Effectiveness of health belief model-based reproductive health education on menarche preparedness: A systematic review
https://doi.org/10.52235/lp.v7i2.723
Keywords:
adolescent, health belief model, health education, menarche, reproductive healthAbstract
Background: Menarche preparedness is an important component of adolescent reproductive health because inadequate knowledge, negative perceptions, and anxiety may hinder girls’ ability to adapt to their first menstruation. Health education based on the Health Belief Model (HBM) has been increasingly used to improve adolescent readiness by addressing beliefs, perceptions, and preventive behaviors related to reproductive health.
Objective: This systematic review aimed to evaluate the effectiveness of HBM-based reproductive health education on menarche preparedness among adolescent girls.
Methods: Literature searches were conducted in ProQuest, Scopus, ScienceDirect, and SAGE Journals, with additional searching through grey literature and reference lists. The search covered publications from 2015 to 2025 in English and Indonesian. Eligible studies included quantitative intervention studies examining HBM-based reproductive health education in relation to menarche preparedness or closely related outcomes among adolescent girls. Data were extracted using a structured form and synthesized narratively because of heterogeneity in study design, intervention format, and outcome measures.
Results: A total of 30,651 records were identified, of which 42 studies met the eligibility criteria for inclusion. The reviewed evidence consistently showed that HBM-based reproductive health education improved menstrual knowledge, increased positive attitudes, reduced anxiety, and enhanced emotional and behavioral readiness for menarche. Several studies also demonstrated improved menstrual hygiene practices and stronger preparedness when family support and culturally sensitive approaches were incorporated. Although the included studies varied in design and measurement, the overall direction of evidence indicated a beneficial effect of HBM-based educational interventions on adolescent girls’ preparedness for menarche.
Conclusion: HBM-based reproductive health education is effective in improving adolescent girls’ preparedness for menarche across cognitive, emotional, and behavioral domains. The integration of theory-based, culturally appropriate, and family-supported educational strategies into school and community health programs may strengthen adolescent reproductive health outcomes.
Downloads
References
Akbar, M. A. (2024). The important role of community nurses post pandemic covid-19. Journal of Community Nursing and Primary Care, 1(1), 26-28. https://doi.org/10.63202/jcnpc.v1i1.26
Al Agili, D. E., & Khalaf, Z. I. (2023). The role of oral and prenatal healthcare providers in the promotion of oral health for pregnant women. BMC Pregnancy and Childbirth, 23(1), 313. https://doi.org/10.1186/s12884-023-05631-4
Altunkurek ŞZ, Yeşilyurt E, Hassan Mohamed S. The Effect of Breast Cancer and Breast Self-Examination Health Education on Awareness, Beliefs, and Practices of Female Students at the Faculty of Health Sciences of a University in Somalia. Breast J. 2026;2026(1):e8854280. doi: 10.1155/tbj/8854280.
Amin, M. R. (2026). Determinants of maternal and reproductive health service utilization among plain land tribal women in Bangladesh: A mixed-methods study. Indonesian Journal of Health Services, 3(1), 27-37. https://doi.org/10.63202/ijhs.v3i1.121
Andre Utama Saputra, Yulinda Ariyani, Suci Wahyuni, & Arsi, R. (2024). The Effect of Health Education on Breast Self-Examination (SADARI) on Knowledge, Attitudes, and Actions of Adolescent Girls. Lentera Perawat, 5(2), 218–225. https://doi.org/10.52235/lp.v5i2.345
Anggaraini, N. D., & Lestari, D. (2025). Relationship between knowledge of anemia and attitudes toward adherence to iron supplementation among high school students: A cross-sectional study. Indonesian Journal of Health Services, 2(3), 88-95. https://doi.org/10.63202/ijhs.v2i3.108
Anisa Yulianti, Siti Aisyah, & Sri Handayani. (2024). Faktor-Faktor yang Berhubungan dengan Anemia pada Remaja Putri. Lentera Perawat, 5(1), 10–17. https://doi.org/10.52235/lp.v5i1.276
Astriana, W., Zahra, T., & Wulandari, P. (2025). Effect of health belief model–based education on the prevention of pathological vaginal discharge: A pre-experimental study. Lentera Perawat, 6(4), 804–812. https://doi.org/10.52235/lp.v6i4.637
Barkhordari-Sharifabad, M., Vaziri-Yazdi, S., & Barkhordari-Sharifabad, M. (2020). The effect of teaching puberty health concepts on the basis of a health belief model for improving perceived body image of female adolescents: a quasi-experimental study. BMC Public Health, 20(1), 370. https://doi.org/10.1186/s12889-020-08482-2
Bashirian, S., Barati, M., Barati, M., Shirahmadi, S., Khazaei, S., Jenabi, E., et al. (2023). Promoting oral health behavior during pregnancy: A randomized controlled trial. Journal of Research in Health Sciences, 23(2), e00584. https://doi.org/10.34172/jrhs.2023.123
Chen P, Li M, Zhang Q, Qiu M, Yu X. Effects of an Oral Health Management Program During Pregnancy: A Randomized Controlled Trial. Oral Dis. 2026 Jan;32(1):240-250. doi: 10.1111/odi.70076.
