245890 Evidence-Based Communication Programming to Improve Health and Nutrition Behaviors in Young Rural Adolescent Girls in Uttar Pradesh, India

Tuesday, November 1, 2011

Nandita Kapadia-Kundu, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Baltimore, MD
Geetali Trivedi, MA , Urban Health Initiative, Johns Hopkins Bloomberg School/Center for Communication Programs, Lucknow, India
Ajay Misra, Phd , Futures Group Inernational, Lucknow, India
Kimberly Rook , Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Basil Safi, Asia Division Chief , Center of Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background India's most populous state, Uttar Pradesh (UP) is home to 17.2 million adolescent girls mostly living in rural areas. Early marriage, undernutrition, anemia and low status of women contribute to an intergenerational cycle of ill health in mothers and children. An in-school communication package was developed to improve nutrition, reproductive health and hygiene behaviors.

Methods The data are part of a baseline assessment for a randomized cluster trial in 30 rural schools in Hardoi district, UP. Baseline data were collected in 2010 from 1195 girls (grades 6-8). Logistic regression models were fit to predict determinants of four behaviors -- food variety, protein consumption a day prior to the survey, handwashing with soap after defecation and vaginal cleansing with soap.

Results: Older girls (14 yrs) were more stunted (45 percent) (< median-2sd ) compared to younger girls (11 yrs) (25 percent stunted); 63 percent reported symptoms of menstrual morbidity; 48 percent reported zero protein consumption a day prior to the survey; 66 percent had low food variety; 70 percent reported handwashing with soap after defecation and 14 percent before eating. Only 8 percent reported daily vaginal cleansing with soap. Self efficacy, social influence for healthy behaviors, intergenerational communication and knowledge were low. Regression analysis indicates that self efficacy, social influence and intergenerational communication were the most significant predictors of the four behaviors studied.

Conclusions The communication intervention was revised to promote self efficacy, intergenerational communication and social influence. It will be scaled to 8000 schools reaching 1.2 million girls.

Learning Areas:
Advocacy for health and health education
Communication and informatics
Implementation of health education strategies, interventions and programs
Public health or related education
Social and behavioral sciences

Learning Objectives:
1. Participants will identify four important nutrition, hygiene and reproductive health behaviors that can be influenced by communication. 2. Participants will be able to list common predictors of the four important nutrition, hygiene and reproductive health behaviors that can provide the basis for an effective health communication strategy.

Keywords: Health Communications, Adolescents, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Served as the Regional Director for this project between 2009 - 2011.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.