Changes in hemoglobin levels in relation to self-efficacy and adherence to weekly iron tablet supplementation among female high school students: a pre-experimental study

Mahfuzhoh Fadillah Heryanda* -  Bachelor of Science in Nutrition Program, Faculty of Public Health, Sriwijaya University, South Sumatra, Indonesia
Faradina Aghadiati -  Bachelor of Science in Nutrition Program, Faculty of Public Health, Sriwijaya University, South Sumatra
Devieka Rhama Dhanny -  Bachelor of Science in Nutrition Program, Faculty of Public Health, Sriwijaya University, South Sumatra, Indonesia
Devi Ardila -  Bachelor of Science in Nutrition Program, Faculty of Public Health, Sriwijaya University, South Sumatra, Indonesia
Widya Lestari Nurpratama -  Bachelor's Program in Nutrition, Faculty of Health Sciences, Suherman Medical University, West Java, Indonesia
DOI : 10.30867/action.v11i3.3076

Iron deficiency anemia (IDA) is a major public health problem, particularly among adolescent girls. The effectiveness of iron (Fe) tablet supplementation programs largely depends on adherence to consumption, which is influenced by behavioral factors such as self-efficacy. Low adherence reduces the success of iron tablet supplementation. This study aimed to analyze the changes in hemoglobin levels associated with self-efficacy and adherence to iron tablet consumption among adolescent girls. This study employed a pre-experimental, one-group, pretest–posttest design without a control group. The intervention consisted of administering iron tablets (60 mg elemental iron and 0.25 mg folic acid) once a week for one month. The study population included female adolescents from the Aulia Cendekia Talang Jambe Integrated Islamic Senior High School in Palembang City. A total of 33 subjects were selected using purposive sampling based on the inclusion and exclusion criteria. The variables in this study included participant characteristics, self-efficacy, adherence to iron tablet consumption, and changes in hemoglobin levels. Wilcoxon and chi-square tests were used for the data analysis. The results showed that 70.4% of patients with high self-efficacy experienced an increase in hemoglobin levels; however, there was no statistically significant relationship between self-efficacy and changes in hemoglobin levels (p = 0.338). In contrast, adherence to iron tablet consumption was significantly associated with changes in hemoglobin levels (p = 0.021). Non-adherent subjects were six times more likely to experience stable or decreased hemoglobin levels than adherent subjects (PR = 6.0; 95% CI: 1.2–28.9). In conclusion, adherence to iron tablet consumption is a significant factor influencing hemoglobin levels among the subjects.

Keywords : Adherence, iron tablet consumption, adolescent girls, iron deficiency anemia, self-efficacy, hemoglobin level

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Open Access Copyright (c) 2026 Mahfuzhoh Fadillah Heryanda, Faradina Aghadiati, Devieka Rhama Dhanny, Devi Ardila, Widya Lestari Nurpratama
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