Effect of Innovative Interactive Approaches to Educating Pregnant Women About Iodine Deficiency

Effect of Innovative Interactive Approaches to Educating Pregnant Women About Iodine Deficiency | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of Innovative Interactive Approaches to Educating Pregnant Women About Iodine Deficiency Heba Alkotb Mohamed, Asmaa Abobakr Ibrahim, Farida Kamel Yousef, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5588752/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Pregnant women are vulnerable to iodine deficiency, which poses risks to maternal and fetal health. Preventive education on iodine intake is essential to reduce these risks. This quasi-experimental study evaluated the effectiveness of innovative interactive education techniques on pregnant women’s knowledge, attitudes, and practices (KAP) regarding iodine deficiency. A total of 132 pregnant women attending Suez Canal University Hospital clinics were divided into an intervention group, which received interactive education, and a control group, which received standard education. The intervention included multimedia presentations, group discussions, and digital tools focused on the importance of iodine. Results indicated significant improvements in knowledge, attitudes, and dietary practices related to iodine intake in the intervention group, with sustained effects at follow-up. These findings highlight the potential of interactive education in promoting preventive health behaviors among pregnant women. Figures Figure 1 Introduction Interactive education techniques are powerful tools for enhancing health literacy, especially in maternal and child health ( Chastnyk et al., 2024 ). These methods create a dynamic, participatory learning experience where healthcare professionals share information and actively involve pregnant women in confirming their understanding before proceeding with new topics ( Orshanskyi et al., 2020 ). Interactive education doesn’t simply assess comprehension; it also encourages positive attitude shifts toward preventive health behaviors, a critical factor during pregnancy when health risks are elevated ( Garrison et al., 2021 ). Pregnant women face multiple potential complications, including preterm birth, preeclampsia, gestational diabetes, and iodine deficiency disorders, each of which poses significant risks to maternal and infant health. Such issues can lead to severe outcomes like miscarriage or developmental issues in infants, underscoring the importance of preventive education ( Jibril et al., 2024 ). Specifically, iodine deficiency is a major concern, as it can result in preterm birth, congenital abnormalities, or intellectual and physical developmental delays in infants. In severe cases, iodine deficiency causes hypothyroidism, which can lead to lifelong disabilities ( Sayed, 2024 ). The need for iodine increases significantly during pregnancy due to factors such as the heightened demand for maternal thyroid hormone production, the transfer of iodide to the fetus, and increased renal clearance, all of which contribute to a higher risk of iodine deficiency disorders ( John et al., 2022 ). To mitigate these risks, the World Health Organization (WHO) recommends a daily iodine intake of 230–260 micrograms during pregnancy and lactation, achievable through iodine-rich foods such as fish, dairy, iodized salt, and specific vegetables ( Bath et al., 2022 ). Monitoring iodine levels through urinary iodine concentration is also suggested, as it reflects recent intake, aiding in early identification of deficiency risks ( Monaghan et al., 2021 ). Despite the availability of guidelines, many pregnant women may struggle to achieve recommended iodine intake, placing them at heightened risk of deficiency and its consequences. Here, interactive education techniques offer a significant advantage. By involving pregnant women in an engaging process of discussing and confirming understanding, these techniques encourage active learning and help reinforce essential health practices. Interactive education thus becomes a critical strategy in empowering women to make informed choices regarding their iodine intake and overall health during pregnancy, potentially reducing the incidence of iodine deficiency disorders and related complications ( Levie, 2020 ). Significance of the study Understanding iodine deficiency among pregnant women in Egypt is crucial due to its significant implications for both maternal and fetal health. Adequate iodine intake during pregnancy is essential for proper fetal brain development, thyroid function, and overall growth. Low awareness and knowledge about iodine deficiency can lead to preventable health complications, including developmental delays and intellectual impairments in children. By enhancing pregnant women’s knowledge of iodine deficiency, this study lies in its potential to improve prenatal health education by assessing the effectiveness of innovative interactive techniques in raising awareness about iodine deficiency among pregnant women in Egypt. This research could offer important insights into enhancing educational strategies, ultimately supporting better health outcomes for mothers and their babies by addressing a critical nutrient deficiency. Aim of the study: To evaluate the innovative interactive approaches to educating pregnant women about iodine deficiency through enhancing pregnant women’s knowledge, practices, and attitudes of iodine deficiency. Hypotheses H1 : Pregnant women who receive innovative interactive education on iodine deficiency will show a greater increase in knowledge scores from pretest to post-test compared to those receiving standard education. H2 : Pregnant women in the innovative interactive education group will exhibit a greater improvement in positive attitudes toward dietary iodine intake compared to those in the control group. Study Design The research was conducted with a quasi-experimental design, a significant choice that allowed for a comprehensive assessment of changes in knowledge, attitudes, and practices regarding iodine deficiency among pregnant women. The two-group matched pretest, post-test, and follow-up test structure was instrumental in comparing the effectiveness of an intervention group, which received innovative interactive education techniques, with a control group that received standard education. The thoroughness of the research design is evident in its structure and methodology. Sample and Sampling Method Population: Pregnant women attending prenatal clinics at the Suez Canal University Hospital's obstetrical outpatient clinic, which has a dedicated facility for routine prenatal care. Sample Size : The total sample size was 132, according to Cohen (1988), with 66 participants per group. Effect Size and Statistical Power: Confirmed the use of partial eta squared (η2\eta^2η2) to clarify the effect size measure. Power and Significance Level Notation: Specified the power as "0.95 (95%)" and the significance level as α=0.05\alpha = 0.05α=0.05 for clarity and to align with standard statistical reporting practices. Revised Sampling and Criteria Description: Study participants were selected using a purposive sampling technique, based on the following inclusion and exclusion criteria: Inclusion Criteria: Primigravid women, regardless of age or educational level. Women recruited during their first trimester of pregnancy. Participants who provided informed consent agreed to comply with study requirements. Exclusion Criteria: Pregnant women with a history of chronic health conditions (e.g., hypothyroidism, diabetes). Individuals who declined participation in the training intervention Tools for data collection: Tool I: The demographic and Baseline Data Collection Forms are meticulously designed to gather a comprehensive understanding of the participants' profiles. These forms, which cover a wide range of factors, including age, education level, socioeconomic status, and gestational age, are crucial in establishing a thorough understanding of the participants' backgrounds, thereby clarifying their role in the study. Tool II: The pre- and Post-Intervention Knowledge Questionnaire, a valuable tool, was administered to participants before and after the educational intervention. This questionnaire allows us to measure changes in knowledge about iodine deficiency. The questionnaire is designed to engage participants with a variety of question types, including Multiple-choice questions (MCQs), True/False questions and Short-answer questions, assessing knowledge of iodine's role in pregnancy, sources of iodine, symptoms of iodine deficiency, and its impact on maternal and fetal health (Alimohammadi et al. (2019) and (Lee et al.,2020). The scoring system for each type of question is as follows: Multiple-Choice Questions (MCQs) and true and false-each correct answer earns a point, and each incorrect answer earns zero points. For short-answer questions, the scoring system was as follows : Full answer with all key points = 2 points, Partial answer (correct but lacks some details) = 1 point and Incorrect or no answer = 0 points. Pre-test and Post-test Comparison : After scoring both the pre- and post-intervention tests, compare the scores to determine knowledge improvement. You can calculate the percentage change in scores for each participant or for the entire sample. Knowledge Improvement Calculation: The Categorizing Knowledge Levels categorize participants' knowledge levels based on their scores: Low Knowledge: 0-40% of the total possible score, Moderate Knowledge: 41-70% of the total possible score and High Knowledge: 71-100% of the total possible score. Tool III: Dietary Practices Changes, which includes: A) Dietary Practices: Measure changes in dietary behaviors related to iodine-rich food consumption, such as increased intake of iodized salt, seafood, dairy products, or sea vegetables. For instance, you can use Food frequency questionnaires (FFQs) or self-reported dietary logs to assess iodine-rich food intake before and after the program. These tools provide a comprehensive view of participants' dietary habits and can help in evaluating the effectiveness of the intervention. B) Salt Usage Behavior: It's vital to track whether participants are more likely to use iodized salt or prefer natural sources of iodine after the education. This data is invaluable in understanding the effectiveness of our