Empowerment of Technical Secondary School Girls Regarding Preconception Care Through Web-based Health Literacy Program: Intervention Study

Background: Preconception care (PCC) for adolescents in low and middle-income countries has become a necessity. Early marital age in these countries requires early intervention to reduce unplanned pregnancies, mortality, and morbidity rates of both mothers and neonates. Nurses play a crucial role in ensuring coverage of health-empowering services for adolescents. With limited resources, there is an urge for nurses and midwives to provide a tailored, accessible, reliable, empowering method that enables adolescents to make informed decisions and actively participate in managing their PCC. Purpose: This study aims to assess the effect of a web-based health literacy program about PCC on technical secondary school girls’ e-health literacy, decision-making self-efficacy, and fetal health locus of control. Methods: A quasi-experimental design (pretest and posttest) was carried out on 250 school girls from six technical secondary schools. A multistage stratified cluster sampling technique was used. A structured self-administered questionnaire; e-health literacy scale, decision self-efficacy, and fetal health locus of control were utilized for data collection before and after three months of the intervention. Results: After 3 months of intervention, there was a significant increase in the mean scores of total e-health literacy, total fetal health locus of control, and decision self-efficacy (P<0.001). There was a positive statistically significant correlation between the secondary school girls’ decision self-efficacy and both their total e-health literacy score and total fetal health locus of control score at both the pre-intervention and three-month post-intervention assessments (P<0.001). Age, family income, and medical condition of the secondary school girls’ had a significant relationship with the total e-health literacy and decision self-efficacy scores pre-intervention (p≤0.001). Conclusions: Web-based health literacy program about PCC is a promising strategy to improve technical secondary school girls’ e-health literacy, decision self-efficacy, and fetal health locus of control. Their e-health literacy, fetal health locus of control, and decision self-efficacy are positively inter-correlated. Their age, family income, and medical condition significantly affected their e-health literacy and decision self-efficacy skills. Recommendation: Health care policymakers and planners, and nurses should adopt web-based health literacy programs to raise the secondary school girls’ awareness regarding their preconception health and provide access to online, credible, and reliable, empowering resources.