The combination of nutrition education at school and home visits to improve adolescents' nutritional literacy and diet quality in food-insecure households in post-disaster area (De-Nulit study): A study protocol of cluster randomized controlled trial (CRCT).

Nutrition education is selected as a method which often used to change eating behaviour, yet, the effectiveness of this method in adolescents who live in household with food insecurity status is rarely investigated. The purpose of this study was to assess the impact of a combination of nutritional education held at school and home visits for increasing the nutritional literacy and its effect on the quality of adolescent diet, so that the result can be used as a strategy to improve nutritional literacy dan diet quality in those adolescents who live in food-insecure households in post-disaster areas. The De-Nulit Study is a Cluster Randomized Controlled Trial (CRCT) with an intervention from a combination of nutritional education given at school and home visits conducted for three months for adolescents who live in food-insecure households with ages ranging from 15 to 17 years old. A randomization sampling was carried out at four schools located the nearest locations which were affected heavily by the major natural disasters in 2018. The nutritional education intervention groups in schools were given in eight sessions, whereas home visits with an interview approach for students with a motivational interview approach were carried out four times. The control group will receive leaflets three times a month for three months, and each group will receive a food stamp $ 7.6 per month for three months. The trial research has been recorded in Thai Clinical Trials Registry (TCTR) with identification number of TCTR 20220203003 issued on 03 February 2022.

Factors Associated with Diet Quality among Adolescents in a Post-Disaster Area: A Cross-Sectional Study in Indonesia.

The diet quality of adolescents in low-middle-income countries is low. Especially in post-disaster areas, adolescents are not a priority target for handling nutritional cases compared with other vulnerable groups. The aim of this study was to examine the factors associated with diet quality among adolescents in post-disaster areas in Indonesia. A cross-sectional study was performed with 375 adolescents aged 15-17 years, representing adolescents living close to the areas most affected by a significant disaster in 2018. The variables obtained include adolescent and household characteristics, nutritional literacy, healthy eating behavior constructs, food intake, nutritional status, physical activity, food security, and diet quality. The diet quality score was low, with only 23% of the total maximum score. Vegetables, fruits, and dairy scored the lowest, whereas animal protein sources scored the highest. Higher eating habits of animal protein sources; being healthy; normal nutritional status of adolescents; higher vegetable and sweet beverage norms of mothers; and lower eating habits of sweet snacks; animal protein sources; and carbohydrate norms of mothers are associated with higher diet quality scores in adolescents (p < 0.05). Improving the quality of adolescent diets in post-disaster areas needs to target adolescent eating behavior and changes in mothers' eating behavior.

Awareness about Anaemia and Weekly Iron-Folic Acid Supplementation (WIFAS) among School-Going Adolescent Girls and Parents in East Java and East Nusa Tenggara, Indonesia.

Since 2016, Indonesia has been implementing a weekly iron-folic acid supplementation (WIFAS) program in two provinces for school going adolescent girls to reduce anaemia. This study aimed to explore the awareness and understanding of school-going adolescent girls and parents regarding anaemia and WIFAS. The study was conducted in 10 districts, each from East Java province and East Nusa Tenggara province. Twenty focused group discussions (FGDs) were conducted with school-going adolescent girls (n=174) and ten FGDs with parents (n=66). Also, in-depth interviews (IDIs) were conducted with school-going adolescent girls (n=20) and their parents (n=10) from 20 schools. All FGDs and IDIs were audio-recorded, transcribed verbatim, and analyzed for themes using NVivo Pro 12 software. School going adolescent girls and parents had high levels of misinformation about anaemia and healthy nutritional practices, which were influenced by socio-cultural milieu and local dietary habits. Both parents and girls perceived low risk of anaemia for school-going adolescent girls. Girls stated that their parents' opinion about anaemia influenced their desire to consume iron supplements. In conclusion, girls and parents would benefit from increased access to information about anaemia risks and prevention, and the benefits of WIFAS for adolescent girls. Prevention of anemia should include relevant dietary guidance that considers their socio-cultural milieu and local dietary habits.

Coverage and Adherence of Weekly Iron Folic Acid Supplementation among School Going Adolescent Girls in Indonesia.

The Weekly Iron Folic Acid (WIFA) supplementation program for school going adolescent girls has been implemented by Indonesian Government since 2016. The objective of this study was to assess the coverage and adherence toward the WIFAS among school going adolescent girls, as part of a baseline assessment of the new intervention. METHODS: A cross-sectional survey was conducted in East Java (EJ) and East Nusa Tenggara (ENT) in year 2018. The samples were drawn from 60 high schools from 20 districts. The data collection was done by using a semi-structured, self-administered questionnaire. RESULTS: The total number of respondents in EJ and ENT was 934 and 922 adolescent girls respectively, with a mean age of 17 y. The percentage of girls who reported to have received WIFAS tablet in the last six months was only 10% in ENT and 31% in EJ. The average number of WIFA tablet received was only 0.4-1.4 tablets and the average number of tablets consumed was only 0.4-0.7 tablet in the last 6 mo. Adolescent girls, who consumed at least 1 tablet was only 9% in ENT and 18% in EJ. The frequently causes of not consuming WIFA were that they forgot; did not think it was necessary; and were scared side effects. CONCLUSION: The coverage and adherence to WIFA program among school going adolescent girls in EJ and ENT provinces were low.