Evaluation of School-based Educational Intervention to Improve Knowledge and Attitude of Adolescent Girls about Puberty Health

Author(s): Batoul Khodakarami, Mansoureh Refaei*, Javad Faradmal, Hakime Uraki

Journal Name: Current Women`s Health Reviews

Volume 16 , Issue 4 , 2020

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Graphical Abstract:


Background: Awareness of pubertal issues has a great influence on the ability of girls to cope with cognitive, social and physical changes that occur during puberty.

Objective: The aim of this study was the evaluation of a school-based educational intervention to improve the knowledge and attitude of adolescent girls about puberty health.

Methods: This randomized clinical trial (Registration number: IRCT 2013111715341N2) was conducted in Hamadan during the period of 2014-2015. Four hundred forty-six (446) adolescent female students were recruited randomly, using a multistage sampling method. Students were randomly assigned to three (3) groups. Group 1(educating to students) and group 2(educating to mothers) received two 90 minutes’ puberty health educational sessions by a midwife; group 3 did not receive any intervention. Girls' knowledge and attitude about puberty health were assessed using a questionnaire administered to each group before and after the intervention. SPSS 16 software was used for analyzing data.

Results: The three groups were similar in terms of demographic characteristics. There was no significant difference in knowledge and attitude scores between the control group and two interventional groups before the intervention. However, after the intervention, there was a significant difference in the knowledge and attitude of the students in the two interventional groups compared with the control group (p<0.001). The knowledge score was significantly higher in the students' group that was taught by the midwife (p<0.001). The attitude score was significantly higher in the students' group to whom their mothers taught (p<0.001).

Conclusion: Mothers would better improve the attitude of adolescent girls toward puberty health if they were properly informed and knew how to transfer this information to their daughters. It seems the involvement of mothers in the educating process by a specialist such as a midwife will have a much better impact on the attitude and awareness of girls about puberty health.

Keywords: Puberty, adolescence, education, health, adolescent female, randomized controlled trial.

