Research Article

A Study to Assess the Effectiveness of Structure Teaching Programme on Knowledge and

Attitude Regarding Reproductive Health among Adolescent Girls in A Selected School
Bengaluru

Tincy Mariam Easow

Assistant Professor, Department of Pediatric Nursing, AECS Maaruti College of Nursing,

RGUHS, Karnataka, India

How to cite this article:Tincy Mariam Easow,A Study to Assess the Effectiveness of Structure Teaching
Programme on Knowledge and Attitude Regarding Reproductive Health among Adolescent Girls in A Selected School
Bengaluru, International Journal of Contemporary Medicine, vol.11,(2)

Abstract
Background And Purpose: Adolescence is a transitional stage of physical and psychological development that
generally occurs during the period from puberty to adulthood. It is a decisive age for girls. They often lack knowledge
regarding reproductive health and are vulnerable to sexual assault and exploitation. This creates various problems
like menstrual problems, STD, unwanted pregnancy unsafe abortions etc. Especially in India the special needs of
adolescent girls are rarely addressed. The present study is aimed to assess the knowledge and attitude regarding
reproductive health among adolescent’s girls in a selected school, Bengaluru.

Methods: Quasi- Experimental Research Design was adopted for the present study. The self-administered structured
questionnaire was used to collect data related to demographic variables and knowledge questionnaire whereas 5-point
rating scale was used to assess the attitude of the adolescent girls regarding reproductive health. 60 adolescent girls
were selected by simple random sampling technique. The main study was conducted from 18/02/2016
to 26/02/2016 at Royal Concorde International School, Bengaluru and the data collected was analyzed
and interpreted based on descriptive and inferential statistics.

Result: The present study showed that the pre-test mean knowledge score obtained by the students was 11.23 and the
pre-test mean attitude score was 41.50. After administering structured teaching programme regarding reproductive
health, post-test mean knowledge score increased to 23.07 and posttest mean attitude score increased to83.25. The
obtained t value (30.20) was found to be highly significant at 0.001 levels. The correlation (r = 0.132) between pretest
knowledge and attitude was found to be highly significant (p=0.00) at 0.001 level whereas posttest correlation
(r=0.412, p=0.00) was significant at 0.001 level. Thus, it was evident that the developed structured teaching
programme was effective in increasing the knowledge and modification of attitude of adolescent girls
regarding reproductive health

Discussion:The overall findings of the study clearly showed that the Structured Teaching Programme was
significantly effective in improving the knowledge and modification of attitude regarding reproductive health of
adolescent girls.

Keywords: Knowledge, Attitude, Reproductive health, Adolescent girls, Anemia, Gynecological diseases

Introduction its physical, psychological and cultural

expressions may begin earlier and end
Adolescence is a Latin word derived from
later.1 The World Health Organization
the verb “Adolescere” which means to
(WHO) defines an adolescent as an
grow into adulthood. Adolescence is a
individual in the 10-19 years age group
time of moving from the immaturity of
and usually uses the term young person
childhood to the maturity of adulthood.
to denote those between 10 and 24
The period of adolescence is most closely
years. Adolescence is a period of
associated with the teenage years, through
transition from childhood to
Corresponding author: Tincy Mariam Easow, Assistant Professor, Department of Pediatric Nursing, AECS Maaruti
College of Nursing, RGUHS, Karnataka, India

Email: tincy3555@[Link]
38 International Journal of Contemporary Medicine / Volume 11 No. 2 / July-December 2023

adulthood during which adolescents develop in society. The young adolescents of 12-19
biologically and psychologically and move years have special needs in all circumstances
towards independence.2 and each age group within this population
Reproductive health is an important has different problems and requirements. In
component of general health, it is a prerequisite India, the populations of the adolescents are
for social and economic and imperative increasing day by day and so is the demand
because human energy and creativity are the for their health. So far the health system has
driving forces of development. Reproductive been more specifically targeted to infants
and children below 6 years, therefore the
health is a crucial part of general health and
unmarried adolescents have been totally
a central feature of adolescent development, ignored by government and other health
reproductive health is a universal concern, sectors.8
but is of special importance for women
Menstrual hygiene is also one of the
particularly during the reproductive years,
important aspects of reproductive health,
that is, from 12-19 years.3 Menstruation is which includes, physical hygiene like taking
generally considered as unclean in the Indian bath regularly during menses, using clean
society. Isolation of the menstruating girls sanitary pads and changing them frequently
and restrictions being imposed on them in the etc. Despite major developments in the
hygiene and sanitation sector in recent years,
family, have reinforced a negative attitude
the menstrual requirements of women
towards this phenomenon.4 Understanding
and adolescent girls have been ignored.
the knowledge, practices, and problems Overcoming this gap is vital. Menstruation is
related to menstruation and reproductive normal and natural but many adolescent girls
health, will help in planning programs for this suffer because of widespread ignorance and
vulnerable group.5 shame.9