intervention. Example: Surveys on salt preference (iodized vs. non-iodized). To comprehensively assess behavioral changes in dietary practices related to iodine intake among pregnant women, we have developed a scoring system . This system, based on their responses in a pre-and post-education questionnaire , is a crucial and practical tool. It includes components such as dietary practices, salt usage behavior, and iodine supplementation adherence, providing a deep understanding of the changes. Assign points based on the selected frequency of each iodine-rich food item (e.g., iodized salt, seafood, dairy, sea vegetables, eggs). Add up the points for each food category: Total possible score : 0 (no intake) to 20 (daily intake of all food items). Interpretation : 0–5 points: Low iodine-rich food intake, 6–10 points: Moderate iodine-rich food intake, 11–15 points: High iodine-rich food intake, and 16–20 points: Very high iodine-rich food intake. Tool V: Attitude Toward Iodine Deficiency Prevention: Measure changes in the participants' attitudes toward iodine deficiency prevention, including the perceived importance of iodine intake during pregnancy based on (Basilious & Salim 2019) . Focus on five parts: Beliefs and Awareness. Perceived Importance of Iodine Deficiency Prevention. Confidence and Self-Efficacy. Motivation and Willingness to Act. Perceived Support and Information Needs. Interpretation of the scores from the 'Attitude Toward Iodine Deficiency Prevention' questionnaire is as follows: Each question in the questionnaire is scored as follows: strongly Disagree (1 point), disagree (2 points), neutral (3 points), agree (4 points), and strongly agree (5 points). With 16 questions, the total possible score ranges from 16 to 80 points. A score of 16–32 indicates a Low attitude, 33–48 a Moderate Attitude, 49–64 a Positive Attitude, and 65–80 a Strong Proactive Attitude. Tools validity and reliability The instrument used in this study was confirmed to be both valid and reliable. Experts in community health nursing from multiple universities reviewed the questionnaire. The reliability testing, conducted with 13 pregnant women who were not part of the main sample, was not only comprehensive but also thorough, providing a strong assurance of the instrument's effectiveness. No modifications to the instrument were necessary, as participants found the content clear and understandable. With an internal consistency of 0.7, as indicated by Cronbach's alpha, the instrument was considered a dependable measure, assessing knowledge, Behavioral Changes and Attitude Toward Iodine Deficiency Prevention. Ethical approval: This study, with ethical approval from the Faculty of Nursing Ethics Committee, Suez Canal University, in April 2022 (Reference No. 217-4/2022). The letter from the faculty dean to the Director of the Suez Canal University Hospital, Outpatient Clinics for Obstetrics and Gynecology, clarified the objectives and importance of the study. The researchers made a firm commitment to adhere to the approved protocol, submit any amendments for re-evaluation, and ensure monitoring throughout the study. This commitment is a testament to our dedication to protect the rights and well-being of the participants and address any concerns that may arise. Informed consent was obtained from the participants after fully informing them of the objectives and procedures of the study, ensuring that potential risks are low and their right to withdraw at any time without consequences. We reiterate our commitment to protecting the rights of our participants, ensuring the highest ethical standards and participant safety in our study. Procedures: 1. Preparing and planning: The study objectives were clearly outlined, focusing on assessing changes in knowledge, behavioral attitudes, and practices related to iodine deficiency. Interactive educational materials were developed, including videos, quizzes, digital applications, and printed materials tailored to the needs of pregnant women. The research was conducted with the utmost respect for ethical standards, as evidenced by the rigorous process of obtaining ethical approval in April 2022 (Ref. No. 217-4/2022), particularly regarding pregnant participants. This process ensures the integrity of the research and the protection of participants' rights. Notably, the study placed a strong emphasis on the role of facilitators, who were trained to deliver interactive education effectively, address participants' questions, and manage data collection tools. 2. Participant Recruitment The researchers aimed to engage pregnant women who met the inclusion criteria from prenatal clinics at Suez Canal University Hospital. They appreciated the participation of eligible women in the study, which invited them to join educational sessions. After explaining the study’s purpose, procedures, and confidentiality assurances [insert confidentiality assurances here], the researchers obtained informed consent from the participants. Following consent, they ensured fairness in the process by randomly assigning participants to either the intervention or control group using a simple randomization method with a random number generator (assigning even numbers to the intervention group and odd numbers to the control group), thereby providing participants with a sense of security. 3. Baseline Data Collection: The researchers conducted baseline data collection by administering a pre-test questionnaire to assess participants' initial knowledge, attitudes, and dietary behaviors related to iodine deficiency. They gathered demographic information, including age, education level, and pregnancy stage, to understand participant backgrounds and enable subgroup analysis. Additionally, they documented baseline iodine intake using a food frequency questionnaire or dietary log. 4. Intervention Delivery: Innovative Interactive Education Techniques The researchers delivered the intervention using Innovative Interactive Education Techniques : Education Sessions : They scheduled group sessions, either in-person or virtual, focusing on interactive learning. Each session lasted about 1–2 hours. Multimedia Presentations : Videos and animations were shown to explain the significance of iodine for maternal and fetal health, enlightening the participants with a clear understanding of the complex concepts. Interactive Tools : Participants engaged with apps, quizzes, and gamified learning activities to reinforce their knowledge. Hands-on Practice : Iodine-rich foods and supplements were demonstrated, and participants were guided to recognize these items within their diets. Group Discussions : Facilitators led peer discussions on challenges and solutions related to maintaining adequate iodine intake. Reminders and Reinforcement : Participants received follow-up messages via texts or emails with crucial points to reinforce the learning outcomes. 5. Immediate Post-Intervention Assessment: Assessment Immediately following the education session, researchers administered a short quiz to assess knowledge retention. They also evaluated any changes in attitudes and intended behaviors regarding iodine intake. Additionally, a brief survey was used to collect participants’ feedback on the education techniques and their perceived effectiveness. 6.Follow-Up Assessment: Four to six weeks after the intervention, the researchers conducted a follow-up assessment to evaluate long-term retention and any sustained behavioral changes in dietary practices related to iodine intake. They re-administered the knowledge questionnaire to measure retained knowledge. Dietary practices and salt preferences were also reassessed to identify ongoing changes in behavior. Additionally, optional qualitative interviews were conducted with a small subset of participants to gain deeper insights into the program’s impact on their beliefs and behaviors. 7.Data Analysis: The researchers conducted a data analysis involving both quantitative and qualitative methods. For the quantitative analysis , they compared pre- and post-intervention scores using paired t-tests or Wilcoxon signed-rank tests to evaluate significant gains in knowledge. For behavioral changes , they assessed alterations in dietary practices and attitudes toward iodine intake, calculating proportions or averages as appropriate. For the qualitative analysis , they performed a thematic analysis on participant feedback to identify perceptions of the program’s strengths and areas needing improvement. Results Table (1); Sociodemographic Characteristics of Control and Study Groups Items Control group (n=61) Study group (n=61) Frequency Percent Frequency Percent Age (years) 18-24 8 12.12% 14 21.21% 25-30 30 45.45% 26 39.39% 31-35 25 37.88% 23 34.85% 36-40 3 4.55% 3 4.55% Range 18.00 37.00 20.00 38.00 Mean, SD 29.42±4.06 28.79±4.63 Education level: Illiterate 26 39.39% 2 3.03% Intermediate level 29 43.94% 58 87.88% High level 11 16.67% 6 9.09% Occupation: Worked 21 31.82% 49 74.24% Housewife 33 50.00% 14 21.21% Student 12 18.18% 3 4.55% Residence Urban 54 81.82% 63 95.45% Rural 12 18.18% 3 4.55% Income Enough 32 48.48% 14 21.21% Not enough 34 51.52% 52 78.79% This table presents a comparison of key sociodemographic factors between the control and study groups. Variables include age distribution, education level, occupation, residence, and income status. Age ranges from 18 to 45 years, with a majority of participants in both groups aged between 25 and 35 years. The study group shows higher levels of intermediate education and employment compared to the control group, where a larger proportion are housewives. Additionally, the study group has a greater urban representation and a higher percentage of participants reporting insufficient income. These differences may influence group responses to health interventions related to iodine deficiency prevention. Table (2); Comparison of total scores of knowledges regarding iodine deficiency during pregnancy between Control and Study Groups at Pre, Immediate Post, and Follow-up Time Points Knowledge scale items Control Group Study Group a t P value Mean SD Mean SD Pre 32.68 12.84 18.51 23.03 4.37 0.00003 Immediate Post 33.01 12.82 93.18 10.66 -29.31 0.00000 Follow-up 34.31 13.79 92.10 8.87 -28.63 0.00000 b F 0.28 501.80 P value 0.75517 (NS) 0.00000 (HS) a independent samples t test for comparing the two groups b One way Anova comparing pre,post and follow-up within each group