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ASSESSING THE EFFECTIVENESS OF E – LEARNING EDUCATION MATERIAL ON NUTRITION AND HEALTH ATTITUDE OF RURAL WOMEN: A QUASI EXPERIMENTAL STUDY

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The use of Information and Communication Technology (ICT) is considered to be a necessity, to overcome the challenges hindering the country from developing and in reducing the digital divide. Hence, the present study is to assess the effectiveness of
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   www.tjprc.org editor@tjprc.org ASSESSING THE EFFECTIVENESS OF E – LEARNING EDUCATION MATERIAL ON NUTRITION AND HEALTH ATTITUDE OF RURAL WOMEN: A QUASI EXPERIMENTAL STUDY NIDA FATIMA HAZARI 1  & V. VIJAYA LAKSHMI 2   1  Msc, Department of Foods & Nutrition, College of Home Science, PJTSAU, Hyderabad, India 2  Professor & Head, Department of Foods & Nutrition, College of Home Science, PJTSAU, Hyderabad, India    ABSTRACT The use of Information and Communication Technology (ICT) is considered to be a necessity, to overcome the  challenges hindering the country from developing and in reducing the digital divide. Hence, the present study is to  assess the effectiveness of the 2 D animated films, on the nutritional and health attitudes of rural women. Educating women through e – learning (EWE), a 2 D animated film was made in English and local language (Telugu), which included educational content on nutritional needs of children (0-6 years), pregnant, lactating women, common  nutritional deficiencies seen among these groups, strategies to control and prevent them. It was a quasi experimental  pre test – post test research design. A total sample of 130 rural women, belonging to the reproductive age group, 15 – 49  years were selected from three villages, one of which served as an experimental group (n=100) and the other acted as  the control group (n=30). A standardized questionnaire developed for the study was used to assess attitude at pre and  post-intervention. There was an increase in the mean attitude score from 52.87 to 70.64, after the intervention. The gain in attitude score was 17.8, for the experimental group which was highly significant (P<0.01)  KEYWORDS: E-Learning, Rural Women, 2d Animated Film & Nutritional Attitude Received:  Aug 28, 2017; Accepted:  Sep 18, 2017; Published:  Sep 28, 2017; Paper Id.:  IJESROCT201710   INTRODUCTION India is poised to emerge as one of the most developed nations by 2020 being more literate, knowledgeable and at the forefront economically. Women empowerment is crucial to the economic growth of any country. Rural women are key actors, in solving the major issues on the development agenda for the coming century, including the need to manage the environment in a sustainable manner, control the exploding rate of population and urbanization, food security, human needs with regard to health, education and literacy and in the elimination of poverty. For the development of the rural environment, education should be taken up on a priority basis, since it is the basis for creativity and foresightedness that triggers change; it helps in economic growth, quality of life and the quality of human resource. Information technology has a profound effect on education. Digital learning is faster and better than the traditional learning, since it integrates multimedia, instructor - led and real - time learning techniques in a facilitated, collaborative learning environment.  Or i   gi  n al  Ar  t  i   c l   e  International Journal of Educational Science and Research (IJESR) ISSN (P): 2249-6947; ISSN (E): 2249-8052 Vol. 7, Issue 5, Oct 2017, 63-70 © TJPRC Pvt Ltd.  64 Nida Fatima Hazari & V. Vijaya Lakshmi  Impact Factor (JCC): 5.9865 NAAS Rating: 4.16 Based on the study by Brug et al. (1996), nutritional education using computers is more effective than traditional nutritional education, as the digital nutritional education package is more readable and memorable, than the traditional educational materials, including booklets and pamphlets. Multimedia helps in creating messages that enhance learning, giving direct information without bias, promoting medical decision support and expert advice with tailoring the information to age, sex, language, literacy level, ethnic background, socio - economic status, medical history and helps consumers ask better questions and get involved in their nutrition treatment plans. Nutrition education is defined as any set of learning experiences, designed to facilitate voluntary adoption of eating and other nutrition related behavior, conducive to health and well-being (Contento, 1995). Nutrition education is essential for promoting knowledge of nutrition, as well as nutritional practices, which have the potential to result in the better nutritional status of the targeted population (Nnakive, 2009). It can