Adolescents are at higher risk for Teenage pregnancy is a serious social

acquiring sexually transmitted diseases problem. Having children at a young age can
(STD) and adolescent girls in particular are damage young women’s mental and physical
disproportionately affected. Adolescent girls health, limit their education and career
have high rates of other sexually transmitted prospects, and increase their risk of living in
infections such as genital herpes, trichomonas, poverty and social isolation. The fetus is at
and bacterial vaginosis, syphilis, gonorhorea, risk of higher rates of prenatal mortality, low
HIV/AIDS. This is because of having a history birth weight, sudden infant death syndrome
of forced sex, a greater number of sexual and substance dependence.10
partners, be younger at first sex, having drugs
etc.6
Objectives of the Study
There are many services started by the
• To assess the level of knowledge and
government which have started working for
attitude regarding reproductive health
adolescent health and are made accessible.
among adolescent girls.
These services are passing information
including education regarding reproductive • To find out the effectiveness of STP
health, counseling of adolescents about how on knowledge and attitude regarding
to prevent sexually transmitted diseases reproductive health among adolescent
and on how to detect and avoid unwanted girls in terms of pretest and posttest
pregnancies and abortions.7 knowledge and attitude.
Adolescence has been described as a • To find out the correlation between
phase of life beginning in biology and ending knowledge and attitude regarding
 International Journal of Contemporary Medicine / Volume 11 No. 2 / July-December 2023 39

reproductive health among adolescent Tool-2 5-point rating scale to assess the
girls. attitude of children regarding reproductive
• To find the association between the health among adolescent girls.
pretest knowledge scores with selected Pilot study was conducted on 25/01/2016
demographic variables. to 01/02/2016 in a school, Bengaluru,
• To find association between the respectively after taking informed consent
pretest attitude scores with selected from the participants to find out the feasibility
demographic variables. of the study. Totally 20 subjects were selected
by using random sampling technique. The
Methodology main study was conducted at two schools,
Bengaluru, from 9/02/2016 to 16/02/2016
The theoretical frame work for the present among 60 adolescent girls who were selected
study is based on the general system theory by random sampling technique and the
by Ludwig Von Bertanlanffy with nursing collected data was analyzed and interpreted
process (1968). The study is based on Quasi- using descriptive and inferential statistics.
experimental; one group pre-test post-test
design was used for data collection. Informed Results
consent has been taken from the participants.
The independent variable refers to structured Demographic Characteristics of Adolescent
Girls
teaching programme on reproductive health
and dependent variable refers to knowledge In the present study the distribution of
and attitude regarding reproductive health the subjects by age revealed that the majority
among adolescent girls. There are 2 tools 23(38.3%) of the adolescent girls belonged to
on reproductive health among adolescent the age group of 16 years, 45(75%) of adolescent
girls was developed to collect the data as girls were Hindus. Majority 35(58.3%) of the
tool 1 which consist of part I and part II and adolescent girls were in 12TH standard. In the
5-point rating scale was developed to assess present study 22(36.7%) of adolescent girls’
the attitude of the adolescent girls which is father had PUC education and 28(46.7%) of
included in tool 2. the adolescent girls’ mother had high school
education, 33(55%) of the adolescent girls’
Tool - 1: father were in business and 45(75%) of the
The tool consists of the following sections: adolescent girls’ mother were house wife.
Majority 24(40%) of the adolescent girls had a
Part-1: consisted of items on demographic
family income of 10000 -15000/month, 49(81
variables which gives base line information
%) of the adolescent girls belonged to nuclear
of the students such as age, religion, grade
family and 37(61.7 %) of the adolescent girls
of study, educational qualification of
got information about reproductive health
parents and occupation of parents, type of
through teachers and parents.
family, family income/month and source of
information related to reproductive health Assessment of level of knowledge and
among adolescent girls. attitude regarding reproductive health
among adolescent girls in a selected school
Part- II: Consisted of 30 items related to
knowledge regarding reproductive health The present study reveals that overall mean
among adolescent girls. It was further divided knowledge score obtained by the adolescent
into 5 sections, 5 questions on anatomy & girls in pre-test was 11.23 with standard
physiology, 4 questions on forms and risk deviation of 3.70 where as in post-test was
factors of bullying, 2 questions related to effects 23.07 with standard deviation of 1.93
of bullying and 8 questions on intervention The present study reveals that overall
and preventive measures of bullying. mean attitude score obtained by the adolescent
40 International Journal of Contemporary Medicine / Volume 11 No. 2 / July-December 2023

