Parenting Communication Education and Adolescents’ Preventive Intentions Toward Early Marriage: A Quasi-Experimental Family-Centered Intervention Study
Abstract
Introduction: Early marriage remains a significant public health concern because it is closely associated with adolescent pregnancy, limited educational attainment, and increased risk of maternal and child health problems, including stunting. Family dynamics and parent–adolescent communication play an important role in shaping adolescents’ knowledge, attitudes, and preventive intentions regarding marriage timing and reproductive health. This study aimed to examine the short-term effect of parenting communication education as a family-based intervention to improve knowledge, attitudes, and behavioral intentions related to early marriage prevention in a community setting.
Methods: This study employed a quasi-experimental design with a pre-test–post-test control group structure. A total of 60 respondents were divided into an intervention group and a control group, each consisting of 30 participants. Participants were adolescents aged 15–18 years and parents from the working area of Biromaru Community Health Center and SMK 1 Sigi, selected according to predefined eligibility criteria. The intervention group received parenting communication education focusing on parent–adolescent dialogue, reproductive health awareness, and the risks associated with early marriage, while the control group did not receive the intervention during the study period. Data were collected using structured questionnaires that had undergone validity and reliability testing to measure knowledge, attitudes, and behavioral intentions related to early marriage prevention. Statistical analysis was conducted using paired t-tests to assess within-group changes and independent t-tests to compare outcomes between groups, with findings interpreted as short-term psychosocial changes rather than verified behavioral outcomes.
Result: The results demonstrated significant improvements in the intervention group across all measured domains. Knowledge scores increased from 55.6 ± 8.2 to 82.4 ± 5.7 (p < 0.001), indicating enhanced understanding of reproductive health risks and the consequences of early marriage. Attitude scores also improved from 60.3 ± 9.1 to 84.1 ± 7.4 (p < 0.001), reflecting stronger rejection of early marriage and greater awareness of the importance of mental and social preparedness for parenthood. Behavioral intention scores showed the largest improvement, increasing from 50.2 ± 8.1 to 88.1 ± 6.9 (p < 0.001), suggesting stronger intention to delay marriage and prioritize education and reproductive health preparation. In contrast, the control group showed only limited changes across the measured domains. These findings suggest that family-based educational interventions may strengthen parent–adolescent communication and reinforce normative support for delaying marriage, although longer-term follow-up is required to determine whether these intentions translate into actual behavioral outcomes.
Conclusion: In conclusion, parenting communication education represents a promising strategy for preventing early marriage by strengthening family communication, improving reproductive health knowledge, and promoting preventive attitudes and behavioral intentions. Integrating family-based education into adolescent health programs may support upstream prevention pathways associated with early marriage and stunting risk, but its effects on actual marriage timing, reproductive health behavior, and child nutritional outcomes require longitudinal verification.
