A Pelvic Health Curriculum in School Settings: The Effect on Adolescent Females' Knowledge

Abstract

Study objective: In this pilot study we ascertained baseline knowledge of pelvic anatomy and function among female adolescents and tested the educational effectiveness of a pelvic health curriculum among female adolescent students with the hypothesis that teaching pelvic anatomy, muscle, and organ function, and pelvic hygiene increases pelvic health knowledge.

Design: Intervention-control group, community-based effectiveness study.

Setting: Three Chicago area schools with racial minority and low-income student populations were selected as study sites.

Participants: One hundred sixty-eight students with a mean age of 14.1 (±0.1) years. Most (69%) self-reported race as black or African American; 23.8% reported Hispanic ethnicity.

Interventions: Pelvic health teachers delivered 6 weekly, 1-hour classes (intervention group, n = 103; control group, n = 65). A comparison control group received standard curricula (physical education or science).

Main outcome measures: Knowledge change was measured using the Adolescent Bladder and Pelvic Health Questionnaire. We used χ² tests to compared bivariate differences between study arms and generalized equation estimate to test for before and after change across groups.

Results: Baseline pelvic anatomy and function knowledge was minimal. The level of anatomical knowledge was very low with few in either group correctly able to identify where urine exits the body or the number of openings in the vulva. After intervention, significant increases in knowledge included pelvic floor muscle awareness in the control and intervention group (20% vs 89%; P < .001), pelvic floor muscle exercise benefit (31% vs 78%; P < .001), and knowledge that urine loss was abnormal (25.4% vs 60%; P < .001). More participants correctly identified organs within the pelvic structure, the vagina (21.5% vs 51.5%; P < .001), pelvic floor (16.9% vs 57.3%; P < .001), and the bladder (12.3% vs 42.7%; P < .001).

Conclusion: In this study we identified pelvic-related knowledge deficits among female adolescents and suggest that short-term pelvic health educational intervention results in significant knowledge acquisition.

Keywords: Adolescent; Bladder; Female; Knowledge; Pelvic health.