girls in pre-test was 41.50 with standard by the adolescent girls was 41.50 with the S.D
deviation 7.02 where as in post-test was 83.25 of 7.024 and in posttest the mean of overall
with standard deviation 6.66 attitude obtained by the adolescent girls was
83.25 with the S.D of 6.66.
Assessment of knowledge and attitude
scores of adolescent girls regarding repro- Effectiveness of stp on knowledge and
ductive health attitude regarding reproductive health
among adolescent girls
The results shows that in pre-test 80% of the
adolescent girls had inadequate knowledge The result showed that the overall mean
and 20% had moderately adequate knowledge pretest knowledge score 11.23 with SD 3.70
regarding reproductive health. Where in was lesser than the mean post-test knowledge
the post-test 81.7% of the adolescent girls score 23.07 with SD 1.93. The obtained’ value
had adequate knowledge and 18.3% had (23.57) was found to be significant (p=0.00) at
moderately adequate knowledge regarding 0.001 level. Further the data shows that there
reproductive health. was a significant difference between area wise
pre and posttest knowledge (p=0.00) at 0.001
level. Thus, structure teaching programme
Areawise mean, S.D and mean percentage of
the pre-test and post test attitude scores of was highly effective on level of knowledge of
adoloscent girls the adolescent girls regarding reproductive
health and hypothesis (H1) was accepted.
The above table shows that in the pretest
maximum mean score obtained by the Similarly, the overall pretest mean
adolescent girls was 10.83 with S.D of 2.11 attitude score of the adolescent girls regarding
in the aspect of menstrual cycle. Where as in reproductive health was 41.50 with SD 7.03
the post test maximum mean obtained by the was lesser than the posttest attitude score
adolescent girls was 21.25 with S.D of 2.50 in 83.25 with SD 6.66. The obtained t value (30.20)
the aspect of Sexual education. Similarly, in was found to be significant (p=.00) at 0.001
pretest the mean of overall attitude obtained

100 85
83.93 83.53 83.25
90 80.53
80
70
Percentage

60
50 43.33 40.67 39.47 42.53 41.5
Pre
40
30 test
20 Post
10 test
0
ex
n
le

e
ud
tio
yc

ls

tit
ca
lc

ita

at
du
ra

ar

ll
stu

le

ra
nt
ua
en

ve
e

e
Pr

sc
x
M

O
Se

lo
do
A

Figure 1: Areawise pre test & post test mean percentage attitude scores of adoloscent girls
 International Journal of Contemporary Medicine / Volume 11 No. 2 / July-December 2023 41

level. Thus, it means that STP was effective reproductive health was 41.50 with SD 7.03
in modification of attitude of adolescent girls. was lesser than the post test attitude score
Hence hypothesis H2 was accepted. 83.25 with SD 6.66. The obtained t value (30.20)
was found to be significant (p=0.00) at 0.001
Mean, sd and paired – t value of knowledge level. Thus, it means that structure teaching
of adoloscent girls regarding reproductive programme was effective in modification of
health attitude of adolescent girls. Hence hypothesis
The result showed that the overall mean pretest H2 was accepted.
knowledge score 11.23 with SD 3.70 was lesser
than the mean post-test knowledge score 23.07 Correlation between knowledge and attitude
with SD 1.93. The obtained t’ value (23.57) was regarding reproductive health before and
after structured teaching programme.
found to be highly significant (p=0.00) at 0.001
level. Further the data shows that there was a The table 1 showed the correlation (r = 0.132)
significant difference between area wise pre between pre test knowledge and attitude
and posttest knowledge (p=0.00) at 0.01, 0.05 was found to be highly significant (p=0.00)
level. Thus, structured teaching programme at 0.001 level. Further data reveals that there
was highly effective on level of knowledge of was low positive correlation between pretest
the adolescen t girls regarding reproductive knowledge and attitude of adolescent girls
health and hypothesis (H1) was accepted. Hence the research hypothesis (H3) was
accepted.
Mean, sd and paired - t value of attitude
of adoloscent girls regarding reproductive Mean, Sd And Pearson Correlation Of Post
health Test Knowledge And Attitude Score
The result showed the overall pretest mean The table 2 shows correlation (r =0.412)
attitude score of the adolescent girls regarding between post test knowledge and attitude

