Exploring the status of mother and adolescent daughter communication on reproductive health: a cross-sectional study

Vijiya Kashyap; Dr. Sonali Choudhari

doi:10.12688/f1000research.146908.1

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Study Protocol

Exploring the status of mother and adolescent daughter communication on reproductive health: a cross-sectional study

[version 1; peer review: 2 approved with reservations]

Vijiya Kashyap ¹, Dr. Sonali Choudhari²

PUBLISHED 20 Mar 2024

Author details Author details

¹ School of Epidemiology and Public Health, The Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India
² Community Medicine and School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India

Vijiya Kashyap
Roles: Conceptualization, Formal Analysis, Visualization, Writing – Review & Editing

Dr. Sonali Choudhari
Roles: Supervision, Validation, Writing – Original Draft Preparation

OPEN PEER REVIEW

REVIEWER STATUS

This article is included in the Datta Meghe Institute of Higher Education and Research collection.

Abstract

Introduction

Adolescents between the ages of 10 and 19 are especially susceptible to problems with sexual and reproductive health (SRH), including unwanted pregnancy, sexually transmitted infections (STIs), and unsafe abortion. Approximately 18% of individuals within this age group reside in India. During this stage, puberty represents a major transition, especially concerning reproductive changes. Sexual and reproductive health conversations with adolescents help to establish their perceptions, attitudes, and values. Mother-daughter conversations serve as an important source of information for adolescent girls, yet many lack access to this knowledge. This study aimed to assess the present status of communication about reproductive health between mothers and their adolescent daughters.

Objectives

This study aims to evaluate the knowledge, attitude and information sources regarding reproductive health among adolescent daughters, also assessing how frequently they engage in communication on these topics.

Methods

A community-based cross-sectional study involving both urban and rural areas will be conducted in the Wardha district. The pre-tested questionnaire survey will be used for this study to gather data using a simple random sampling method. A descriptive approach will outline the frequency, communication type, and number of topics for discussions regarding reproductive health between mothers and adolescent daughters. To investigate the communication status between mother and adolescent daughter the chi-square test will be applied.

Study implications

The findings from this study could contribute significantly to implementing policies, interventions, and educational initiatives that promote better mother-daughter communication about reproductive health issues, ultimately leading to better adolescent health outcomes.

Keywords

adolescent girl, India, knowledge and attitude, mother and daughter communication, reproductive health

Corresponding author: Vijiya Kashyap

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2024 Kashyap V and Choudhari DS. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Kashyap V and Choudhari DS. Exploring the status of mother and adolescent daughter communication on reproductive health: a cross-sectional study [version 1; peer review: 2 approved with reservations]. F1000Research 2024, 13:196 (https://doi.org/10.12688/f1000research.146908.1) First published: 20 Mar 2024, 13:196 (https://doi.org/10.12688/f1000research.146908.1) Latest published: 20 Mar 2024, 13:196 (https://doi.org/10.12688/f1000research.146908.1)

Introduction

Adolescents between the ages of 10 and 19 are considered to be one of the most susceptible populations to a variety of sexual and reproductive health (SRH) problems.¹ Reproductive health comprises all aspects of one’s physical, mental, and social well-being, not just the lack of illness or disability, about the reproductive system and its processes and functions.² Every individual has the right to achieve optimal physical and mental well-being, with sexual and reproductive health being essential components. The worldwide Strategy includes a monitoring framework consisting of sixty indicators. This framework aims to help countries and their allies maintain accountability, avoid unnecessary deaths, maintain general health and well-being, and create supportive environments. The goal that no one is “Left Behind” ensures that all women, children, and adolescents can reach their full potential without facing discrimination.³ The Sustainable Development Goals (SDGs) of the United Nations have acknowledged and emphasised the significance of sexual and reproductive health (SRH) as well as rights in promoting gender equality, overall health, and comprehensive social and economic development.⁴ India holds the largest number of adolescents globally, totalling 1,428.6 million individuals, representing 18% of its population between the ages of 10 and 19.⁵^,⁶

