“Iron Supplementation Adherence in Anemic Populations: Investigating Factors Influencing Adherence to Iron Supplementation among Anemic Individuals رسالة ماجستير

Abstract

Background: Iron deficiency anemia (IDA) remains a major public health challenge in Palestine, with suboptimal adherence to iron supplementation limiting the effectiveness of treatment programs. Aims: This study aimed to assess the level of adherence to oral iron supplementation and to identify the psychosocial, demographic, and contextual factors influencing adherence among anemic adults in the Northern West Bank of Palestine. Methodology: A quantitative, multi-center, cross-sectional design was employed, involving 391 adult outpatients diagnosed with IDA and receiving oral iron therapy at public and private hospitals in Jenin. Data were collected using a structured questionnaire grounded in the Health Belief Model (HBM), incorporating measures of perceived benefits, perceived barriers, and perceived behavioral control, alongside demographic and clinical variables. Statistical analyses included descriptive statistics, reliability testing, multiple linear regression, hierarchical regression, t-tests, and ANOVA. Results: The findings revealed a generally high level of self-reported adherence to iron supplementation. Perceived benefits emerged as the strongest positive predictor of adherence, while perceived barriers, particularly side effects, misconceptions, and logistical challenges, were negatively associated with adherence. Perceived behavioral control did not demonstrate a statistically significant independent effect. Several demographic and contextual factors moderated adherence behaviors: age, education, income, duration of supplementation, employment status, and type of healthcare institution significantly influenced how perceived benefits translated into adherence, whereas gender showed no significant effect. Patients attending private hospitals and those who were employed exhibited higher adherence levels. Conclusion: Adherence to iron supplementation among anemic adults in the Northern West Bank is primarily driven by patients’ perceptions of benefits and barriers, rather than by perceived behavioral control alone. These findings support the applicability of the Health Belief Model in the Palestinian context and highlight the need for targeted, culturally sensitive educational interventions, side-effect management, and strengthened support within public healthcare settings to sustain and improve adherence to iron therapy