Effectiveness of structured teaching program on sex education among adolescent girls in a selected school of Vadodara

 

Keval Patel*, Anjali Patel, Priyanka Parmar, Archita Patel, Reepal Parmar

Department of Community Health Nursing, Sumandeep Nursing College, Sumandeep Vidyapeeth, Piparia, Vadodara-391760, Gujarat, India

 

ABSTRACT:

Sex education is an important preventive and continuing approach to the care of preadolescent and adolescents.According to WHO young people aged 15–24 years acquire half of all new sexually transmitted disease and that 1 in 4 sexually active adolescent females have an STD, such as Chlamydia or human Papillomavirus (HPV). OBJECTIVES: To assess the pre-test and post-test knowledge level regarding sex education among adolescent girls. To evaluate the effectiveness of structured teaching program on sex education by comparing pre-test and post- test knowledge score. To associate the pre-test knowledge level on sex education among adolescent girls with selected demographic variables. METHODOLOGY: The research design is pre-experimental. The research approach is a Quantitative. The study was conducted in Shree AmbeVidyalaya, Waghodia road, Vadodara. The sample consisted of 100 adolescent girls. Structure knowledge questionnaire was used to assess the knowledge. Structured teaching program on sex education was the intervention of the study. In the present study 100 adolescent girls selected using Probability Simple random sampling technique. FINDINGS OF THE STUDY: The overall Pretest mean knowledge score was found to be 45.9 % with SD as 3.1. The overall Post test mean knowledge score was found to be 77.7 % with SD as 2.9.The ‘t’ Test value was 31.49* (Significant at 5% level) which indicates the effectiveness of structure teaching on knowledge regarding sex education among adolescent girls There is a significant association between pre-test knowledge of mother with selected demographic variables such as age, educational status, religion, family type, monthly family income, education of father, source of information. However, the other selected demographic variables in the Pre test such as number of female siblings, ordinal position, education of mother, occupation of father and mother were found to be non-significant in the Pre test knowledge.CONCLUSION: The findings of the study makes the researcher hopeful that such initiatives has increased the adolescent girls’ knowledge regarding sex education.

 

 

 

 

 

 

INTRODUCTION:

Teaching about sexuality encourages students to develop a coherent set of personal values based upon respecting themselves and others.¹ It protects from sexual abuse, exploitation and molestation. It prevents sexual calamities and promotes positive attitude toward sex in socially approved and desired means.² Adolescence is a particularly stressful and confusing time as both physical and cognitive aspects of sexual expression begin to align, and the opportunities for personal decision making expand. From a young age, children are exposed to sexual imagery and language in their environment, and their bodies are experiencing and developing sexual responsiveness.³ Sexuality education begins at home. Parents and caregivers are and ought to be the primary sexuality educators of their children.⁴ A number of surveys have shown that girls who were not educated about sexuality, including changes during puberty are more likely to embark on sexual indiscretion and become pregnant in their teenage years than those who were educated about sex.⁵

 

Along with the academic subjects, sex-education should be given equal importance. Trained teachers, psychologists and medical consultants should deal with the subject.⁶ Sex education is need to though in school to prevent the sexually transmitted disease like HIV, AIDS, Hepatitis, Syphilis, Gonorrhea, Chlamydia etc.⁷ In India approximately 1.4 million reported cases of Chlamydia, a rate of 456.1 cases per 100,000 Population, is up 2.8 percent since 2013.⁸Gujarat state estimated an annual incidence of 1.8 million STI/RTI episodes in the state means population of 6 million with 50 % of it as adult and with a rate of 6 % of STI episodes per year among adult population. 23.6 per cent of the adolescents that there were HIV/AIDS infected people in their district.⁹ Additionally, previous estimates suggest that young people in this age group acquire half of the estimated 20 million new STDs diagnosed each year.¹⁰

 

HYPOTHESIS:

H₁:There is significant difference between the Pre and Post-test knowledge scores on sex education among adolescent girls.

H₂:There is a significant association in Pre-test knowledge level scores regarding sex education among the adolescent girls with selected demographic variables.

 

MATERIAL AND METHODS:

Research approach:

Descriptive evaluative approach

 

Research design:

One group pre-test post-test design

 

Independent variable:

In this study independent variable is structured teaching program on sex education.

 

Dependent variable:

In this study dependent variable isknowledge of adolescent girls regarding sex education.

 

Target population:

In this study, the samples were adolescent girls between 14-17 years.

 

 

Sample:

In this study, the samples wereadolescent girls from standard 8^th, 9^th and 10^th of Shree AmbeVidyalaya, Waghodia road, Vadodara.