Dara Anggun Prasasti, Mastina, Eka Afrika, & Siti Aisyah. (2024). Faktor yang Berhubungan dengan Kejadian Keputihan pada Remaja Putri di Sekolah Menengah Pertama. Lentera Perawat, 5(1), 110–115. https://doi.org/10.52235/lp.v5i1.271
Destiana, C., Harokan, A., & Zaman, C. (2025). Analysis of factors associated with the incidence of anemia in adolescent girls at the Muara Enim Health Center: A cross-sectional study. Lentera Perawat, 6(3), 504–512. https://doi.org/10.52235/lp.v6i3.491
Eghbal, S. B., Kenari, Z. A., Ashouri, A., Rouhani-Tonekaboni, N., Kasmaei, P., Mehrabian, F., Karimy, M., Rezaei, F., & Fattahi, E. (2023). The effectiveness of educational program based on health belief model on promotion of puberty health concepts among teen girls: a cross-sectional study in north of Iran. BMC Women’s Health, 23(1), 239. https://doi.org/10.1186/s12905-023-02391-3
El Maghawry, H. A. (2022). The effect of health belief model based educational program on oral and dental health among pregnant women: An interventional study. Egyptian Journal of Community Medicine, 40(4), 292–299. https://doi.org/10.21608/ejcm.2022.260764
Heriani, H. (2025). Factors associated with leukorrhea symptoms among female adolescents in high school: A cross-sectional study. Lentera Perawat, 6(4), 767–775. https://doi.org/10.52235/lp.v6i4.623
Jahan, F., Shuchi, N. S., Shoab, A. K., Alam, M. U., Bashar, S. M. K., Islam, K., Jahan, H., Hasan, M., Alam, M. M., & Rahman, M. (2024). Changes in the menstrual hygiene management facilities and usage among Bangladeshi school girls and its effect on school absenteeism from 2014 to 2018. Global Health Action, 17(1). https://doi.org/10.1080/16549716.2023.2297512
Je, M., Lee, J., & Park, S. (2025). Development and Effect of an IMB Skills Model–based Online Reproductive Health Promotion Program for Late Adolescent Women. Asian Nursing Research. https://doi.org/10.1016/j.anr.2025.09.007
Khalilzadeh, P., Amirzadeh-iranagh, J., Khalkhali, H. R., & Maheri, M. (2023). Evaluating the effect of educational intervention based on the health belief model on the lifestyle related to premenstrual syndrome and reduction of its symptoms among the first-grade high school girls. BMC Public Health, 23(1), 1001. https://doi.org/10.1186/s12889-023-15950-y
Kheirandish S, Javadzadeh H, Mahmoodi M, Mousavi SH, Abbasi H. The effect of web-based educational intervention on caries-preventive oral health behaviors in pregnant women: an application of the health belief model. BMC Public Health. 2026 Feb 11;26(1):903. doi: 10.1186/s12889-026-26315-6.
Mahar B, Osman MB, Fauzi FA. From awareness to action: Health Belief Model-based educational intervention to improve breast self-examination practice among college teachers in Pakistan (CRCT). PLoS One. 2026 Jan 29;21(1):e0341804. doi: 10.1371/journal.pone.0341804.
