Improving awareness of preconception health among adolescents: experience of a school-based intervention in Lebanon

BMC Public Health

Khalid Yunis²  Anwar Nassar⁴  Walid Ammar¹  Salimah R Walani³  Christopher P Howson³  Kawthar Alamiddine²  Durriyah Sinno²  Sophie Azizi⁵  Rym El Rafei²  Lama Charafeddine² 

[1] Director General of the Ministry of Public Health of Lebanon, Beirut, Lebanon;Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon;March of Dimes Foundation, White Plains, New York, U.S;American University of Beirut Medical Center, Beirut, Lebanon;the National Collaborative Perinatal Neonatal Network, American University of Beirut Medical Center, Beirut, Lebanon

关键词: Health information;    Health education program;    Awareness campaign;    Adolescents;    Preconception;   

Others  :  1128860
DOI  :  10.1186/1471-2458-14-774

 received in 2014-01-27, accepted in 2014-06-27,  发布年份 2014

【 摘 要 】

Background

Maternal behavior before and after conception affects maternal and child health. Limited awareness of adolescents in preconception health may be addressed through school education. The aim of this intervention is to assess preconception health awareness among adolescents in Lebanese high schools and to test the effectiveness of a one-time educational session in improving preconception knowledge.

Methods

The intervention consisted of a 30-minute educational session about good practices in preconception health, developed by the National Collaborative Perinatal Neonatal Network’s (NCPNN) research team. A convenience sample of high school Lebanese students in grades 10 to 12, aged 14 to 26 years old, from 70 private and public schools in all six Lebanese provinces, participated in the intervention in 2011 and 2012. A multiple-choice questionnaire administered prior to and 2 months after the session was used to assess knowledge improvement among the students.

Results

A total of 7,290 students were enrolled. After the session, mean scores of correct answers increased from 4.36 to 6.42 out of 10, representing a 47.2% improvement (p < 0.001). The percent of correct answers increased for all the questions regarding health practices (p < 0.001). The greatest improvement was observed for questions about Trisomy 21, folic acid intake and toxoplasmosis with percentages improvement of 96%, 172% and 83% respectively. Being female or in private school was a significant predictor of higher scores in both pre-test and post-test (p < 0.001).

Conclusions

Awareness campaigns in schools increased the preconception health knowledge among high school students. We recommend expanding the scope of this intervention into universities in Lebanon.