Adolescent sexual and reproductive health problems are a major concern in low-income countries. 95% of pregnancies worldwide emerge in nations with lower and middle economic standings, and adolescents between the ages of 15 and 19 account for 11% of all pregnancies worldwide. Offspring born to mothers in their adolescence face a higher risk of early childhood stunting, which impact their cognitive and physical development and reduces their future productivity. Adolescents face many challenges such as early marriage, the higher chance of maternal mortality, unsafe abortions, violence, and STIs like HIV/AIDS. Moreover, improved communication between mothers and their adolescent daughters could lessen the negative effects on society, such as expulsion from school for lack of knowledge.⁵^,⁷^,⁸ Communication is an essential process that parents use to convey information, knowledge, expectations, values, and beliefs to their children.⁹

Nowadays, there is a growing concern for the health of adolescents due to civilization, urbanisation, and lifestyle changes.¹⁰ Adolescents face many unfulfilled healthcare needs as well as obstacles, such as insufficient experience and education regarding healthcare access. Adolescent births per 1,000 girls in the 15–19 age range are 11 in 2023 and decision-making on reproductive rights and sexual and reproductive health is 66 percent in the year between 2007-2022.⁶ Around 2.1 million children and young people were estimated to have passed away in just 2021; adolescents between the ages of 10 and 19, accounted for 43% of these deaths.¹¹ Laws have a substantial influence on the health and well-being of adolescents. Some prevent adolescents from harm (e.g., by prohibiting child marriage); others may be harmful by restricting their access to necessary products and services, like contraception.¹²

Socio-cultural hindrance between mothers and adolescents regarding sexual and reproductive health include shame, generational divides, gender differences, mothers’ education, mothers’ perceptions of their children’s understanding, mothers’ occupations, traditional and religious misconceptions, and a lack of time dedicated to these conversations.¹³ Adolescents need adults who can relate to them, talk to them, spend time with them, and genuinely care about them.¹⁴ One of the most important health-promoting variables for adolescents is their mothers. Their daughters’ general attitudes and behaviours regarding health, including SRH, are greatly influenced by them. They might serve as a valuable resource for their daughters when it comes to learning about SRH.¹⁵

Rationale

Individuals between the ages of 10–19 face various challenges while transitioning from childhood to adulthood and one of the reasons for this problem is the lack of sufficient and precise knowledge about sexual and reproductive matters.¹⁶ One of the known obstacles to successfully implementing the programmes is the social taboo and stigma associated with educating adolescents about reproductive health. Numerous unintended pregnancies result in abortions, and unsafe and occasionally self-induced abortions can result in death or serious health issues. On the other hand, a lot of these issues can be resolved with strong proof and open discussion.¹⁰ Global research has demonstrated that parents can be an effective source of information for adolescents regarding sexual health. Research suggests that healthy reproductive practices among adolescents can be prevented and their health can be improved through effective mother-adolescent-daughter communication.¹⁷

Many developed nations have carried out studies on parent-adolescent communication about reproductive health. However, there are few studies examining the communication about reproductive health between mothers and adolescent daughters in low- and middle-income countries.⁹ The United Nations’ goal of providing all people with access to sexual and reproductive health care cannot be achieved unless we reach adolescents through various interventions, such as interacting with parents in low and middle-income nations. To help policymakers, programme planners, and implementers create effective interventions to address adolescent reproductive health issues. This study aims to assess the reproductive health communication between mothers and adolescent daughters.

Aim

This study aims to analyse the mother and adolescent daughter communication status on reproductive health in urban and rural areas of Wardha district.

Objectives

1. To assess the knowledge and attitude of reproductive health in adolescent daughters.
2. To find out the source of knowledge on reproductive health.
3. To assess the communication frequency.