The data in Table (2) demonstrates that at the pre-intervention stage, the study group had significantly lower knowledge levels than the control group, indicating a baseline gap. This sets a crucial starting point for evaluating the intervention’s effect, as the study group began at a knowledge disadvantage. However, after the intervention, as shown in the same table 2, the study group's knowledge scores exhibited a remarkable and statistically significant increase compared to the control group. The mean score difference of 60.17 (93.18 - 33.01) underlines the immediate and substantial improvement in knowledge due to the interactive education techniques, which should excite the audience about the intervention's impact. The low p-value (<0.001) reinforces the intervention’s effectiveness, indicating the observed changes are not due to chance. The study group maintained high knowledge scores at the follow-up time point, demonstrating the sustained impact of the intervention. The persistence of the knowledge gap between the control and study groups (Mean Difference = 57.79) indicates that the benefits of the interactive education techniques extend beyond the immediate post-intervention period. The b F scores further illustrate the profound effect of the intervention, with the control group experiencing negligible change, as reflected in the non-significant p-value, and the study group showing substantial and statistically significant improvement. Figure (1) demonstrates that the significant improvement in dietary practices immediately post-intervention and at follow-up in the study group highlights the efficacy of the educational intervention in promoting healthier nutritional behaviors related to iodine-rich foods. Despite a slight reduction in the study group’s scores from the immediate post-intervention to the follow-up, the substantial improvement from baseline reaffirms the lasting impact of the intervention.The control group showed negligible changes in dietary practices over time, indicating that without intervention, dietary habits remain static. Table (3); Comparison of attitude toward iodine deficiency prevention Between Control and Study Groups at Pre, Immediate Post, and Follow-up Time Points Control Group Study Group Mean SD Mean SD a t P value Pre 36.86 7.43 40.08 10.83 -1.99 0.04846 Immediate Post 42.59 7.55 99.62 3.08 -56.85 0.00000 Follow-up 43.20 7.85 99.24 2.80 -54.60 0.00000 b F 13.96 1728.80 P value 0.00000 ( HS) 0.00000 (HS) a independent samples t test for comparing the two groups b One way Anova comparing pre,post and follow-up within each group Table (3) shows that the difference (Mean Difference = -1.99, p = 0.04846) in pre-intervention scores show a small the two groups , with the study group having a slightly more favorable attitude toward iodine deficiency prevention at baseline. Following the intervention, the study group exhibits a remarkable and dramatic increase in mean attitude scores to 99.62 SD3.08, significantly surpassing the control group. The highly significant p-value (<0.001) indicates that this improvement is not due to chance. The sharp increase, a testament to the effectiveness of the interactive education techniques, suggests that positive change is indeed possible in attitudes toward iodine deficiency prevention. Discussion Innovative Interactive Education Techniques are a powerful tool for health education, particularly in improving knowledge, attitudes, and practices related to dietary habits. Their ability to engage learners actively, provide personalized experiences, and most importantly, ensure long-term behavior change, makes them vital to modern public health strategies( Alvarez & Risko 2020) . To achieve sustainable health outcomes, these techniques should be prioritized in addressing nutrition-related challenges, including iodine deficiency. The study demonstrates the significant impact of innovative interactive education techniques on pregnant women’s knowledge of iodine deficiency. These techniques effectively improve knowledge retention, surpassing traditional methods. The findings align with existing literature advocating for interactive and tailored educational approaches to address nutritional deficiencies and support sustainable health outcomes. The findings align with Wang et al. (2018) , who reported that interactive educational programs significantly improved participants' knowledge of micronutrient deficiencies, particularly iodine deficiency. Similar to this study, the intervention group in Wang et al.'s research retained higher knowledge levels at follow-up. Li et al. (2020) also observed that tailored educational methods are more effective than traditional approaches in addressing nutritional deficiencies. This supports the dramatic improvement seen in the study group compared to the control group. The lack of improvement in the control group highlights the limited efficacy of standard educational practices, as discussed by Sharma and Romas (2021) , who advocate for more interactive and engaging methods. The results of this study demonstrate the effectiveness of innovative interactive education techniques in improving dietary practices related to iodine-rich foods. The substantial and sustained improvements in the study group highlight the potential of such interventions to address nutrition-related public health challenges. These findings align with other studies advocating for participatory and tailored educational approaches to achieve sustainable health outcomes. The findings align with previous research emphasizing the role of interactive education techniques in promoting dietary changes as Lim and Lee (2019) conducted a meta-analysis that demonstrated significant improvements in dietary habits following interactive nutritional education interventions, similar to the improvements seen in the study group here. Sharma and Romas (2021) emphasize that tailored, participatory educational approaches can lead to lasting behavioral changes, consistent with the sustained improvements observed in the study group. Interactive education techniques are highly effective in improving and sustaining positive attitudes toward iodine deficiency prevention. Their success lies in engaging participants actively, which enhances understanding and personal relevance. These results advocate for the incorporation of interactive methods into public health education programs to maximize impact and foster long-term attitude changes. The success of interactive education in this context also mirrors the conclusions of Sharma and Romas (2021) , who emphasized that health education grounded in participatory methods enhances self-efficacy, motivation, and long-term commitment to health practices. This is particularly important in addressing nutritional challenges like iodine deficiency, as attitudes play a critical role in dietary decision-making and adherence to preventive measures. Finally, the sustainability of attitudinal improvements observed in this study is comparable to findings by Kirkpatrick and Kirkpatrick (2016) , who outlined the importance of engagement and feedback in education to achieve long-term outcomes. The significant difference in attitude scores between the intervention and control groups during follow-up underscores the enduring impact of interactive education techniques, supporting their broader application in public health initiatives. Conclusion The study concludes that innovative interactive education techniques are highly effective in enhancing pregnant women's knowledge, attitudes, and practices regarding iodine deficiency. The intervention group demonstrated substantial improvements immediately after the education sessions, with these changes persisting in the follow-up assessments. These findings suggest that interactive education fosters not only knowledge retention but also meaningful and sustained behavior change. Integrating interactive educational approaches into prenatal care could significantly benefit maternal and fetal health by preventing iodine deficiency and promoting healthy dietary practices. Recommendations Integration of Interactive Education in Prenatal Programs: Healthcare institutions should incorporate interactive education techniques into prenatal programs to improve knowledge, attitudes, and dietary practices among pregnant women, particularly concerning iodine intake and other essential nutrients. Routine Follow-Up for Sustained Impact: To maintain the positive effects of such interventions, routine follow-up sessions should be scheduled for pregnant women, ensuring long-term adherence to preventive practices related to iodine deficiency. Expansion to Other Nutritional Topics: The success of this educational approach warrants its expansion to cover other critical prenatal health issues, such as iron deficiency, gestational diabetes, and preeclampsia, to further support maternal and fetal health. Further Research: Future studies should examine the scalability and adaptability of interactive education techniques across various demographic settings and assess their cost-effectiveness. Further research could also explore the impact of family involvement in promoting positive dietary behaviors among pregnant women. Policy Development: Public health policies should prioritize innovative education programs in prenatal care, with sufficient funding allocated to training healthcare providers in delivering these interactive methods effectively. Declarations Acknowledgement: The authors sincerely thank all the pregnant women who participated in this study for their time, enthusiasm, and invaluable contributions. Funding : The authors had no funding for this study. Data availability: The data from which this manuscript was produced is with the corresponding author. It is available on request. Consent for publication: We sought permission from all the participants to publish the research findings . Competing interests: The authors of this study declare that they have no competing interests. Ethical considerations: Ethical approval for this study was granted by the Ethics Committee of the Nursing Faculty at Suez Canal University, under Ethics Review Board reference number 217-4/2022, issued in April 2022. Before the commencement of data collection, all participants provided informed consent and agreed to the publication of the study findings. References Chastnyk, O., Zoria, M., Poletay, O., Shumskyi, O., & Klochkova, Y. (2024). Exploring the influence of interactive education on academic progress: Evaluating effectiveness and implementation approaches. Multidisciplinary Reviews , 7 . https://azkurs.org/pars Orshanskyi, L., Krasnopolskyi, V., Fednova, I., Vysochan, L., Novalska, T., & Ivantsiv, O. (2020). 