Public Health Division, Kuala Lumpur and Putrajaya Health Department, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
PLoS One. 2022 Dec 6;17(12):e0278192. doi: 10.1371/journal.pone.0278192. eCollection 2022.
Anemia in pregnancy is a public health concern. It has been diagnosed in 27% of pregnant women in Malaysia and up to 40% of pregnant women globally. This study aimed to develop and evaluate the effectiveness of an intervention initiative based on the health belief model. The MyPinkMom program was disseminated through a mobile messaging application to pregnant women to educate them on the prevention of anemia in pregnancy. We conducted a two-arm cluster-assignment, single-blinded, randomized control trial at two government antenatal clinics in Selangor. One clinic was randomly chosen as the intervention group, and the other was chosen as the control group. Sixty pregnant women with anemia from the intervention group received the MyPinkMom intervention program in the form of six infographic video clips, and 60 pregnant women with anemia from the control group received routine counseling on anemia in pregnancy. Pregnant women who had anemia secondary to hemoglobinopathy or other chronic diseases were excluded from this study. MANOVA showed significant increases in hemoglobin, knowledge, attitude, subjective norms, and perceived behavioral control scores for adherence to iron supplements, dietary iron, and dietary vitamin C intake (p < 0.001) in the intervention group at week 6. A significant reduction also occurred in dietary tannin intake (p < 0.001) in the intervention group at week 6. The intervention group at week 6 showed a large effect on hemoglobin level increments (partial eta squared, Ƞp2 0.268), dietary iron intake (Ƞp2 0.213), knowledge of anemia in pregnancy (Ƞp2 0.622), subjective norm scores for adherence to iron supplements (Ƞp2 0.167), and reduction in dietary tannin intake (Ƞp2 0.353). Similarly, repeated measures ANOVA showed that changes in hemoglobin levels were significantly different over time (i.e., at baseline, week 6, and week 12) between the intervention and control groups (p < 0.001). Hemoglobin increased rapidly over time among participants in the intervention group but gradually in the control group. To conclude, the newly developed MyPinkMom program that was delivered through a messaging application showed effectiveness in preventing anemia during pregnancy.
妊娠贫血是一个公共卫生问题。在马来西亚，27%的孕妇被诊断出患有贫血，而全球高达 40%的孕妇患有贫血。本研究旨在基于健康信念模式开发和评估一项干预措施的有效性。MyPinkMom 项目通过移动消息应用程序向孕妇传播，以教育她们预防妊娠贫血。我们在雪兰莪州的两家政府产前诊所进行了一项两臂集群分配、单盲、随机对照试验。一家诊所被随机选为干预组，另一家诊所被选为对照组。干预组中 60 名患有贫血的孕妇接受了 MyPinkMom 干预计划，包括六段信息图视频剪辑，对照组中 60 名患有贫血的孕妇接受了妊娠贫血常规咨询。本研究排除了因血红蛋白病或其他慢性疾病导致贫血的孕妇。MANOVA 结果显示，干预组在第 6 周时，血红蛋白、知识、态度、主观规范和对补充铁剂、饮食铁和饮食维生素 C 摄入的可感知行为控制评分显著增加（p<0.001）。干预组在第 6 周时，饮食中单宁摄入量也显著减少（p<0.001）。第 6 周时，干预组的血红蛋白水平增量（部分 eta 平方，Ƞp2 0.268）、饮食铁摄入量（Ƞp2 0.213）、妊娠贫血知识（Ƞp2 0.622）、补充铁剂依从性的主观规范评分（Ƞp2 0.167）和饮食中单宁摄入量减少（Ƞp2 0.353）均有较大影响。同样，重复测量方差分析表明，血红蛋白水平的变化在干预组和对照组之间随着时间的推移（即基线、第 6 周和第 12 周）有显著差异（p<0.001）。干预组的血红蛋白水平随着时间的推移迅速上升，而对照组则逐渐上升。总之，通过消息应用程序传递的新开发的 MyPinkMom 项目在预防妊娠贫血方面显示出了有效性。
