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\begin{document}

\title{Impact of a school-based nutrition educational intervention on knowledge
related to iron deficiency anaemia in rural Karnataka, India: A mixed
methods pre-post interventional study}



\author[1]{Geetanjali Katageri}%
\author[2]{Shumona Sharmin Salam}%
\author[1]{Umesh Ramadurg}%
\author[3]{Umesh Charantimath}%
\author[2]{Bronwen Gillespie}%
\author[1]{Jayaraj Mhetri}%
\author[1]{Shrinivas Patil}%
\author[1]{Ashalata Mallapur}%
\author[3]{Chandrashekhar Karadiguddi}%
\author[4]{Phaniraj Vastrad}%
\author[3]{Ashwini Dandappanavar}%
\author[5]{Subarna Roy}%
\author[6]{Basavaraj Peerapur}%
\author[3]{Shivaprasad Goudar}%
\author[2]{Dilly Anumba}%
\affil[1]{BVVS S Nijalingappa Medical College and HSK Hospital and Research Centre}%
\affil[2]{The University of Sheffield Department of Oncology and Metabolism}%
\affil[3]{Jawaharlal Nehru Medical College}%
\affil[4]{Model Rural Health Research Unit}%
\affil[5]{ICMR-National Institute of Traditional Medicine}%
\affil[6]{Raichur Institute of Medical Sciences}%


\vspace{-1em}



  
  \date{May 21, 2024}


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\selectlanguage{english}
\begin{abstract}
\textbf{Objective:} To understand the extent to which adolescent
awareness of and attitudes about anaemia and anaemia prevention can be
changed by nutrition messages received at school. \textbf{Design:}
Mixed-methods pre--post intervention study Setting: Three Government
schools in Bagalkot, Belagavi and Raichur districts of Karnataka, India
\textbf{Population or Sample:} Students of grade six and seven and
teachers involved in implementing the intervention. \textbf{Methods:} An
education intervention was co-developed by school teachers and nutrition
experts using locally adapted resource materials that consisted of
lectures, role play and practical demonstrations. Seven half-hour
educational sessions were delivered by school teachers over seven weeks
to 455 students. Pre- and post-intervention tests measured changes in
adolescents' knowledge about anaemia. In-depth interviews with teachers
and focus groups with students explored reactions to the intervention.
\textbf{Main outcome measures:} Knowledge score related to anaemia
Results: The percentage of children with correct scores increased by 7.3
- 49.0 percentage points for the tested questions after implementation
of the intervention. The mean knowledge score increased by
3.67\selectlanguage{ngerman}±0.17(p\textless{}0.01). During interviews, teachers and students
highlighted high acceptance of the intervention and materials, an
increase in awareness, a positive attitude towards changing behaviour
around diet, an increase in the demand for iron folic acid supplements
and improved sharing of messages learned with peers and families.
Challenges expressed included need for further training, time
limitations and hesitancy in teaching about menstruation and pregnancy.
\textbf{Conclusions:} Educational interventions carried out for
adolescents by teachers in schools are effective in improving awareness
and attitude related to anaemia.%
\end{abstract}\selectlanguage{ngerman}%



\sloppy


\section*{Introduction}

{\label{introduction}}

Despite several decades of programming, anaemia continues to be a
critical public health problem in India, affecting 59\% adolescent girls
and 31\% boys aged 15-19 years.\textsuperscript{1} This is an increase
from the 2015-16 estimates and has raised concerns regarding
the~effectiveness of anaemia prevention programs.\textsuperscript{2,
3}In India, the prevalence of anaemia is highest in the early years,
decreases until about 11 years of age and then increases again during
adolescence, particularly in girls due to the start of menstruation and
as a consequence of early marriage and teenage
pregnancy.\textsuperscript{4-8} Nutritional anaemia due to lack of iron,
folate, or vitamin B12 is the most prevalent form in this age
group\textsuperscript{6} and has long term negative implications on
growth and development, school performance and work
productivity.\textsuperscript{8-12} Anaemia during adolescent pregnancy
is associated with poor pregnancy outcomes such premature births, low
birth weight, and perinatal and maternal mortality.\textsuperscript{8,
13, 14}

