{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T22:27:05Z","timestamp":1783031225371,"version":"3.54.6"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,7,27]],"date-time":"2017-07-27T00:00:00Z","timestamp":1501113600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Food Nutr Bull"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Positive deviance (PD) is an asset-based social and behavior change communication strategy, utilizing successful outliers within a specific context. It has been applied to tackling major public health problems but not adolescent anemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The study, first of its kind, used PD to improve compliance to adolescent anemia control program in Jharkhand, India, where anemia prevalence in adolescent girls is 70%, and program compliance is low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>With leadership of state government, the study was designed and implemented by a multidisciplinary 42 member PD team, in Khunti district, in 2014. Participatory appraisals were undertaken with 434 adolescent girls, 18 frontline workers, 15 teachers, and 751 community leaders\/parents\/relatives. Stakeholders were interviewed to identify positive deviants and PD determinants across 17 villages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Perceived benefits of iron folic acid tablet and nutritional care during adolescence are low. Positive deviants exist among adolescent girls (26 of 434), villages (2 of 17), and schools (2 of 17). Positive deviant adolescent girls consumed variety of iron-rich foods and in higher frequency, consumed iron folic acid tablets, and practiced recommended personal hygiene behaviors. Deviant practices in schools included supervision of students during tablet distribution among others.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Government-led PD approach uncovered local solutions and provided a forum for government functionaries to listen to and dialogue with, and an opportunity to adapt the program according to the needs of the affected communities, who are missing partners in program design and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0379572117712791","type":"journal-article","created":{"date-parts":[[2017,7,27]],"date-time":"2017-07-27T06:45:14Z","timestamp":1501137914000},"page":"447-452","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Applying Positive Deviance for Improving Compliance to Adolescent Anemia Control Program in Tribal Communities of India"],"prefix":"10.1177","volume":"38","author":[{"given":"Vani","family":"Sethi","sequence":"first","affiliation":[{"name":"Child Development and Nutrition Section, UNICEF India Country Office, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Sternin","sequence":"additional","affiliation":[{"name":"Positive Deviance Initiative, Tufts University, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Sharma","sequence":"additional","affiliation":[{"name":"UNICEF State Office of Madhya Pradesh, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Bhanot","sequence":"additional","affiliation":[{"name":"Independent consultant"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Mebrahtu","sequence":"additional","affiliation":[{"name":"Child Development and Nutrition Section, UNICEF India Country Office, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,7,27]]},"reference":[{"key":"bibr1-0379572117712791","volume-title":"National Family Health Survey (NFHS-3), 2005\u201306","author":"International Institute for Population Sciences (IIPS) and Macro International","year":"2007"},{"key":"bibr2-0379572117712791","volume-title":"Population Enumeration Data","author":"Ministry of Home Affairs; Office of the Registrar General and Census Commissioner","year":"2011"},{"key":"bibr3-0379572117712791","volume-title":"National Family Health Survey (NFHS-3), 2005\u201306","author":"International Institute for Population Sciences (IIPS) and Macro International","year":"2007"},{"key":"bibr4-0379572117712791","volume-title":"The Adolescent Girls Anaemia Control Programme\u2014Breaking The Inter-Generational Cycle Of Undernutrition In India With A Focus On Adolescent Girls","author":"UNICEF","year":"2011"},{"key":"bibr5-0379572117712791","unstructured":"Government of India. Operational Framework : Weekly Iron and Folic Acid Supplementation Programme. Ministry of Health and Family Welfare: New Delhi 2012. http:\/\/nrhm.gov.in\/nrhmcomponnets\/reproductivechild-health\/adolescent-health\/wifs.html. Accessed April 2016."},{"key":"bibr6-0379572117712791","doi-asserted-by":"publisher","DOI":"10.1177\/156482650802900304"},{"key":"bibr7-0379572117712791","doi-asserted-by":"publisher","DOI":"10.5455\/ijmsph.2015.14042015280"},{"issue":"4","key":"bibr8-0379572117712791","first-page":"1","volume":"2","author":"Bhatt RJ","year":"2011","journal-title":"GJMEDPH"},{"key":"bibr9-0379572117712791","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7475.1177"},{"key":"bibr10-0379572117712791","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.66.1.38"},{"issue":"4","key":"bibr11-0379572117712791","first-page":"130","volume":"23","author":"Lapping K","year":"2002","journal-title":"Food Nutr Bul"},{"key":"bibr12-0379572117712791","author":"Singhal A","year":"2013","journal-title":"Monthly Developments"},{"key":"bibr13-0379572117712791","first-page":"49","volume-title":"The hearth nutrition model: applications in Haiti, Vietnam, and Bangladesh. Report of a technical meeting at World Relief Corporation Headquarters","author":"Sternin M","year":"1997"},{"key":"bibr14-0379572117712791","volume-title":"Interaction of Iron Deficiency & Psychosocial Care on Child Behavior & Cognitive Outcome: A Longitudinal Study of Senegalese Children","author":"Stephanie Ortolano","year":"2012"},{"key":"bibr15-0379572117712791","volume-title":"The LIFE SKILLS \u2018Positive Deviance\u2019 Project and childhood anemia in Palestine"},{"key":"bibr16-0379572117712791","unstructured":"Positive Deviance Initiative. Basic Guide to the Positive Deviance (PD) Approach. PDI, 2009. http:\/\/www.positivedeviance.org\/about_pd\/Final%20revised%2006-03-09Basic_PD_Steps_2.pdf. Accessed June 2017."},{"key":"bibr17-0379572117712791","volume-title":"Haemoglobin Levels For The Diagnosis of Anaemia And Assessment of Severity. Vitamin and Mineral Nutrition Information System","author":"World Health Organization","year":"2011"},{"key":"bibr18-0379572117712791","volume-title":"Weekly Iron\u2013Folic Acid Supplementation (WIFS) In Women of Reproductive Age: Its Role In Promoting Optimal Maternal And Child Health","author":"World Health Organization","year":"2009"},{"key":"bibr19-0379572117712791","first-page":"19","volume-title":"SCN News","author":"Dwivedi A","year":"2006"},{"key":"bibr20-0379572117712791","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-261"},{"key":"bibr21-0379572117712791","first-page":"2014","author":"Ministry of Health and Family Welfare","year":"2015","journal-title":"Annual Report"},{"key":"bibr22-0379572117712791","unstructured":"Sternin J. The Vietnam story: narrated by Jerry Sternin. http:\/\/www.positivedeviance.org\/about_pd\/Monique%20VIET%20NAM%20CHAPTER%20Oct%2017.pdf."},{"key":"bibr23-0379572117712791","unstructured":"Singhal A, Shirley S, Marston EH. The value of positive deviations. Monthly developments. http:\/\/utminers.utep.edu\/asinghal\/Singhal_Value%20of%20Positive%20Deviations_2013_Development%20Magazine.pdf."},{"key":"bibr24-0379572117712791","doi-asserted-by":"publisher","DOI":"10.1177\/156482650202300111"},{"key":"bibr25-0379572117712791","doi-asserted-by":"publisher","DOI":"10.1177\/15648265020234S205"}],"container-title":["Food and Nutrition Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0379572117712791","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0379572117712791","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0379572117712791","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:18:28Z","timestamp":1777443508000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0379572117712791"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,27]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1177\/0379572117712791"],"URL":"https:\/\/doi.org\/10.1177\/0379572117712791","relation":{},"ISSN":["0379-5721","1564-8265"],"issn-type":[{"value":"0379-5721","type":"print"},{"value":"1564-8265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,27]]}}}