Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study.
Adolescent sexual and reproductive health (SRH) decision-making is crucial for long-term well-being. It plays a significant role in public health efforts, including reducing sexually transmitted infections (STIs) and teenage pregnancies. While cultural and socio-political influences on adolescent se...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2025-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0004733 |
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| author | Jacqueline Nkrumah Aaron Asibi Abuosi Lily Yarney Gordon Abekah-Nkrumah Anita Asiwome Adzo Baku |
| author_facet | Jacqueline Nkrumah Aaron Asibi Abuosi Lily Yarney Gordon Abekah-Nkrumah Anita Asiwome Adzo Baku |
| author_sort | Jacqueline Nkrumah |
| collection | DOAJ |
| description | Adolescent sexual and reproductive health (SRH) decision-making is crucial for long-term well-being. It plays a significant role in public health efforts, including reducing sexually transmitted infections (STIs) and teenage pregnancies. While cultural and socio-political influences on adolescent sexual and reproductive health (SRH) decision-making are well-documented, less is known about the effect of SRH educational materials' difficulty levels on decision-making, particularly in Ghana and Sub-Saharan Africa. This study used a quasi-experimental design to assess the effectiveness of SRH educational materials of varying difficulty levels on decision-making skills using 317 adolescents, ages 11-15. Participants were assigned to a control group or one of the three intervention arms: difficult text, simplified text-only, or picture-enhanced text. Over six weeks, weekly sessions were conducted, followed by an end-line assessment with 249 participants and an 8-week post-intervention evaluation. Data analysis employed SPSS (version 26.0) and STATA (version 15.0), utilizing difference-in-difference and high-dimension fixed-effects models, paired sample t-test, and Kendall's coefficient of concordance. Results show participants (66%) were females and were 7th graders (56%). All three treatments, difficult text (10.808 points; CI = 1.2-20.36; P = 0.027), simplified text (11.60 points; CI = 4.68-18.52; P = 0.001), and picture-enhanced text (11.145 points; CI = 3.96-18.32; P = 0.002) significantly improved adolescents' decision-making scores. After controlling for time-invariant characteristics within groups, the difficult-text material's effect on decision-making scores declined (β3 = -6.442 points; CI = -13.908 to 1.096; P = 0.094) while that of the simplified and picture-enhanced materials was maintained. The study highlights the need for well-designed materials and effective pedagogy in SRH education to enhance learning and retention. Incorporating structured reading and discussion-based sessions into the school health program is recommended to promote the real-world application of SRH information and improve long-term SRH outcomes in adolescents. |
| format | Article |
| id | doaj-art-fac8bd972be34eb199fd391929407186 |
| institution | Kabale University |
| issn | 2767-3375 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-fac8bd972be34eb199fd3919294071862025-08-20T03:42:26ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752025-01-0157e000473310.1371/journal.pgph.0004733Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study.Jacqueline NkrumahAaron Asibi AbuosiLily YarneyGordon Abekah-NkrumahAnita Asiwome Adzo BakuAdolescent sexual and reproductive health (SRH) decision-making is crucial for long-term well-being. It plays a significant role in public health efforts, including reducing sexually transmitted infections (STIs) and teenage pregnancies. While cultural and socio-political influences on adolescent sexual and reproductive health (SRH) decision-making are well-documented, less is known about the effect of SRH educational materials' difficulty levels on decision-making, particularly in Ghana and Sub-Saharan Africa. This study used a quasi-experimental design to assess the effectiveness of SRH educational materials of varying difficulty levels on decision-making skills using 317 adolescents, ages 11-15. Participants were assigned to a control group or one of the three intervention arms: difficult text, simplified text-only, or picture-enhanced text. Over six weeks, weekly sessions were conducted, followed by an end-line assessment with 249 participants and an 8-week post-intervention evaluation. Data analysis employed SPSS (version 26.0) and STATA (version 15.0), utilizing difference-in-difference and high-dimension fixed-effects models, paired sample t-test, and Kendall's coefficient of concordance. Results show participants (66%) were females and were 7th graders (56%). All three treatments, difficult text (10.808 points; CI = 1.2-20.36; P = 0.027), simplified text (11.60 points; CI = 4.68-18.52; P = 0.001), and picture-enhanced text (11.145 points; CI = 3.96-18.32; P = 0.002) significantly improved adolescents' decision-making scores. After controlling for time-invariant characteristics within groups, the difficult-text material's effect on decision-making scores declined (β3 = -6.442 points; CI = -13.908 to 1.096; P = 0.094) while that of the simplified and picture-enhanced materials was maintained. The study highlights the need for well-designed materials and effective pedagogy in SRH education to enhance learning and retention. Incorporating structured reading and discussion-based sessions into the school health program is recommended to promote the real-world application of SRH information and improve long-term SRH outcomes in adolescents.https://doi.org/10.1371/journal.pgph.0004733 |
| spellingShingle | Jacqueline Nkrumah Aaron Asibi Abuosi Lily Yarney Gordon Abekah-Nkrumah Anita Asiwome Adzo Baku Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study. PLOS Global Public Health |
| title | Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study. |
| title_full | Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study. |
| title_fullStr | Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study. |
| title_full_unstemmed | Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study. |
| title_short | Enhancing sexual and reproductive health decision-making skills in underserved communities in Ghana: A quasi-experimental study. |
| title_sort | enhancing sexual and reproductive health decision making skills in underserved communities in ghana a quasi experimental study |
| url | https://doi.org/10.1371/journal.pgph.0004733 |
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