Int J Adolesc Med Health 2015; 27(1): 73–77
Zohreh Shahhosseini and Kobra Abedian*
Health care providers and adolescents’ perspectives towards adolescents’ health education needs: a need assessment based on comparative approach Abstract Aim: Health care providers have considerable influence on adolescents’ health promotion. Thus, it is important to focus on the views of this group as one of the most reliable sources in the evaluation of teenagers’ health needs. The aim of this study was to compare the attitudes of Iranian health care providers and adolescents towards the latter’s health education needs. Materials and methods: A quantitative cross-sectional survey, including 72 health care providers and 402 female students from 14 high schools in northern Iran, was carried out in 2011. Topics in a self-administrated questionnaire covered the participants’ perspectives towards the educational health needs of adolescents in a five-point Likert scale. Results: Findings revealed from health care providers’ views indicate that the highest mean score was assigned to “Education about prevention of sexual high risk behavior”, which was significantly different from adolescents’ perspective (t = 8.42, p 0.05). Conclusion: Provision of health education programs for adolescents, which are based on integration of health care providers’ perspectives and the adolescents’ views, are essential in meeting adolescents’ educational health needs. Keywords: adolescents; health care providers; health needs; Iran. *Corresponding author: Kobra Abedian, Vesal Street, Amir Mazandarani Boulevard, Sari, Mazandaran Province, Iran, Phone: +98-151-2267342, Fax: +98-151-2268915, E-mail: [email protected] Zohreh Shahhosseini: Department of Midwifery and Reproductive Health, Mazandaran University of Medical Sciences, Sari, Iran Kobra Abedian: Department of Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
DOI 10.1515/ijamh-2014-0007 Received February 9, 2014; accepted April 17, 2014; previously published online May 31, 2014
Introduction One of the most prominent features of the population of eastern Mediterranean countries, including Iran, is their young population (1, 2). Based on the general census in 2011, the age group between 10 to19 years comprises 21.8% of the Iranian population (3). During the critical period of adolescence, teenagers encounter physical, psychological and social changes, and may have different needs as a result of these various changes (4, 5). In female adolescents, this period is more important, because of their valuable role in reproduction. For this reason, the United Nation Population Fund expresses that the girls’ health is the main key to overcoming the cycle of poverty between generations and to maintaining the organization’s Millennium Development Goals (6–8). To promote adolescents’ health, it is essential to consider their health needs and meet them with principled planning. It is currently considered that the gap between adolescence and adulthood is too much. Compared with the previous generation, today’s teens spend more time in schools, and marriage and pregnancy occur later among them. This means that they have a greater need for skills and services to promote their health status (9, 10). In this regard, there is an urgent need to educate them with health-related issues. Existing evidence shows that there is a significant gap in terms of teenagers’ education in health-related matters. Their knowledge regarding healthrelated topics ranged from low to average and came mostly from friends who were as unaware and inexperienced as they were (11, 12). Meanwhile, the lack of necessary education with appropriate contents has also exposed them to high risk behaviors (13, 14). One of the basic steps in appropriate planning for the provision of health education is need assessment, which is
Brought to you by | La Trobe University Authenticated Download Date | 11/28/17 8:31 PM
74 Shahhosseini and Abedian: Health-related educational needs of adolescents considered a method for identifying health needs and providing suggestions for meeting them. It is a vital health care planning tool that can be used at the family, community, and population levels (15, 16). There are different approaches in conducting need assessment, and these include the comparison approach (17, 18). Here, the services received and expected from health care providers (HCPs) and clients, respectively, are compared with each one another. To the best of our knowledge, conducted studies have presented the differences between teenagers’ opinions with their parents and teachers’ perspectives in health-related education (19–21). However, few published studies have simultaneously investigated the differences in the opinions between health care providers and adolescents. It is anticipated that a need assessment based on comparative approach could clarify the ambiguous points of this subject.
