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Heidari F, Mirbagri F, Moridi M. Effects of Multimedia-based Puberty Health Education on Knowledge, Practice, Self-esteem and Emotion Regulation of Adolescent Girls. JHNM 2025; 35 (1) :35-44
URL: http://hnmj.gums.ac.ir/article-1-2215-en.html

Introduction: Studies have reported that Iranian adolescent girls have low self-esteem and emotion regulation and recommended education to help improve them. 
Objective: This study aimed to assess the effects of multimedia-based puberty health education on knowledge and practice of puberty health, self-esteem and emotion regulation in girls aged 11-14 years in Iran.
Materials and Methods: This quasi-experimental study was conducted on 100 adolescent girls aged 11-14 years from Saveh City, Markazi Province, Iran in 2022. They were selected randomly from two public middle schools and divided into two groups of intervention (n=50) and control (n=50). The intervention group participated in five multimedia-based educational sessions about physical and psychological health during puberty, while the control group did not receive any education. The data were collected using the puberty health knowledge and practice scales, the emotion regulation questionnaire (ERQ) and the coopersmith self-esteem inventory (CSEI). All adolescent girls completed the study questionnaire three times (before, immediately after, and three months after the intervention). The collected data were analyzed using independent t-test, chi-square, Fisher’s exact test, repeated measures ANOVA and logistic regression analysis. In all statistical tests, the significant level was set at 0.05.
Results: The majority of participants were 13 years old and had moderate socioeconomic status. The pre-test, post-test and follow-up scores of the puberty health knowledge in the intervention group were 23.56±3.7, 38.56±6.9 and 38.6±6.91, respectively (P=0.01) and in the control group, the scores were 23.9±3.12, 23.44±3.82 and 23.74±3.4. For the practice variable, the scores were 37.98±6.93, 68.94±4.84, and 71.68±5.93 in the intervention group (P=0.01) and 38.86±6.25, 38.18±6.82 and 38.88±6.26 in the control group, respectively. For the CSEI, the scores were 29.92±7.25, 35.8±7.28 and 36.38±6.93 in the intervention group (P=0.01) and 29.04±3.77, 29.12±4.01 and 28.86±5.13 in the control group, respectively. For the ERQ, the scores were 44±8.6, 56.5±11.83 and 58.08±8.74 in the intervention group (P=0.01) and 44.04±10.48, 44±10.45 and 43.36±9.39in the control group, respectively; therefore, all four variables in the intervention group increased immediately and three months after the education, while no significant changes were observed in the control group. The knowledge factor had a significant association with emotion regulation (β=0.32, 95% CI; 0.22%, 0.45%, P=0.001) and self-esteem (β=0.54, 95% CI; 0.32%, 0.84%, P=0.001) in the post-test phase. In addition, knowledge had a significant association with self-esteem (β=0.09, 95% CI; 0.01%, 0.12%, P=0.04) and practice had a significant association with emotion regulation (β=0.39, 95% CI; 0.26% 0.54%, P=0.001) in the follow-up phase.
Conclusion: Education about physical and psychological puberty health can improve the emotion regulation and self-esteem of adolescent girls. The girls with high self-esteem and proper emotion regulation can better adapt to body changes and obtain better social status in the future compared to their peers.