Methods

Ethics

Ethical approval was obtained from the Datta Meghe Institute of Higher Education and Research (DU) Institutional Ethics Committee (approval number: DMIHER (DU)/IEC/2023/31), on 20^th December 2023. Additionally, written informed consent will be obtained from all the participants before their inclusion in the study. Privacy and confidentiality will be strictly maintained throughout the study. Measures will be taken to minimize any potential harm or risks to the participants such as referrals for medical consultation if needed. We will ensure that the interviewee has privacy and feels comfortable throughout the interview.

Study design

Community-based cross-sectional study will be conducted.

Study setting

Wardha district’s rural and urban areas will be selected for the present study.

Study participants/population

School-going adolescent girls in the Wardha district’s rural and urban areas, between the age group 13 to 19 will be included in the study.

Inclusion criteria

Girls between the ages of 13 and 19 must be enrolled in school, living with their biological mother and who are willing to participate in the study.

Exclusion criteria

The study excluded girls who lived in hostels, had mothers who passed away, lived with their stepmother, or refused to grant consent to be part of the study.

Sample size

According to the previous study titled “reproductive health communication between mother and adolescent daughter”,¹⁸ the P value was found to be 50% and the sample size was calculated using the following formula.

N = \frac{Z_{1 - α / 2}^{2} * p * (1 - p)}{d^{2}}

Alpha (α) = 0.05

Estimated proportion (p) = 0.5

Estimated error (d) = 0.05

Minimum sample size required 385

Hence, the current status of mother and daughter communication on reproductive health will be assessed by analyzing data collected from a sample of 385 adolescent girls.

Sampling method

Simple random sampling will be employed for selecting the girls who will participate in the interview.

Variables

The primary outcome variables for this study will be related to knowledge and attitude, the amount of topics covered on reproductive health, the frequency and types of interactions that occur between mother and daughter when it comes to sexual and reproductive health, as well as socio-demographic data, knowledge sources, and barriers related to sexual and reproductive health (Table 1: lists the main study parameters, their variables, data sources, and data collection method).

Table 1. The key study parameters, their variables, data sources and data collection method.

Key study parameters	Variables	Data sources	Data collection method
Collection of socio-demographic data	Age Grades Area of residency Religion Family size Educational status of the mother Occupation Housing environment	Schools going adolescent girls.	A survey using the interview method with the Kobo toolbox.
Topics discussed on reproductive health in mother-daughter interactions	Puberty Menstrual hygiene Pregnancy Sexually transmitted disease Contraception Sexual harassment Reproductive health services		A survey using the interview method with the Kobo toolbox.
Communication status and sources of communication	Frequency of communication Communication type The initiator of communication Starting time of reproductive health communication Sources of communication		A survey using the interview method with the Kobo toolbox.

Data tool

Information on the mother-adolescent daughter’s communication status on reproductive health will be collected using pre-tested and pre-validated, close-ended questionnaires in both English and Hindi language. The objective to assess the knowledge and attitude of reproductive health in adolescent daughters will be covered using a knowledge and attitude questionnaire under the variable topics discussed on reproductive health in mother-daughter interactions. Knowledge score will be assessed through dichotomized techniques that is ‘Yes’ (1) and ‘No’ (0) and attitude will be scored using a Likert scale that is Strongly agree (1), Agree (2), Nor agree/Nor disagree (3), Disagree (4), Strongly disagree (5).

Data collection procedure

The data collection process will be carried out electronically using the Kobo toolbox after informed consent has been obtained, and it should take about ten minutes. The online survey will be completed by the participants.

Bias

Selection bias: If the sample is not representative of the entire population, the study’s findings regarding the communication patterns between mothers and daughters regarding reproductive health might not be accurate. This can be overcome by using a random sampling technique.

Response bias: Instead of telling the truth participants might answer that they believe is socially acceptable or desirable. This can be reduced by rapport building with the participants to create a comfortable and non-judgemental environment.

Data analysis plan and expected outcomes

Data analysis plan

The information gathered from the Kobo toolbox will be imported into a Microsoft Excel spreadsheet and subjected to statistical analysis utilising the R Statistical Software https://www.r-project.org. The data will be tallied and visualised using tables and graphs. The mother’s and the adolescent daughter’s communication status will be investigated through bivariate analysis. To determine whether socio-demographic information and communication status are related, the Chi Square test will be applied.

