Effects of Health Education Intervention Using Health Belief Model on Haemoglobin Level Among Anaemic Pregnant Women in rural Malaysia: a quasi–experimental study

Abstract Background Anaemia in pregnancy is a problem threatening public health throughout the world especially in the developing countries. Current anaemia prevention programme in Malaysia includes oral iron supplementation and health education. However, the effect of the existing intervention in ensuring compliance to the subscribed regimen and the impact of nutrition education in enhancing dietary modification during pregnancy were minimal. This study aims to develop, implement and evaluate the effects of a theory-based health educational intervention using Health Belief Model (HBM) on haemoglobin level among anaemic pregnant women. Methods This is a quasi-experimental research with pre-post test design with control group involving 81 participants per group from two health clinics in Sepang, Malaysia. The primary outcome was haemoglobin level. Secondary outcome include knowledge on anaemia, HBM constructs, dietary iron intake and compliance towards iron supplementation. Both groups received routine antenatal care. Additionally, the intervention group received a theory-based health education intervention programme. Results The response rate in the intervention and control group were 83.9% and 82.7% respectively. Generalized estimating equations analysis showed that the intervention was effective in improving the mean haemoglobin level (β=0.75, 95%CI=0.52, 0.99, P<0.001), the knowledge score (β=1.42, 95%CI=0.36, 2.49, P=0.009), perceived severity score (β=2.2, 95%CI= 1.02, 3.39, P<0.001) and increased proportion of high compliance level (AOR=4.59, 95%CI=1.58, 13.35, P=0.005). Conclusion Health education intervention based on the HBM is proven to be effective in improving the mean haemoglobin level, knowledge score, perceived severity score and compliance level of participants. The study results emphasized on the effectiveness of such an approach, therefore it is recommended that future educational interventions which aim at increasing preventive healthy behaviours in pregnant women could benefit from applying this model in primary health care settings. Trial registry Australian New Zealand Clinical Trials Registry with registration number of ACTRN12618001824257 (retrospectively registered)