Developing Anemia Prevention Interventions for Pregnant Women with the Behavior Change Wheel

Pregnancy anemia is a significant public health issue in Indonesia, requiring effective monitoring of iron tablet use with support from spouses and healthcare workers. Previous interventions often lacked strong theoretical foundations and population-specific approaches. This study documents the systematic development of the ANECMA intervention, integrating the Behavior Change Wheel (BCW) framework based on feedback from target users. The study involved 18 pregnant women, five spouses, and nine healthcare providers (midwives, nutritionists, and general practitioners) from primary healthcare centers in Surakarta, Indonesia, in 2024. Semi-structured interviews and consultation sessions were conducted, and findings were analyzed using deductive and inductive methods within the BCW framework. Behavioral analysis (Steps 1–4) identified nine intervention goals aligned with the COM-B components: Capability, Opportunity, and Motivation. Six intervention functions and 16 behavior change techniques were chosen to drive behavior change. The intervention employs a triadic approach, engaging spouses and healthcare providers to support pregnant women’s anemia prevention behaviors, complemented by a mobile app. This study outlines the rationale for selecting intervention components and behavior change techniques. It provides a practical guide to using the BCW framework, emphasizing the active involvement of target groups and stakeholders in designing effective interventions to prevent pregnancy anemia

Behavior change · Behavior change communication · Behavior change methods · Behaviour change · Health care · Intervention (counseling · Psychological intervention · Public health · Behavioral Health and Interventions · Child Nutrition and Water Access · Iron Metabolism and Disorders