Expected outcomes

Investigating how the quality and extent of communication between mothers and daughters influence adolescent health behaviours. It helps in understanding the frequency, depth, and comfort level of discussions between mothers and daughters regarding reproductive health topics. It also identifies barriers that hinder open communication, such as being culturally unacceptable, feelings of shame, ignorance, and lack of communication skills. Communication on these topics is less likely to suffer from adverse issues related to reproductive health than those who have less knowledge, believe that communicating on this topic has no importance or feel embarrassed to talk on such topics.

Dissemination

The study protocol will be publish in indexed journal and will be presented in seminars and conference.

Study status

This study is not yet started. The proposal of the study clited for ethical approval to the IEC department of DMIHER (DU) and is under process.

Discussion

A cross-sectional study on the discussion of reproductive health issues between a mother and her adolescent daughter in Bangladesh was carried out by Zakaria et al. (2019). This study found that 78% of students said they had their first conversation with their mothers after the onset of their period, and 62% of students said that their mothers were the main source of information about reproductive health. These findings aligned with past research conducted in developing nations. the principal information source about reproductive health was found to be positively correlated with a high communication level in this study. This suggests that if students learned about reproductive health primarily from friends, classmates, or the internet, they were less likely to have positive interactions with their mothers.¹⁸

Only 23.1% of parents reported having at least two conversations about SRH issues in the previous year, according to the Bekele et al. (2022) study. This level of communication is also in line with results from other research conducted in Ethiopia, which showed that even though it is acknowledged to be important, the discussion is infrequent. it is, however, higher than the outcomes of a study conducted in Dera Town and lower than other findings from Southern Ethiopia and overseas in the USA. These discrepancies could be caused by social-economic, cultural, and variations in how each group experiences and learns about SRH from their mothers.⁸

Shiferaw et al. (2014) reported that 36.9% of participants said they had discussed sexual and reproductive health (SRH)-related matters with their parents in the preceding year. A related investigation done in Hawasa and Ethiopia, uncovered that students who had literate mothers were more likely to discuss these issues than students who had illiterate mothers. Differences in communication abilities, the significance of SRH conversations, and the accessibility of information regarding sexual and reproductive health could all contribute to this variance.¹⁰

The majority of mothers who took part in the study thought that adolescents shouldn’t have access to information about sexual health, according to Mataraarachchi et al. (2023). Mothers in this study stated that they would feel more comfortable talking to their adolescents about sexual matters if they had previously received sex education in school. Research has already shown that when adolescents take part in sexual health education programmes at school, there is an increase in the amount of sexual communication that happens between parents and adolescent children.¹⁹

Kusheta et al. (2019) reported that only 35.0% of adolescents had conversations with their parents. This is lower than the percentage reported in research conducted in the Ethiopian cities of Debremarkos (36.9%), Sidama Zone (59.1%), Dire Dawa (37%), and Mekele (43.5%). The reason for the discrepancy could be attributed to the fact that 59.4% of participants reside in rural areas, potentially limiting their access to sexual and reproductive health information. Consequently, their less exposure probably made them less inclined to talk to their parents about these topics.¹⁴

Implication of study

The findings from this study could contribute significantly to implementing policies, interventions, and educational initiatives that promote better mother-daughter communication about reproductive health issues, ultimately leading to better adolescent health outcomes.

Limitations

In this study we didn’t explore how mothers influence their adolescent daughters’ conversations with their mothers concerning reproductive health.

Data availability

Underlying data

No data are associated with this article.

