(LB02-31-26) Exploring Adolescent Preferences for a Micronutrient Supplementation Intervention in Rural Northwestern Bangladesh

Objectives: This formative qualitative research study in rural northwestern Bangladesh engaged 10–18-year-old girls and their parents in a human-centered “co-design” process of a micronutrient supplementation intervention to be tested in a planned randomized controlled trial examining growth, cognitive development, and health outcomes. To promote adherence to daily supplementation over a year-long intervention period, we sought to determine the preferred sensory properties and an acceptable combination of tablets and fortified foods to deliver 17 vitamins and minerals and docosahexaenoic acid (DHA), as well as effective reminder strategies and adherence support materials.

Methods: Eighteen in-depth interviews (IDIs) and 6 focus group discussions (FGDs) were conducted with adolescent girls, in addition to 6 FGDs with mothers and fathers. Interviewers used semi-structured guides to explore attitudes toward supplements, impressions of various multiple micronutrient supplementation (MMS) tablets, sensory impressions of fortified lipid-based nutrient supplement (LNS) samples, and recommendations for reminder strategies and adherence support materials. Interview data were analyzed using Gale’s framework approach.

Results: Preliminary findings suggest that girls and their parents generally preferred food products over tablets. Several girls shared they were unwilling to take larger-sized tablets or a regimen of 4 tablets/day, indicating that tablet size and dosing frequency may affect acceptability and adherence. Girls and parents agreed that the LNS product should be sweet, mild-smelling, and smooth in texture. Girls cited family members, especially mothers, as a primary source of reminders to support adherence to a daily supplementation regimen, while visual cues, such as calendars, checklists, and stickers, could also be helpful.

Conclusions: While adult perceptions of MMS in Bangladesh are well studied, little is known about adolescent perceptions of nutritional supplements and effective reminder strategies to support regular consumption. These findings will inform the development of an intervention package to ensure adherence in the upcoming Micronutrient Enhancement for Development and Health in Adolescents (MEDHA) trial.

Funding Sources: Gates Foundation (149820)