The Effects of Multimedia-Based Puberty Health Education on Male Students' Self-Esteem in the Middle School

Using the health beliefs model to implement mobile puberty health education in Iranian adolescent boys: a randomized controlled trial

Introduction

Given boys' low health knowledge and their unhealthy behavior during puberty, which can cause many physical, mental, and psychological problems, it is important to prevent these complications. This study was therefore aimed to determine the efficacy of a mobile health educational intervention based on the Health Beliefs Model (HBM) on Iranian adolescent boys.

Materials and methods

This randomized controlled trial involved junior high school boys (n = 148) in Iran studying during the 2020-2021 school year. Educational content concerning healthy behaviors during puberty (e.g., the importance of bathing) was developed based on HBM and sent to the intervention group via mobile phone. HBM addresses multiple factors (e.g., perceived disease risk) that explain health behaviors. The intervention was delivered in five sessions over four weeks using real-time Internet communication and texting. The control group did not receive any intervention. One school was randomly selected from each of the four districts of the study site. The schools were then randomized into intervention and control groups. The boys were then randomly selected from each school to participate in the study. Data collected at baseline and 2-month follow-up assessments included demographic information, health knowledge (e.g., physical changes during puberty), health behaviors (e.g., bathing), and HBM constructs (e.g., self-efficacy to perform healthy behaviors). Data analysis was done using the chi-square, independent and paired t-tests, and analysis of covariance (ANCOVA).

Results

The two groups did not differ in terms of demographic characteristics. Before the intervention, the two groups were slightly different in terms of knowledge, health behavior, and HBM constructs. Following the intervention, the scores of the intervention group improved significantly (p < 0.05). After adjusting for pre-intervention knowledge, HBM, and health behavior scores, the intervention group remained superior to the control group in terms of improvement of knowledge, HBM constructs, and healthy behaviors (p < 0.05). Effect sizes ranged from medium to large (0.25-0.86).

Conclusion

Mobile phone education based on the HBM is efficacious in encouraging healthy behavior in boys during puberty. Organizations interested in encouraging healthy behaviors in boys should consider the use of such a program.

"When I woke up I was so worried and ashamed, I thought it was a disease": Adolescent boys' transitions through puberty in Kenya

Growing evidence suggests a need for more focused attention on boys' experiences of puberty in sub-Saharan Africa to assure healthy transitions into young adulthood. Existing research remains limited on the masculinity norms shaping boys' maturation experiences in Kenya. To help fill this gap, we conducted a comparative case study using qualitative methodologies with 16-19-year-old male youth in rural and urban Kenya, and with adults interacting in boys' daily lives. Findings suggest that Kenyan boys experience shame, confusion and silence around changes happening in their bodies; face pressures from new societal expectations as they become young men; and have adolescent lives shaped by minimal supervision, increased peer pressures and engagement in more risky health behaviors. Additional research and targeted interventions on boys transitioning through puberty and early adolescence are needed to better understand their vulnerabilities and prevent or reduce their engagement in unsafe behaviors.