Reporting guidelines

Figshare: STROBE checklist for ‘Exploring the status of mother and adolescent daughter communication on reproductive health: a cross-sectional study’. https://doi.org/10.6084/m9.figshare.25311223.v1.²⁰

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

References

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3. nina: UNICEF DATA. Women’s, children’s and adolescents’ health country profiles and dashboards.2022 [cited 2023 Sep 25]. Reference Source
4. Investing in sexual and reproductive health and rights: essential elements of universal health coverage.[cited 2023 Aug 20]. Reference Source
5. Adolescent development and participation|UNICEF India: [cited 2023 Aug 28]. Reference Source
6. UNFPA India|United Nations Population Fund: [cited 2023 Aug 28]. Reference Source
7. Vongxay V, Albers F, Thongmixay S, et al.: Sexual and reproductive health literacy of school adolescents in Lao PDR. PLoS One. 2019 Jan 16; 14(1): e0209675. PubMed Abstract | Publisher Full Text | Free Full Text
8. Bekele D, Deksisa A, Abera W, et al.: Parental communication on sexual and reproductive health issues to their adolescents and affecting factors at Asella town, Ethiopia: a community-based, cross-sectional study. Reprod. Health. 2022 May 8; 19: 114. PubMed Abstract | Publisher Full Text | Free Full Text
9. Jerman P, Constantine NA: Demographic and Psychological Predictors of Parent–Adolescent Communication About Sex: A Representative Statewide Analysis. J. Youth Adolesc. 2010; 39(10): 1164–1174. PubMed Abstract | Publisher Full Text | Free Full Text
10. Shiferaw K, Getahun F, Asres G: Assessment of adolescents’ communication on sexual and reproductive health matters with parents and associated factors among secondary and preparatory schools’ students in Debremarkos town, North West Ethiopia. Reprod. Health. 2014 Jan 8; 11: 2. PubMed Abstract | Publisher Full Text | Free Full Text
11. UNICEF DATA: Child and youth mortality data ages 5-24.[cited 2023 Sep 25]. Reference Source
12. Patton GC, Sawyer SM, Santelli JS, et al.: Our future: a Lancet commission on adolescent health and wellbeing. Lancet Lond. Engl. 2016 Jun 11; 387(10036): 2423–2478. PubMed Abstract | Publisher Full Text | Free Full Text
13. Barriers between mothers and their adolescent daughters with regards to sexual and reproductive health communication in Taunggyi Township, Myanmar: What factors play important roles? - PMC.[cited 2023 Aug 17]. Reference Source
14. Kusheta S, Bancha B, Habtu Y, et al.: Adolescent-parent communication on sexual and reproductive health issues and its factors among secondary and preparatory school students in Hadiya Zone, Southern Ethiopia: institution based cross sectional study. BMC Pediatr. 2019 Jan 7; 19: 9. PubMed Abstract | Publisher Full Text | Free Full Text
15. Parent–adolescent communication on sexual and reproductive health and the utilization of adolescent-friendly health services in Kailali, Nepal - PMC.[cited 2023 Aug 17]. Reference Source
16. Manu AA, Mba CJ, Asare GQ, et al.: Parent–child communication about sexual and reproductive health: evidence from the Brong Ahafo region, Ghana. Reprod. Health. 2015 Mar 7; 12: 16. PubMed Abstract | Publisher Full Text | Free Full Text
17. Buffer or Brake? The Role of Sexuality-Specific Parenting in Adolescents’ Sexualized Media Consumption and Sexual Development. J. Youth Adolesc. [cited 2023 Sep 24]; 47: 1427–1439. PubMed Abstract | Publisher Full Text | Free Full Text
18. Zakaria M, Xu J, Karim F, et al.: Reproductive health communication between mother and adolescent daughter in Bangladesh: a cross-sectional study. Reprod. Health. 2019 Jul 24; 16: 114. PubMed Abstract | Publisher Full Text | Free Full Text
19. Mataraarachchi D, Buddhika Mahesh PK, Pathirana TEA, et al.: Mother’s perceptions and concerns over sharing sexual and reproductive health information with their adolescent daughters- A qualitative study among mothers of adolescent girls aged 14–19 years in the developing world, Sri Lanka. BMC Womens Health. 2023 May 3; 23: 223. PubMed Abstract | Publisher Full Text | Free Full Text
20. Kashyap V: STROBE checklist for Exploring the status of mother and adolescent daughter communication on reproductive health: A cross-sectional study. figshare. 2024. Publisher Full Text

