Rahman Md Jiaur, Rahman Md Moshiur, Sarker Mohammad Habibur Rahman, Matsuyama Ryota, Kakehashi Masayuki, Tsunematsu Miwako, Ali Mohammad, Ahmed Ashir, Hawlader Mohammad Delwer Hossain, Kawasaki Hiromi, Shimpuku Yoko
Department of Health Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Technical Training Unit, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
BMC Public Health. 2025 Jul 28;25(1):2567. doi: 10.1186/s12889-025-23687-z.
Anemia is a global public health concern, particularly among adolescent girls in rural Bangladesh, owing to inadequate knowledge and insufficient nutritional intake. Mobile health (mHealth) education has the potential to solve these limitations. This study aimed to evaluate the impact of mHealth education on raising hemoglobin levels and reducing anemia among adolescent girls in rural Bangladesh.
This open-label, parallel-group, randomized controlled trial was conducted at two schools in Chandpur district, Bangladesh from late May 2022 to January 2023. We randomly assigned one school to the intervention group and another to the control group and then performed simple random sampling to recruit 138 adolescent girls with anemia from the intervention (n = 69) and control (n = 69) groups. The intervention group received online counseling sessions and health education via mHealth technology, whereas the control group received usual care, and both groups were observed for 8 months. We performed mixed-effects model and generalized estimating equations (GEE) to evaluate the outcomes.
The study analyzed 121 participants (intervention group, 62; control group, 59). After adjusting for covariates, mixed-effects model observed that body mass index (BMI) [coefficient: 1.10, 95% confidence interval (CI): 0.44-1.76, P = 0.001], mid-upper arm circumference (MUAC) (coefficient: 0.77, 95% CI: 0.27-1.26, P = 0.002), hip circumference (coefficient: 2.24, 95% CI: 0.62-3.87, P = 0.007), and waist circumference (coefficient: 2.20, 95% CI: 0.74-3.66, P = 0.003) were significantly improved in intervention group. Although hemoglobin levels improved in the intervention group, the change was not statistically significant. However, the intervention group experienced a higher anemia recovery than the control group (25.8% vs. 13.6%). The GEE showed improvement in knowledge (coefficient: 4.11, 95% CI: 3.63-4.58, p = < 0.001), attitude (coefficient: 1.59, 95% CI: 1.24-1.96, p = < 0.001), and practice (coefficient: 0.39, 95% CI: 0.13-0.66, p = 0.004) in the intervention group compared to the control group after adjusting for relevant covariates.
The mHealth education led to improvements in knowledge, attitude, and practice (KAP) scores related to anemia among adolescent girls. Furthermore, the intervention resulted in improvements in BMI, MUAC, and hip and waist circumference measurements. Additionally, there were positive trends indicating a reduction in anemia prevalence, accompanied by an upward trend in hemoglobin levels. Therefore, implementing this strategy could enhance KAP and contribute to reducing adolescent girls' anemia in low-resource settings.
NCT05185661 ( https://www.
gov/ ), registered [January 11, 2022] with ClinicalTrials.gov.
贫血是一个全球公共卫生问题，在孟加拉国农村地区的少女中尤为突出，这是由于知识不足和营养摄入不足所致。移动健康（mHealth）教育有潜力解决这些局限性。本研究旨在评估mHealth教育对提高孟加拉国农村少女血红蛋白水平和减少贫血的影响。
本开放标签、平行组、随机对照试验于2022年5月下旬至2023年1月在孟加拉国钱德布尔县的两所学校进行。我们将一所学校随机分配到干预组，另一所学校分配到对照组，然后进行简单随机抽样，从干预组（n = 69）和对照组（n = 69）招募138名贫血少女。干预组通过mHealth技术接受在线咨询和健康教育，而对照组接受常规护理，两组均观察8个月。我们使用混合效应模型和广义估计方程（GEE）来评估结果。
该研究分析了121名参与者（干预组62名；对照组59名）。在调整协变量后，混合效应模型观察到干预组的体重指数（BMI）[系数：1.10，95%置信区间（CI）：0.44 - 1.76，P = 0.001]、上臂中段周长（MUAC）（系数：0.77，95% CI：0.27 - 1.26，P = 0.002）、臀围（系数：2.24，95% CI：0.62 - 3.87，P = 0.007）和腰围（系数：2.20，95% CI：0.74 - 3.66，P = 0.003）有显著改善。虽然干预组的血红蛋白水平有所提高，但变化无统计学意义。然而，干预组的贫血恢复率高于对照组（25.8%对13.6%）。GEE显示，在调整相关协变量后，干预组在知识（系数：4.11，95% CI：3.63 - 4.58，p = < 0.001）、态度（系数：1.59，95% CI：1.24 - 1.96，p = < 0.001）和行为（系数：0.39，95% CI：0.13 - 0.66，p = 0.004）方面相比对照组有改善。
mHealth教育使与贫血相关的少女知识、态度和行为（KAP）得分得到改善。此外，干预使BMI、MUAC以及臀围和腰围测量值得到改善。此外，有积极趋势表明贫血患病率降低，同时血红蛋白水平呈上升趋势。因此，实施该策略可提高KAP，并有助于在资源匮乏地区减少少女贫血。
NCT05185661（https://www.CLINICALTRIALS.gov/），于2022年1月11日在ClinicalTrials.gov注册。