 

Sample size:

The sample size constitutes 100adolescent girls who fulfills the inclusive criteria.

 

Sampling technique:-

The sampling technique used for this study is Probability Simple random sampling technique.

 

CRITERIA FOR SELECTION OF SAMPLE:

Inclusion criteria:-

·        Adolescent girls between the age group of 14-17 years.

·        Adolescent girls willing to participate in the study.

·        Adolescent girls who can read and write Gujarati and English.

 

Exclusion criteria:-

·        Adolescent girls who are not present at the time of study.

 

Data collection instrument:

Data collection tool is the instrument i.e. the written device that the researcher uses to collect the knowledge data. In this study the structured knowledge questionnaire was used.

 

Development of the tool:

The tools were prepared on the basis of the objectives of the study. The following steps were adopted in the development of the instruments.

 

·        Review of literature provided adequate content for the tool preparation.

·        Personal experience.

·        Consultation with experts.

·        Discussion with the peer groups.

·        Perpetration of blue prints.

·        Reliability

 

DESCRIPTION OF THE TOOL:

This consists of two parts:

 

SECTION-1:

Consist of socio demographic variables such as age, education status, number of female siblings, ordinal position, religion, type of family, family income, educational status of parents, occupational status of parents, sources of information regarding sex education.

 

SECTION-2:

Structuredknowledge questionnaire will be used to assess the knowledge of adolescent girls regarding sex education.

 

SCORING PROCEDURE:

It consists of 30 knowledge questionnaire.

For each correct response score “one” will be assigned.

For each response score “zero” will be assigned.

The total minimum and maximum score of knowledge assessment found to be “0” and “30”.

 

SCORING INTERPRETATION:

The total knowledge score obtained will be classified as follows,

Inadequate: ≤50%

Moderate: 51-75%

Adequate: >75%

 

RESULTS:

SECTION-1:

Demographic Characteristics of Respondents

 

TABLE – 1: Classification of Respondents by Personal Characteristics

Characteristics	Category	Respondents
		Number	Percent
Age group	14 years	39	39.0
	15 years	48	48.0
	16 years	13	13.0
Educational status	8th Std	26	26.0
	9th Std	56	56.0
	10th Std	18	18.0
Number of female siblings	No	60	60.0
	One	35	35.0
	Two	5	5.0
Ordinal position	First	72	72.0
	Second	25	25.0
	Third	3	3.0
Religion	Hindu	86	86.0
	Muslim	14	14.0
Type of family	Joint	32	32.0
	Nuclear	68	68.0
Family income/month	Rs.10,000-15,000	34	34.0
	Rs.15,000 and above	66	66.0
Education of Father	High school	36	36.0
	Graduation	64	64.0
Education of Mother	Non-formal education	19	19.0
	Primary	36	36.0
	Secondary	22	22.0
	High school	16	16.0
	Graduation	7	7.0
Occupation of Father	Government	12	12.0
	Private	41	41.0
	Business/Self employed	47	47.0
Occupation of Mother	House wife	73	73.0
	Government	13	13.0
	Private	10	10.0
	Business/Self employed	4	4.0
Source of information	Newspaper/Magazine/Books	4	4.0
	Television/Telephone/Radio	9	9.0
	Friends/Neighbors	4	4.0
	Others	83	83.0
Total		100	100.0

 

SECTION – 2(a): Overall and Aspect wise Pre test Knowledge Scores of Respondents on among Adolescent girls

 

TABLE – 2: Classification of Respondent Pre test Knowledge level on Sex education

Knowledge Level	Category	Respondents
		Number	Percent
Inadequate	≤ 50 % Score	66	66.0
Moderate	51-75 % Score	34	34.0
Adequate	> 75 % Score	0	0.0
Total		100	100.0

 

 

TABLE - 3: Aspect wise Pre test Mean Knowledge scores of Respondents on Sex education                                                                    N=100

No.	Knowledge Aspects	Statements	Max. Score	Knowledge Scores
				Mean	SD	Mean (%)	SD (%)
I	General information on Sex education	4	4	2.68	1.1	67.0	28.0
II	Anatomy and Physiology of Female reproductive system	5	5	1.97	1.0	39.4	20.3
III	Menstruation and Menstrual hygiene	9	9	3.63	1.5	40.3	16.4
IV	Reproductive health	12	12	5.49	1.8	45.8	14.8
	Combined	30	30	13.77	3.1	45.9	10.5

 

 