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Version 1

VERSION 1 PUBLISHED 20 Mar 2024

Author details Author details

¹ School of Epidemiology and Public Health, The Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India
² Community Medicine and School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, 442001, India

Vijiya Kashyap
Roles: Conceptualization, Formal Analysis, Visualization, Writing – Review & Editing

Dr. Sonali Choudhari
Roles: Supervision, Validation, Writing – Original Draft Preparation

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

Article Versions (1)

version 1

Published: 20 Mar 2024, 13:196

https://doi.org/10.12688/f1000research.146908.1

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© 2024 Kashyap V and Choudhari DS. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Kashyap V and Choudhari DS. Exploring the status of mother and adolescent daughter communication on reproductive health: a cross-sectional study [version 1; peer review: 2 approved with reservations]. F1000Research 2024, 13:196 (https://doi.org/10.12688/f1000research.146908.1)

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Version 1

VERSION 1

PUBLISHED 20 Mar 2024

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7

Reviewer Report 29 Jun 2024

Dilini Mataraarachchi, Ministry of Health, Family Health Bureau, Colombo, Sri Lanka

Approved with Reservations

https://doi.org/10.5256/f1000research.161039.r284997

This study addresses an important issue in adolescent health, which is timely and relevant to the study context. The manuscript is generally well-organized and clearly written. Yet, some sections of the manuscript need more improvement.

Abstract
... Continue reading

This study addresses an important issue in adolescent health, which is timely and relevant to the study context. The manuscript is generally well-organized and clearly written. Yet, some sections of the manuscript need more improvement.

Abstract
Accurately provides the content of the study.

Title
The title should include the setting of the study and the study sample. Additionally, you assess mother-daughter communication, adolescents' sexual health knowledge and attitudes. These should be mentioned in the title.

Introduction and Justification
Provide literature on any similar studies that have been carried out in the region.
Similar studies are done in Sri Lanka and Bangladesh, which you may cite in your lit review. Have any similar topics been carried out in India?

The rationale is clear. Yet, you could give a more detailed description of why the particular study is needed in Wardha district.

Objectives
Objectives are clearly stated. Yet objective 3 needs rephrasing to clarify what you are measuring.

Methodology
Since this manuscript mainly provides the methodology of the study. Please provide a detailed description of each section.

Inclusion criteria: Why was the participants' age limited to 13-19? Any particular reason? When you say 'living with their biological mother', how did you decide the adolescents lived adequately to communicate a sensitive issue with their parents? Was any particular demarcation used to decide whether participants lived adequately with their mothers?

Sample size: Why was p taken as 50%? It is important that you keep a reserve for the non-respondents when you calculate the sample size.

The sampling method is not clear. Please give more details on how you selected the sample. Describe the procedure used to draw a random sample of adolescents from the district.

Elaborate more on how the questionnaire was pretested and validated.

Mentioning the methods to minimise potential bias is commendable. However, provide information on how you are planning to handle recaller bias.

Mention the measures you will take to improve adolescent participation in this study. How will you ensure the confidentiality of the information?

Discussion
The discussion section is well written. However, it would be useful to provide information on how the findings of this research will be used to promote adolescent sexual health in the study setting.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Adolescent health, sexual health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

CITE

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Reviewer Report 14 Jun 2024

Sari Kistiana, Research Center for Population, National Research and Innovation Agency (BRIN), Jakarta Selatan, Indonesia

Approved with Reservations

https://doi.org/10.5256/f1000research.161039.r285004

Introduction, Rationale & Objective

1. Consider narrowing the scope of the introduction to better align with the main research question, additional context about adolescents RH issues in India. Focus on information directly related to the research question
... Continue reading

Introduction, Rationale & Objective

1. Consider narrowing the scope of the introduction to better align with the main research question, additional context about adolescents RH issues in India. Focus on information directly related to the research question

2. The context of the study is well-established, but additional references about mother-daughter communication would enhance the background.