improve the knowledge and also bring about a change in their behavior. It has been recommended that, effective nutrition interventions should have a behavioral focus, that will minimize the targeted risk factors, utilize theoretical framework, consist of changes to the environment, provide adequate dose and include strategies, that are developmentally and culturally appropriate. However, to achieve the desired behavioral changes related to health and nutrition, it will require the attainment of adequate knowledge, attitudes, skills and self-efficacy (Contento et al., 2002, Wardle et al ., 2000 and Vereecken et al ., 2005). Nutrition and Health, Attitude Attitude, refers to the inclinations to react in a certain way to certain situations, to see and interpret events according to certain predispositions or to organize opinions into coherent and interrelated structures. According to Hogg and Vaughan (2005), an attitude is defined as a relatively enduring organization of beliefs, feelings and behavioral tendencies towards socially significant objects, groups, events or symbols. Albarracin et al. (2005) mentioned that, attitude is a mental or neural state of readiness organized through experience, exerting a directive or dynamic influence upon the individual's response, to all objects and situations with which it is related. Attitude towards healthy eating were explored by Hearty et al. ( 2007). According to dietary intake, lifestyle and socio – demographic correlates in Irish adults, it was seen that females, increasing age, higher social class, tertiary education, non – smokers, lower body weight and increased recreational activities were associated with a negative attitude towards healthy eating behavior. The results from the study of mother’s nutritional knowledge and attitude on children’s dietary intake, by Shookri et al.  (2011) support the inclusion of knowledge and attitudes, in dietary interventions. It was shown that, a lower dietary adequacy of children’s food intake was seen in mothers with low educational levels, high - ranked occupation and lower levels of both nutritional knowledge and food related health attitudes. The highest food intake and healthy eating attitude scores were found in children of mothers, with high education level and mother without a job. Thus, the association of the dietary adequacy with socio - demographic background can help the Omani healthcare decision makers, to develop better tailored nutrition interventions, which are more suitable for the Omani community.   Assessing the Effectiveness of E – Learning Education Material on Nutrition and 65  Health Attitude of Rural Women: A Quasi Experimental Study www.tjprc.org editor@tjprc.org Smriti et al.  (2010), carried out a community based health and nutrition education intervention, focusing on several factors influencing child health with special emphasis on diarrhea in an urban slum. Results showed that, health and nutrition - education intervention improved the knowledge and attitudes of mothers, towards the usage of ORS packets and the sugar salt solution.   Concerning occupation, the results revealed that, Omani mothers’ work had an inverse effect on their nutritional knowledge and healthy eating attitudes (Shookri et al. 2011). Although, age and education level of the participants were significant predictors of the attitude level in univariate analyses, after adjusting for confounding factors in multiple regressions, only education level and the interaction term of sex and age remained significant predictors in multivariate analyses. Study participants, who had completed higher secondary education, were found to have higher odds of good attitude, compared to illiterates. Furthermore, females of older age group had significantly higher attitude scores than males (Dhimal et al . 2014). Szucs et al.  (2015) explored Hungarian consumer’s attitude towards a healthy diet and identified three different consumer groups. One of which was, the ambitious cluster, which showed positive attitude, the other was a “health conscious” cluster, which actively supported a healthy diet and the members of the “indifferent” cluster were the least interested in healthy diets. Athletes lack nutritional knowledge, but have a positive attitude towards nutrition, which was observed by Marquitta et al. (2014) in a study on nutritional knowledge and attitudes of adolescent swimmers, wherein it was seen that, nutritional knowledge was positively and significantly related to the attitudes. E - Learning technologies have great potential to spread learning. However, the benefits of these technologies have to reach the rural masses of India, otherwise they will be one of the causes of the Digital Divide., “a gap between those able to benefit from digital technology and those who cannot” (Smyth, 2006) widening for residents in these rural areas. If e - learning reaches the remote and rural parts of India, it would be much faster to educate people. Hence, the present study is planned to develop e – nutrition education material and assess its effectiveness on the nutritional attitude of the rural masses, keeping in mind the following objective. General Objective  The main objective of the study, was to assess the effectiveness of the developed e – nutrition education material, on the nutritional attitudes of rural women. MATERIALS AND METHODS   In the present study, quasi experimental design has been used for pre – post testing, with a control group which is useful in assessing the effectiveness of the material, developed on the attitudes of the rural women before and after the educational intervention. Research design: Design of the Experiment:  Assessment of KAP before and after intervention Number of Villages: 3  66 Nida Fatima Hazari & V. Vijaya Lakshmi  Impact Factor (JCC): 5.9865 NAAS Rating: 4.16 Number of Treatments: 1 Figure 1: Categorization of Respondents in Three Different Villages in the Experimental Group and Control Group As shown in figure 1, a total sample of 130 rural women belonging to the reproductive age group of (15-49) years was selected from three villages namely Pudur, Gangupaly and Mirzapur of Pudurmandal, Rangareddy district, Telangana. The control group constituted of 30 women, 10 from each village and the rest of 100 rural women were divided among the three villages which comprised the experimental group. Table 1: Distribution of Respondents According to their Profile Characteristics in Experimental Group and Control Group Sr. No Variable Category Experimental Group N=100 Control Group N=30 Age F % F % 1 Young women 15-25 years 40 40 9 30 Middle aged women 26-35 years 44 44 14 47 Old women 36-49 years 16 16 7 23 2 Marital status Married 82 82 26 87 Unmarried 18 18 4 13 3 Education Illiterate 15 15 0 0 primary school 14 14 26 86 middle school 8 8 2 7 high school 48 48 0 0 College 15 15 2 7 4 Occupation house wife 81 81 23 76 working women 8 8 5 17 Student 11 11 2 7 5 Family type Nuclear 55 55 18 60 Joint 45 45 12 40 6 Income -poor upto 2000 2 2 2 7 -low 2000-5000 39 39 5 17 -medium 5000-10000 40 40 23 76 -high > 10000 19 19 0 0 7 Possession of Audio-visual material Television 51 51 18 60 Mobile 36 36 12 40 CD Player/Laptop 13 13 0 0 8 Mass media exposure Never 2 2 2 7 occasional 2 2 28 93 daily 96 96 0 0 9. Urban contact Medium 77 77 30 100 High 23 23 0 0   Assessing the Effectiveness of E – Learning Education Material on Nutrition and 67  Health Attitude of Rural Women: A Quasi Experimental Study www.tjprc.org editor@tjprc.org The data were collected at the beginning of the study, in both the experimental group and the control group. A standardized knowledge questionnaire on aspects of nutrition, health and hygiene was developed, for the present research. After the collection of the relevant data, an E - nutrition education material, “educating women through e – learning’’ a digital nutrition education package called ‘EWE’, a short educational film of 15 minutes duration was prepared for the rural women, with a well-defined concept and properly formulated dialogues, which included basic information on nutrition, health and hygiene. The major focus in developing e – nutrition education material, was to cover aspects like nutritional needs of children (0- 6 years), pregnant and lactating women, maintaining proper hygiene and sanitation, diarrhea, immunization, malaria and de-worming, as the most common nutritional deficiencies seen in these vulnerable groups of rural population and strategies, to prevent and control these deficiencies. The educational intervention was shown to the experimental group, only for a period of 6 months. After the intervention, final data were collected in both the groups. The   attitude questionnaire, which composed of 24 questions was given to both the experimental and control groups, after a period of six months to assess the effectiveness of the animated film, on the attitude of rural women.  RESULTS The present study showed that, the e – learning education intervention, conducted over a period of 6 months had a positive impact on attitude on nutrition and health, among rural women. Table 2: Distribution of KAP Scores in Experimental Group and Control Group before Educational Intervention Experimental Group (N=100) Control Group (N=30) Scores Pre – Test n % Pre – Test n % Attitude 45 – 52 34 34 16 53.33 52 – 59 64 64 14 46.67 59 – 66 0 0 0 0.00 66 – 73 2 2 0 0.00 Table 3: Distribution of KAP Scores in Experimental Group and Control Group after Educational Intervention Experimental Group (N=100) Control Group (N=30) Scores Post – Test n % Post – Test n % Attitude 45 – 52 0 0 15 50.00 52 – 59 0 0 14 46.67 59 – 66 1 1 1 3.33 66 – 73 99 99 0 0.00
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