The Government of India has highlighted the importance of improving the
nutrition of adolescents by modifying schemes originally aimed at the
welfare of pregnant women and children. The Scheme for Adolescent Girls
(SAG), the \emph{Kishori Shakti Yojana} , RMNCH+A initiative, Sneha
Clinics, the National Iron Plus Initiative, the Anaemia \emph{Mukt
Bharat} (AMB, Anaemia free India) initiative and \emph{POSHAN} Abhiyaan,
all include special features for empowering and improving the health and
nutrition of adolescents. The revamped AMB initiative, aimed to break
the intergenerational cycle of anaemia, focuses on six groups likely to
benefit, six institutional mechanisms and six
interventions.\textsuperscript{15, 16} Several of these interventions
such as weekly iron and folic acid (IFA) supplementation, anaemia
testing and treatment, deworming and education, specifically target
adolescent boys and girls.\textsuperscript{15}

Regardless of these interventions, findings from our recent study in
rural Karnataka and others studies as well, revealed gaps in community
awareness of adolescent anaemia and its prevention, poor dietary
behaviour, low compliance with regular IFA consumption and lack of
adequate nutrition education in schools.\textsuperscript{17-21} Students
and teachers described a vigilance-oriented approach i.e., supervised
swallowing of IFA tablets, without any meaningful communication on what
they were receiving, and why.\textsuperscript{22} In addition to
addressing supply side barriers and careful programming, studies have
continually highlighted a need to implement interventions to address
demand-side barriers by improving awareness and changing behaviours
surrounding diet and iron consumption.\textsuperscript{4, 16, 19,
23-27}To this end, we conducted research to understand the extent to
which adolescent awareness of and attitudes about anaemia can change
through short, targeted nutritional messages delivered by teachers at
school.

\section*{Material and Methods}

{\label{material-and-methods}}

\subsection*{Design and setting}

{\label{design-and-setting}}

To investigate the effects of targeted nutritional education, a
mixed-methods pre--post intervention study was conducted in three
Government schools of Karnataka, one each in Bagalkot, Belagavi and
Raichur districts. All students in grades six and seven in the three
schools were invited to participate in the study. Written informed
consent was obtained from the students' parents and assent from the
students. Pre and post - intervention tests were used to measure changes
in adolescents' awareness due to the intervention, and qualitative
interviews were used to capture reactions and facilitators or barriers
to the implementation of the intervention.

\subsection*{Nutrition education
intervention}

{\label{nutrition-education-intervention}}

A multimodal learning approach was used as a basis to develop the
intervention. The education intervention was delivered through teachers
and divided into seven sessions containing lectures, role play and
practical demonstrations. Teachers were chosen as educators to ensure
sustainability of the intervention and students of grades six and seven
were chosen, considering the higher attrition among older students. The
content and modes of delivery were co-developed through multiple
deliberations and discussions with community leaders, local school
teachers and nutrition experts. The resource materials were adapted from
the resources available for the Anemia Mukt Bharat programme and the
National Institute of Nutrition. The final intervention materials
included illustrative, pictorial, and colourful books, cards, wall
charts, handbooks for teachers and food samples (legumes, grains, dry
fruits, vegetables etc.). Emphasis was put on ensuring that materials
developed were appealing to children and easy to understand. All
materials were translated into the local language (Kannada) with photos
of local foods added, and messages modified as appropriate for the
Kannada language. The sessions covered: (i) Balanced diet; (ii) Anaemia
and its importance; (iii) Anaemia in pregnancy; (iv) Diet and anaemia --
iron-rich foods; (v) IFA supplementation; (vi) Myths and facts about
IFA, do's / don'ts of IFA consumption; (vii) Good habits to be adopted;
(viii) Summary and mantras for adolescent health. The intervention was
delivered in Kannada in sessions of approximately half an hour once
every week for seven weeks.

A total of 11 teachers (one male and 10 female) from the three schools
were initially provided a one-day in-person training on the materials
and approach before the start of the intervention. Regular online weekly
refresher training was conducted during the intervention to reinforce
the material and resolve any challenges.