3. The research aim is clearly stated, but ensure that the stated objectives align with the aim (could be more explicitly defined mother and daughter communication)

Methods

1. It would be helpful to provide a more detailed explanation to measure the outcome variables (knowledge and attitude), how these two will be categorised after giving the score in the analysis.

2. Ensure that the stated aim align with the study outcome. Based on the aim of the study, should the outcome variable the quality of mother daughter communication? Please provide more detailed information measurement of mother-daughter communication

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Sexuality and Reproductive Health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

CITE

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VERSION 1 PUBLISHED 20 Mar 2024

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Version 1 20 Mar 24	read	read

Sari Kistiana, National Research and Innovation Agency (BRIN), Jakarta Selatan, Indonesia
Dilini Mataraarachchi, Family Health Bureau, Colombo, Sri Lanka

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Reviewer Report

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29 Jun 2024 | for Version 1

Dilini Mataraarachchi, Ministry of Health, Family Health Bureau, Colombo, Sri Lanka

7 Views Cite this report Responses(0)

Approved With Reservations

This study addresses an important issue in adolescent health, which is timely and relevant to the study context. The manuscript is generally well-organized and clearly written. Yet, some sections of the manuscript need more improvement.

Abstract
Accurately provides the content of the study.

Title
The title should include the setting of the study and the study sample. Additionally, you assess mother-daughter communication, adolescents' sexual health knowledge and attitudes. These should be mentioned in the title.

Introduction and Justification
Provide literature on any similar studies that have been carried out in the region.
Similar studies are done in Sri Lanka and Bangladesh, which you may cite in your lit review. Have any similar topics been carried out in India?

The rationale is clear. Yet, you could give a more detailed description of why the particular study is needed in Wardha district.

Objectives
Objectives are clearly stated. Yet objective 3 needs rephrasing to clarify what you are measuring.

Methodology
Since this manuscript mainly provides the methodology of the study. Please provide a detailed description of each section.

Inclusion criteria: Why was the participants' age limited to 13-19? Any particular reason? When you say 'living with their biological mother', how did you decide the adolescents lived adequately to communicate a sensitive issue with their parents? Was any particular demarcation used to decide whether participants lived adequately with their mothers?

Sample size: Why was p taken as 50%? It is important that you keep a reserve for the non-respondents when you calculate the sample size.

The sampling method is not clear. Please give more details on how you selected the sample. Describe the procedure used to draw a random sample of adolescents from the district.

Elaborate more on how the questionnaire was pretested and validated.

Mentioning the methods to minimise potential bias is commendable. However, provide information on how you are planning to handle recaller bias.

Mention the measures you will take to improve adolescent participation in this study. How will you ensure the confidentiality of the information?

Discussion
The discussion section is well written. However, it would be useful to provide information on how the findings of this research will be used to promote adolescent sexual health in the study setting.

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Adolescent health, sexual health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

Responses (0)

Back to all reports

Reviewer Report

8 Views

14 Jun 2024 | for Version 1

Sari Kistiana, Research Center for Population, National Research and Innovation Agency (BRIN), Jakarta Selatan, Indonesia

8 Views Cite this report Responses(0)

Approved With Reservations

Introduction, Rationale & Objective

1. Consider narrowing the scope of the introduction to better align with the main research question, additional context about adolescents RH issues in India. Focus on information directly related to the research question

2. The context of the study is well-established, but additional references about mother-daughter communication would enhance the background.

3. The research aim is clearly stated, but ensure that the stated objectives align with the aim (could be more explicitly defined mother and daughter communication)

Methods

1. It would be helpful to provide a more detailed explanation to measure the outcome variables (knowledge and attitude), how these two will be categorised after giving the score in the analysis.

2. Ensure that the stated aim align with the study outcome. Based on the aim of the study, should the outcome variable the quality of mother daughter communication? Please provide more detailed information measurement of mother-daughter communication

Is the rationale for, and objectives of, the study clearly described?

