INTRODUCTION:

Health is a fundamental human right and is crucial for social and economic development. Quality of life is the central concept of health. Health promotion is acknowledged as an essential component of health development. According to World Health Organization projections, the total annual number of deaths from NCDs will increase to 55 million by 2030, if timely interventions are not done for prevention and control of NCDs.^1,2 Visually challenged people are having 1.5–2 times greater risk to endure chronic illnesses.³

Adolescence is crucial period for future well-being, as habits acquired during this period may retain in adulthood.^4,5 The convergence of visual impairment, heightened susceptibility to chronic diseases, and unhealthy lifestyle habits emphasise the need for more personalized health promotion strategies and educational programs for this population.⁶

Audio aids are utilized to impart health education to the visually impaired. Audio aids are useful in being time saving and can be played repeatedly to achieve desired results.^7,8Audio drama method of teaching to the visually impaired is effective, compact and economic and also very easy to follow.⁹ The role of Community health nurse is main step in the preventive aspect to promote health education as a whole.¹

STATEMENT OF THE PROBLEM:

A quasi-experimental study to evaluate the effectiveness of non communicable disease prevention audio drama on knowledge and expressed practices regarding healthy lifestyle among visually challenged adolescents in selected schools.

OBJECTIVES OF THE STUDY:

1. To assess the pre and post-test level of knowledge and expressed practices regarding healthy lifestyle among visually challenged adolescents in experimental and control group.

2. To evaluate the effectiveness of non communicable disease prevention audio drama on knowledge regarding healthy lifestyle among visually challenged adolescents in experimental group.

3. To evaluate the effectiveness of non communicable disease prevention audio drama on expressed practices regarding healthy lifestyle among visually challenged adolescents in experimental group.

4. To assess the correlation between post-test knowledge score and expressed practices score regarding healthy lifestyle among visually challenged adolescents in experimental group.

5. To find the association between pre-test level of knowledge regarding healthy life style and selected demographic variables among visually challenged adolescents in experimental group.

6. To find the association between pre-test level of expressed practices regarding healthy life style and selected demographic variables among visually challenged adolescents in experimental group.

7. To find the level of satisfaction of non communicable disease prevention audio drama on knowledge and expressed practices regarding healthy life style among visually challenged adolescents in experimental group.

RESEARCH HYPOTHESES:

· H1-There is a significant difference in the post-test mean knowledge score regarding healthy lifestyle among visually challenged adolescents who received non communicable disease prevention audio drama.

· H2-There is a significant difference in the post-test expressed practices score regarding healthy lifestyle among visually challenged adolescents who received non communicable disease prevention audio drama.

· H3-There is a significant correlation between post-test knowledge score and expressed practices score regarding healthy lifestyle among visually challenged adolescents in experimental group.

· H4-There is a significant association between pre-test level of knowledge regarding healthy lifestyle and selected demographic variables among visually challenged adolescents in experimental group.

· H5-There is a significant association between pre-test level of expressed practices regarding healthy lifestyle and selected demographic variables among visually challenged adolescents in experimental group.

MATERIAL AND METHODS:

A quantitative approach with a quasi-experimental research design was adopted in this study. The independent variable was Non-Communicable Disease Prevention Audio drama and the dependent variable was Knowledge and Expressed practices on Healthy Lifestyle. The study was conducted at Government Girls Higher Secondary School for Visually Impaired, Trichy; Thanthai Roever Higher Secondary School, Perambalur and Government Higher Secondary School for Visually Impaired, Tanjore. By using purposive sampling technique 30 sample were recruited to each experimental and control group.

Criteria for Sample Selection:

Inclusion Criteria:

Visually challenged adolescents in the age group of 13-18 years.

Visually challenged adolescents who were willing to participate in the study.

Exclusion Criteria:

Visually challenged adolescents who were absent during research period.

Visually challenged adolescents who were sick.

Description of The Tool:

The tools used for the study were Demographic variables proforma, Braille method Structured knowledge questionnaire, Expressed practices assessment scale and Audio drama satisfactory scale.

Section-A: Demographic Variables Proforma:

The researcher constructed this tool to collect the demographic variables of the study samples which includes age in completed years, gender, type of stay, area of residence, type of family, monthly family income, education of the head of the family, body mass index, family history of NCD and previous knowledge regarding healthy lifestyle.

