R. Gopal and T. Chand (2017) Int. J. Soc. Sc. Manage. Vol.

4, Issue-3: 192-197
DOI: 10.3126/ijssm.v4i3.17561

Research Article

A Study to Assess the Effectiveness of Structured Teaching Programme on

Knowledge Regarding Prevention of Anemia among Adolescent Girls in A
Selected Senior Secondary Schools of, Bharatpur
Ram Gopal* and Tara Chand
Department of Medical Surgical Nursing Shree Digamber College of Nursing Bharatpur India
Corresponding author’s email: tarachandch@gmail.com

Abstract
Anemia is a condition in which the number of red blood cells or the amount of hemoglobin is low. Red blood cells contain
hemoglobin protein that it enables them to carry oxygen from the lungs and deliver it to all parts of the body. A study conducted
to assess the effectiveness of structured teaching programme on knowledge regarding prevention of anemia among adolescent
girls in a selected senior secondary schools of Bharatpur. During the study, 60 adolescence girls were selected for them pretest
is administered for assessing knowledge. After evaluation pretest score was showing lower knowledge regarding prevention of
anemia then structured teaching program on knowledge of prevention from anemia administered after one week post test
conducted by using same questionnaire this time girls shows increased knowledge regarding prevention of anemia and they are
following healthy food habits for the prevention of anemia. Results showing adequate knowledge various methods are used for
measuring the variables such as mean, mode, and standard deviation for significance of demographic variables chi square test
were used there is no significant demographic variables.

Keywords: - Knowledge; prevention of anemia; adolescent girls

Introduction their cognitive performance and growth. At all levels, the

Anemia is a condition in which the number of red blood negative effects of anemia during adolescence justify public
cells or the amount of hemoglobin is low. Red blood cells health action; unfortunately because initiatives to prevent
contain hemoglobin protein that it enables them to carry anemia commonly target infants, young children and
oxygen from the lungs and deliver it to all parts of the body. pregnant and lactating women, and not necessarily
When the number of red blood cells is reduced or the adolescents the needs of adolescents may remain unmet,
amount of hemoglobin in them is low, the blood cannot and the consequences of anemia in adolescents. Iron –
carry an adequate supply of oxygen. An inadequate supply deficiency anemia is a serious public – health concern in
of oxygen in the tissues produces the symptoms of anemia most developing countries. Iron deficiency anemia is
(Gupta and Kochar, 2009). Adolescence has been defined estimated to cause 591,000 prenatal deaths and 115,000
by the world health organization as the period of life maternal deaths globally (Meier et al., 2003). Prevalence of
spanning the ages between 10 to 19 years (WHO, 2017). anemia in South Asia is among the highest in the world,
This is the formative period of life when the maximum mirroring overall high rates of malnutrition (Steven and
amount of physical, psychological, and behavioral changes Abrams, 2008). Anemia remains a major cause of mortality
take place. That is a vulnerable period in the human life and morbidity in developing countries where resources to
cycle for the development of nutritional anemia, which has determine the underlying etiology remain poor. There are
been constantly neglected by public health programmers. three basic mechanisms for developing anemia, namely: (i)
During adolescence, (i.e. 10-19 years of age, anemia is blood loss (hemorrhage); (ii) decreased production of red
estimated to be the greatest nutritional problem. Anemia in cells; and (iii) increased destruction of red cells and
adolescents and young adults can have negative effects on mortality. Adolescent girls who are potential mothers and