Table- 3 shows the aspect wise Pre test mean knowledge scores among adolescent girls. The result indicates that the adolescent girls had highest Mean knowledge score of 67% in the aspect of General Information on sex education followed by mean knowledge score of 39.4% in the aspect of anatomy and physiology of female reproductive system, followed by a mean knowledge score of 40.3% in the aspect of menstruation and menstrual hygiene, and a mean knowledge score of 45.8% were seen in the aspect of reproductive health. However, the overall Pretest mean knowledge score was found to be 45.9 % with SD as 3.1

 

 

SECTION – 2(b): Overall and Aspect wise Post test Knowledge Scores of RespondentsonSex Education

TABLE - 4: Classification of Respondents of Post test Knowledge level on Sex education

Knowledge Level	Category	Respondents
		Number	Percent
Inadequate	≤ 50 % Score	0	0.0
Moderate	51-75 % Score	40	40.0
Adequate	> 75 % Score	60	60.0
Total		100	100.0

 

 

 

 

 

TABLE - 5: Aspect wise Post test Mean Knowledge scores on Sex education among Adolescent girls                                                   N=100

No.	Knowledge Aspects	Statements	Max. Score	Knowledge Scores
				Mean	SD	Mean (%)	SD (%)
I	General information on Sex education	4	4	3.60	0.7	90.0	16.6
II	Anatomy and Physiology of Female reproductive system	5	5	3.74	1.0	74.8	19.1
III	Menstruation and Menstrual hygiene	9	9	7.06	1.4	78.4	15.1
IV	Reproductive health	12	12	8.91	1.5	74.3	12.4
	Combined	30	30	23.31	2.9	77.7	9.8

 

Table- 5 shows the aspect wise Post -test mean knowledge scores among adolescent girls. The result indicates that theadolescent girls had highest Mean knowledge score of 90% in the aspect of General Information on sex education followed by mean knowledge score of 74.8% in the aspect of anatomy and physiology of female reproductive system, followed by a mean knowledge score of 78.4% in the aspect of menstruation and menstrual hygiene, and a mean knowledge score of 74.3% were seen in the aspect of reproductive health. However, the overall Post test mean knowledge score was found to be 77.7 % with SD as 2.9.

SECTION – 2(c): Overall and Aspect wise Pre test and Post test Knowledge Scores onSex education among Adolescent girls

TABLE – 6: Over all Pre test and Post test Mean Knowledge scores on Sex education among Adolescent girls                    N=100

Aspects	Max. Score	Knowledge Scores				Paired ‘t’ Test
		Mean	SD	Mean (%)	SD (%)
Pre test	30	13.77	3.1	45.9	10.5	31.49*
Post test	30	23.31	2.9	77.7	9.8
Enhancement	30	9.54	3.0	31.8	10.1

* Significant at 5% level, 35          t (0.05, 99df) = 1.96

 

TABLE – 7: Aspect wise mean Pre test and Post test Knowledge scores on Sex education among Adolescent girls

No.	Knowledge Aspects	Respondents Knowledge (%)						Paired ‘t’ Test
		Pre test		Post test		Enhancement
		Mean	SD	Mean	SD	Mean	SD
I	General information on Sex education	67.0	28.0	90.0	16.6	23.0	25.7	8.95*
II	Anatomy and Physiology of Female reproductive system	39.4	20.3	74.8	19.1	35.4	23.6	15.00*
III	Menstruation and Menstrual hygiene	40.3	16.4	78.4	15.1	38.1	21.3	17.89*
IV	Reproductive health	45.8	14.8	74.3	12.4	28.5	15.5	18.39*
	Combined	45.9	10.5	77.7	9.8	31.8	10.1	31.49*

* Significant at 5% level,                                                                                               t (0.05, 99df ) = 1.96

 

TABLE – 8: Classification of Respondents on Pre test and Post test Knowledge level on Sex education

Knowledge Level	Category	Classification of Respondents				χ 2 Value
		Pre test		Post test
		Number	Percent	Number	Percent
Inadequate	≤ 50 % Score	66	66.0	0	0.0	126.49*
Moderate	51-75 % Score	34	34.0	40	40.0
Adequate	> 75 % Score	0	0.0	60	60.0
Total		100	100.0	100	100.0

* Significant at 5% level,                                                                                               χ² (0.05, 2df) = 5.991

 

Statistical paired ‘t’ test value 31.49* reflects the significant enhancement of mean knowledge score for all the selected knowledge aspects at 0.05 level of significance which indicates the effectiveness of structure teaching on knowledge regarding sex education among adolescent girls. Hence research hypothesis (H₁) is accepted.