Section-B: Braille method Structured Knowledge Questionnaire:

Braille method Structured knowledge questionnaire to assess the Knowledge on Healthy lifestyle was developed by the investigator. It included 25 MCQ items with 3 options (one right answer and 2 distractors).

Scoring	Percentage	Interpretation
0 – 12	< 50%	Inadequate Knowledge
13 – 18	50 % – 74%	Moderately Adequate Knowledge
19 – 25	>75%	Adequate Knowledge

Section-C: Expressed practices assessment scale

The expressed practice assessment scale was designed by the researcher. It consisted of 10 items to measure their practices with 4 options.

Scoring	Percentage	Interpretation
10 – 19	< 50%	Poor Practices
20 – 29	50% – 74%	Moderate Practices
30 – 40	>75%	Good Practices

Section-D: Audio drama satisfactory scale:

The investigator developed Audio drama satisfactory scale to assess the level of satisfaction of the visually challenged adolescents regarding NCD prevention audio drama and it was assessed by researcher at the end of second time of playing audio drama. It consisted of 10 items with 3 options.

Scoring	Percentage	Interpretation
10 – 15	< 50%	Dissatisfied
16 – 22	51% – 74%	Satisfied
23 – 30	>75%	Highly satisfied

Description of Intervention:

Audio drama was developed as recorded audio conversation between researcher where she acted as a school health nurse and students about knowledge and practices regarding healthy lifestyle in the areas of General information regarding NCD, Healthy nutrition, Physical activity and Relaxation technique for the duration of 20 minutes. Experimental group was gathered in one class room. Audio drama was played via Bluetooth speaker on 1^st and 3^rd day.

Data Collection Procedure:

On the first day baseline data was collected from study participants by using Demographic variables proforma and pre-test was conducted to the experimental and control group by using Braille method Structured knowledge questionnaire and Expressed practices assessment scale.

Audio drama was played to the experimental group for 2 times on 1^st and 3^rd day. Audio drama satisfaction was assessed to the experimental group on the 3^rd day. Post test was conducted on the 28^th day to the experimental and control group visually challenged adolescents.

Ethical Considerations:

· Institutional ethical committee approval was obtained from KMC College of Nursing, Trichy.

· Formal permissions were obtained from Headmasters of Government Higher Secondary for visually impaired at Trichy and Tanjore and Thanthai Roever Higher Secondary School, Perambalur.

· Consent obtained from each participant.

· Confidentiality was maintained throughout the study.

Statistical Methods:

Data entry and statistical analysis were done by using the Statistical package (SPSS version 25). Data were presented using descriptive Statistics in the form of frequencies and percentages for qualitative variables, mean and standard deviation for quantitative variables. Inferential Statistics like Dependent and Independent T-test was calculated to evaluate the effectiveness of NCD prevention Audio drama. Karl Pearson’s coefficient correlation was used to correlate between post test mean score of knowledge and expressed practices in experimental group. Chi square was calculated to know the association of pre test level of knowledge and expressed practices regarding healthy lifestyle with selected demographic variables in experimental group.

RESULTS:

Distribution of Demographic Variables:

Majority of participants were in the age group of 15-16 years in experimental 56.66% and control group 36.66%. Experimental group had 73.33% and control group had 66.66% of female visually challenged adolescents’ participants. Majority of visually challenged adolescents were hostellers in the experimental 83.33% and control 90% group. 86.66% participants in experimental group and 83.33% participants in control group resides in rural. In experimental group 53.33% participants were belongs to joint family where as in control group 66.66% participants belongs to nuclear family. Majority of the visually challenged adolescents monthly family income was below 10,000 in both experimental 60% and control group 46.66%. Regarding education of the head of the family in experimental group 63.33% belongs to primary and in control group 53.33% belongs to high school. In Body mass index 63.33% participants in experimental group and 43.33% participants in control group falls under normal weight.