\textbf{Data collection}

A pre- and post-intervention test on knowledge and attitudes about
anaemia was conducted with participating adolescents before and after
the education sessions. A structured pretested Knowledge Assessment
Questionnaire with a maximum score of 18 was administered in Kannada.
Post-intervention testing was conducted approximately 1-2 weeks after
the last classroom session. In addition, post-intervention in-depth
interviews (IDIs) with seven teachers and six focus group discussions
(FGDs) with students, two in each district (one for girls and one for
boys), were conducted to elicit information and opinions about how the
intervention was carried out, including the strong and weak points of
the educational methods used.

\subsection*{Data analysis}

{\label{data-analysis}}

For quantitative data, descriptive statistics including means, standard
deviations, percentages, and frequencies were used to illustrate
respondents' characteristics and intervention participation. Pre- and
post- knowledge scores were calculated, and paired t-tests were used to
determine significant changes in knowledge scores after the
implementation of the intervention. The score obtained was also
categorized as low (score between 0--5), medium (score between 6--11),
and high (score between 12--18). Statistical analyses were done using
the statistics programme STATA 17.0 (www.stata.com).~Qualitative data
was analysed using an inductive thematic approach. Transcripts were read
by team members to develop separate coding framework for FGDs and IDIs,
based on the topic guides. Coded sections were reviewed to generate
themes, and team discussions were held to cross-check findings.

\section*{Results}

{\label{results}}

\subsection*{Background characteristics of
participants}

{\label{background-characteristics-of-participants}}

A total of 455 children were enrolled in the study, about 60\% were
11-12 years of age and 56\% were girls. The children were studying in
year six (51.9\%) or seven (48.1\%) during the implementation of the
intervention. A total of 413 (90.8\%) children participated in both the
tests: 419 (92.1\%) in the pre-intervention test and 447 (98.2\%) in the
post-intervention test. IDIs were conducted with seven participating
teachers aged 30-45 years.

\subsection*{Intervention compliance}

{\label{intervention-compliance}}

Table 1 shows the attendance rates (percentages) of children in the
education sessions. About 71\% (86.1\% in Belagavi, 64.4\% in Raichur
and 63.1\% in Bagalkot) of the children attended a majority (6-7) of the
sessions. Average attendance ranged from 5.7 to 6.3 sessions across the
districts.

\subsection*{{[}Insert Table 1{]}}

{\label{insert-table-1}}

\subsection*{Impact of the intervention on
knowledge}

{\label{impact-of-the-intervention-on-knowledge}}

Baseline or pre-intervention knowledge of several aspects related to
anaemia, iron and iron-rich food, IFA supplements and deworming were
low, with 13.1\% to 46.0\% of the respondents providing correct answers
to the test questions. A significant increase was seen in the percentage
of children who provided correct responses to the questions after the
implementation of the intervention. The percentage of children with
correct scores increased by 7.3-49.0 percentage points for the tested
questions except for Q6\_6 where most of the children did not mention
''dates'' as a source of iron-rich food (Table 2).

\textbf{{[}Insert Table 2{]}}

The mean score of the students in pre-intervention test was 5.64\selectlanguage{ngerman}±2.66
which significantly increased to 9.32±3.52 after the intervention
(p\textless{}0.01) (Table 3). The mean difference was 3.67±0.17.

\textbf{{[}Insert Table 3{]}}

Table 4 shows pre- and post-intervention test performance of students by
district, age, gender, and attendance level. The performance of students
improved in all districts, and with increasing attendance level.
Although knowledge of boys was low compared to girls prior to the
intervention, the gap was reduced following the intervention. No major
difference was observed by age.

\subsection*{{[}Insert Table 4{]}}

{\label{insert-table-4}}

\subsection*{Perception and experience of the
intervention}

{\label{perception-and-experience-of-the-intervention}}

IDIs with teachers and FGDs with students elucidated high acceptance and
positive feedback regarding the interventions, the communication
materials used, the education sessions, increase in knowledge, as well
as a positive attitude towards behaviour change and wider sharing of
information. Teachers also highlighted some challenges in implementation
and how the intervention could be improved.