References
Abdullahi LH, Rithaa GK, Muthomi B, Kyallo F, Ngina C, Hassan MA, et al. Best practices and opportunities for integrating nutrition specific into nutrition sensitive interventions in fragile contexts: a systematic review. BMC Nutr. 2021;7(1):46. Available from: https://doi.org/10.1186/s40795-021-00443-1
Akseer N, Tasic H, Nnachebe Onah M, Wigle J, Rajakumar R, Sanchez-Hernandez D, et al. Economic costs of childhood stunting to the private sector in low- and middle-income countries. eClinicalMedicine. 2022;45:101320. Available from: https://doi.org/10.1016/j.eclinm.2022.101320
Dassie GA, Chala Fantaye T, Charkos TG, Sento Erba M, Balcha Tolosa F. Factors influencing concurrent wasting, stunting, and underweight among children under five who suffered from severe acute malnutrition in low- and middle-income countries: a systematic review. Front Nutr. 2024;11:1350742. Available from: https://doi.org/10.3389/fnut.2024.1350742
González-Fernández D, Williams TS, Vaivada T, Bhutta ZA. Early Growth and Impacts on Long-Term Neurodevelopment and Human Capital. Ann Nutr Metab. 2024;80(Suppl 1):39–52. Available from: https://doi.org/10.1159/000540144
Li Z, Kim R, Vollmer S, Subramanian SV. Factors Associated With Child Stunting, Wasting, and Underweight in 35 Low- and Middle-Income Countries. JAMA Netw Open. 2020;3(4):e203386. Available from: https://doi.org/10.1001/jamanetworkopen.2020.3386
Smith Fawzi MC, Andrews KG, Fink G, Danaei G, McCoy DC, Sudfeld CR, et al. Lifetime economic impact of the burden of childhood stunting attributable to maternal psychosocial risk factors in 137 low/middle-income countries. BMJ Glob Health. 2019;4(1):e001144. Available from: https://doi.org/10.1136/bmjgh-2018-001144
Le Roux K, Christodoulou J, Stansert-Katzen L, Dippenaar E, Laurenzi C, le Roux IM, et al. A longitudinal cohort study of rural adolescent vs adult South African mothers and their children from birth to 24 months. BMC Pregnancy Childbirth. 2019;19(1):24. Available from: https://doi.org/10.1186/s12884-018-2145-9
Ahinkorah BO, Kang M, Perry L, Brooks F, Hayen A. Prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa: A multi-country analysis. PLoS One. 2021;16(2):e0246308. Available from: https://doi.org/10.1371/journal.pone.0246308
Silveira SL, Richardson EV, Motl RW. Social cognitive theory as a guide for exercise engagement in persons with multiple sclerosis who use wheelchairs for mobility. Health Educ Res. 2020;35(4):270–282. Available from: https://doi.org/10.1093/her/cyaa018
Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013;382(9890):452–477. Available from: https://doi.org/10.1016/S0140-6736(13)60996-4
Muhwezi WW, Katahoire AR, Banura C, Mugooda H, Kwesiga D, Bastien S, et al. Perceptions and experiences of adolescents, parents and school administrators regarding adolescent-parent communication on sexual and reproductive health issues in urban and rural Uganda. Reprod Health. 2015;12:110. Available from: https://doi.org/10.1186/s12978-015-0099-3
Reinhardt K, Fanzo J. Addressing Chronic Malnutrition through Multi-Sectoral, Sustainable Approaches: A Review of the Causes and Consequences. Front Nutr. 2014;1:13. Available from: https://doi.org/10.3389/fnut.2014.00013
Yaya S, Odusina EK, Bishwajit G. Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries. BMC Int Health Hum Rights. 2019;19:33. Available from: https://doi.org/10.1186/s12914-019-0219-1
Wells JCK, Sawaya AL, Wibaek R, Mwangome M, Poullas MS, Yajnik CS, et al. The double burden of malnutrition: aetiological pathways and consequences for health. Lancet. 2020;395(10217):75–88. Available from: https://doi.org/10.1016/S0140-6736(19)32472-9
Millward DJ. Nutrition, infection and stunting: the roles of deficiencies of individual nutrients and foods, and of inflammation, as determinants of reduced linear growth of children. Nutr Res Rev. 2017;30(1):50–72. Available from: https://doi.org/10.1017/S0954422416000238
Kalamar AM, Lee-Rife S, Hindin MJ. Interventions to Prevent Child Marriage Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature. J Adolesc Health. 2016;59(3 Suppl):S16–S21. Available from: https://doi.org/10.1016/j.jadohealth.2016.06.015
