Exploring Behavioral Interventions to Enhance Adherence to Multiple Micronutrient Supplementation Among Pregnant Women in Cambodia: A Mixed-Methods Study.
Background/Objectives: Multiple micronutrient supplements (MMS) are more effective in improving maternal and birth outcomes compared to iron and folic acid (IFA) supplementation during pregnancy. High adherence to MMS is critical to achieving all the anticipated health benefits. Therefore, to ensure...
| Published in: | Nutrients Vol. 18; no. 4; pp. 583 - 603 |
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| Main Authors: | , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
MDPI
Feb2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191973143&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191973143 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20726643 B0TT jtl: Nutrients issn: 20726643 maglogo: N pubinfo: dt: Feb2026 vid: 18 iid: 4 pid: 97109 pub: MDPI artinfo: ui: 191973143 191973143 191973143 10.3390/nu18040583 191973143 ppf: 583 ppct: 20 formats: tig: atl: Exploring Behavioral Interventions to Enhance Adherence to Multiple Micronutrient Supplementation Among Pregnant Women in Cambodia: A Mixed-Methods Study. aug: au: Sauer, Cassandra Sokchea, Meng Sreang, Sambo Kroeun, Hou Hun, Vannary Sen Gupta, Aman Rattana, Kim Chea, Mary Hoang, Mai-Anh affil: Food, Nutrition & Health, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada sug: subj: Micronutrients Dietary Supplementation Education Health Behavior Education Patient Compliance Education Maternal Behavior Education Expectant Mothers Education Outcomes of Education Evaluation Program Implementation Program Evaluation Human Multimethod Studies Cambodia Female Adult Implementation Science Patient Attitudes Focus Groups Thematic Analysis Audiovisuals Structured Interview Guides Semi-Structured Interview Content Analysis Descriptive Statistics Prenatal Care Office Visits Funding Source Adult: 19-44 years Female ab: Background/Objectives: Multiple micronutrient supplements (MMS) are more effective in improving maternal and birth outcomes compared to iron and folic acid (IFA) supplementation during pregnancy. High adherence to MMS is critical to achieving all the anticipated health benefits. Therefore, to ensure successful program implementation of transitioning to MMS in Cambodia, implementation research has been prioritized. The objective of this study was to assess the relevance, acceptability, utility and short-term, exploratory adherence outcomes of three behavioral interventions designed to support adherence to daily MMS intake and to promote healthy pregnancy practices. Methods: This mixed-methods study, conducted in four provinces in Cambodia, involved 12 focus group discussions (FGD) with 36 pregnant women who were exposed to three distinct behavioral interventions (family support, a tracking calendar, and educational videos). FGDs were held after three weeks of exposure to each intervention. Data was analyzed using a COM-B model, with inductive codes added to capture emerging themes. Results: Family support emerged as the most preferred and perceived as the most effective intervention, with participants consistently valuing the presence, encouragement, and practical assistance offered by husbands and other close family members. The second most preferred were educational videos, which were perceived to effectively convey key messages in an engaging, relatable way, overcoming literacy barriers. Finally, the calendar supported habit formation and appealed to first-time mothers but posed challenges for low-literacy users. Across interventions, findings reflect participants' perceived effectiveness and preferences rather than comparative efficacy. Conclusions: This study provided insights into Cambodian women's preferences and experiences with three distinct interventions designed to improve adherence over a short-term, 3-week exposure period per intervention. An integrated, multilevel approach that combines family-focused, educational, and system-level strategies is recommended for further piloting and scale-up, with longer-term studies needed to assess comparative efficacy for adherence and health outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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