\emph{Overall high acceptance and positive feedback about the
intervention}

Both teachers and students mentioned that the pictorial nature of the
behaviour change communication (BCC) materials and the multimodal
stimulation created interest in the students, including those who had
difficulty in reading and writing. During the FGDs, students mentioned
that they particularly liked the cards, pictorial book, and practical
sessions using grains, vegetables, and other food items. These are
highlighted in the excerpts below:

\begin{itemize}
\tightlist
\item
  ``\ldots{}\emph{we have learnt a lot after reading this book. We know
  things in detail now; we never felt bored while reading.''~(Student,
  FGD)}
\item
  \emph{``\ldots{}they want to see pictures and have activities; they
  can learn better that way.'' (Teacher, IDI)}
\item
  \emph{``Some children are not very bright, they have difficulty in
  reading and writing, even such children found the book very useful,
  they used to see the pictures and understand.'' (Teacher, IDI)}
\end{itemize}

\emph{Increase in knowledge}

Participating teachers and students expressed that these topics were
either new to them or that they did not have in-depth knowledge.
Teachers perceived that their knowledge had increased after the training
and after reviewing the materials, as one teacher mentioned: \emph{``We
did not even know that anaemia exists in pregnancy\ldots{}Now through
this syllabus, we have attained basic knowledge about why a pregnant
woman has anaemia''} (Teacher, IDI)\emph{.} Similarly, students shared
several positive influences of the education sessions on their knowledge
and awareness regarding anaemia, iron consumption, anaemia in pregnancy,
balanced diet etc:

\emph{``Earlier I never used to eat well or consume tablets. After these
classes, I am aware of how to eat good food.'' (Student, FGD)}

\emph{``We learnt about parasitic infection and tablets to consume for
that\ldots{}they were health related. We didn't know previously, and the
topics were new.'' (Student, FGD)}

\emph{Positive attitude towards behaviour change}

Although our study was not intended to measure change in behaviour, we
asked teachers and students whether there were any changes after the
implementation of the education sessions. Findings reflect a change in
attitude and behaviour regarding vegetable consumption, exercise,
handwashing, reducing junk food, tea, tobacco, alcohol consumption and
an increase in the demand for IFA tablets. For example, teachers as well
as students mentioned that there was more acceptance of eating
vegetables after the sessions:

\emph{``\ldots{}before this project began, we used to make sure that
they ate all the vegetables\ldots{}but now, they are doing it
voluntarily.'' (Teacher, IDI)}

\emph{``I used to not eat vegetables at school, but now I eat. After the
lessons we have started eating properly. Earlier our teachers used to
repeatedly tell us, but we used to ignore.'' (Student, FGD)}

Similarly, a teacher shared an incident where a student showed her
father the pictures and spoke to him about the negative effects of
tobacco: \emph{``See, if you continue to drink and chew tobacco, you
will get all these diseases.''} The teacher further mentioned:\emph{``He
rang me up immediately that night and thanked me. He said his daughter
has ``changed my mind in this manner''} (Teacher, IDI)\emph{.}

\emph{Increase in demand for IFA supplements}

Due to Covid-19, there was a discontinuation in the supply of IFA
tablets in the schools during the study period. However, several
teachers and students expressed that the demand for IFA had increased
after the education sessions. Teachers shared that the sessions created
an understanding amongst the students that the food consumed may not be
enough to meet the iron requirements and hence they were asking when the
school could provide IFA tablets: \emph{``They asked us, `Why are we not
being given the tablets?' They asked the headmistress. They have
understood the concept that our food does not contain enough iron and
hence we need to take the tablets. That is the reason they asked for the
tablets.'' (Teacher, IDI)}