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R. Gopal and T. Chand (2017) Int. J. Soc. Sc. Manage. Vol. 4, Issue-3: 192-197
future homemakers constitute an important part of our Part I: the demographic variables had a total of 6 items. It
society. includes regarding Age, class of study, Religion, Age of
menarche Educational status Dietary Pattern.
Materials and Method
This chapter deals with description of methodology and Parts II: Self administered knowledge questionnaire
different steps, which are under taken for collecting and regarding use of the Anemia. It consists of 30 items which
organizing data for investigation. A Questionnaire (pre were divided into three parts namely:
experimental one group pre-test post- test) research design  General questions regarding blood.
was adopted for the study. In the study, the base measure  General knowledge regarding causes, signs and
was structured questionnaire to assess the knowledge of symptoms.
adolescent girls regarding prevention & management of
 Knowledge questions regarding treatment and
anemia. Research approach is the most significant part of
prevention of anaemia.
any research. An evaluative research approach was
considered the best to assess the knowledge on prevention Each correct answer was given a score of one and the wrong
of anemia among adolescent girls .Variables are answer was assigned a score of zero. The maximum score
characteristics that vary among the subjects being studied. for the structured questionnaire was 30.
There are two types of variables were identified in this
The resulting scores were ranged as follows
study. They are research variables and demographic
variables. Knowledge regarding prevention of anemia It 1. Adequate knowledge-Above 75%
contains baseline characteristic of adolescent girls such as 2. Moderately adequate knowledge-51-75%
Age, class of study, Religion, Age of menarche 3. In adequate knowledge-below- ≤50%
Educational status Dietary Pattern. The population of the
present study comprises of adolescent girls living at Sr. Sec. Development of STP
School, Bharatpur. The setting refers to the physical Teaching program is the plan of action of a teacher, which
location and conditions where data collection takes place. includes the working philosophy of a teacher, his
The study was conducted in the selected school, Bharatpur. knowledge, information about and understanding of his
The setting was chosen on the basis of feasibility in terms pupils, his comprehension of the objectives of education,
of availability of the subjects. Sample is subset of his knowledge of the material to be taught and his ability to
population. The sample size is 60 adolescent girls who were utilize effective methods.
available at the time of data collection and who fulfill the Steps involved in the development of STP
inclusion criteria Sampling technique is an important step 1. Laying out a teaching plan.
in the research process of selecting reprehensive units or 2. Preparing an outline of the contents.
subsets of population of the study in a research. Simple 3. Deciding methods for instruction.
random sampling technique was used to select the sample. 4. Development of audio- visual aids.
The investigator selected the samples from selected School, 5. Development of criteria check list
Bharatpur. Pre-testing is the process of measuring the 6. Content validation of STP
effectiveness of an instrument. Reliability of the tool is the
degree of consistency with which it measures the attributes Contents in STP
it is supposed to measure. It refers to the extent to which the  Define anemia
same result is obtained on repeated administration of the  Incidence of anemia
instrument.  causes, signs and symptoms of anemia.
In order to establish the reliability of the tool, split-half  treatment and prevention of anemia.
method was used. The tool was administered to 10 subjects
Teaching aids: The method of instruction was lecture cum
and the test was first divided into two equal halves and
discussion. Aids like L.C.D and hand out, OHP, charts,
correlation of the half test was found by using Karl Pearson
black board, flash cards.
correlation coefficient formula and the significance of the
correlation was tested by using probable error. The Pilot Study
reliability of whole test was estimated by Spearman- Pilot study is a small version or trial run of the main study.
Brown’s Prophecy formula. The reliability of the structured It is conducted to obtain information for improving the main
questionnaire was found to be 0.799, hence the tool was projects or for assessing its feasibility and to test the
found to be highly reliable. reliability of the tool. The pilot study conducted at Govt. Sr.
Sec. School Utarda Bharatpur, after obtaining the
Description of the Tool
permission from the concerned authorities. The pilot study
The tool consists of two parts:
period was from 20 June of 2016 until 30 June 2016. Totally
six adolescent girls were selected in Govt. Sr. Sec. School
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R. Gopal and T. Chand (2017) Int. J. Soc. Sc. Manage. Vol. 4, Issue-3: 192-197
Utarda Bharatpur. Pre-test and Structured teaching Program of structured teaching program. The method of instruction
on Anemia was given on 21 June of 2016 the pre- and the was lecture cum discussion. A.V. Aids like L.C.D and hand
post- test was given on 27 of June 2016. The samples in the out, OHP, charts, black board, flashcards. The time taken
study possessed the same characteristics as that of the for S T P is 45 minutes. The data obtained was analyzed in
samples for the main study. The data collected through the terms of the objectives and hypothesis of the study by both
questionnaire was analyzed by using descriptive and descriptive and inferential statistics.
inferential statistics, which are necessary to provide
substantive summary of results. The analyzed data was
Results and Discussion
organized and presented in the form of tables. Tool and STP Distribution of adolescent girls according to
were found to be effective. The pilot study confirmed that demographic variables
the final study is feasible. From the Table 1, it can be deduced that 33.3 percent of the
sample [20] were in the age group of 12-13 years, 33.3
Data collection Process
percent [20] were in the age group of 14-15 years and 33.3
A formal permission from the concerned authorities was
percent of the sample [20] were in the age group of 16-17.
obtained for conducting the study. Duration of the study
Age of menarche age group is 11-12 years percent of
was from 1 July 2016 to 27th of July 2016. The investigator
samples is 48.3 percent and the age group 13-14 years
took consent from the adolescent girls students.
percent is 51.7 percent. The religions of the participants
Confidentiality was maintained during data collection.Pre-
have Hindu 6.3 percent and Muslims are having 31.7
test was done by administering the questionnaire to the
percent. The education qualification is those studying in
samples. An average of six samples was selected. The
10th has 31.7 percent, those in 11th having 43.3 percent and
Structured teaching Program was conducted after pre-test
12th having 25 percent. The dietary pattern of participants
on same day. On seventh day, a post-test was conducted
is non vegetarian has 33.3 percent and vegetarian 66.7
using the same questionnaire to evaluate the effectiveness
percent.

