{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:02:55Z","timestamp":1788267775754,"version":"build-2803163510"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>\nIntroduction\n<\/jats:title>\n<jats:p>Iron deficiency anemia represents the most common form of anemia globally and constitutes a significant public health concern, particularly in developing nations. Therefore, supplementation is one of the best strategies for protecting children from anemia. The objective of the study was to assess the level of knowledge and practices of mothers with children aged 12 to 24 months and to assess the mediating role of health literacy in this relationship.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>\nMethods and materials\n<\/jats:title>\n<jats:p>This cross-sectional study was conducted on 435 mothers of children (aged 12 to 24 months) referred to Tehran healthcare centers. Information was collected through socio-demographic and reproductive checklists, knowledge and practice questionnaires, and health literacy questionnaires. The data were analyzed by SPSS26 and AMOS24 software and a significance level less than 0.05 was considered.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>Among the participants, 18.4% had poor knowledge, 47.4% had moderate knowledge, and only 34.2% had good knowledge. The mothers\u2019 practice score regarding iron drop feeding was moderate (8.22\u2009\u00b1\u20092.27)<jats:italic>.<\/jats:italic> A total of 37.9%, 54.7%, and 7.4% had good, moderate, and poor performance, respectively. Pearson\u2019s correlation coefficient indicated a significant positive association between mothers\u2019 understanding of iron drop feeding and their corresponding practices, as well as the practices of mothers with children aged 12 to 24 months (P\u2009&lt;\u20090.001, r\u2009=\u20090.421). According to the results, health literacy and mothers\u2019 knowledge can predict 40% of the changes in mothers\u2019 practices, which is partial or moderate. Health literacy plays a mediating role in the relationship between mothers\u2019 knowledge and practices.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>\nConclusion\n<\/jats:title>\n<jats:p>Considering the effect of anemia on children\u2019s health, paying attention to mothers\u2019 health literacy as an important factor to improve their performance is essential.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319845","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T18:47:52Z","timestamp":1743706072000},"page":"e0319845","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["The role of health literacy in the relationship between mothers\u2019 knowledge and practices of iron supplementation in children (aged 12 to 24 months): A structural equation model"],"prefix":"10.1371","volume":"20","author":[{"given":"Ghazal","family":"Afshari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5026-9399","authenticated-orcid":true,"given":"Shabnam","family":"Omidvar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Kordbagheri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"issue":"11","key":"pone.0319845.ref001","doi-asserted-by":"crossref","first-page":"693","DOI":"10.3390\/nu8110693","article-title":"The proportion of anemia associated with iron deficiency in low, medium, and high human development index countries: a systematic analysis of national surveys","volume":"8","author":"N Petry","year":"2016","journal-title":"Nutrients"},{"issue":"Suppl 6","key":"pone.0319845.ref002","first-page":"1547S-1554S","article-title":"Introduction to workshop on iron screening and supplementation in iron-replete pregnant women and young children","volume":"106","author":"CL Taylor","year":"2017","journal-title":"Am J Clin Nutr"},{"key":"pone.0319845.ref003","first-page":"109","article-title":"Iron deficiency anemia: a public health problem of global proportions","author":"CV Charles","year":"2012","journal-title":"Public Health\u2013Methodol Environ Systems"},{"issue":"3","key":"pone.0319845.ref004","doi-asserted-by":"crossref","first-page":"339","DOI":"10.2174\/1573396320666230727102042","article-title":"Iron deficiency anemia: an updated review","volume":"20","author":"AKC Leung","year":"2024","journal-title":"Curr Pediatr Rev"},{"issue":"1","key":"pone.0319845.ref005","first-page":"32","article-title":"Anaemia \u2018a silent killer\u2019 among women in India: present scenario","volume":"3","author":"K Kaur","year":"2014","journal-title":"Eur J Zool Res"},{"key":"pone.0319845.ref006","unstructured":"De Benoist B, Cogswell M, Egli I, McLean E. 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