Seifi Zahra, Zarei Fatemeh, Ahmadi Fazlollah
Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran Jalal AleAhmad Nasr, P.O. Box: 14115-111, Tehran, Iran.
Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
BMC Public Health. 2025 May 13;25(1):1762. doi: 10.1186/s12889-025-23019-1.
Microplastic (MP) contamination has emerged as a critical global concern. The most effective approach to mitigating this issue involves substantially minimizing the release of plastic waste into the environment. While addressing such an extensive environmental challenge is inherently complex, public education remains a vital component of any comprehensive solution. In this context, a randomized controlled trial (RCT) was conducted to assess the effectiveness of an educational intervention delivered through a mobile phone application in enhancing women's knowledge, attitudes, and practices concerning the health-related impacts of MPs.
This two-arm, parallel-design randomized controlled trial (RCT) was conducted from September 2024 to November 2024 with 136 women aged 18 years and older who owned smartphones, had basic literacy skills, and provided informed consent. Participants were recruited through an online call disseminated via social media platforms and health system networks in Iran. They were randomly assigned via block randomization to an intervention group (n = 68) that received the educational program through the app or a control group (n = 68). The sample size was calculated via G*Power software to ensure sufficient power (80%), with an alpha level of 0.05, resulting in a 15% dropout rate. Primary outcome data (Microplastic Knowledge, Attitude, and Practice (MIKAP) questionnaire scores were collected at baseline, immediately postintervention, and 8 weeks postintervention via self-report questionnaires. Data analysis included descriptive statistics and inferential tests, such as independent t tests and paired t tests, to assess group differences and within-group changes over time.
Demographic homogeneity was confirmed between the intervention and control groups (P > 0.05 for all baseline variables). The app-based educational intervention significantly improved knowledge scores in the intervention group at posttest 1 (Immediately follow-up; P < 0.001) and posttest 2 (8 weeks later follow-up; P < 0.001), whereas the control group presented declining knowledge (P = 0.009). The attitude scores did not significantly improve in the intervention group (P = 0.155) but significantly decreased in the control group (P = 0.008). Practice scores increased markedly in the intervention group postintervention (P < 0.001), with sustained gains at follow-up, whereas controls showed no significant changes (P = 0.105). Mann‒Whitney tests confirmed significant between-group differences in all outcomes postintervention (P < 0.001).
The mobile app-based educational intervention effectively enhanced women's knowledge and practices regarding microplastics and health. These findings highlight the potential of digital tools in addressing environmental health challenges through targeted public education.
Protocol Version 1, 2024-07-12. The enrollment of participants began on 2024-09-22. Recruitment is estimated to be completed by 2024-11‒21.
Iranian Clinical Trial Register (IRCT20240529061941N1). URL: https://irct.behdasht.gov.ir/user/trial/77069/view .
微塑料（MP）污染已成为全球关注的关键问题。减轻这一问题的最有效方法是大幅减少塑料垃圾向环境中的排放。虽然应对如此广泛的环境挑战本质上很复杂，但公众教育仍是任何全面解决方案的重要组成部分。在此背景下，开展了一项随机对照试验（RCT），以评估通过手机应用程序提供的教育干预在增强女性对微塑料健康相关影响的知识、态度和行为方面的有效性。
这项双臂平行设计的随机对照试验于2024年9月至2024年11月进行，招募了136名18岁及以上的女性，她们拥有智能手机、具备基本读写能力并提供了知情同意书。参与者通过在伊朗社交媒体平台和卫生系统网络上发布的在线招募信息招募而来。通过区组随机化将她们随机分配到干预组（n = 68），该组通过应用程序接受教育项目，或对照组（n = 68）。样本量通过G*Power软件计算，以确保有足够的效能（80%），α水平为0.05，得出失访率为15%。主要结局数据（微塑料知识、态度和行为（MIKAP）问卷得分）在基线、干预后立即以及干预后8周通过自我报告问卷收集。数据分析包括描述性统计和推断性检验，如独立t检验和配对t检验，以评估组间差异和组内随时间的变化。
干预组和对照组之间的人口统计学同质性得到确认（所有基线变量的P > 0.05）。基于应用程序的教育干预在干预后测试1（立即随访；P < 0.001）和干预后测试2（8周后随访；P < 0.001）时显著提高了干预组的知识得分，而对照组的知识得分下降（P = 0.009）。干预组的态度得分没有显著提高（P = 0.155），但对照组显著下降（P = 0.008）。干预组干预后的行为得分显著增加（P < 0.001），随访时持续上升，而对照组无显著变化（P = 0.105）。Mann-Whitney检验证实干预后所有结局的组间差异显著（P < 0.001）。
基于手机应用程序的教育干预有效地增强了女性对微塑料与健康的知识和行为。这些发现凸显了数字工具通过有针对性的公众教育应对环境卫生挑战的潜力。
方案版本1，2024 - 07 - 12。参与者招募于2024年9月22日开始。预计招募于2024年11月21日完成。
伊朗临床试验注册中心（IRCT20240529061941N1）。网址：https://irct.behdasht.gov.ir/user/trial/77069/view 。