\emph{Sharing information with peers and relatives}

Students also cited that they shared information and materials received
with their family members, friends, other students who were appreciative
of the topic and materials. This included informing family members about
balanced meal, harmful effects of tea, tobacco and alcohol, benefits,
and appropriate ways of consuming IFA tablets amongst others. One
student mentioned: \emph{``We have explained to our family members that
we do not get harmed by the tablets in any way. The teachers also take
them. They are supplied by the Government. Because we do not eat too
many vegetables, this incorporates all that. It has lots of iron
content''} (Student, FGD)\emph{.} Another teacher cited, ``\emph{Few
girls have explained} \emph{about importance of Iron and folic acid to
their sisters or aunts who are pregnant\ldots{}the girl students have
given them correct information. We initially thought teaching people
would be difficult, but it wasn't as difficult''} (Teacher,
IDI)\emph{.}Additionally, a teacher reflected that education through
children may be a better way to bring about a change in the community:
\emph{``Also people here don't cooperate much. If we force and tell them
about these things, they may not accept. So, the best way to teach them
is through children''} (Teacher, IDI)\emph{.}

\emph{Challenges in implementation}

Participants, particularly teachers identified some challenges regarding
training needs, time constraints and hesitancy in talking to all
students together about pregnancy and menstruation.

The teachers included in the study varied by background and were not
necessarily science teachers. A one-day training was arranged for all
teachers, and some felt that the training duration should have been
increased, whilst others expressed that, more details should have been
included for teachers in the training manual.

A few teachers (both male and female) were hesitant to discuss
menstruation and pregnancy-related session to all boys and girls
together and felt that the students were not interested in the topics or
were more suitable for older students. As one teacher mentioned,
``\emph{\ldots{}We called the 7th grade girls separately and told them
about changes in body during puberty''} (Teacher, IDI)\emph{.} On the
contrary, several teachers and students expressed that it was the topic
which was most interesting.

Although all teachers expressed interest in continuing the sessions,
lack of time was also consistently mentioned as a barrier. To overcome
this and ensure sustainability, teachers suggested incorporating these
topics as part of the primary and secondary school curriculum:
``\emph{Instead of keeping it as a separate subject, if it is
incorporated in our subject textbooks, it will be better\ldots{}if this
happens, the basics will be covered in the primary school and as the
child goes into higher classes, it will be taught more and more in
depth.''} (Teacher, IDI)

Other suggestions included incorporating more activities, such as drama,
plays, and videos to stimulate learning and using these methods to teach
other topics.

\section*{Discussion}

{\label{discussion}}

\textbf{Main findings}

The present study demonstrated that an interactive and multimodal
nutrition education intervention on knowledge and attitude regarding
anaemia among a sample of school-going adolescents in rural Karnataka,
India is effective. We report a significant improvement in nutrition
knowledge and awareness after the implementation of the intervention.
IDIs with teachers and FGDs with students reveal high acceptance of the
intervention and materials. Participants highlighted positive outcomes
including an increase in their knowledge, a positive attitude towards
behaviour change around diet and an increase in the demand for IFA
supplements and dissemination of messages learnt with peers and
families. Challenges expressed were related to the need for further
training, time limitations, and hesitancy in talking and learning about
information related to menstruation and pregnancy.

\textbf{Strengths and limitations}

One of the major strengths of the study was the co-development of the
education materials and the implementation plan with relevant local
stakeholders including teachers and health and nutrition experts to
ensure acceptability and viability.\textsuperscript{28} Based on
repeated discussions with stakeholders, a few key decisions were made.
These included incorporating information on balanced diet and health and
hygiene in addition to topics related to anaemia, contextual adaptation
of existing BCC (Behaviour Change Communication materials),
implementation of the intervention among grade six and seven students,
and involvement of teachers as educators.

The study was designed to measure changes in knowledge, not in
behaviour. However, several studies in India have reported a change in
behaviour after the implementation of school-based nutrition education
interventions. Due to planned school closures because of the Covid-19
pandemic, the post-intervention test was carried out after a gap of only
1-2 weeks, and retention in knowledge was not studied. Also, to
sustainably enhance knowledge, the education intervention would need to
be repeatedly implemented.