76.66% participants in experimental group and 60% participants in control group did not have the family history of NCD. In experimental group 13.33% had family history of Diabetes Mellitus and 10.00% had family history of Hypertension. In control group 33.33% had family history of Diabetes Mellitus and 6.66% had family history of Hypertension 56.66% participants in experimental group did not have previous knowledge regarding healthy lifestyle and in control group 56.66% participants had previous knowledge regarding healthy lifestyle. Majority of visually challenged adolescents acquired knowledge regarding NCD from school education in both experimental and control group as 30.00% and 40.00% respectively.

Pre test and post test level of knowledge regarding healthy lifestyle among visually challenged adolescents.

In the pre test experimental group participants 63.33% had inadequate knowledge, 33.33% had moderately adequate knowledge and 3.33% had adequate knowledge at overall level of knowledge, whereas in post test 86.66% had adequate knowledge, 10.00% had moderately adequate knowledge and 3.33% had inadequate level of knowledge.

In control group 50.00% of participants had inadequate knowledge, 40.00% had moderately adequate knowledge and 10.00% had adequate knowledge at overall level of knowledge in the pre test, whereas in the post test 56.66% had moderately adequate knowledge, 26.66% had inadequate knowledge and 16.66% had adequate knowledge.

Pre test and post test level of expressed practices regarding healthy lifestyle among visually challenged adolescents:

In experimental group 70.00% of participants had moderate, 16.66% had poor and 13.33% had good at overall level of expressed practices in the pre test. In post test 80.00% had good, 20.00% had moderate and none had poor level of expressed practices.

In the pre test control group participants 76.66% had moderate, 16.66% had good and 6.66% had poor overall level of expressed practices. In post test 73.33% had moderate and 26.66% had good level and none had poor level of overall practices.

Table 1 depicts that in experimental group pretest mean knowledge score was 11.40+3.78 and 21.30+2.73 in post test with a mean difference of 9.9. The calculated t- value 15.29 was significant at p<0.001. In control group pretest mean knowledge score was 12.93+4.10 and 14.70+4.35 in post test with a mean difference of 1.77. The calculated t- value 3.31 was significant at p<0.01.

Table 2 signifies that in experimental group pretest mean expressed practices score was 23.70+4.09 and 33.00+ 2.99 in post test with a mean difference of 9.30. The calculated t- value 12.67 was significant at p<0.001. In control group pretest mean expressed practices score was 25.23+4.12 and 27.77+3.41 in post test with a mean difference of 2.54. The calculated t- value 2.82 was significant at p<0.01.

Table: 3 Comparison of post test mean knowledge score regarding healthy lifestyle among visually challenged adolescents.

Group

Mean

Mean Difference

Independent t-value

Experimental Group (n=30)

21.30

2.73

6.6

7.03

Control Group (n=30)

14.70

4.35

Table 3 shows that post test mean knowledge score in experimental group was 21.30+2.73 and in control group it was 14.70+4.35 with a mean difference of 6.6. The calculated independent t value 7.03 was significant at p<0.001.

Figure 3: Comparison of pre and post test mean knowledge scores

Figure 3 signifies that in experimental group pre test knowledge scores ranged from 3 to 19(M=11.4), in post test it was from 17 to 24(M=21.3). In control group pre test knowledge scores ranged from 7 to 21(M=12.93) but in post test it was from 7 to 24 (M=14.7).

Table: 4 Comparison of post test mean expressed practices score regarding healthy lifestyle among visually challenged adolescents.

Group

Mean

Difference

Independent t-value

Experimental Group (n=30)

33.00

2.99

5.23

6.31

Control Group (n=30)

27.77

3.41

Table 4 shows that the post test mean expressed practices score was 33.00+2.99 in experimental group and 27.77+3.41 in control group. The calculated t value 6.31 was significant at p<0.001.

Figure 4: Comparison of pre and post test mean expressed practices scores

Figure 4 signifies that in experimental group pre test expressed practices scores ranged from 17 to 32 (M=23.7) and in post test it was from 27 to 37(M=33). In control group pre test knowledge score ranged from 19 to 32(M=25.23) but in post test it was from 22 to 35 (M=27.77).

Correlation between Post Test Knowledge Score and Expressed Practices Score in Experimental Group:

There was weak positive correlation (r=0.35) between knowledge and expressed practices regarding healthy lifestyle among visually challenged adolescents in experimental group at p<0.001.