Table 1: Distribution of adolescent girls according to demographic variables.

S.N. Demographic Characters No. (60) %
variables

1 Age 12-13 20 33.3

14-15 20 33.3

16-17 20 33.3

18-19 0 0

2 Age of menarche 11-12 29 48.3

13-14 31 51.7

3 Religion Hindu 41 68.3

Muslim 19 31.7

4 Educational status 10th 19 31.7

11th 26 43.3

12th 15 25.0

5 Dietary Pattern Non vegetarian 20 33.3

vegetarian 40 66.7

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R. Gopal and T. Chand (2017) Int. J. Soc. Sc. Manage. Vol. 4, Issue-3: 192-197
pre-test mean percentage score is 30.3% in the aspect of
Distribution of samples based on age
Blood. This is followed by general knowledge on anemia
It is clear from Fig. 1 that age of adolescent girls divided in
and knowledge on Anemia with the mean pre-test
to 4 categories (12-13, 14-15, 16-17 & 18-19 years), equal
percentage scores 40.7%and 30.7%respectively. The lowest
number was observed in first three categories (20 each) and
post-test mean percentage score is 78.2% in the aspect of
no any belongs to the age category of 18-19.
Level of knowledge regarding anemia. This is followed by
general knowledge on Anemia (82.8%) and Blood (87.0%).

Fig. 1: Age of adolescent girls recorded during

study.
Fig. 2: Data showing assessment of knowledge
Assessment of knowledge on anaemia before STP on anaemia before STP.
The Fig. 2 shows the level of knowledge were seen into 3
The ‘t-value’ was computed to determine the effectiveness
categories, such as- inadequate, moderate and adequate
of STP on Anaemia. The following hypothesis was stated.
knowledge on anaemia. Majority of adolescent girls i.e., 60
H1: There will be significant increase in knowledge of
(100%) showed inadequate knowledge.
Adolescent girls regarding the Anemia after the STP. The
The data presented in Table 2 reveals that the highest pre- data in Table 3 illustrates that the mean post-test knowledge
test mean score is 40.7% in general information regarding score [24.78] is higher than the pre-test knowledge score
anemia and post-test mean score is 87.0% in aspect of [10.07].The mean difference between pre-test and post-test
General information regarding blood. In per test this is score [14.71] of knowledge is significant at P<0.05 level, as
followed by Causes, signs and symptoms and treatment and ‘t-value’=59.83. Hence the research hypothesis H1 is
of General information regarding blood with the mean pre- accepted. The difference of means observed is a true
test percentage scores 31% and 30.3% respectively. But in difference. Hence, it can be concluded that the STP has an
post-test general information regarding anemia; General influence in improving the knowledge of adolescent girls
information regarding blood; Causes, signs and symptoms regarding the Anemia.
and treatment 78.2, 87.0, 82.8 in each aspect. The lowest