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Journal of Public Health Education, 45(2), 345–356. https://www.researchgate.net/ Kirkpatrick, J. D., & Kirkpatrick, W. K. (2016). Kirkpatrick's four levels of training evaluation . Association for Talent Development. https://books.google.com.sa/ Sharma, M., & Romas, J. A. (2021). Theoretical foundations of health education and health promotion (3rd ed.). Jones & Bartlett Learning. https://books.google.com.sa/ Wang, S., Li, X., & Zhang, Y. (2018). School-based interventions focusing on reproductive health education: A systematic review. Journal of School Health, 88 (5), 365–375. https://doi.org/10.1111/josh.12636 Li, W., Liao, J., Li, Q., Baskota, M., Wang, X., Tang, Y., ... & Liu, E. (2020). Public health education for parents during the outbreak of COVID-19: a rapid review. Annals of translational medicine , 8 (10). https://pmc.ncbi.nlm.nih.gov/ Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 10 Dec, 2024 Editor assigned by journal 06 Dec, 2024 Submission checks completed at journal 06 Dec, 2024 First submitted to journal 05 Dec, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5588752","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":387257707,"identity":"ec22fef9-ed15-4946-966a-92b3df75a29c","order_by":0,"name":"Heba Alkotb Mohamed","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6UlEQVRIiWNgGAWjYBACAwYeEHUARBg+YGyAsYnUYmxAshYzCaK0mLP3Hvx0o+KOvG5787Zq3h0Mcnw3Epg//MCjxbLnXLJ0zplnhtvOHCu7zXuGwVjyRgKbZA8+h93IMZDObTvMuO1Gjtlt3jaGxA1ALRDX4tJy/43xb6AW+23335gVA7XUA7Uwf/yD1xYeM5AtiduADGaglgSDGwkM0nhtOZOXZp1z5nDytjNpxZJzz0gYzjzzsE1aBp+W42cP386pOGy77fjhjR/e7rCR5zuefPjjGzxa0IEEEINjZxSMglEwCkYBJQAAQE9YXLUB6nEAAAAASUVORK5CYII=","orcid":"","institution":"Faculty of nursing, Suez Canal university","correspondingAuthor":true,"prefix":"","firstName":"Heba","middleName":"Alkotb","lastName":"Mohamed","suffix":""},{"id":387257709,"identity":"7574335e-6251-46e8-b3a4-4098b3f74857","order_by":1,"name":"Asmaa Abobakr Ibrahim","email":"","orcid":"","institution":"Faculty of nursing, Suez Canal university","correspondingAuthor":false,"prefix":"","firstName":"Asmaa","middleName":"Abobakr","lastName":"Ibrahim","suffix":""},{"id":387257720,"identity":"5e3fa62f-c57c-425b-b738-82fe8f7fab15","order_by":2,"name":"Farida Kamel Yousef","email":"","orcid":"","institution":"Faculty of nursing, Suez Canal university","correspondingAuthor":false,"prefix":"","firstName":"Farida","middleName":"Kamel","lastName":"Yousef","suffix":""},{"id":387257723,"identity":"9de0d6c9-5f61-4c11-a4c9-fa4bc5770f68","order_by":3,"name":"Ohood Alkaabi","email":"","orcid":"","institution":"College of Applied Medical Sciences, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Ohood","middleName":"","lastName":"Alkaabi","suffix":""},{"id":387257725,"identity":"396eca19-5ea1-4c61-8e38-19341bd5fcd9","order_by":4,"name":"Abdulaziz Asiri","email":"","orcid":"","institution":"College of Applied Medical Sciences, University of Bisha","correspondingAuthor":false,"prefix":"","firstName":"Abdulaziz","middleName":"","lastName":"Asiri","suffix":""}],"badges":[],"createdAt":"2024-12-05 17:23:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5588752/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5588752/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":70929275,"identity":"ca5d7f03-885c-4d42-b5f7-f289ddad5397","added_by":"auto","created_at":"2024-12-09 09:40:11","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":49061,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMean values of the dietary Practice Scale score related to rich iodine food for the control and study groups at three time points.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5588752/v1/3186fa453c4ed2239cc07771.png"},{"id":70930439,"identity":"a7c2a897-f18f-4186-ac83-e8fab0c68fa3","added_by":"auto","created_at":"2024-12-09 09:56:10","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1104304,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5588752/v1/36c9bdaf-a289-4f20-a3a4-2cd1b713b6bb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of Innovative Interactive Approaches to Educating Pregnant Women About Iodine Deficiency","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInteractive education techniques are powerful tools for enhancing health literacy, especially in maternal and child health \u003cb\u003e(\u003c/b\u003eChastnyk et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). These methods create a dynamic, participatory learning experience where healthcare professionals share information and actively involve pregnant women in confirming their understanding before proceeding with new topics \u003cb\u003e(\u003c/b\u003eOrshanskyi et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Interactive education doesn\u0026rsquo;t simply assess comprehension; it also encourages positive attitude shifts toward preventive health behaviors, a critical factor during pregnancy when health risks are elevated \u003cb\u003e(\u003c/b\u003eGarrison et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePregnant women face multiple potential complications, including preterm birth, preeclampsia, gestational diabetes, and iodine deficiency disorders, each of which poses significant risks to maternal and infant health. Such issues can lead to severe outcomes like miscarriage or developmental issues in infants, underscoring the importance of preventive education \u003cb\u003e(\u003c/b\u003eJibril et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Specifically, iodine deficiency is a major concern, as it can result in preterm birth, congenital abnormalities, or intellectual and physical developmental delays in infants. In severe cases, iodine deficiency causes hypothyroidism, which can lead to lifelong disabilities \u003cb\u003e(\u003c/b\u003eSayed, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2024\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe need for iodine increases significantly during pregnancy due to factors such as the heightened demand for maternal thyroid hormone production, the transfer of iodide to the fetus, and increased renal clearance, all of which contribute to a higher risk of iodine deficiency disorders \u003cb\u003e(\u003c/b\u003eJohn et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). To mitigate these risks, the World Health Organization (WHO) recommends a daily iodine intake of 230\u0026ndash;260 micrograms during pregnancy and lactation, achievable through iodine-rich foods such as fish, dairy, iodized salt, and specific vegetables \u003cb\u003e(\u003c/b\u003eBath et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Monitoring iodine levels through urinary iodine concentration is also suggested, as it reflects recent intake, aiding in early identification of deficiency risks \u003cb\u003e(\u003c/b\u003eMonaghan et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e Despite the availability of guidelines, many pregnant women may struggle to achieve recommended iodine intake, placing them at heightened risk of deficiency and its consequences. Here, interactive education techniques offer a significant advantage. By involving pregnant women in an engaging process of discussing and confirming understanding, these techniques encourage active learning and help reinforce essential health practices. Interactive education thus becomes a critical strategy in empowering women to make informed choices regarding their iodine intake and overall health during pregnancy, potentially reducing the incidence of iodine deficiency disorders and related complications \u003cb\u003e(\u003c/b\u003eLevie, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2020\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e"},{"header":"Significance of the study","content":"\u003cp\u003eUnderstanding iodine deficiency among pregnant women in Egypt is crucial due to its significant implications for both maternal and fetal health. Adequate iodine intake during pregnancy is essential for proper fetal brain development, thyroid function, and overall growth. Low awareness and knowledge about iodine deficiency can lead to preventable health complications, including developmental delays and intellectual impairments in children. By enhancing pregnant women\u0026rsquo;s knowledge of iodine deficiency, this study lies in its potential to improve prenatal health education by assessing the effectiveness of innovative interactive techniques in raising awareness about iodine deficiency among pregnant women in Egypt. This research could offer important insights into enhancing educational strategies, ultimately supporting better health outcomes for mothers and their babies by addressing a critical nutrient deficiency.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim of the study:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo evaluate the innovative interactive approaches to educating pregnant women about iodine deficiency through enhancing pregnant women\u0026rsquo;s knowledge, practices, and attitudes of iodine deficiency.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHypotheses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eH1\u003c/strong\u003e: Pregnant women who receive innovative interactive education on iodine deficiency will show a greater increase in knowledge scores from pretest to post-test compared to those receiving standard education.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eH2\u003c/strong\u003e: Pregnant women in the innovative interactive education group will exhibit a greater improvement in positive attitudes toward dietary iodine intake compared to those in the control group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research was conducted with a quasi-experimental design, a significant choice that allowed for a comprehensive assessment of changes in knowledge, attitudes, and practices regarding iodine deficiency among pregnant women. The two-group matched pretest, post-test, and follow-up test structure was instrumental in comparing the effectiveness of an intervention group, which received innovative interactive education techniques, with a control group that received standard education. The thoroughness of the research design is evident in its structure and methodology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample and Sampling Method\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003ePopulation:\u0026nbsp;\u003c/strong\u003ePregnant women attending prenatal clinics at the Suez Canal University Hospital\u0026apos;s obstetrical outpatient clinic, which has a dedicated facility for routine prenatal care.