Wallace J, Covassin T, Nogle S, Gould D, Kovan J. Concussion Knowledge and Reporting Behavior Differences Between High School Athletes at Urban and Suburban High Schools. J Sch Health. 2017;87(9):665–674. Available from: https://doi.org/10.1111/josh.12543
Raj A, McDougal L, Silverman JG, Rusch MLA. Cross-Sectional Time Series Analysis of Associations between Education and Girl Child Marriage in Bangladesh, India, Nepal and Pakistan, 1991–2011. PLoS One. 2014;9(9):e106210. Available from: https://doi.org/10.1371/journal.pone.0106210
Hanieh S, Ha TT, Simpson JA, Thuy TT, Khuong NC, Thoang DD, et al. Exclusive breast feeding in early infancy reduces the risk of inpatient admission for diarrhea and suspected pneumonia in rural Vietnam: a prospective cohort study. BMC Public Health. 2015;15:1166. Available from: https://doi.org/10.1186/s12889-015-2431-9
Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340–357. Available from: https://doi.org/10.1016/S0140-6736(07)61692-4
Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nutr. 2013;9(Suppl 2):27–45. Available from: https://doi.org/10.1111/mcn.12088
Wang K, Xu SS, Liu Z, Wang W, Hee J, Tang K. A quasi-experimental study on the effectiveness of a standardized comprehensive sexuality education curriculum for primary school students. J Adolesc. 2023;95(8):1666–1677. Available from: https://doi.org/10.1002/jad.12214
Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. Lancet. 2016;387(10036):2423–2478. Available from: https://doi.org/10.1016/S0140-6736(16)00579-1
Kigongo E, Tumwesigye R, Anyolitho MK, Musinguzi M, Kwizera G, Achan E, et al. Access to family planning services and associated factors among young people in Lira city northern Uganda. BMC Public Health. 2024;24(1):1146. Available from: https://doi.org/10.1186/s12889-024-18604-0
Ma X, Yang Y, Chow KM, Zang Y. Chinese adolescents’ sexual and reproductive health education: A quasi-experimental study. Public Health Nurs. 2022;39(1):116–125. Available from: https://doi.org/10.1111/phn.12970
Salam RA, Faqqah A, Sajjad N, Lassi ZS, Das JK, Kaufman M, et al. Improving adolescent sexual and reproductive health: a systematic review of potential interventions. J Adolesc Health. 2016;59(4 Suppl):S11–S28. Available from: https://doi.org/10.1016/j.jadohealth.2016.05.022
Kululanga LI, Sundby J, Malata A, Chirwa E. Striving to promote male involvement in maternal health care in rural and urban settings in Malawi: a qualitative study. Reprod Health. 2011;8:36. Available from: https://doi.org/10.1186/1742-4755-8-36
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–451. Available from: https://doi.org/10.1016/S0140-6736(13)60937-X
Robertson L, Mushati P, Eaton JW, Dumba L, Mavise G, Makoni J, et al. Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial. Lancet. 2013;381(9874):1283–1292. Available from: https://doi.org/10.1016/S0140-6736(12)62168-0
Kapetanovic S, Skoog T, Bohlin M, Gerdner A. Aspects of the parent–adolescent relationship and associations with adolescent risk behaviors over time. J Fam Psychol. 2019;33(1):1–11. Available from: https://doi.org/10.1037/fam0000436
Melnikas AJ, Ainul S, Ehsan I, Haque E, Amin S. Child marriage practices among the Rohingya in Bangladesh. Confl Health. 2020;14:28. Available from: https://doi.org/10.1186/s13031-020-00274-0
Sebastian MP, Khan ME, Kumari K, Idnani R. Increasing Postpartum Contraception in Rural India: Evaluation of a Community-Based Behavior Change Communication Intervention. Int Perspect Sex Reprod Health. 2012;38(2):68–77. Available from: https://doi.org/10.1363/3806812
Widman L, Choukas-Bradley S, Noar SM, Nesi J, Garrett K. Parent–adolescent sexual communication and adolescent safer sex behavior: a meta-analysis. JAMA Pediatr. 2016;170(1):52–61. Available from: https://doi.org/10.1001/jamapediatrics.2015.2731
Zuilkowski SS, Jukes MCH. The impact of education on sexual behavior in sub-Saharan Africa: A review of the evidence. AIDS Care. 2012;24(5):562–576. Available from: https://doi.org/10.1080/09540121.2011.630342
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