Shirzadi S, Asghari Jafarabadi M, Nadrian H, Mahmoodi H. Determinants of puberty health among female adolescents residing in boarding welfare centers in Tehran: An application of health belief model. Med J Islam Repub Iran 2016; 30: 432-8.
[PMID: 28210597]
Rafiee Z, Assarroudi A, Zare M, Heidarian Miri H, Behboudifar A, Heshmati Nabavi F. Effects of a school-based interventional program on smoking refusal self-efficacy in adolescent females. Evid Based Care J 2018; 8(3): 46-56.
Brooks-Gunn J, Peterson AC, Eds. Girls at puberty: Biological and psychosocial perspectives. Springer Science & Business Media New York 2013.
Yousefi M, Karmaus W, Zhang H, et al. Relationships between age of puberty onset and height at age 18 years in girls and boys. World J Pediatr 2013; 9(3): 230-8.
[http://dx.doi.org/10.1007/s12519-013-0399-z] [PMID: 23335183]
World Health Organization. Adolescents: health risks and solutions 2014. Available from: http://www.who.int/mediacentre/factsheets/fs345/en/ [Accessed on: July 28, 2018]
Moodi M, Zamanipour N, Sharifirad GR, Shahnazi H. Evaluating puberty health program effect on knowledge increase among female intermediate and high school students in Birjand, Iran. J Educ Health Promot 2013; 2: 57.
[http://dx.doi.org/10.4103/2277-9531.120851] [PMID: 24520555]
World Health Organization. WHO recommendations on adolescent health: guidelines approved by the WHO Guidelines Review Committee 2017. Available from: https://www.who.int/maternal_child_adolescent/documents/adolescent-health-recommendations/en/ [Accessed on: August 3, 2017]
Yamamoto T. Health Education in Puberty: -From the standpoint of an obstetrician-gynecologist. Japan Med Assoc J 2012; 55(4): 292-7.
[PMID: 25237235]
Kapoor J. A descriptive study to assess the knowledge and practices of menstrual hygiene among adolescent girls of government women college parade, Jammu. J Pharm Innov 2017; 16(18): 19-21.
Statistical center of Iran. Results of population and housing census 2016. Available from: https://www.amar.org.ir [Accessed on: August 3, 2017]
Alavi M, Poushaneh K, Khosravi A. Puberty health: knowledge, attitude and practice of the adolescent girls in Tehran, Iran. Payesh 2009; 8(1): 59-65.
Mosavi Z, Parsa P, Cheraghi F, Farhadian M. Investigating the effective demographic factors on menstrual health knowledge and practices among High School Girls in Hamadan, in 2014. Avicenna J Nurs Midwifery Care 2018; 26(1): 26-32.
Agha Yusefi A, Ali Poor A, Najari Hasanzad F. The Effectiveness of puberty and menstrual health education on the general health of girls in the third grade of middle school. Jpn Psychol Res 2009; 1(3): 105-18. [Persian]
Afghari A, Eghtedari SH, Pashmi R, Sadri GH. Effects of puberty health education on 10-14 year-old girls’ knowledge, attitude, and behavior. Iran J Nurs Midwifery Res 2008; 13(1): 24-7.
McPherson ME, Korfine L. Menstruation across time: menarche, menstrual attitudes, experiences, and behaviors. Womens Health Issues 2004; 14(6): 193-200.
[http://dx.doi.org/10.1016/j.whi.2004.08.006] [PMID: 15589769]
Askarinejad F, Kian M, Mazloomy SS. Designing the puberty health curriculum for girl students of secondary education in Iran. Tolooe Behdasht J 2018; 16(6): 43-52.
Afsari A, Mirghafourvand M, Valizadeh S, Abbasnezhadeh M, Galeshi M, Fatahi S. The effects of educating mothers and girls on the girls’ attitudes toward puberty health: a randomized controlled tria Int J Adolesc Med Health 2017; 29(2)http:///j/ijamh.2017.29.issue- 2/ijamh-2015-0043/ijamh-2015-0043.xml
Mokari H, Khaleghparast S, Samani L. Impact of puberty health education on anxiety of adolescents. Health Sci 2016; 5(5): 284-91. [Persian]
İşgüven P, Yörük G, Çizmecioğlu FM. İşgüven p, Yörük g, and Çizmecioğlu FM. Educational needs of adolescents regarding normal puberty and menstrual patterns. J Clin Res Pediatr Endocrinol 2015; 7(4): 312-22.
[http://dx.doi.org/10.4274/jcrpe.2144] [PMID: 26777043]
Hennegan J, Dolan C, Steinfield L, Montgomery P. A qualitative understanding of the effects of reusable sanitary pads and puberty education: implications for future research and practice. Reprod Health 2017; 14(1): 78.
[http://dx.doi.org/10.1186/s12978-017-0339-9] [PMID: 28655302]
Zendehdel M, Elyasi F. Biopsychosocial etiology of premenstrual syndrome: A narrative review. J Family Med Prim Care 2018; 7(2): 346-56.
[http://dx.doi.org/10.4103/jfmpc.jfmpc_336_17] [PMID: 30090776]
Kazemi Z. The effect of family variables on information rate of guidance school female students about maturity health. J Fam Res 2012; 8(31): 319-35.
Haji Amini Z, Ebadi A, Kh A, Ajali A. Effect of puberty health education through reliable sources on health behaviors of girls. J Behav Sci 2010; 4(2): 155-61. [Persian]
Reyes C, Barakat-Haddad C, Barber W, Abbass-Dick J. Investigating the effectiveness of school-based breastfeeding education on breastfeeding knowledge, attitudes and intentions of adolescent females. Midwifery 2019; 70: 64-70.
[http://dx.doi.org/10.1016/j.midw.2018.12.010] [PMID: 30580074]
Keramati M, Mahjobe-Eshratabadi H, Esfandyyari M. Effect of puberty health education program on adolescences’ knowledge, attitude and public health. J New Thoughts Educ 2010; 5(1): 35-50. [Persian]
Haque SE, Rahman M, Itsuko K, Mutahara M, Sakisaka K. The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh. BMJ Open 2014; 4(7)e004607
[http://dx.doi.org/10.1136/bmjopen-2013-004607] [PMID: 24993753]
Majlesi F, Mahmoodi M, Rahimi A, Shojaeizadeh D, Mojtahedi Y. Comparing two educational methods (lecture and educational package methods) in knowledge and attitude of teenage girls on puberty health, in Kish Island, Iran. In: The first International & 4th National Congress on Health Education & Promotion, 16-19 May 2011, Tabris, Iran.
Akbari F, Azadbakht L. A systematic review on diet quality among Iranian youth: focusing on reports from Tehran and Isfahan. Arch Iran Med 2014; 17(8): 574-84.
[PMID: 25065282]
Najafi F, Mozafari S, Mirzaee S. Assessment of 3rd grade junior school girl students’ knowledge and attitude toward puberty age sanitation. J Guilan Uni Med Sci 2012; 21(81): 22-8.
Sistani N, Khoi M, Taghdisi MH. Promoting knowledge, attitude and practices (KAP) of the mothers in their Girls’ pubertal health based on peer education approach. Majallah-i Danishgah-i Ulum-i Pizishki-i Babul 2010; 11(6): 33-9.
Young DR, Haskell WL, Taylor CB, Fortmann SP. Effect of community health education on physical activity knowledge, attitudes, and behavior. The Stanford Five-City Project. Am J Epidemiol 1996; 144(3): 264-74.
[http://dx.doi.org/10.1093/oxfordjournals.aje.a008921] [PMID: 8686695]
Chen Y, Ma L, Ma Y, et al. A national school-based health lifestyles interventions among Chinese children and adolescents against obesity: rationale, design and methodology of a randomized controlled trial in China. BMC Public Health 2015; 15(1): 210.
[http://dx.doi.org/10.1186/s12889-015-1516-9] [PMID: 25885323]

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Article Details

Year: 2020
Published on: 08 September, 2020
Page: [341 - 347]
Pages: 7
DOI: 10.2174/1573404816999200420111101
Price: $65

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