The effect of education based on health belief model on improving puberty health and healthy life style in adolescent girls: a randomized controlled field trial

Abstract

Background: Factors such as lack of proper knowledge on puberty health in adolescent girls leads to wrong behavior in this period. Puberty health education would be futile or ineffective without a plan. Choosing an education based on health belief model starts the program on the right track and keeps it in the right direction. Consequently, present study aimed to determine the effect of education based on this model on improving puberty health and healthy lifestyle in girl adoloescents in sarab in 2019. Methods: This study was a parallel controlled randomized controlled trial. The participants were 168 eligible girl students aged 13-15 years old in the 12 first grade high schools in Sarab, Dozdozan, Mehrban and sharabiyan city that randomly divided into experimental and control groups (6 schools for each group). Twenty eight students from each school were randomly enrolled. Data regarding puberty health were collected by Shirzadie questionnaire. Healthy Lifestyle Questionnaire based on Health Belief Model was a self-made questionnaire inspired by Walker health-promoting lifestyle questionnaire for adolescents. The validity of the questionnaire was assessed based on face and content validity and its reliability was assessed by Cronbach's alpha. Education was based on the Health Belief Model. The primary outcomes were the mean scores of puberty health and healthy lifestyle 8 weeks after education. The data were analyzed through SPSS/ 21 software using Chi-square test, Independent t-test, Fisher exact test, and analysis of covariance. Results: Findings of the present study showed that demographic variables were not significantly different in two groups (p>0.05) except famaily size, maternal age, education of mothers and fathers, and number of sisters. After intervention, significant increases were observed in the mean scores of nutrition (adjusted mean difference (aMD): 2.3; 95% confidence interval (CI): 1.1 to 3.6), health responsibility (aMD: 2.6; 95% CI: 0.6 to 4.7) and stress management (aMD: 1; 95% CI: 0.2 to 1.7) subdomains in the intervention group compared to the control group. There was a significant increase in the mean score of perceived severity subdomain of healthy lifestyle in the intervention group compared to the control group (aMD: 1.08; 95% CI: 0.2 to 1.9). A significant decrease was shown in the mean score of subscales of perceived barriers in puberty health questionnaire in the education group compared to the control group (aMD: -1.1; 95% CI: -2.2 to -0.03). Conclusion: The findings of this study showed that education based on Health Belief Model reduces perceived barriers regarding puberty health and increases perceived severity of problems due to non-compliance with healthy lifestyle. Educational interventions are recommended according to the educational needs of individuals with longer duration of intervention. It is suggested applying and comparing different types of health education models in educational planning for puberty health of adolescents.