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSample Size\u003c/strong\u003e: The total sample size was 132, according to Cohen (1988), with 66 participants per group. Effect Size and Statistical Power: Confirmed the use of partial eta squared (\u0026eta;2\\eta^2\u0026eta;2) to clarify the effect size measure. Power and Significance Level Notation: Specified the power as \u0026quot;0.95 (95%)\u0026quot; and the significance level as \u0026alpha;=0.05\\alpha = 0.05\u0026alpha;=0.05 for clarity and to align with standard statistical reporting practices.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eRevised Sampling and Criteria Description:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy participants were selected using a purposive sampling technique, based on the following inclusion and exclusion criteria:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion Criteria:\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003ePrimigravid women, regardless of age or educational level.\u003c/li\u003e\n \u003cli\u003eWomen recruited during their first trimester of pregnancy.\u003c/li\u003e\n \u003cli\u003eParticipants who provided informed consent agreed to comply with study requirements.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion Criteria:\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003ePregnant women with a history of chronic health conditions (e.g., hypothyroidism, diabetes).\u003c/li\u003e\n \u003cli\u003eIndividuals who declined participation in the training intervention\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eTools for data collection:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTool I: The demographic and Baseline Data Collection Forms are meticulously designed to\u003c/strong\u003e gather a comprehensive understanding of the participants\u0026apos; profiles. These forms, which cover a wide range of factors, including age, education level, socioeconomic status, and gestational age, are crucial in establishing a thorough understanding of the participants\u0026apos; backgrounds, thereby clarifying their role in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTool II: The pre- and Post-Intervention Knowledge Questionnaire, a valuable tool, was\u0026nbsp;\u003c/strong\u003eadministered to participants before and after the educational intervention. \u003cstrong\u003eThis questionnaire allows us to measure changes in knowledge about iodine deficiency.\u003c/strong\u003e The questionnaire is designed to engage participants with a variety of question types, including Multiple-choice questions (MCQs), True/False questions and Short-answer questions, assessing knowledge of iodine\u0026apos;s role in pregnancy, sources of iodine, symptoms of iodine deficiency, and its impact on maternal and fetal health \u003cstrong\u003e(Alimohammadi et al. (2019) and (Lee et al.,2020).\u003c/strong\u003e The scoring\u003cstrong\u003e\u0026nbsp;system\u003c/strong\u003e for each type of question is as follows: \u003cstrong\u003eMultiple-Choice Questions (MCQs) and true and false-each\u003c/strong\u003e \u003cstrong\u003ecorrect answer\u003c/strong\u003e earns a point, and each \u003cstrong\u003eincorrect answer\u003c/strong\u003e earns zero points. For short-answer questions, the \u003cstrong\u003escoring system\u003c/strong\u003e was\u003cstrong\u003e\u0026nbsp;as follows\u003c/strong\u003e: \u003cstrong\u003eFull answer with all key points\u003c/strong\u003e = 2 points, \u003cstrong\u003ePartial answer (correct but lacks some details)\u003c/strong\u003e = 1 point and \u003cstrong\u003eIncorrect or no answer\u003c/strong\u003e = 0 points.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePre-test and Post-test Comparison\u003c/strong\u003e: After scoring both the pre- and post-intervention tests, compare the scores to determine knowledge improvement. You can calculate the percentage change in scores for each participant or for the entire sample.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge Improvement Calculation:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/58895_8739fc6c57c1c19a/58895_custom_files/img1733736699.png\" width=\"676\" height=\"61\"\u003e\u003c/p\u003e\n\u003cp\u003eThe Categorizing Knowledge Levels categorize participants\u0026apos; knowledge levels based on their scores: Low Knowledge: 0-40% of the total possible score, Moderate Knowledge: 41-70% of the total possible score and High Knowledge: 71-100% of the total possible score.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTool III: Dietary Practices Changes, which includes:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA) Dietary Practices:\u003c/strong\u003e Measure changes in dietary behaviors related to iodine-rich food consumption, such as increased intake of iodized salt, seafood, dairy products, or sea vegetables.\u003c/p\u003e\n\u003cp\u003eFor instance, you can use Food frequency questionnaires (FFQs) or self-reported dietary logs to assess iodine-rich food intake before and after the program. These tools provide a comprehensive view of participants\u0026apos; dietary habits and can help in evaluating the effectiveness of the intervention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eB) Salt Usage Behavior:\u003c/strong\u003e It\u0026apos;s vital to track whether participants are more likely to use iodized salt or prefer natural sources of iodine after the education. This data is invaluable in understanding the effectiveness of our intervention. Example: Surveys on salt preference (iodized vs. non-iodized).\u003c/p\u003e\n\u003cp\u003eTo comprehensively assess \u003cstrong\u003ebehavioral changes\u003c/strong\u003e in dietary practices related to iodine intake among pregnant women, we have developed a \u003cstrong\u003escoring system\u003c/strong\u003e. This system, based on their responses in a \u003cstrong\u003epre-and post-education questionnaire\u003c/strong\u003e, is a crucial and practical tool. It includes components such as dietary practices, salt usage behavior, and iodine supplementation adherence, providing a deep understanding of the changes. Assign points based on the selected frequency of each iodine-rich food item (e.g., iodized salt, seafood, dairy, sea vegetables, eggs). Add up the points for each food category: \u003cstrong\u003eTotal possible score\u003c/strong\u003e: 0 (no intake) to 20 (daily intake of all food items). \u003cstrong\u003eInterpretation\u003c/strong\u003e: 0\u0026ndash;5 points: Low iodine-rich food intake, 6\u0026ndash;10 points: Moderate iodine-rich food intake, 11\u0026ndash;15 points: High iodine-rich food intake, and 16\u0026ndash;20 points: Very high iodine-rich food intake.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTool V: Attitude Toward Iodine Deficiency Prevention:\u0026nbsp;\u003c/strong\u003eMeasure changes in the participants\u0026apos; attitudes toward iodine deficiency prevention, including the perceived importance of iodine intake during pregnancy based on\u003cstrong\u003e\u0026nbsp;(Basilious \u0026amp; Salim 2019)\u0026nbsp;\u003c/strong\u003e. Focus on five parts:\u003c/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eBeliefs and Awareness.\u003c/li\u003e\n \u003cli\u003ePerceived Importance of Iodine Deficiency Prevention.\u003c/li\u003e\n \u003cli\u003eConfidence and Self-Efficacy.\u003c/li\u003e\n \u003cli\u003eMotivation and Willingness to Act.\u003c/li\u003e\n \u003cli\u003ePerceived Support and Information Needs.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eInterpretation of the scores from the \u0026apos;Attitude Toward Iodine Deficiency Prevention\u0026apos; questionnaire is as follows: Each question in the questionnaire is scored as follows: strongly Disagree (1 point), disagree (2 points), neutral (3 points), agree (4 points), and strongly agree (5 points). With 16 questions, the total possible score ranges from 16 to 80 points. A score of 16\u0026ndash;32 indicates a Low attitude, 33\u0026ndash;48 a Moderate Attitude, 49\u0026ndash;64 a Positive Attitude, and 65\u0026ndash;80 a Strong Proactive Attitude.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTools validity and reliability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe instrument used in this study was confirmed to be both valid and reliable. Experts in community health nursing from multiple universities reviewed the questionnaire. The reliability testing, conducted with 13 pregnant women who were not part of the main sample, was not only comprehensive but also thorough, providing a strong assurance of the instrument\u0026apos;s effectiveness. No modifications to the instrument were necessary, as participants found the content clear and understandable. With an internal consistency of 0.7, as indicated by Cronbach\u0026apos;s alpha, the instrument was considered a dependable measure, assessing knowledge, Behavioral Changes and Attitude Toward Iodine Deficiency Prevention.