Document Type : Original Article



Background: Puberty is one of the most critical periods in a female adolescents’ life. This
intervening study aimed to evaluate the effect of educational program for puberty health
on improving intermediate and high school female students’ knowledge in Birjand, Iran.
Materials and Methods: In this quasi‑experimental study, 325 female intermediate and high
school students were selected through randomized cluster sampling during several stages.
Then, researcher‑made questionnaire including 20 questions, each having one point regarding
puberty health, was distributed. After completion of the questionnaires were gathered. Following
this, under a systemic educational plan all intermediate and high school selected students were
given the same instruction by trained instructors. Instruction time for each meeting was estimated
1.5 hours. One month after the educational program and handing out the pamphlets in schools,
the previous questionnaires were again distributed among the students to fill out. At the end,
302 students who had filled out the questionnaires before and after intervention were studied.
Results: Out of 302 students, 151 were intermediate and 151 high school students. Knowledge
level among intermediate students was 5.03 ± 3.7 before intervention and was 10.8 ± 4.8 after
intervention. Among high school students, the scores were 4.1±2.3 and 8.7±3.8, respectively. There
was a significant difference between pre and post intervention stages in both groups (P < 0.001).
Furthermore, mean knowledge grade in all the students increased from 4.6 ± 3.1 before intervention
to 9.7 ± 4.4 after intervention (P < 0.001). Conclusion: Performing educational programs during
puberty has a crucial role in young girls’ knowledge increase. Since young girls often do not share
their problems with their parents and their peers during the period, instructional classes in schools
provide a good opportunity for them to present their problems and finding solutions.


1. Hugh House, Health Promotion in Schools. In: Saedinejad M,
Kavehzadeh F, Poureslami M, Rafiefar SH, editors. 1st ed. Tehran:
UNICEF (United Nation Children’s Fund); 2001.
2. Department of Health Deputy in Semnan University of Medical
Sciences; under the guidance and supervision of Malek Afzali H.
1st ed. Tehran: TablighateShahr; 2001.
3. Marandi A. “Health in Islamic Republic of Iran”. 1st ed. Tehran:
UNICEF; 1998.
4. Edelman C, Lium M, Carole L. Health promotion throughout the
lifespan. St. Louis: Mosby; 1998.
5. Katica LG, Dekovic M, Opacic G. Pubertal status, interaction with
significant others and self‑esteem of adolescent girls. Adolescence
6. Pietila AM, Hentinen M, Myhrman A. The health behavior of
northern Finnish men in adolescence and adulthood; Int J Nurs
Stud 1995;32:325‑38.
7. Ministry of Health and Medical Education; Adolescent Health: Guide for
Parents and Teachers. 1st ed. Tehran: Ministry of Health and Medical
Education, Department of Health (Bureau of Family Health); 1997.
8. World Health Organization. “Women Health across Age and
Frontier”. Geneva: WHO; 1992. p. 25.
9. UNICEF, the Status of the World’s Children in 1991. J World Health
10. Eskandari M. “Reviewing the effect of counseling with mother on
health behaviors of girls during menstruation in female guidance
schools of Arsanjan”; MSc thesis. Tehran: Tarbiat Modares
University; 1998.
11. Kaplan Elaine Bell. Women’s perceptions of the adolescent
experience. Adolescence 1997;32:715‑32.
12. Koff E, Rierdan J. Preparing girls for menstruation recommendation
from adolescent girls. Adolescence 1995;30:798‑811.
13. Zabihi A. Investigating the Effect of Education on Knowledge Level
of Girl Students in relation with Puberty Health. J Babol Univ Med
Sci 2002;4:58‑62.
14. Ghahramani L, Heidarnia A, Babaie Gh, Nazari M. Assessing the
effect of puberty health education on health behaviors in girls
guidance schools of Chabahar City, The 2nd National Conference
on Education and Health Promotion in Zahedan 2005;15‑17:6.
15. Jahandideh A. Evaluating the Effect of Puberty Public Health on
Knowledge, Attitude and Practice of 10 to 14‑year‑old Girls and
Knowledge and Attitude of their Mothers in West Karand City,
2000; The 2nd Congress of Public Health and Preventive Medicine,
Kermanshah, 2001.
16. Firouzan A. Reviewing the impact of health education on health
behaviors of adolescent girls during menstrual cycle, MSc thesis
in Health Education. Tehran: Tarbiat Modares University; 2001.
17. UNFPA. Partners for change. Enlisting man in HIV/AIDS prevention.
New York; USA: UNFPA; 2000.
18. WHO, UNFPA.UNICEF. Programming for adolescent and
development. Geneva: WHO; 1999. p. 21.
19. Sohrabi S. Assessing knowledge, attitudes and health behaviors in
adolescent girls during puberty; Shahrekord, 1997. J World Health
Univ Publ 1999;13:38‑41.
20. Doustar Sanaye M. Health education of adolescents in the Eastern
Mediterranean Region. J World Health Univ Publ 1999;13:52