DISCUSSION:

The main aim of the study was to assess the effectiveness of non communicable disease prevention audio drama on knowledge and expressed practices regarding healthy lifestyle among visually challenged adolescents. Study findings revealed a significant impact with post test mean knowledge score 21.30+2.73 in experimental group and 14.70+4.35 in control group (t=7.03; p<0.001). Post test mean expressed practices score were 33.00+2.99 in experimental group and 27.77 + 3.41 in control group (t=6.31; p<0.001). This findings came in agreement with ¹⁰as they reported that pre-test mean and SD was (15.72+2.24), whereas in post-test it was 26.38+2.34) and the paired t test value (37.6537) showed the significant difference in the knowledge level with audio drama intervention of visually challenged adolescents. Result was similar to ⁷they mentioned that mean score of both knowledge and practice on personal hygiene was changed due to audio assisted teaching from 63.6 to 80.1.

The study findings revealed that in experimental group majority 86.66% of participants had adequate and in control group majority 56.66% had moderately adequate level of knowledge. In experimental group majority 80.00% had good and in control group 73.33% had average level of expressed practices in the post test. The study report was supported byresearch on Effect of Audio drama based educational program on Healthy lifestyle practices among visually impaired students. Study findings revealed 74.3% of students had good level of lifestyle practices post program as compared to 19.5% pre program and showed statistically significant difference in participants healthy life practices between pre and post audio drama teaching programme at p<0.001.⁵

The demographic variable age (χ²=6.924; P=0.140) had shown significant association with pre test level of knowledge regarding healthy lifestyle and residence (χ²=14.615; P=0.06) and monthly family income (χ²=6.922; P=0.140) had shown significant association with pre test level of expressed practices where as other demographic variables had not shown any association. This is supported byresearch on effectiveness of audio drama teaching session on knowledge regarding healthy lifestyle practice among visually impaired children. It revealed that pre-intervention level of knowledge regarding healthy lifestyle practice was not found statistically significant relationship with the demographic factors except religion.⁸

The results of the current study revealed that all the participants in the experimental group (100%) had highly satisfied level of satisfaction of NCD prevention audio drama.

IMPLICATIONS:

Community health nurse can utilize the study findings to plan periodical educational sessions in schools of visually impaired. Implement mass educational programme on healthy lifestyle by using NCD prevention audio drama. Nurse educator should teach and motivate her students to innovate various effective teaching methods for the visually challenged adolescents. Nurse administrator must organize periodical In-service education programme regarding how to promote healthy lifestyle among visually challenged. Nurse administrator can create and implement protocol for audio drama creation and utilization. Nurse Researcher should appraise the challenges and produce best way for healthy lifestyle among visually challenged adolescents.

LIMITATIONS:

· Non equivalent control group design was used based on the inconvenience of the researcher to reach study participants.

· Research findings cannot be generalized due to limited sample size.

CONCLUSION:

The study findings revealed that the knowledge and expressed practices are better in the experimental group of visually challenged adolescents. Non communicable disease prevention audio drama brought effective changes in healthy lifestyle of visually challenged adolescents thus the researcher concludes that Audio drama is one of the best teaching method.

ACKNOWLEDGEMENT:

The investigator is very thankful to the:

· Managing trustee and faculty of KMC CON for their expert guidance and support.

· Headmaters and study participants of Government Girls Higher Secondary School for Visually Impaired, Trichy; Thanthai Roever Higher Secondary School, Perambalur and Government Higher Secondary School for Visually Impaired, Tanjore

· Mr.M.Paramasivam, B.A (ENGLISH), B.Ed (SPECIAL), who helped in braille typing.

CONFLICT OF INTEREST:

None.

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Received on 09.06.2025 Revised on 17.07.2025

Accepted on 22.08.2025 Published on 25.10.2025

Available online from November 04, 2025

Asian J. Nursing Education and Research. 2025;15(4):198-204.

DOI: 10.52711/2349-2996.2025.00041

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Test	Experimental Group (n=30)				Control Group (n=30)
Test	Mean	SD	Mean Difference	Paired t- value	Mean	SD	Mean Difference	Paired t- value
Pre test	11.40	3.78	9.9	15.29	12.93	4.10	1.77	3.31
Post test	21.30	2.73	9.9	15.29	14.70	4.35	1.77	3.31