Materials and methods This descriptive cross-sectional study was conducted from November 2010 to March 2011 by collecting data through census method. The participants included 72 HCPs (43 midwives, 23 family health practitioners, and six family physicians) who came all of the urban health care centers (14 centers) in Sari City, Northern Iran. From 83 questionnaires distributed, data of 11 questionnaires were excluded because of missing data. Hence, our response rate was 86.74%. In addition, 402 high school students between 15 and 18 years were recruited by single-stage cluster sampling method. First, all of the high schools in the study area were identified. Then, with the help of random number table, 14 schools (one school in each health care center region) were selected and then in each school, one classroom was randomly considered as the selected class, considering students’ population in each grade. Finally, in each class, all present students in the sampling day who were willing to participate in the study filled out the self-administered questionnaire for about 10–15 min. The research instrument was developed by researchers based on a review of existing studies in this area and the opinions of experts. The research instrument consisted of two parts. The first part was related to the sociodemographic characteristics of participants (eight questions), and the second part contained 14 statements that assessed their perspectives towards the educational health needs of adolescents as well as their opinions about proper source of education in this issue (12 questions). The participants were requested to determine their opinions in a five-point Likert scale, with scores ranging from 1 (strongly disagree) to 5 (strongly agree). The total score of each domain was the average score of the statements based on five points. The questionnaire’s psychometric properties were determined by content validity and reliability. Validity of the questionnaire was established through a comprehensive literature review on existing surveys that assessed educational health needs of adolescents (22, 23) and the opinions of experts. In this regard, the average index (S-CVI/Ave) of 0.92 was approved by 15 experts in the field of midwifery and health education. Reliability of questionnaire assessed by Cronbach’s α = 0.79 in a sample of 20 HCPs, indicating that the instrument enjoyed a reasonable internal consistency. Moreover, the
stability of questionnaire was established with test-retest reliability = 0.90 with an interval of 2 weeks. The collected data were fed into the SPSS version 13.0 (SPSS Inc., Chicago, IL, USA) for further analysis. Means and standard deviations were computed and reported. Finally, to analyze the data, independent t-tests were conducted. In this case, p
Zohreh Shahhosseini and Kobra Abedian*
Health care providers and adolescents’ perspectives towards adolescents’ health education needs: a need assessment based on comparative approach Abstract Aim: Health care providers have considerable influence on adolescents’ health promotion. Thus, it is important to focus on the views of this group as one of the most reliable sources in the evaluation of teenagers’ health needs. The aim of this study was to compare the attitudes of Iranian health care providers and adolescents towards the latter’s health education needs. Materials and methods: A quantitative cross-sectional survey, including 72 health care providers and 402 female students from 14 high schools in northern Iran, was carried out in 2011. Topics in a self-administrated questionnaire covered the participants’ perspectives towards the educational health needs of adolescents in a five-point Likert scale. Results: Findings revealed from health care providers’ views indicate that the highest mean score was assigned to “Education about prevention of sexual high risk behavior”, which was significantly different from adolescents’ perspective (t = 8.42, p 0.05). Conclusion: Provision of health education programs for adolescents, which are based on integration of health care providers’ perspectives and the adolescents’ views, are essential in meeting adolescents’ educational health needs. Keywords: adolescents; health care providers; health needs; Iran. *Corresponding author: Kobra Abedian, Vesal Street, Amir Mazandarani Boulevard, Sari, Mazandaran Province, Iran, Phone: +98-151-2267342, Fax: +98-151-2268915, E-mail: [email protected] Zohreh Shahhosseini: Department of Midwifery and Reproductive Health, Mazandaran University of Medical Sciences, Sari, Iran Kobra Abedian: Department of Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
DOI 10.1515/ijamh-2014-0007 Received February 9, 2014; accepted April 17, 2014; previously published online May 31, 2014