Table-1

Variable Mean SD r P value Inferences

Knowledge 11.233 3.702
0.132 0.00** Low positive
Pre test Attitude 41.50 7.024 correlation

**highly Significance at p<0.001, df 59

70

60

50
pre test attitude

40 CORREAL
TION
30

20

10

0
0 5 pre test knowledge
10 15 20

Figure 2: Correlation between pre-test knowledge and attitude scores of adoloscent girls
42 International Journal of Contemporary Medicine / Volume 11 No. 2 / July-December 2023

Table-2 n=60

Variable Mean SD r p value Inferences

Knowledge 23.066 1.929
POST TEST Significant positive
Attitude 83.25 6.663 0.412 0.00**
Correlation

*Significance at P<0.01 and p<0.05, df 59

100
90
80
70
pre test attitude

60
CORRELA
50 TION
40
30
20
10
0
0 5 10
pre 15 20
test knowledge 25 30

Figure 3: Correlation between post test knowledge and attitude score

was found significant (p =0.00) at 0.001 level. adolescent girls with selected demographic
Further data reveals that there was positive variables such as age, religion, class, education
correlation between posttest knowledge of parent, occupation of parent, types of family,
and attitude of adolescent girls regarding income of family and sources of information. It
reproductive health. Hence the research shows that there was no significant association
hypothesis (H3) was accepted. between attitude scores of the adolescent girls
regarding reproductive health with selected
A) Association of pre-test knowledge score demographic variables at p<0.01 and p<0.05.
with selected demographic variables Thus hypothesis (H5) was rejected
The finding showed that computated χ2 value
Association between pre-test knowledge
between the pre-test knowledge scores of
scores regarding reproductive health
adolescent girls with selected demographic among adoloscent girls with the selected
variables such as age, religion, class, education demographic variables
of parent, occupation of parent, types of family,
The above table 2 depicts computation of
income of family and sources of information. It
χ2 value between the pre-test knowledge
shows that there was no significant association
scores of adolescent girls with selected
between knowledge scores of the adolescent
demographic variables such as age, religion,
girls regarding reproductive health with
class, education of parent, occupation of
selected demographic variables at p<0.01 and
parent, types of family, income of family
p<0.05. Thus hypothesis (H4) was rejected.
and sources of information. It shows that
there was no significant association between
B) Association of pre-test attitude score
knowledge scores of the adolescent girls
with selected demographic variables
regarding reproductive health with selected
The finding revealed that computated χ2 demographic variables at p<0.01 and p<0.05.
value between the pre-test attitude scores of Thus hypothesis (H4) was rejected.
 International Journal of Contemporary Medicine / Volume 11 No. 2 / July-December 2023 43

