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BMC Public Health
Published in: BMC Public Health 1/2023

Open Access 01-12-2023 | Anxiety | Research

Factors affecting students’ attitudes towards reproductive health in the north of Iran: Designing an educational program

Authors: Afsaneh Bakhtiari, Hajar Pasha, Fatemeh Kashefi, Fatemeh Nasiri-Amiri, Fatemeh Bakouei

Published in: BMC Public Health | Issue 1/2023

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Abstract

Background

It is essential to empower young people to promote reproductive health (RH) and develop effective educational programs to prevent risky behaviors. This study aimed to investigate the factors affecting students’ attitudes towards RH based on the ecological model and then design an educational program.

Methods

This cross-sectional study was conducted on 461 female students aged 18–29 in the north of Iran. This study was done in two stages. In the first stage, factors affecting the attitude towards RH including demographic questionnaire, interpersonal communication skills, family communication pattern, depression, stress and anxiety, body self-image, and self-confidence were determined. In the second stage, an educational program was designed based on the most effective factors. Independent t-test, ANOVA, and multiple linear regression were employed using SPSS version 20 software. Also, STATA version 15 software was utilized for statistical modeling to predict the best predictive model of attitude towards RH.

Results

47.7% of students had a good attitude toward RH. The majority of students had problems with interpersonal communication skills (60.7%). Also, 28.5% experienced depression, 35.8% anxiety, and 12.8% stress at different levels. More than a quarter of the students (26.5%) had poor body self-image and 18.7% had Undesirable self-esteem. Interpersonal skills (P = 0.002), family communication pattern (P = 0.004), stress (p = 0.019), anxiety (P = 0.001), and body self-image (P = 0.034) have a significant relationship with the attitude towards RH. The multiple regression showed that the most important effective factor on RH is the dialogue orientation of family communication pattern (P = 0.041), stress (P = 0.002), and anxiety (P = 0.001).