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study, with ethical approval from the Faculty of Nursing Ethics Committee, Suez Canal University, in April 2022 (Reference No. 217-4/2022). The letter from the faculty dean to the Director of the Suez Canal University Hospital, Outpatient Clinics for Obstetrics and Gynecology, clarified the objectives and importance of the study. The researchers made a firm commitment to adhere to the approved protocol, submit any amendments for re-evaluation, and ensure monitoring throughout the study. This commitment is a testament to our dedication to protect the rights and well-being of the participants and address any concerns that may arise. Informed consent was obtained from the participants after fully informing them of the objectives and procedures of the study, ensuring that potential risks are low and their right to withdraw at any time without consequences. We reiterate our commitment to protecting the rights of our participants, ensuring the highest ethical standards and participant safety in our study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedures:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1. Preparing and planning:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study objectives were clearly outlined, focusing on assessing changes in knowledge, behavioral attitudes, and practices related to iodine deficiency. Interactive educational materials were developed, including videos, quizzes, digital applications, and printed materials tailored to the needs of pregnant women. The research was conducted with the utmost respect for ethical standards, as evidenced by the rigorous process of obtaining ethical approval in April 2022 (Ref. No. 217-4/2022), particularly regarding pregnant participants. This process ensures the integrity of the research and the protection of participants\u0026apos; rights. Notably, the study placed a strong emphasis on the role of facilitators, who were trained to deliver interactive education effectively, address participants\u0026apos; questions, and manage data collection tools.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eParticipant Recruitment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe researchers aimed to engage pregnant women who met the inclusion criteria from prenatal clinics at Suez Canal University Hospital. They appreciated the participation of eligible women in the study, which invited them to join educational sessions. After explaining the study\u0026rsquo;s purpose, procedures, and confidentiality assurances [insert confidentiality assurances here], the researchers obtained informed consent from the participants. Following consent, they ensured fairness in the process by randomly assigning participants to either the intervention or control group using a simple randomization method with a random number generator (assigning even numbers to the intervention group and odd numbers to the control group), thereby providing participants with a sense of security.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eBaseline Data Collection:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe researchers conducted baseline data collection by administering a pre-test questionnaire to assess participants\u0026apos; initial knowledge, attitudes, and dietary behaviors related to iodine deficiency. They gathered demographic information, including age, education level, and pregnancy stage, to understand participant backgrounds and enable subgroup analysis. Additionally, they documented baseline iodine intake using a food frequency questionnaire or dietary log.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4. Intervention Delivery: Innovative Interactive Education Techniques\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe researchers delivered the intervention using \u003cstrong\u003eInnovative Interactive Education Techniques\u003c/strong\u003e: \u003cstrong\u003eEducation Sessions\u003c/strong\u003e: They scheduled group sessions, either in-person or virtual, focusing on interactive learning. Each session lasted about 1\u0026ndash;2 hours. \u003cstrong\u003eMultimedia Presentations\u003c/strong\u003e: Videos and animations were shown to explain the significance of iodine for maternal and fetal health, enlightening the participants with a clear understanding of the complex concepts. \u003cstrong\u003eInteractive Tools\u003c/strong\u003e: Participants engaged with apps, quizzes, and gamified learning activities to reinforce their knowledge. \u003cstrong\u003eHands-on Practice\u003c/strong\u003e: Iodine-rich foods and supplements were demonstrated, and participants were guided to recognize these items within their diets. \u003cstrong\u003eGroup Discussions\u003c/strong\u003e: Facilitators led peer discussions on challenges and solutions related to maintaining adequate iodine intake. \u003cstrong\u003eReminders and Reinforcement\u003c/strong\u003e: Participants received follow-up messages via texts or emails with crucial points to reinforce the learning outcomes.\u003c/p\u003e\n\u003cp\u003e5. \u003cstrong\u003eImmediate Post-Intervention Assessment:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAssessment Immediately following the education session, researchers administered a short quiz to assess knowledge retention. They also evaluated any changes in attitudes and intended behaviors regarding iodine intake. Additionally, a brief survey was used to collect participants\u0026rsquo; feedback on the education techniques and their perceived effectiveness.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6.Follow-Up Assessment:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFour to six weeks after the intervention, the researchers conducted a follow-up assessment to evaluate long-term retention and any sustained behavioral changes in dietary practices related to iodine intake. They re-administered the knowledge questionnaire to measure retained knowledge. Dietary practices and salt preferences were also reassessed to identify ongoing changes in behavior. Additionally, optional qualitative interviews were conducted with a small subset of participants to gain deeper insights into the program\u0026rsquo;s impact on their beliefs and behaviors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7.Data Analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe researchers conducted a data analysis involving both quantitative and qualitative methods. \u003cstrong\u003eFor the quantitative analysis\u003c/strong\u003e, they compared pre- and post-intervention scores using paired t-tests or Wilcoxon signed-rank tests to evaluate significant gains in knowledge. \u003cstrong\u003eFor behavioral changes\u003c/strong\u003e, they assessed alterations in dietary practices and attitudes toward iodine intake, calculating proportions or averages as appropriate. \u003cstrong\u003eFor the qualitative analysis\u003c/strong\u003e, they performed a thematic analysis on participant feedback to identify perceptions of the program\u0026rsquo;s strengths and areas needing improvement.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eTable (1); Sociodemographic Characteristics of Control and Study Groups\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"629\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eItems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 191px;\"\u003e\n \u003cp\u003eControl group (n=61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003eStudy \u0026nbsp;group (n=61)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e12.12%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e21.21%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp; 25-30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e45.45%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e39.39%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp; 31-35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e37.88%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e34.85%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp; 36-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e4.55%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4.55%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eRange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e18.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e37.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e38.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eMean, SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 191px;\"\u003e\n \u003cp\u003e29.42\u0026plusmn;4.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 213px;\"\u003e\n \u003cp\u003e28.79\u0026plusmn;4.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eEducation level:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp; Illiterate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e39.39%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.03%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp; Intermediate level\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e43.94%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e87.88%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eHigh level\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e16.67%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e9.09%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eOccupation:\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eWorked\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e31.82%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e74.24%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp;Housewife \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e50.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e21.21%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp;Student\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e18.18%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4.55%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eResidence\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eUrban\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e81.82%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e95.45%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eRural\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e18.18%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4.55%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003e\u0026nbsp;Enough\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e48.48%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e21.21%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 225px;\"\u003e\n \u003cp\u003eNot enough\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 89px;\"\u003e\n \u003cp\u003e51.52%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 109px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e78.79%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThis table presents a comparison of key sociodemographic factors between the control and study groups. Variables include age distribution, education level, occupation, residence, and income status. Age ranges from 18 to 45 years, with a majority of participants in both groups aged between 25 and 35 years. The study group shows higher levels of intermediate education and employment compared to the control group, where a larger proportion are housewives. Additionally, the study group has a greater urban representation and a higher percentage of participants reporting insufficient income. These differences may influence group responses to health interventions related to iodine deficiency prevention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (2); Comparison of total scores of knowledges regarding iodine deficiency during pregnancy between Control and Study Groups at Pre, Immediate Post, and Follow-up Time Points\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"679\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 185px;\"\u003e\n \u003cp\u003eKnowledge scale items\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 153px;\"\u003e\n \u003cp\u003eControl Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eStudy Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003csup\u003ea\u003c/sup\u003et\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 92px;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 91px;\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 185px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003e32.