Partly
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Sexuality and Reproductive Health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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[8] 8. Bekele D, Deksisa A, Abera W, et al.: Parental communication on sexual and reproductive health issues to their adolescents and affecting factors at Asella town, Ethiopia: a community-based, cross-sectional study. Reprod. Health. 2022 May 8; 19: 114. PubMed Abstract | Publisher Full Text | Free Full Text

[9] 9. Jerman P, Constantine NA: Demographic and Psychological Predictors of Parent–Adolescent Communication About Sex: A Representative Statewide Analysis. J. Youth Adolesc. 2010; 39(10): 1164–1174. PubMed Abstract | Publisher Full Text | Free Full Text

[10] 10. Shiferaw K, Getahun F, Asres G: Assessment of adolescents’ communication on sexual and reproductive health matters with parents and associated factors among secondary and preparatory schools’ students in Debremarkos town, North West Ethiopia. Reprod. Health. 2014 Jan 8; 11: 2. PubMed Abstract | Publisher Full Text | Free Full Text

[11] 11. UNICEF DATA: Child and youth mortality data ages 5-24.[cited 2023 Sep 25]. Reference Source

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[13] 13. Barriers between mothers and their adolescent daughters with regards to sexual and reproductive health communication in Taunggyi Township, Myanmar: What factors play important roles? - PMC.[cited 2023 Aug 17]. Reference Source

[14] 14. Kusheta S, Bancha B, Habtu Y, et al.: Adolescent-parent communication on sexual and reproductive health issues and its factors among secondary and preparatory school students in Hadiya Zone, Southern Ethiopia: institution based cross sectional study. BMC Pediatr. 2019 Jan 7; 19: 9. PubMed Abstract | Publisher Full Text | Free Full Text

[15] 15. Parent–adolescent communication on sexual and reproductive health and the utilization of adolescent-friendly health services in Kailali, Nepal - PMC.[cited 2023 Aug 17]. Reference Source

[16] 16. Manu AA, Mba CJ, Asare GQ, et al.: Parent–child communication about sexual and reproductive health: evidence from the Brong Ahafo region, Ghana. Reprod. Health. 2015 Mar 7; 12: 16. PubMed Abstract | Publisher Full Text | Free Full Text

[17] 17. Buffer or Brake? The Role of Sexuality-Specific Parenting in Adolescents’ Sexualized Media Consumption and Sexual Development. J. Youth Adolesc. [cited 2023 Sep 24]; 47: 1427–1439. PubMed Abstract | Publisher Full Text | Free Full Text

[18] 18. Zakaria M, Xu J, Karim F, et al.: Reproductive health communication between mother and adolescent daughter in Bangladesh: a cross-sectional study. Reprod. Health. 2019 Jul 24; 16: 114. PubMed Abstract | Publisher Full Text | Free Full Text

[19] 19. Mataraarachchi D, Buddhika Mahesh PK, Pathirana TEA, et al.: Mother’s perceptions and concerns over sharing sexual and reproductive health information with their adolescent daughters- A qualitative study among mothers of adolescent girls aged 14–19 years in the developing world, Sri Lanka. BMC Womens Health. 2023 May 3; 23: 223. PubMed Abstract | Publisher Full Text | Free Full Text

[20] 20. Kashyap V: STROBE checklist for Exploring the status of mother and adolescent daughter communication on reproductive health: A cross-sectional study. figshare. 2024. Publisher Full Text

Exploring the status of mother and adolescent daughter communication on reproductive health: a cross-sectional study

Abstract

Introduction

Objectives

Methods

Study implications

Keywords

Introduction

Rationale

Aim

Objectives

Methods

Ethics

Study design

Study setting

Study participants/population

Inclusion criteria

Exclusion criteria

Sample size

Sampling method

Variables

Table 1. The key study parameters, their variables, data sources and data collection method.

Data tool

Data collection procedure

Bias

Data analysis plan and expected outcomes

Data analysis plan

Expected outcomes

Dissemination

Study status

Discussion

Implication of study

Limitations

Data availability

Underlying data

Reporting guidelines

References

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