 

 

SECTION– 3: Association between Demographic variables and Pre-test Knowledge levelonSex education among Adolescent girls

TABLE – 9: Association between Demographic variables and Pre test Knowledge level on Sex education among Adolescent girls    N=100

Demographic Variables	Category	Sample	Knowledge Level				χ2 Value	P Value	Table Value
			Inadequate		Moderate
			N	%	N	%
Age group	14 years	39	30	76.9	9	23.1	6.51* (df=2)	P<0.05 (5.991)	5.99
	15 years	48	31	64.6	17	35.4
	16 years	13	5	34.5	8	61.5
Educational status	8th Std	26	21	80.8	5	19.2	6.26* (df=2)	P<0.05 (5.991)	5.99
	9th Std	56	37	66.1	19	33.9
	10th Std	18	8	44.4	10	55.6
Number of female siblings	No	60	37	61.7	23	38.3	1.40	P>0.05 (5.991)
	One	35	25	71.4	10	28.6
	Two	5	4	80.0	1	20.0
Ordinal position	First	72	49	68.1	23	31.9	0.54	P>0.05 (5.991)
	Second	25	15	60.0	10	40.0
	Third	3	2	66.7	1	33.3
Religion	Hindu	86	55	61.6	33	38.4	4.00* (df=1)	P<0.05 (3.841)	3.84
	Muslim	14	13	92.7	1	7.1
Type of family	Joint	32	16	50.0	16	50.0	5.37* (df=1)	P<0.05 (3.841)	3.84
	Nuclear	68	50	73.5	18	26.5
Family income/month	Rs.10,000-15,000	34	17	50.0	17	50.0	5.88* (df=1)	P<0.05 (3.841)	3.84
	Rs.15,000 and above	66	49	74.2	17	25.8
Education of Father	High school	36	19	52.8	17	47.2	4.38* (df=1)	P<0.05 (3.841)	3.84
	Graduation	64	47	73.4	17	26.6
Education of Mother	Non-formal education	19	10	52.6	9	47.4	3.63	P>0.05 (9.488)
	Primary	36	27	75.0	9	25.0
	Secondary	22	15	68.2	7	31.8
	High school	16	9	56.3	7	43.7
	Graduation	7	5	71.4	2	28.6
Occupation of Father	Government	12	7	58.3	5	41.7	2.83	P>0.05 (5.991)
	Private	41	24	58.5	17	41.5
	Business/     Self employed	47	35	74.5	12	25.5
Occupation of Mother	House wife	73	49	67.1	24	32.9	2.33	P<0.05 (7.815)
	Government	13	10	76.9	3	23.1
	Private	10	5	50.0	5	50.0
	Business/     Self employed	4	2	50.0	2	50.0
Source of information	Newspaper/ Magazine/ Books	4	4	100.0	0	0.0	9.91* (df=3)	P<0.05 (3.841)	7.82
	Television/ Telephone/ Radio	9	6	66.7	3	33.3
	Friends/ Neighbors	4	0	0.0	4	100.0
	Others	83	56	67.5	27	32.5
Combined		100	66	66.0	34	34.0

 

The Chi-square value shows that there is a significant association between knowledge of adolescent girls with their age, educational status, religion, family type, monthly family income, education of father and source of information.

 

There is no significant association between knowledge of adolescent girls with selected socio-demographic variables such as number of female siblings, ordinal position, education of mother, occupation of father and mother.

 

DISCUSSION:

The findings of the study were based on its objectives and are discussed under the following headings:-

 

OBJECTIVE 1: To assess the pre-test and post-test knowledge level regarding sex education among adolescence girls:.

In Pre-test out of 100 School Teachers 66 adolescent girls had inadequate knowledge, 34 adolescent girls had moderate knowledge and none of the adolescent girls had adequate knowledge. The highest mean percentage knowledge score of 67% in the aspect of General Information on sex education followed by mean knowledge score of 39.4% in the aspect of anatomy and physiology of female reproductive system, followed by a mean knowledge score of 40.3% in the aspect of menstruation and menstrual hygiene, and a mean knowledge score of 45.8% were seen in the aspect of reproductive health. Thus, the investigator assumes that there is a need for imparting knowledge to all the adolescent girls. The overall pre-test mean score is 13.77 and standard deviation is 3.1 in the different aspect of knowledge regarding sex education.