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e12.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 91px;\"\u003e\n \u003cp\u003e23.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e4.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0.00003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 185px;\"\u003e\n \u003cp\u003eImmediate Post\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003e33.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e12.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e93.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 91px;\"\u003e\n \u003cp\u003e10.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e-29.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0.00000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 185px;\"\u003e\n \u003cp\u003eFollow-up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003e34.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e13.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e92.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 91px;\"\u003e\n \u003cp\u003e8.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e-28.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e0.00000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 185px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003csup\u003eb\u003c/sup\u003eF\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 153px;\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003e501.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 185px;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 153px;\"\u003e\n \u003cp\u003e0.75517 (NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003e0.00000 (HS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 91px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 92px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-bottom: 10px !important; color: rgb(0, 0, 0); font-family: \"Times New Roman\"; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;'\u003e\u003cem\u003ea independent samples t test for comparing the two groups\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp style='margin-bottom: 10px !important; color: rgb(0, 0, 0); font-family: \"Times New Roman\"; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(255, 255, 255); text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;'\u003e\u003cem\u003eb One way Anova comparing pre,post and follow-up within each group\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe data in Table (2) demonstrates that at the pre-intervention stage, the study group had significantly lower knowledge levels than the control group, indicating a baseline gap. This sets a crucial starting point for evaluating the intervention\u0026rsquo;s effect, as the study group began at a knowledge disadvantage. However, after the intervention, as shown in the same table 2, the study group\u0026apos;s knowledge scores exhibited a remarkable and statistically significant increase compared to the control group. The mean score difference of 60.17 (93.18 - 33.01) underlines the immediate and substantial improvement in knowledge due to the interactive education techniques, which should excite the audience about the intervention\u0026apos;s impact. The low p-value (\u0026lt;0.001) reinforces the intervention\u0026rsquo;s effectiveness, indicating the observed changes are not due to chance. The study group maintained high knowledge scores at the follow-up time point, demonstrating the sustained impact of the intervention. The persistence of the knowledge gap between the control and study groups (Mean Difference = 57.79) indicates that the benefits of the interactive education techniques extend beyond the immediate post-intervention period. The \u003csup\u003eb\u003c/sup\u003eF scores further illustrate the profound effect of the intervention, with the control group experiencing negligible change, as reflected in the non-significant p-value, and the study group showing substantial and statistically significant improvement.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFigure (1) demonstrates that the significant improvement in dietary practices immediately post-intervention and at follow-up in the study group highlights the efficacy of the educational intervention in promoting healthier nutritional behaviors related to iodine-rich foods. Despite a slight reduction in the study group\u0026rsquo;s scores from the immediate post-intervention to the follow-up, the substantial improvement from baseline reaffirms the lasting impact of the intervention.The control group showed negligible changes in dietary practices over time, indicating that without intervention, dietary habits remain static.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (3); Comparison of attitude toward iodine deficiency prevention Between Control and Study Groups at Pre, Immediate Post, and Follow-up Time Points\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"636\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 148px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eControl Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 163px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003et\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e36.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e40.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e10.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.04846\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eImmediate Post\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e42.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e99.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e3.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-56.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.00000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e43.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e7.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003e99.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e-54.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.00000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csub\u003e\u0026nbsp;\u003c/sub\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eF\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 157px;\"\u003e\n \u003cp\u003e13.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 163px;\"\u003e\n \u003cp\u003e1728.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.00000 (\u003cstrong\u003eHS)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 163px;\"\u003e\n \u003cp\u003e0.00000 \u003cstrong\u003e(HS)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003ea independent samples t test for comparing the two groups\u003c/p\u003e\n\u003cp\u003eb One way Anova comparing pre,post and follow-up within each group\u003c/p\u003e\n\u003cp\u003eTable (3) shows that the difference (Mean Difference = -1.99, p = 0.04846) in pre-intervention scores show a small \u0026nbsp;the two groups \u0026nbsp; , with the study group having a slightly more favorable attitude toward iodine deficiency prevention at baseline. Following the intervention, the study group exhibits a remarkable and dramatic increase in mean attitude scores to 99.62 SD3.08, significantly surpassing the control group. The highly significant p-value (\u0026lt;0.001) indicates that this improvement is not due to chance. The sharp increase, a testament to the effectiveness of the interactive education techniques, suggests that positive change is indeed possible in attitudes toward iodine deficiency prevention.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eInnovative Interactive Education Techniques are a powerful tool for health education, particularly in improving knowledge, attitudes, and practices related to dietary habits. Their ability to engage learners actively, provide personalized experiences, and most importantly, ensure long-term behavior change, makes them vital to modern public health strategies( \u003cstrong\u003eAlvarez \u0026amp; Risko 2020)\u003c/strong\u003e. To achieve sustainable health outcomes, these techniques should be prioritized in addressing nutrition-related challenges, including iodine deficiency.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study demonstrates the significant impact of innovative interactive education techniques on pregnant women\u0026rsquo;s knowledge of iodine deficiency. These techniques effectively improve knowledge retention, surpassing traditional methods. The findings align with existing literature advocating for interactive and tailored educational approaches to address nutritional deficiencies and support sustainable health outcomes. The findings align with \u003cstrong\u003eWang et al. (2018)\u003c/strong\u003e, who reported that interactive educational programs significantly improved participants\u0026apos; knowledge of micronutrient deficiencies, particularly iodine deficiency. Similar to this study, the intervention group in Wang et al.\u0026apos;s research retained higher knowledge levels at follow-up. \u003cstrong\u003eLi et al. (2020)\u003c/strong\u003e also observed that tailored educational methods are more effective than traditional approaches in addressing nutritional deficiencies. This supports the dramatic improvement seen in the study group compared to the control group. The lack of improvement in the control group highlights the limited efficacy of standard educational practices, as discussed by \u003cstrong\u003eSharma and Romas (2021)\u003c/strong\u003e, who advocate for more interactive and engaging methods.