MAJOR FINDINGS OF THE STUDY data shows that there was a significant
difference between area wise pre and
• In knowledge, pre-test 48 (80%) of
post-test knowledge (p=0.00) at 0.001.
the adolescent girls had inadequate
Thus, structure teaching programme was
knowledge and 12 (20%) had
highly effective on level of knowledge
moderately adequate knowledge
of the adolescent girls regarding
regarding reproductive health. and 0%
reproductive health and hypothesis (H1)
had adequate knowledge regarding
was accepted.
reproductive health. Likewise In post-
test 49 (81.7%) of the adolescent girls had • the overall pre-test mean attitude
adequate knowledge and 11(18.3%) had score of the adolescent girls regarding
moderately adequate knowledge and 0% reproductive health was 41.50 with SD
have inadequate knowledge regarding 7.03 was lesser than the post-test attitude
reproductive health. score 83.25 with SD 6.66. The obtained t
value (30.20) was found to be significant
• The maximum mean score obtained by
(p=0.00) at 0.001 level. Thus, it means
the adolescent girls in pre-test was 2.72
that structure teaching programme was
with SD 1.47. Whereas in post-test 6.05
effective in modification of attitude of
with SD 0.98 in menstrual cycle and
adolescent girls. Hence hypothesis H2
menstrual hygiene. Similarly, the overall
was accepted.
post-test mean score was 23.07with the
S.D of 1.93 and pre-test mean score was • The computed χ2 value between the pre-
11.23 with SD of 3.70. test attitude scores of adolescent girls
with selected demographic variables
• In attitude pre-test, 48(80%) of the
such as age, religion, class, education of
adolescent girls had inadequate attitude,
parent, occupation of parent, types of
12(20%) had moderately adequate
family, income of family and sources of
attitude 0% had adequate attitude.
information. It shows that there was no
Likewise in post-test 49(81.7%) had
significant association between attitude
Adequate Attitude and 11(18.3%) had
scores of the adolescent girls regarding
moderately adequate attitude and 05 had
reproductive health with selected
inadequate knowledge.
demographic variables at p<0.01 and
• In the pre-test maximum mean score p<0.05. Thus hypothesis (H5) was rejected.
obtained by the adolescent girls was
10.83 with S.D of 2.11 in the aspect of Conclusion
menstrual cycle. Where as in the post
test maximum mean obtained by the The focus of this study was to assess the
adolescent girls was 21.25 with S.D of effectiveness of STP on knowledge and
2.50 in the aspect of Sexual education. attitude regarding reproductive health
Similarly in pre-test the mean of overall among adolescent girls. The collected data
attitude obtained by the adolescent girls was subjected to analysis using descriptive
was 41.50 with the S.D of 7.024 and in statistics such as frequency, mean and mean
post-test the mean of overall attitude percentage, median and standard deviation.
obtained by the adolescent girls was Inferential statistical methods like paired’ test,
83.25 with the S.D of 6.66. correlation coefficient and Chi- square (χ2)
were used for analysis. The overall results of
• The overall mean pre-test knowledge
the study sound good comparatively to the
score 11.23 with SD 3.70 was lesser than
post test from pre-test.
the mean post-test knowledge score
23.07 with SD 1.93. The obtained ‘t’
value (23.57) was found to be significant
List of Abbreviation
(p=0.00) at 0.001 level. Further the STP - Structured teaching programme.
 International Journal of Contemporary Medicine / Volume 11 No. 2 / July-December 2023
44

SD - Standard Deviation 6. Thakre SB, Thakre SS, Reddy M, Rathi N, Pathak

K, Ughade S. Menstrual hygiene: knowledge and
STD - Sexually Transmitted Disease practice among adolescent school girls of saoner,
Nagpur district. Journal of clinical and diagnostic
Ethical Clearance research. 2011 October [cited: 2016 Feb. 25];
5:1027-1033. [Link]
Ethical clearance has been obtained from the asp?issn=0973
concerned authority and participants. 7. Muller N. Research must to address menstruation-
related issues among school girls. The economic
Source of Funding times. Press trust of India [internet]. 2015 [cited
2015 Aug. 2]. [Link].
This is a self-funded study. com › Collections › Sanitation
8. Dawn UM, Yasamin K. Associations between forced
Conflict of Interest sex, sexual and protective practices and sexually
transmitted diseases among a national sample of
Have no conflict of interest relevant to this adolescent girls. May –June 2004; 14(3):75–[Link].
research study. [Link] › Publications.
9. Marlow DR, Barbara RA. Text book of Paediatric
References Nursing. 6th edition. Sanders publication; 1122,
1133-1134
1. Manivannan.C. Sex education among adolescent
10. Appala N, Bodhi VVS, Prasad KVS. Knowledge
girls. Nightingale Nursing Times [Internet]. 2009;
about reproductive health among adolescent
4(2): 48-51.
high school girls (rural) in Karapa mandal.
2. [Link]/cdc/onlinecdc/uploads/05_ International Journal of Research and Health
N013_9606.doc Science. 2014; 2(2): 2321–7251. [Link]/issues.
3. Mouli VC. Introduction to adolescent health php?val=Volume2&iss=Issue2
& adolescent sexual and reproductive health. 11. Solanki DH, Gosalia DV, Patel DH, Vora DF, Singh
Adolescent and youth reproductive health D. A study of menstrual problems & practices
[internet]. 2015. among girls of manila college. National Journal of
4. [Link]/...2015/adolescent-health/.../ Integrated research and medicine [internet].2012
introduction-adolescence-he... [cited February 25, 2016]; 3(4): 24-27. www.
5. Rao RS, Lena A, Nair NS, Kamath V. Effectiveness [Link]/?mno=27535
of reproductive health education among rural 12. Varid M , Sharaddha D, Kumar D, Dabral S.B.
adolescent girls: A school based study in Udupi Knowledge and attitude of adolescent girls about
taluk Karnataka. Indian journal of medical science reproductive health and sexual issues in urban area
[internet]. 2008 Nov; 11(62): 439-43. [Link]. of Allahabad. Indian Journal of Preventive and
[Link]/request?ms08079 Social medicine.2002; July-Dec (3&4) 33:131-139