Table 2: Mean, range and SD of anemia among adolescent girls before and after STP (n=60)
S.N. Aspects of knowledge Max. Before STP After STP
score Range Mean SD Mean Range Mean SD Mean
% %
1 General information regarding 6 0-3 1.82 0.74 30.3 3-6 5.22 0.82 87.0
blood
2 General information regarding 7 1-4 2.85 0.73 40.7 4-6 5.48 0.50 78.2
anemia
3 Causes, signs and symptoms 17 1-7 5.40 0.97 31.7 12-16 14.08 0.59 82.8
and treatment
4 Over all 30 6-13 10.07 1.49 33.6 12-27 24.78 1.23 82.6

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R. Gopal and T. Chand (2017) Int. J. Soc. Sc. Manage. Vol. 4, Issue-3: 192-197
Table 3: Comparison of pre- and post-test knowledge and statistical significance.
S.N. Aspects of knowledge Max. Mean % of mean difference Paired t-test p<value
Score difference (enhancement) value
1 General information 6 3.40 56.7 23.45* p<0.05
regarding blood
2 General information 7 2.63 37.5 23.11* p<0.05
regarding anemia
3 Causes,signs and symptoms 17 8.68 51.0 49.48* p<0.05
and treatment
4 Over all 30 14.72 49.0 59.83* p<0.05

n=60 Note : * -denotes significant at 5% level P<0.05.

Table 4: Association between demographic variables with knowledge regarding anemia among adolescents girls.
S.N. Demographic variables Characters Sample Knowledge χ2-value
No. (60) % ≤ Median >Median
No % No %
1 Age 12-13 20 33.3 13 35.1 7 30.4 0.141, df=2, NS
14-15 20 33.3 12 32.4 8 34.8
16-17 20 33.3 12 32.4 8 34.8
18-19 - - - - - -
2 Age of menarche 10-12 29 48.3 17 45.9 12 52.2 0.220, df=1, NS
13-14 31 51.7 20 54.1 11 47.8
3 Religion Hindu 41 68.3 23 62.2 18 78.3 1.669, df=1, NS
Muslim 19 31.7 14 37.8 5 21.7
4 Educational status 10th 19 31.7 11 29.7 8 34.8 1.184, df=3, NS
11th 26 43.3 18 48.6 8 34.8
12th 15 25.0 8 21.6 7 30.4
5 Dietary Pattern Non vegetarian 20 33.3 12 32.4 8 34.8 0.035, df=1, NS
vegetarian 40 66.7 25 67.6 15 65.2
Note: S-denotes the significant at 5% level (p<0.05); NS- not significant at 5% level (p>0.05).

Educational status: 10th class student and the number. of

Assessment of effectiveness of STP
samples 19 and the below the median and above the median
In Table 4, all of the given demographic variables are not
significant with the pre-test knowledge. is 11 and 8 and the school of freedom is 3 and it non-
Age: In 12-13 yrs total no of sample are 20 and the below significant. 11 th class student is 26 and the below the
the median and above 13 and 7,and the degree of freedom median and above the median is 18 and 8 and the school of
is 2 and it is non-significant. In14-15 yrs total no of samples freedom is 3 and it non-significant. 12th class students 15
are 20 and the below the median and above 12 and 8, and and the below the median and above the median is 8 and 7
the degree of freedom is 2. In 16-17 yrs total number of and the school of freedom is 3 and it non-significant.
samples are 20 and the below the median and above the Dietary pattern: There are 20 number of samples are non-
median 12 and 8, and the degree of freedom is 2 vegetarian and the below the median and above the median
Age of menarche: In adolescent girls are 29 number of is 12 and 8 and the degree of freedom is 1 and it non-
sample and the below the median and above the median 17 significant. There are 40 no of samples are vegetarian and
and 12 and degree of freedom is 1 and it is non-significant. the below the median and above the median is 25 and 15
In female are 31 number of sample and the below the and the school of freedom is 1 and it non-significant.
median and above the median is 20 and 11
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nutrition and wellness 7(1): 1-5.
19 number of samples the below the median and the above
the median is 14 and 15.
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