Conclusion

Stress and anxiety management training and the use of dialogue orientation in the family communication pattern for young female students are recommended based on the scientific model.
Appendix
Available only for authorised users
Literature
1.
Benyamini Y, Todorova I. Women’s reproductive health in sociocultural context. Int J Behav Med. 2017;24(6):799–802.PubMedCrossRef
2.
Farahani FK. Adolescents and young people’s sexual and reproductive health in Iran: a conceptual review. J Sex Res. 2020;57(6):743–80.PubMedCrossRef
3.
4.
Khalajabadi Farahani F, Darabi F, Yaseri M. The Effect of theory-based HIV/AIDS educational program on preventive behaviors among female adolescents in tehran: a Randomized Controlled Trial. 2020;21(3):194–206.
5.
Beymer M, Willmes CG. Fruitful futures for reproductive health. Trends Endocrinol Metab. 2021;32(8):531–2.PubMedCrossRef
6.
Swartzendruber A, Brown JL, Sales JM, Windle M, Haardörfer R. Age-related associations between substance use and sexual risk behavior among high-risk young african american women in the South. Addict Behav. 2019;96:110–8.PubMedPubMedCentralCrossRef
7.
Gollub EL, Beauvais S, Roye C. College-attending young men’s sexual and reproductive health knowledge, attitudes and practices. J Am Coll Health. 2022;70(3):706–16.PubMedCrossRef
8.
Zakaria M, Karim F, Mazumder S, Cheng F, Xu J. Knowledge on, attitude towards, and practice of sexual and reproductive health among older adolescent girls in Bangladesh: an Institution-Based cross-sectional study. Int J Environ Res Public Health. 2020;17(21):7720.PubMedPubMedCentralCrossRef
9.
10.
Darabi F, Yaseri M, Kaveh MH, Khalajabadi Farahani F, Majlessi F, Shojaeizadeh D. The Effect of a theory of planned behavior-based educational intervention on sexual and reproductive health in iranian adolescent girls: a Randomized Controlled Trial. J Res Health Sci. 2017;17(4):e00400. https://​pubmed.​ncbi.​nlm.​nih.​gov/​29233954/​.PubMed
11.
Denno DM, Hoopes AJ, Chandra-Mouli V. Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support. J Adolesc Health. 2015;56(1):22–41.CrossRef
12.
13.
14.
15.
16.
Kilfoyle KA, Vitko M, O’Conor R, Bailey SC. Health literacy and women’s reproductive health: a systematic review. J Womens Health (Larchmt). 2016;25(12):1237–55.PubMedCrossRef
17.
Mazza D, Botfield JR. Sexual and reproductive health. Semin Reprod Med. 2022;40(5–06):227–8.PubMed
18.
19.
Honarvar B, Salehi F, Barfi R, Asadi Z, Honarvar H, Odoomi N, Arefi N, Lankarani KB. Attitudes toward and experience of singles with premarital sex: a Population-Based study in Shiraz, Southern Iran. Arch Sex Behav. 2016;45(2):395–402.PubMedCrossRef
20.
Kashefi F, Bakhtiari A, Pasha H, Amiri FN, Bakouei F. Student attitudes about reproductive health in public universities: a cross-sectional study. Int Q Community Health Educ. 2021;41(2):133–42.PubMedCrossRef
21.
22.
23.
Olfati F, Aligholi S. A study on educational needs of teenager girls regarding the reproductive health and determination of proper strategies in achieving the target goals in Qazvin. J Inflamm Dis. 2008;12(2):76–82.
24.
Vakili MM, Hidarnia AR, Niknami S. Development and psychometrics of an interpersonal communication skills scale (A.S.M.A) among Zanjan health volunteers. J Hayat. 2012;18(1):5–19.
25.
Hassanzadeh M. Investigation of the relationship between family communication patterns and social creativity in students. IJBS. 2013;7(2):109–16.
26.
27.
Izaadi A, Karimi J, Rahmani M. Psychometric analysis of persian version of body image flexibility questionnaire (BI-AAQ) among University students. J Hayat. 2013;19(3):56–69.
28.
Shapurian R, Hojat M, Nayerahmadi H. Psychometric characteristics and dimensionality of a persian version of Rosenberg Self-esteem scale. Percept Mot Skills. 1987;65(1):27–34.PubMedCrossRef
29.
Khodakarami B, Aligholi S. The Effect of education based on James Brown Pattern on Knowledge of Reproductive & sexual health in women participant marriage council classes in Hamadan. Avicenna J Nurs Midwifery Care. 2011;19(1):52–62.
30.
Yosefi Z, Afshar M, Mirbagher Ajorpaz N, Sadat Z. The Effect of training based on James Brown Model on self-efficacy in adolescents with type 1 diabetes mellitus. J Holist Nurs Midwifery. 2021;31(2):76–84.CrossRef
31.
Salazar LF, Bradley EL, Younge SN, Daluga NA, Crosby RA, Lang DL, DiClemente RJ. Applying ecological perspectives to adolescent sexual health in the United States: rhetoric or reality? Health Educ Res. 2010;25(4):552–62.PubMedCrossRef
32.
Abedini S, Nooraddin S, Ghanbarnejad A. The effectiveness of educational programs based on james brown model on knowledge, attitudes and behaviors related to nutritional iron deficiency anemia in female high school students. J Chem Pharm Res. 2015;7(10):664–9.
33.
34.
Namazi A, Homauonfar H. Assessment of interpersonal communication skills and related factors in nursing and midwifery students. Health_Based Res. 2017;2(4):369–80.
35.
Cherie A, Berhane Y. Peer pressure is the prime driver of risky sexual behaviors among school adolescents in Addis Ababa, Ethiopia. World J AIDS. 2012;2(3):159–64.CrossRef
36.
Srahbzu M, Tirfeneh E. Risky sexual behavior and associated factors among adolescents aged 15–19 years at governmental high schools in Aksum Town, Tigray, Ethiopia, 2019: an Institution-Based, cross-sectional study. Biomed Res Int. 2020;2020:3719845.PubMedPubMedCentralCrossRef