【 授权许可】

   
2014 Charafeddine et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Centers for Disease Control and Prevention: Achievements in public health, 1900–1999: Family planning. MMWR 1999, 48(47):1073-80.
• [2]Atrash H, Jack BW, Johnson K: Preconception care: a 2008 update. Curr Opin Obstet Gynecol 2008, 20(6):581-9. doi:10.1097/GCO.0b013e328317a27c
• [3]Centers for Disease Control and Prevention: Use of supplements containing folic acid among women of childbearing age-United States, 2007. MMWR Morb Mortal Wkly Rep 2008, 57(01):5-8.
• [4]Anderson JE, Ebrahim S, Floyd L, Atrash H: Prevalence of risk factors for adverse pregnancy outcomes during pregnancy and the preconception period—United States, 2002–2004. Matern Child Health J 2006, 10:S101-S106. doi:10.1007/s10995-006-0093-z
• [5]U.S. Department of Health and Human Services: Prenatal Care fact sheet. Washington, D.C.: U.S: Department of Health and Human Services, Office on Women’s Health; 2009.
• [6]Centers for Disease Control and Prevention: Recommendations to Improve Preconception Health and Health Care—United States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR Recomm Rep 2006, 55(No. RR-6):1-23.
• [7]Atrash H, Jack BW, Johnson K, Coonrod DV, Moos MK, Stubblefield PG, Cefalo R, Damus K, Reddy UM: Where is the “W”oman in MCH? Am J Obstet Gynecol 2008, 199(6 Suppl 2):S259-65. doi:10.1016/j.ajog.2008.08.059
• [8]Biermann J, Dunlop AL, Brady C, Dubin C, Brann A Jr: Promising practices in preconception care for women at risk for poor health and pregnancy outcomes. Matern Child Health J 2006, 10:S21-S28. doi:10.1007/s10995-006-0097-8
• [9]Institute of Medicine of the National Academies: Preterm Birth: Causes, Consequences, and Prevention. Washington, D.C.: Institute of Medicine of The National Academies; 2006.
• [10]Jack BW, Atrash H, Coonrod DV, Moos MK, O’Donnell J, Johnson K: The clinical content of preconception care: an overview and preparation of this supplement. Am J Obstet Gynecol 2008, 199(6 Suppl 2):S266-79. doi:10.1016/j.ajog.2008.07.067
• [11]Korenbrot CC, Steinberg A, Bender C, Newberry S: Preconception care: a systematic review. Matern Child Health J 2002, 6(2):75-88. doi:10.1023/A:1015460106832
• [12]Coonrod DV, Jack BW, Stubblefield PG, Hollier LM, Boggess KA, Cefalo R, Cox SN, Dunlop AL, Hunter KD, Prasad MR, Lu MC, Conry JA, Gibbs RS, Hogan VK: The clinical content of preconception care: infectious diseases in preconception care. Am J Obstet Gynecol 2008, 199(6 Suppl 2):S296-S309. doi:10.1016/j.ajog.2008.08.062
• [13]Nasr Hage C, Jalloul M, Sabbah M, Adib SM: Awareness and intake of folic acid for the prevention of neural tube defects among Lebanese women of childbearing age. Matern Child Health J 2012, 16(1):258-65. doi:10.1007/s10995-010-0736-y
• [14]Tamim H, Harrison G, Atoui M, Mumtaz G, El-Kak F, Seoud M, Yunis K: Preconceptional folic acid supplement use in Lebanon. Public Health Nutr 2009, 12(05):687-92. doi:10.1017/S136898000800298X
• [15]World Health Organization, Center for disease Control and Prevention: Lebanon 2011 (Ages 13–15) Global Youth Tobacco Survey (GYTS) fact sheet. Lebanon: World Health Organization; 2012.
• [16]Nasreddine L, Naja F, Chamieh M, Adra N, Sibai AM, Hwalla N: Trends in overweight and obesity in Lebanon: evidence from two national cross-sectional surveys (1997 and 2009). BMC Public Health 2012, 12:798. doi:10.1186/1471-2458-12-798 BioMed Central Full Text
• [17]Feig DS, Naylor CD: Eating for two: are guidelines for weight gain during pregnancy too liberal? Lancet 1998, 351(9108):1054-5. doi:10.1016/S0140-6736(97)06261-2
• [18]Burdorf A, Figa-Talamanca I, Jensen TK, Thulstrup AM: Effects of occupational exposure on the reproductive system: core evidence and practical implications. Occup Med (Lond) 2006, 56(8):516-20. doi:10.1093/occmed/kql113
• [19]Grant SG: Qualitatively and quantitatively similar effects of active and passive maternal tobacco smoke exposure on in utero mutagenesis at the HPRT locus. BMC Pediatr 2005, 5:20. doi:10.1186/1471-2431-5-20 BioMed Central Full Text
• [20]U.S. Department of Health and Human Services: The health consequences of involuntary exposure to tobacco smoke: A report of the surgeon general. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Diseases Prevention and Health Promotion, Office on Smoking and Health; 2006.
• [21]Delgado CE: Undergraduate student awareness of issues related to preconception health and pregnancy. Matern Child Health J 2008, 12(6):774-82. doi:10.1007/s10995-007-0300-6
• [22]Delgado CE: Pregnancy 101: A Call for Reproductive and Prenatal Health Education in College. Matern Child Health J 2013, 17(2):240-7. doi:10.1007/s10995-012-0967-1
• [23]National Collaborative Perinatal Neonatal Network. [Accessed August 10, 2013]. [Online] Available at: http://www.ncpnn.org webcite
• [24]World Health Organization, Lebanese Ministry of Public Health, Lebanese Ministry of Education and Higher Education, Centers for Disease Control and Prevention: Lebanon 2005: Global School-based Student Health Survey. Lebanon; 2007. http://www.who.int/chp/gshs/lebanondataset/en/ webcite
• [25]Rao RSP, Lena A, Nair NS, Kamath V, Kamath A: Effectiveness of reproductive health education among rural adolescent girls: a school-based intervention study in Udupi Taluk , Karnataka. Indian. J Med Sci 2008, 62(11):439-43. doi:10.4103/0019-5359.48455
• [26]Quillin J, Silberg J, Board P, Pratt L, Bodurtha J: College women’s awareness and consumption of folic acid for the prevention of neural tube defects. Genet Med 2000, 2(4):209-213.
• [27]National Birth Defects Prevention Network: Neural tube defect ascertainment project 2010. [Accessed August 10, 2013]. [Online] Available at: http://www.nbdpn.org/current/resources/ntd_fa_info.html webcite
• [28]Charron-Prochownik D, Sereika SM, Wang SL, Hannan MF, Fischl AR, Stewart SH, Dean-McElhinny T: Reproductive health and preconception counseling awareness in adolescents with diabetes: what they don’t know can hurt them. Diabetes Educ 2006, 32(2):235-42. doi:10.1177/0145721706286895
• [29]Chaaya M, Awwad J, Campbell OMR, Sibai A, Kaddour A: Demographic and Psychosocial Profile of Smoking Among Pregnant Women in Lebanon: Public Health Implications. Matern Child Health J 2003, 7(3):179-86. doi:10.1023/A:1025136421230
• [30]Saadé G, Abou Jaoude S, Afifi R, Warren CW, Jones NR: Patterns of tobacco use: Results from the 2005 Global Youth Tobacco Survey in Lebanon. East Mediterr Health J 2008, 14(6):1280-9.
• [31]Nakkash RT, Khalil J, Chaaya M, Afifi RA: Building research evidence for policy advocacy: a qualitative evaluation of existing smoke-free policies in Lebanon. Asia Pac J Public Health 2010, 22(3 Suppl):168S-174S. doi:10.1177/1010539510373020
• [32]Tobacco Control Research Group: TCRG News. American University of Beirut, Faculty of Health Sciences, Center for Research on Population and Health: Lebanon; 2012. Issue 2
• [33]Law No. 174: Tobacco Control and Regulation of Tobacco Products’ Manufacturing, Packaging and Advertising. Lebanon: Lebanese parliament, Administration and Justice Committee; 2011.