\u003c/p\u003e\n\u003cp\u003eThe results of this study demonstrate the effectiveness of innovative interactive education techniques in improving dietary practices related to iodine-rich foods. The substantial and sustained improvements in the study group highlight the potential of such interventions to address nutrition-related public health challenges. These findings align with other studies advocating for participatory and tailored educational approaches to achieve sustainable health outcomes.\u0026nbsp;The findings align with previous research emphasizing the role of interactive education techniques in promoting dietary changes as\u0026nbsp;\u003cstrong\u003eLim and Lee (2019)\u003c/strong\u003e conducted a meta-analysis that demonstrated significant improvements in dietary habits following interactive nutritional education interventions, similar to the improvements seen in the study group here.\u0026nbsp;\u003cstrong\u003eSharma and Romas (2021)\u003c/strong\u003e emphasize that tailored, participatory educational approaches can lead to lasting behavioral changes, consistent with the sustained improvements observed in the study group.\u003c/p\u003e\n\u003cp\u003eInteractive education techniques are highly effective in improving and sustaining positive attitudes toward iodine deficiency prevention. Their success lies in engaging participants actively, which enhances understanding and personal relevance. These results advocate for the incorporation of interactive methods into public health education programs to maximize impact and foster long-term attitude changes. The success of interactive education in this context also mirrors the conclusions of \u003cstrong\u003eSharma and Romas (2021)\u003c/strong\u003e, who emphasized that health education grounded in participatory methods enhances self-efficacy, motivation, and long-term commitment to health practices. This is particularly important in addressing nutritional challenges like iodine deficiency, as attitudes play a critical role in dietary decision-making and adherence to preventive measures. Finally, the sustainability of attitudinal improvements observed in this study is comparable to findings by \u003cstrong\u003eKirkpatrick and Kirkpatrick (2016)\u003c/strong\u003e, who outlined the importance of engagement and feedback in education to achieve long-term outcomes. The significant difference in attitude scores between the intervention and control groups during follow-up underscores the enduring impact of interactive education techniques, supporting their broader application in public health initiatives.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study concludes that innovative interactive education techniques are highly effective in enhancing pregnant women\u0026apos;s knowledge, attitudes, and practices regarding iodine deficiency. The intervention group demonstrated substantial improvements immediately after the education sessions, with these changes persisting in the follow-up assessments. These findings suggest that interactive education fosters not only knowledge retention but also meaningful and sustained behavior change. Integrating interactive educational approaches into prenatal care could significantly benefit maternal and fetal health by preventing iodine deficiency and promoting healthy dietary practices.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations\u003c/strong\u003e\u003c/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003e\u003cstrong\u003eIntegration of Interactive Education in Prenatal Programs:\u003c/strong\u003e Healthcare institutions should incorporate interactive education techniques into prenatal programs to improve knowledge, attitudes, and dietary practices among pregnant women, particularly concerning iodine intake and other essential nutrients.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eRoutine Follow-Up for Sustained Impact:\u003c/strong\u003e To maintain the positive effects of such interventions, routine follow-up sessions should be scheduled for pregnant women, ensuring long-term adherence to preventive practices related to iodine deficiency.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eExpansion to Other Nutritional Topics:\u003c/strong\u003e The success of this educational approach warrants its expansion to cover other critical prenatal health issues, such as iron deficiency, gestational diabetes, and preeclampsia, to further support maternal and fetal health.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eFurther Research:\u003c/strong\u003e Future studies should examine the scalability and adaptability of interactive education techniques across various demographic settings and assess their cost-effectiveness. Further research could also explore the impact of family involvement in promoting positive dietary behaviors among pregnant women.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003ePolicy Development:\u003c/strong\u003e Public health policies should prioritize innovative education programs in prenatal care, with sufficient funding allocated to training healthcare providers in delivering these interactive methods effectively.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement:\u0026nbsp;\u003c/strong\u003eThe authors sincerely thank all the pregnant women who participated in this study for their time, enthusiasm, and invaluable contributions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: The authors had no funding for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability:\u003c/strong\u003e The data from which this manuscript was produced is with the corresponding author. It is available on request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eWe sought permission from all the participants to publish the research findings\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors of this study declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was granted by the Ethics Committee of the Nursing Faculty at Suez Canal University, under Ethics Review Board reference number 217-4/2022, issued in April 2022. Before the commencement of data collection, all participants provided informed consent and agreed to the publication of the study findings.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eChastnyk, O., Zoria, M., Poletay, O., Shumskyi, O., \u0026amp; Klochkova, Y. (2024). Exploring the influence of interactive education on academic progress: Evaluating effectiveness and implementation approaches. \u003cem\u003eMultidisciplinary Reviews\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e. https://azkurs.org/pars\u003c/li\u003e\n\u003cli\u003eOrshanskyi, L., Krasnopolskyi, V., Fednova, I., Vysochan, L., Novalska, T., \u0026amp; Ivantsiv, O. (2020). Interactive teaching methods as a change in the purpose of modern education. \u003cem\u003eSystematic Reviews in Pharmacy\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(10), 549-555. https://d1wqtxts1xzle7.cloudfront.net/\u003c/li\u003e\n\u003cli\u003eGarrison, E., Colin, S., Lemberger, O., \u0026amp; Lugod, M. 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Public health education for parents during the outbreak of COVID-19: a rapid review. \u003cem\u003eAnnals of translational medicine\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(10). https://pmc.ncbi.nlm.nih.gov/\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-health-population-and-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"johp","sideBox":"Learn more about [Journal of Health, Population and Nutrition](http://jhpn.biomedcentral.com/)","snPcode":"41043","submissionUrl":"https://submission.nature.com/new-submission/41043/3","title":"Journal of Health, Population and Nutrition","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-5588752/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5588752/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePregnant women are vulnerable to iodine deficiency, which poses risks to maternal and fetal health. Preventive education on iodine intake is essential to reduce these risks. This quasi-experimental study evaluated the effectiveness of innovative interactive education techniques on pregnant women\u0026rsquo;s knowledge, attitudes, and practices (KAP) regarding iodine deficiency. A total of 132 pregnant women attending Suez Canal University Hospital clinics were divided into an intervention group, which received interactive education, and a control group, which received standard education. The intervention included multimedia presentations, group discussions, and digital tools focused on the importance of iodine. Results indicated significant improvements in knowledge, attitudes, and dietary practices related to iodine intake in the intervention group, with sustained effects at follow-up. These findings highlight the potential of interactive education in promoting preventive health behaviors among pregnant women.\u003c/p\u003e","manuscriptTitle":"Effect of Innovative Interactive Approaches to Educating Pregnant Women About Iodine Deficiency","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-09 09:40:05","doi":"10.21203/rs.3.rs-5588752/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-12-10T17:02:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-12-06T19:31:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-12-06T19:30:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Health, Population and Nutrition","date":"2024-12-05T17:20:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-health-population-and-nutrition","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"johp","sideBox":"Learn more about [Journal of Health, Population and Nutrition](http://jhpn.biomedcentral.com/)","snPcode":"41043","submissionUrl":"https://submission.nature.com/new-submission/41043/3","title":"Journal of Health, Population and Nutrition","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b42d7d05-933f-4ceb-8db6-ca39ce3a1dd3","owner":[],"postedDate":"December 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-01-17T09:23:50+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-09 09:40:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5588752","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5588752","identity":"rs-5588752","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}