Effect of nutrition education on iodine deficiency disorder and iodized salt intake in south west Ethiopian women: a cluster randomized controlled trial

Abstract Background: Although iodine nutrition status is improving globally, the progress is not uniform throughout the world due to several factors. Among these, poor knowledge, negative attitude and improper practice of iodized salt are the main risk factors for poor iodine nutrition in Ethiopia.Objectives: This study was aimed to assess the effect of nutrition education intervention in improving the knowledge, attitude and practice (KAP) towards iodine deficiency disorder and iodized salt intake in southwest Ethiopia.Methods: A cluster randomized controlled trial was carried out among 652 women of reproductive age group in southwest Ethiopia. A total of 24 clusters were selected and randomized in to an intervention and control villages. Women in the intervention village received iodine nutrition related education for six months; while those in the control village did not receive any education. Baseline and endline data were collected from both groups. Generalized Estimating Equations (GEE) was used to determine the effect of intervention.Results: A total of 647 (99.2%) participants were successfully involved in the study. In the intervention group the median attendance was 10 out of 12 education sessions. There was significant change in mean KAP scores for intervention group (p < .001). In multivariable GEE model, after adjusting for other background characteristics, the knowledge score from the baseline increased by approximately nine points (β= 8.674, P<0.0001) and three points for both attitude ((β=3.193, P<0.0001) and practice (β=2.926, P<0.0001) after six months of intervention.Conclusions: Well designed and community-based iodine nutrition education is an effective strategy to improve the KAP of iodine deficiency disorder and iodized salt utilization.Trial registration: PACTR201809544276357 (Retrospectively registered on 14, Sept. 2018), http://www.pactr.org