\textbf{Interpretation (in light of other evidence)}

The findings of this study are consistent with prior studies that
suggest that nutrition education in schools can improve knowledge and
awareness about anaemia; increase demand and improve compliance with IFA
supplements; and change adolescent dietary
behaviour.\textsuperscript{29-33} The pedagogical approach employed in
the education sessions differed from conventional approaches in schools
and was designed to be interactive and participatory, which we believe
crucially contributed towards greater acceptance of the intervention and
a positive impact on knowledge and attitude.\textsuperscript{34} Similar
studies conducted in school settings in India using varied approaches,
such as single or multiple interactive education sessions delivered by
doctors, trained experts using flipcharts, videos and other interactive
methods have been found to improve knowledge and/or change behaviours
related to anaemia and its prevention. \textsuperscript{29-32}Evaluation
of the Weekly Iron and Folic Acid Supplementation (WIFS) programme in
India and other low-and-middle-income countries found that one of the
key factors influencing increased uptake of IFA supplements was
implementation of a coordinated and timely information education and
communication strategy that dispelled misconceptions and rumours, and
capitalised on the positive effects. \textsuperscript{25,
35-39}Moreover, as indicated by Joe et al (2022), increased awareness
and subsequent demand-generation by target groups will help address
other institutional barriers related to the supply and distribution of
IFA supplements.\textsuperscript{16}

The present study also reported knowledge about anaemia to be low among
boys before the start of the intervention, in concordance with several
other studies.\textsuperscript{40-42} Although recent data indicate no
major gender disparities in the coverage of IFA supplementation in
schools, being aware of anaemia itself acts as a motivation for
consumption of IFA tablets.\textsuperscript{17, 18} Equal emphasis must
therefore be given to educating both boys and girls about anaemia and
its prevention.

The inclusion of nutrition education in formal education programmes
targeted to children in primary schools is one of the most commonly
recommended strategies because of its potential in developing positive
health, eating, and lifestyle habits that may persist into
adulthood.\textsuperscript{43, 44} Murimi et al (2018) highlighted
several features of successful school-based nutrition education
interventions: engagement of parents, identification of specific
behaviours to be modified, ensuring fidelity by training educators,
adequate dosage, and age-appropriateness of
interventions.\textsuperscript{45} Several of these features warranted
more attention in the present study, including training, appropriateness
of content, dosage and engagement of parents. For example, the role of
teachers was essential to intervention success, but they expressed
difficulties related to time constraints and training. To resolve time
limitations as well to ensure continuation and viability, they suggested
the content be included in the national curriculum. Gaining an
understanding of anaemia motivated teachers, to help ensure fidelity and
realise project objectives, but this could be further improved by
providing adequate training, endorsement and implementing a
teacher-friendly intervention.\textsuperscript{25, 46-48}

Despite co-development of the content of the education sessions, some
teachers were hesitant to focus on topics related to menstruation and
pregnancy, particularly in the presence of boys. In patriarchal
societies like India where gender norms are strict, menstruation and
pregnancy are considered as 'women's' topics and exclusion of boys from
related discussions can further increase gender
disparities.\textsuperscript{49, 50} Hence, research needs to be
conducted to understand how best to include these topics in sessions
involving both boys and girls.

One of the benefits of school-based health and nutrition education
programmes is that children act to spread the information, bringing it
to their homes to achieve transmission of the information to the whole
family.\textsuperscript{51, 52} Our findings reveal the same with
students discussing and sharing topics learnt with friends and families.
However, to achieve better impact, studies recommend involvement of
families and communities in the nutritional education programmes from
the beginning. \textsuperscript{52-55}

\section*{Conclusion}

{\label{conclusion}}

Appropriate education and counselling on anaemia, iron-rich diet and IFA
supplementation is crucial for adolescents and can help reduce the
burden and consequences of anaemia. Our findings indicate that an
education intervention employing a multimodal learning approach carried
out for adolescents by teachers in schools is effective in improving
awareness and attitude related to anaemia and its prevention. Adoption
of such intervention in the national curriculum and scale-up may help
make marked improvements in the nutritional status of adolescents.
Future studies to assess impact on behaviours related to diet and
consumption of IFA supplements as well anaemia status will provide
insights regarding the effectiveness of the intervention.

\section*{References}

{\label{references}}

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\section*{Acknowledgements}

{\label{acknowledgements}}

The authors are grateful to the community leaders, schools, teachers and
students who agreed to participate in this research. We would also like
to thank the health and education sector for supporting and facilitating
the development of the education materials and supporting the study.

\section*{Disclosure of interests}

{\label{disclosure-of-interests}}

None declared. Completed disclosure of interests forms are available to
view online as supporting information.