 

In post-test out of 100 School Teachers 60 adolescent girls had adequate knowledge, 40 adolescent girls had moderate knowledge and none of the adolescent girls had inadequate knowledge. The highest Mean knowledge score of 90% in the aspect of General Information on sex education followed by mean knowledge score of 74.8% in the aspect of anatomy and physiology of female reproductive system, followed by a mean knowledge score of 78.4% in the aspect of menstruation and menstrual hygiene, and a mean knowledge score of 74.3% were seen in the aspect of reproductive health. The overall post-test mean score is 23.31 and standard deviation is 2.9 in the different aspect of knowledge regarding sex education.

 

OBJECTIVE 2: To evaluate the effectiveness of structured teaching program on sex education by comparing pre-test and post- test knowledge score.

The Pre test mean knowledge is 13.77 (45.9 %) with standard deviation of 3.1. Further, Post test mean knowledge found to be 23.31 (77.7 %) with standard deviation of 2.9. It indicates that there is enhancement of knowledge score of 9.54 (31.8%) of the adolescent girls. The statistical paired ‘t’ test value is found significant (31.49*) revealing the effectiveness of structured teachingprogramon sex education among adolescent girls. However, this study reveals that, the structured teaching program on sex education among adolescent girls was effective. Thus, the analysis reveals that there is significant difference between Pre test and Post test knowledge score of adolescent girls on sex education. Hence, the Researcher based on the findings, stated that the hypothesis (H₁) “There is a significant difference between Pre and Post test knowledge scores on sex education among adolescent girls” has been accepted.

 

OBJECTIVE 3: To associate the pre-test knowledge level on sex education among adolescence with selected demographic variables:.

The χ² value computed between the knowledge level of adolescent girls regarding sex education and selected socio-demographic variables.

 

Variables of age (χ²=6.51), educational status (χ²=6.26), religion (χ²=4.00), family type (χ²=5.37), monthly family income (χ²=5.88), education of father (χ²=4.38), source of information (χ²=9.91) were found significant at 0.05 level of significance. Hence, the Researcher based on the findings stated that the hypothesis (H₂) “There is a significant association in Pre test knowledge level on sex education among adolescent girls with selected demographic variables” has been partially accepted.

 

However, the stated hypothesis (H₂) is rejected with the other selected demographic variables in the Pre test such as number of female siblings, ordinal position, education of mother, occupation of father and mother as the association of knowledge score of adolescent girls regarding sex education were found to be non significant in the Pre test knowledge.

 

H₁: There will be significant difference in the Pre and Post-test knowledge scores regarding sex education among the adolescent girls.

The investigator found that in the pre-test overall mean score is 13.77 and standard deviation is 3.1 in the different aspect of knowledge regarding sex education. In the post-test, the overall mean score is 23.31 and standard deviation is 2.9 in the different aspect of knowledge regarding sex education.

 

The Chi-square value shows that there is a significant association between knowledge of adolescent girls with their age, educational status, religion, family type, monthly family income, education of father, source of information. There is no significant association between knowledge of adolescent girls with selected socio-demographic variables such as number of female siblings, ordinal position, education of mother, occupation of father and mother.

 

Comparison of knowledge scores of adolescent girls regarding sex education. Means, standard deviation, and mean score percentage, value are compared and paired ‘t’ test is applied at 0.05 level of significance. The tabulated ‘t’ value for 99 degree of freedom is 1.96 and calculated values were much higher than tabulated value at 0.05 level of significance which was statistically acceptable level of significance.

 

So it is statistically proved that there was significance difference in knowledge scores of adolescent girls regarding sex education in selected school of Vadodara. Thus, H₁ is accepted.

 

H₂: There will be significant association in Pre-test knowledge level scores regarding sex education among the adolescence girls with their selected demographic variables.

 

The χ² value computed between the knowledge level of adolescent girls regarding sex education and selected socio-demographic variables.

 

Variables of age (χ²=6.51), educational status (χ²=6.26), religion (χ²=4.00), family type (χ²=5.37), monthly family income (χ²=5.88), education of father (χ²=4.38), source of information (χ²=9.91) were found significant at 0.05 level of significance. Thus it can be interpreted that there is a significant association between pre-test knowledge of mother with selected demographic variables such as age, educational status, religion, family type, monthly family income, education of father, source of information.

 

However, the other selected demographic variables in the Pre test such as number of female siblings, ordinal position, education of mother, occupation of father and mother were found to be non-significant in the Pre test knowledge.Hence H₂ is partially accepted.

 

ACKNOWLEDGEMENT:

The authors are grateful to the authorities of Sumandeep Nursing College, SumandeepVidyapeeth, Pipariafor the facilities.

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest.

 

REFERENCES:

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Received on 05.09.2017       Modified on 28.10.2017

Accepted on 08.01.2018      ©A&V Publications All right reserved