Melia Rahma, Ririn Anggraini, Titin Apriyani, & Divaliana Shafira Hernanda. (2023). Hubungan Tingkat Stres dan Dismenore Terhadap Siklus Menstruasi Mahasiswa. Lentera Perawat, 4(2), 99–105. https://doi.org/10.52235/lp.v4i2.232
Mohammadkhah, F., Ramezankhani, A., Atashpoosh, A., Ahmady Moghadam, F., Bakhtiar, M., & Khani Jeihooni, A. (2022). Effect of training based on health belief model and behavioral intention on improving dental and oral self-care behavior in 9–12-year-old Iranian female students. BMC Oral Health, 22(1), 515. https://doi.org/10.1186/s12903-022-02552-0
Mohammed, S., & Larsen-Reindorf, R. E. (2020). Menstrual knowledge, sociocultural restrictions, and barriers to menstrual hygiene management in Ghana: Evidence from a multi-method survey among adolescent schoolgirls and schoolboys. PLOS ONE, 15(10), e0241106. https://doi.org/10.1371/journal.pone.0241106
Nakić Radoš, S. (2020). Construction and validation of the Self-assessed Successful Aging Scale. Suvremena Psihologija, 23(1), 21–34. https://doi.org/10.21465/2020-SP-231-02
Nannan, M., Xiaoping, L., & Ying, J. (2022). Periodontal disease in pregnancy and adverse pregnancy outcomes: Progress in related mechanisms and management strategies. Frontiers in Medicine, 9, 963956. https://doi.org/10.3389/fmed.2022.963956
Nickbin Poshtamsary, S., Emami Sigaroudi, A., Farmanbar, R., Radafshar, G., & Atrkar Roushan, Z. (2020). The effect of educational intervention based on the health belief model on oral and dental health behavior in pregnant women. Journal of Holistic Nursing and Midwifery, 30(3), 182–190. https://doi.org/10.32598/jhnm.30.3.182
Radwan-Oczko, M., Hirnle, L., Szczepaniak, M., & Duś-Ilnicka, I. (2023). How much do pregnant women know about the importance of oral health in pregnancy? Questionnaire-based survey. BMC Pregnancy and Childbirth, 23(1), 348. https://doi.org/10.1186/s12884-023-05677-4
Rakkini L, M., & Hema, V. H. (2023). Influence of a Teaching Module on Adolescent Girls’ Understanding and Perception of Early Menarche. Salud, Ciencia y Tecnología, 3, 511. https://doi.org/10.56294/saludcyt2023511
Ridwan, S. B., LO, M., & Mujiarti, M. (2025). Gambaran Tingkat Pengetahuan Remaja Tentang Pernikahan Dini Di Desa Sukapura Kabupaten Bandung. Bakti Nusantara Pengabdian Masyarakat Indonesia, 2(1), 14-20. https://doi.org/10.63202/bnpmi.v2i1.84
Rizkia, M., Setyowati, & Ungsianik, T. (2019). Female Adolescents’ Preparations, Knowledge, and Emotional Response toward Menarche: A Preliminary Study. Comprehensive Child and Adolescent Nursing, 42(sup1), 108–114. https://doi.org/10.1080/24694193.2019.1578431
Salahshouri, A., Raisi-Philabadi, P., Ghanbari, S., Stein, L., & Araban, M. (2024). Using the health beliefs model to implement mobile puberty health education in Iranian adolescent boys: a randomized controlled trial. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1175262
Sharm, A., & Kappor, P. (2025). Investigation of the relationship between internet addiction with emotion regulation in adolescent: A cross-sectional study. Journal of Community Nursing and Primary Care, 2(2), 65-74. https://doi.org/10.63202/jcnpc.v2i2.116
Singh AD, Bedard AV, Rodak T, Nexha E, Krzeczkowski J, Plamondon A, Andrade BF. Barriers and Facilitators of Psychosocial Treatment Participation for Youth With Depression and Anxiety: A Scoping Review. Clin Child Psychol Psychiatry. 2026 Apr;31(2):392-411. doi: 10.1177/13591045251410332.
Soleha, M., Zelharsandy, V. T., Sepiwiryanti, W., & Ciselia, D. (2025). Effectiveness of Acupressure Therapy at Points SP6 AND LI4 Against Dysmenorrhea in Adolescent Girls in College : A Pre-experimental Study. Lentera Perawat, 6(2), 288–295. https://doi.org/10.52235/lp.v6i2.457
Than, K. K., Mohamed, Y., Oliver, V., Myint, T., La, T., Beeson, J. G., & Luchters, S. (2017). Prevention of postpartum haemorrhage by community-based auxiliary midwives in hard-to-reach areas of Myanmar: a qualitative inquiry into acceptability and feasibility of task shifting. BMC Pregnancy and Childbirth, 17(1), 146. https://doi.org/10.1186/s12884-017-1324-6
Tsikouras, P., Oikonomou, E., Nikolettos, K., Andreou, S., Kyriakou, D., Damaskos, C., et al. (2024). The impact of periodontal disease on preterm birth and preeclampsia. Journal of Personalized Medicine, 14(4), 345. https://doi.org/10.3390/jpm14040345
Tsuda, S., & Takada, S. (2024). Assessing the effectiveness of a comprehensive menstrual health education program for preadolescent girls with intellectual disability and high support needs in Japan. Journal of Intellectual Disabilities, 28(1), 93–103. https://doi.org/10.1177/17446295221130423
Widhawati, R., Rivani, B., & Nurazizah, S. B. (2026). Association of food consumption patterns and physical activity with obesity among junior high school students in Tangerang, Indonesia: A cross-sectional study. Indonesian Journal of Health Services, 3(1), 16-26. https://doi.org/10.63202/ijhs.v3i1.143
Yao, X., Shan, S., Li, Y., Ding, L., Wan, Y., Zhao, Y., & Huang, R. (2024). Roles and challenges encountered by midwives in the management of postpartum haemorrhage following normal vaginal delivery: A scoping review. Nursing Open, 11(6). https://doi.org/10.1002/nop2.2221
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sitti Nurhaisa, Sri Wahyuni, Herry Susanto
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
