education Journal, 7(2), 42-54. (in Thai)

Nesari, M., Olson, J. K., Nasrabadi, A. N., & Norris, C. (2019). Registered nurses' knowledge of and experience with health literacy. Health Literacy Research and Practice, 3(4), e268-e279. doi.org/10.3928/24748307-20191021-01

Nutbeam D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259-267. doi: 10.1093/heapro/15.3.259.

Nutbeam, D. (2008). The evolving concept of health literacy. Social Science & Medicine, 67(12), 2072-2078.

Pengchan, W. (2017). Health Literacy in the Document for Department of Personnel Capacity Development Workshop, Health Department, Ministry of Public Health. Nonthaburi, Thailand: Ministry of Public Health.

Pillitteri, A. (2018). Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family (8th ed.). Wolters Kluwer Health: Lippincott Williams & Wilkins.

Sorensen, K., Van den Broucke, S., Pelikan, J. M., Fullam, J., Doyle G., Slonska, Z., et al. (2013). Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 10(13), doi: 10.1186/1471-2458-13-948. PMID: 24112855; PMCID: PMC4016258.

Suabjakdee, S., & Phetsindechakul, R. (2024). The effects of a self-care literacy promotion program for pregnant women with iron-deficiency anemia attending antenatal care at the health promotion hospital, regional health center 3. Regional Health Promotion Center 10 Journal, 12(2), 88-103. (in Thai)

Suratemeekul, S., & Saranrittichai, K. (2021). The effects of health literacy development and social support program on behaviors and hematocrit levels among pregnant women with Iron deficiency anemia. Journal of Nursing Science & Health, 44(4), 41-54. (in Thai)

Wanjaroen, M., Sonklin, J., Suramanit, C., & Maprajak, A. (2023). The effects of health literacy development program to improve anemia in pregnancy. Research and Development Health System Journal, 16(3), 253-267, 12(2), (in Thai)

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Published

2025-05-07