37.
Francis DB, Zelaya CM, Fortune DA, Noar SM. Black college women’s interpersonal communication in response to a sexual health intervention: a mixed methods study. Health Commun. 2021;36(2):217–25.PubMedCrossRef
38.
Helme DW, Noar SM, Allard S, Zimmerman RS, Palmgreen P, McClanahan KJ. In-depth investigation of interpersonal discussions in response to a safer sex mass media campaign. Health Commun. 2011;26(4):366–78.PubMedPubMedCentralCrossRef
39.
Frank LB, Chatterjee JS, Chaudhuri ST, Lapsansky C, Bhanot A, Murphy ST. Conversation and compliance: role of interpersonal discussion and social norms in public communication campaigns. J Health Commun. 2012;17(9):1050–67.PubMedCrossRef
40.
Jeong M, Bae RE. The effect of campaign-generated interpersonal communication on campaign-targeted Health Outcomes: a Meta-analysis. Health Commun. 2018;33(8):988–1003.PubMedCrossRef
41.
Brindis CD, Decker MJ, Gutmann-Gonzalez A, Berglas NF. Perspectives on adolescent pregnancy prevention strategies in the United States: looking back, looking Forward. Adolesc Health Med Ther. 2020;11:135–45.PubMedPubMedCentral
42.
Bingham A, Drake JK, Goodyear L, Gopinath CY, Kaufman A, Bhattarai S. The role of interpersonal communication in preventing unsafe abortion in communities: the dialogues for life project in Nepal. J Health Commun. 2011;16(3):245–63.PubMedCrossRef
43.
Farahani FK, Cleland J, Mehryar AH. Associations between family factors and premarital heterosexual relationships among female college students in Tehran. Int Perspect Sex Reprod Health. 2011;37(1):30–9.PubMedCrossRef
44.
45.
Mashalpoure Fard M. The relationship between family communication patterns and adjustment with resiliency in children. J Res Health. 2020;10(4):267–74.CrossRef
46.
Ghaffari M, Esmali A, Mohammadi R. The mediating role of family communication patterns in the relationship between emotional maturity and self-compassion with vulnerability to stress in soldiers. JPMed. 2021;10(4):287–92.
47.
Dorrance Hall E, Scharp K, Sanders M, Beaty L. Family communication patterns and the mediating effects of support and resilience on students’ concerns about college. Fam Relat. 2020;69(2):273–91.CrossRef
48.
Ehyakonandeh M, Yousefi F. Relationship between family communication patterns and adjustment to university: mediating role of coping strategies. J Family Res. 2017;13(50):273–91. [In Persian].
49.
Rahimi M, Meratian N, Zareei Mahmoodabadi H. The role of family communication dimensions in adolescents’ depression with the mediation of cognitive flexibility. J Fundamentals Mental Health. 2018;20(5):289–97.
50.
Ajeli Lahiji L, Besharat MA. The role of personality traits in predicting family functioning and quality of life among nurses, Shiraz, Iran 2017–2018. J Occup Health Epidemiol. 2019;8(2):81–7.CrossRef
51.
Racic M, Todorovic R, Ivkovic N, Masic S, Joksimovic B, Kulic M. Self- perceived stress in relation to anxiety, depression and health-related quality of life among health professions students: a cross-sectional study from Bosnia and Herzegovina. Zdr Varst. 2017;56(4):251–59.PubMedPubMedCentral
52.
Gilliam ML, Berlin A, Kozloski M, Hernandez M, Grundy M. Interpersonal and personal factors influencing sexual debut among mexican-american young women in the United States. J Adolesc Health. 2007;41(5):495–503.PubMedCrossRef
53.
Lehrer JA, Shrier LA, Gortmaker S, Buka S. Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students. Pediatrics. 2006;118(1):189–200.PubMedCrossRef
54.
55.
Giovenco D, Kahn K, Hughes JP, MacPhail C, Wagner R, Pettifor A. Self-esteem as an Indicator of Transactional Sex among Young Women in Rural South Africa (HPTN 068). AIDS Behav. 2020;24(3):823–26.PubMedPubMedCentralCrossRef
56.
Duchesne AP, Dion J, Lalande D, Bégin C, Émond C, Lalande G, et al. Body dissatisfaction and psychological distress in adolescents: is self-esteem a mediator? J Health Psychol. 2017;22(12):1563–69.PubMedCrossRef
57.
58.
Lin H-C, Lin Y-C. The study of body image, self-esteem and sexual satisfaction of college students in southern Taiwan. Univers J Educational Res. 2018;6(4):647–52.CrossRef
59.
Zare N, Daneshpajooh F, Amini M, Razeghi M, Fallahzadeh MH. The relationship between self-esteem, general health and academic achievement in students of Shiraz University of Medical Sciences. Iran J Med Educ. 2007;7(1):59–67.
60.
Arshad M, Zaidi SM, Mahmood D. Self-esteem & academic performance among university students. J Educ Pract. 2015;6(5):156–62.
61.
Niemz K, Griffiths M, Banyard P. Prevalence of pathological internet use among university students and correlations with self-esteem, the General Health Questionnaire (GHQ), and disinhibition. Cyberpsychol Behav. 2005;8(6):562–70.PubMedCrossRef
Metadata
Title
Factors affecting students’ attitudes towards reproductive health in the north of Iran: Designing an educational program
Authors
Afsaneh Bakhtiari
Hajar Pasha
Fatemeh Kashefi
Fatemeh Nasiri-Amiri
Fatemeh Bakouei
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Anxiety
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-16217-2

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