Introduction One of the most prominent features of the population of eastern Mediterranean countries, including Iran, is their young population (1, 2). Based on the general census in 2011, the age group between 10 to19 years comprises 21.8% of the Iranian population (3). During the critical period of adolescence, teenagers encounter physical, psychological and social changes, and may have different needs as a result of these various changes (4, 5). In female adolescents, this period is more important, because of their valuable role in reproduction. For this reason, the United Nation Population Fund expresses that the girls’ health is the main key to overcoming the cycle of poverty between generations and to maintaining the organization’s Millennium Development Goals (6–8). To promote adolescents’ health, it is essential to consider their health needs and meet them with principled planning. It is currently considered that the gap between adolescence and adulthood is too much. Compared with the previous generation, today’s teens spend more time in schools, and marriage and pregnancy occur later among them. This means that they have a greater need for skills and services to promote their health status (9, 10). In this regard, there is an urgent need to educate them with health-related issues. Existing evidence shows that there is a significant gap in terms of teenagers’ education in health-related matters. Their knowledge regarding healthrelated topics ranged from low to average and came mostly from friends who were as unaware and inexperienced as they were (11, 12). Meanwhile, the lack of necessary education with appropriate contents has also exposed them to high risk behaviors (13, 14). One of the basic steps in appropriate planning for the provision of health education is need assessment, which is
Brought to you by | La Trobe University Authenticated Download Date | 11/28/17 8:31 PM
74 Shahhosseini and Abedian: Health-related educational needs of adolescents considered a method for identifying health needs and providing suggestions for meeting them. It is a vital health care planning tool that can be used at the family, community, and population levels (15, 16). There are different approaches in conducting need assessment, and these include the comparison approach (17, 18). Here, the services received and expected from health care providers (HCPs) and clients, respectively, are compared with each one another. To the best of our knowledge, conducted studies have presented the differences between teenagers’ opinions with their parents and teachers’ perspectives in health-related education (19–21). However, few published studies have simultaneously investigated the differences in the opinions between health care providers and adolescents. It is anticipated that a need assessment based on comparative approach could clarify the ambiguous points of this subject.
Materials and methods This descriptive cross-sectional study was conducted from November 2010 to March 2011 by collecting data through census method. The participants included 72 HCPs (43 midwives, 23 family health practitioners, and six family physicians) who came all of the urban health care centers (14 centers) in Sari City, Northern Iran. From 83 questionnaires distributed, data of 11 questionnaires were excluded because of missing data. Hence, our response rate was 86.74%. In addition, 402 high school students between 15 and 18 years were recruited by single-stage cluster sampling method. First, all of the high schools in the study area were identified. Then, with the help of random number table, 14 schools (one school in each health care center region) were selected and then in each school, one classroom was randomly considered as the selected class, considering students’ population in each grade. Finally, in each class, all present students in the sampling day who were willing to participate in the study filled out the self-administered questionnaire for about 10–15 min. The research instrument was developed by researchers based on a review of existing studies in this area and the opinions of experts. The research instrument consisted of two parts. The first part was related to the sociodemographic characteristics of participants (eight questions), and the second part contained 14 statements that assessed their perspectives towards the educational health needs of adolescents as well as their opinions about proper source of education in this issue (12 questions). The participants were requested to determine their opinions in a five-point Likert scale, with scores ranging from 1 (strongly disagree) to 5 (strongly agree). The total score of each domain was the average score of the statements based on five points. The questionnaire’s psychometric properties were determined by content validity and reliability. Validity of the questionnaire was established through a comprehensive literature review on existing surveys that assessed educational health needs of adolescents (22, 23) and the opinions of experts. In this regard, the average index (S-CVI/Ave) of 0.92 was approved by 15 experts in the field of midwifery and health education. Reliability of questionnaire assessed by Cronbach’s α = 0.79 in a sample of 20 HCPs, indicating that the instrument enjoyed a reasonable internal consistency. Moreover, the
stability of questionnaire was established with test-retest reliability = 0.90 with an interval of 2 weeks. The collected data were fed into the SPSS version 13.0 (SPSS Inc., Chicago, IL, USA) for further analysis. Means and standard deviations were computed and reported. Finally, to analyze the data, independent t-tests were conducted. In this case, p