\section*{Contribution to authorship}

{\label{contribution-to-authorship}}

DA, GK, BG, and SS were in the conceptualisation and design of the
study. DA, SG, AM, SR, BP provided overall guidance. SS and UR drafted
the manuscript and incorporated all feedback. SS, UR, UC, GK, BG, JM, SP
were involved in data analysis and interpretation. UR, UC, GK, JM, SP,
PV, CK, AD were involved in data acquisition and overall implementation
of the study. All authors read and approved the manuscript.

\section*{Details of ethics approval}

{\label{details-of-ethics-approval}}

The research protocol was approved by the institutional ethics
committees at the three study sites and the University of Sheffield. The
Health Ministry's Screening Committee at the Indian Council for Medical
Research approved the project. The trial was registered with the
Clinical Trial Registry of India (CTRI/2020/09/027515) on 01/09/2020.

\textbf{Table 1: Attendance in education sessions by District}\selectlanguage{english}
\begin{longtable}[]{@{}lllllllll@{}}
\toprule
Session & Bagalkot (N=149) & Bagalkot (N=149) & Belagavi (N=151) &
Belagavi (N=151) & Raichur (N=155) & Raichur (N=155) & Total (N=455) &
Total (N=455)\tabularnewline
\midrule
\endhead
& n & \% & n & \% & n & \% & n & \%\tabularnewline
0-2 sessions & 5 & 3.4 & 4 & 2.6 & 6 & 3.9 & 15 & 3.3\tabularnewline
3-5 sessions & 50 & 33.6 & 17 & 11.3 & 49 & 31.6 & 116 &
25.5\tabularnewline
6-7 sessions & 94 & 63.1 & 130 & 86.1 & 100 & 64.5 & 324 &
71.2\tabularnewline
Mean (SD) sessions attended & 149 & 5.67(1.24) & 151 & 6.25(1.32) & 155
& 5.70 (14.3) & 455 & 5.87(1.36)\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 2: Percentage of children with correct response for each
question by test type}\selectlanguage{english}
\begin{longtable}[]{@{}llllll@{}}
\toprule
Topic area & & Questions & Pre-test (n=413) & Post-test (n=413) &
p-value\tabularnewline
\midrule
\endhead
& & & \% & \% &\tabularnewline
Anaemia & Q1 & Anaemia: Low Iron (haemoglobin) in blood & 40.7 & 75.3 &
\textbf{\textless{}0.01}\tabularnewline
& Q2 & In India prevalence of anaemia is approximately 50\% & 13.1 &
58.8 & \textbf{\textless{}0.01}\tabularnewline
& Q3\_2 & Anaemia can cause: Poor growth & 23.2 & 33.2 &
\textbf{\textless{}0.01}\tabularnewline
& Q3\_3 & Anaemia can cause: Repeated infections & 45.0 & 57.4 &
\textbf{\textless{}0.01}\tabularnewline
& Q3\_4 & Anaemia can cause: Difficulty with studies & 13.6 & 29.5 &
\textbf{\textless{}0.01}\tabularnewline
Iron and iron rich foods & Q5 & Iron consumption is mainly needed for
Blood improvement & 28.3 & 35.6 &
\textbf{\textless{}0.05}\tabularnewline
& Q6\_1 & The following are iron rich foods: Meat & 28.3 & 41.4 &
\textbf{\textless{}0.01}\tabularnewline
& Q6\_2 & The following are iron rich foods: Sprouted vegetables & 31.0
& 39.2 & \textbf{\textless{}0.05}\tabularnewline
& Q6\_3 & The following are iron rich foods: Groundnut Laddoo & 32.4 &
43.8 & \textbf{\textless{}0.01}\tabularnewline
& Q6\_6 & The following are iron rich foods: Dates & 19.4 & 17.2 &
\textbf{ns}\tabularnewline
& Q6\_8 & The following are iron rich foods: Green leafy Vegetables &
46.0 & 59.1 & \textbf{\textless{}0.01}\tabularnewline
& Q8 & Guava increases the absorption of iron & 38.7 & 59.1 &
\textbf{\textless{}0.01}\tabularnewline
& Q9 & Tea inhibits the absorption of iron & 38.7 & 63.0 &
\textbf{\textless{}0.01}\tabularnewline
IFA supplement & Q10 & The Government of India recommends one IFA tablet
be taken by adolescents once a week & 34.6 & 52.3 &
\textbf{\textless{}0.01}\tabularnewline
& Q11 & The best time to consume IFA tablet is one hour after meals &
34.1 & 83.1 & \textbf{\textless{}0.01}\tabularnewline
& Q12 & Blackish stool after IFA tablet consumption is a normal
occurrence with iron consumption & 18.6 & 43.6 &
\textbf{\textless{}0.01}\tabularnewline
& Q13 & The colour of Government supplied IFA supplement is
Red/blue/pink & 42.4 & 72.2 & \textbf{\textless{}0.01}\tabularnewline
Deworming & Q18 & Deworming is recommended once in six (6) months & 36.1
& 68.0 & \textbf{\textless{}0.01}\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 3: Comparison of test score before and after intervention}\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
Score & n & Mean\selectlanguage{ngerman}±2SD & Mean Difference\selectlanguage{ngerman}±2SE & p-value\tabularnewline
\midrule
\endhead
Pre-intervention test score & 413 & 5.644\selectlanguage{ngerman}±2.66 & 3.673\selectlanguage{ngerman}±0.17 &
\textless{}0.01\tabularnewline
Post-intervention test score & 413 & 9.317\selectlanguage{ngerman}±3.52 & &\tabularnewline
\bottomrule
\end{longtable}

