Exploration of Knowledge and Behaviors of Adolescent Girls Regarding Iron-Deficiency Anemia Using a Sequential Explanatory Mixed-Method Approach: A Study at Pasundan 1 Senior High School, Bandung City

Abstract

Introduction: Iron-deficiency anemia (IDA) is a major nutritional problem commonly experienced by adolescent girls due to increased iron requirements during menstruation and unbalanced dietary patterns. This condition affects health, academic performance, and productivity. The prevention of IDA strongly depends on adolescents’ knowledge and behaviors in maintaining adequate iron intake and adhering to iron supplementation (TTD) consumption. This study aims to describe the level of knowledge and behaviors of adolescent girls at Pasundan 1 Senior High School in Bandung regarding IDA.

Methods: This study employed a mixed-method approach with a Sequential Explanatory design. The quantitative phase was conducted through a survey using a questionnaire administered to 74 female students in grades X and XI selected through simple random sampling. The measured variables included levels of knowledge and behaviors related to iron-deficiency anemia (IDA). The qualitative phase involved in-depth interviews with teachers to explore their perceptions of anemia incidence and prevention efforts in the school. Quantitative data were analyzed using univariate analysis, while qualitative data were processed through data reduction, presentation, and conclusion drawing.

Results: Most students had a high level of knowledge (97.3%) and demonstrated good preventive behaviors toward anemia (86.5%). The interviews revealed that symptoms of anemia, such as dizziness and fatigue, were still commonly observed, and highlighted the important roles of schools and healthcare workers in providing iron supplementation (TTD) and health education.

Conclusions: The high level of knowledge suggests that information accessed through social media, schools, and healthcare providers contributes positively to students’ understanding of IDA. However, inappropriate behaviors such as consuming tea/coffee (which inhibit iron absorption) were still identified. Continuous nutritional education, monitoring of iron supplementation, and cross-sector collaboration are needed to reduce the prevalence of anemia among adolescent girls.