Paired t-test, t, dF=-21.5, 412 SE=Standard Error, SD=Standard deviation



\textbf{Table 4: Comparison of pre and post intervention performance by
background characteristics}\selectlanguage{english}
\begin{longtable}[]{@{}lllllllllll@{}}
\toprule
\begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Variables\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Pre-intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Pre-intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Pre-intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Pre-intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Pre-intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Post intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Post intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Post intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Post intervention test score\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Post intervention test score\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{Low} \textbf{(0-5) (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{Medium (6-11) (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{High} \textbf{(12-18) (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{Mean}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{N}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{Low} \textbf{(0-5) (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{Medium (6-11) (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{High (12-18) (\%)}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{Mean}\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
\textbf{N}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
District\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
Bagalkot\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
26.8\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
71.7\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
1.5\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
6.61\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
138\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
7.5\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
49.3\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
43.2\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
10.89\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
146\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
Belagavi\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
47.5\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
51.1\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
1.4\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
5.94\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
139\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
19.2\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
65.1\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
15.8\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
8.22\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
146\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
Raichur\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
73.2\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
26.8\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
0.0\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
4.35\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
142\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
13.6\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
66.5\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
20.0\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
8.79\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
155\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Age\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
11-12`\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
54.7\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
44.9\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
0.4\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
5.25\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
245\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
13.2\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
62.4\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
24.4\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
9.23\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
266\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
13-14`\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
42.0\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
56.3\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
1.7\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
6.14\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
174\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
13.8\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
57.5\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
28.7\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
9.38\strut
\end{minipage} & \begin{minipage}[t]{0.09\columnwidth}\raggedright\strut
181\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Gender\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Male\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
53.6\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
44.2\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2.2\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
5.39\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
181\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
17.8\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
60.4\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
21.8\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
8.73\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
197\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Female\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
46.2\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
53.8\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
5.80\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
238\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
10.0\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
60.4\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
29.6\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
9.74\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
250\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Intervention attendance\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Low\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
66.7\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
33.3\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
3.25\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
27.3\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
63.6\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
9.1\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
8.18\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Medium\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
49.1\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
49.1\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
1.9\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
5.52\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
106\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
13.9\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
63.5\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
22.6\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
9.27\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
115\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Regular\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
48.8\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
50.5\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.7\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
5.75\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
301\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
12.8\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
59.2\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
28.0\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
9.33\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
321\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Total\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
49.4\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
49.6\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
1.0\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
5.62\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
419\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
13.4\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
60.4\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
26.2\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
9.29\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
447\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

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\end{document}

