• adolescent health;
  • China;
  • health promotion;
  • nurses;
  • nursing;
  • puberty;
  • sexuality

Background.  Puberty signifies noticeable physical, psychosocial and sexual development. It is crucial to help adolescents reach an understanding about puberty and related health issues. Considering the sexually conservative culture in some areas, to explore appropriate ways to address sexuality and health-related concerns during puberty is of interest to all stakeholders.

Aims.  This study aimed to examine the effectiveness of the ecological approach to improve adolescents’ understanding about puberty and related health risks.

Design.  Modified Solomon four group design.

Methods.  Two Grade7 classes were randomly selected to form experiment and control group, respectively. A two-hour seminar and a brochure about health and development during puberty were provided, and some students, parents and instructors in the experimental group commented on the intervention. Pre- and post-tests were conducted to measure students’ pubertal development status and their knowledge, attitudes and behaviours related to puberty.

Results.  Students (n = 228) were aged 13·0 years (SD 0·45). The majority was categorised at the stage of mid-puberty or later, and approximately 11·2% of 116 girls and 22·3% of 112 boys were classified as overweight or obese according to body mass index. No significant changes were identified within or between groups about knowledge, attitudes and behaviours related to puberty and health before and after the intervention. The invention was considered helpful, and an enriched delivery was required.

Conclusions.  Although the overall feedback was positive, this ecological approach to adolescent health and development targeting at Grade7 students failed to generate significant effects on students’ knowledge, attitudes and behaviours surrounding puberty and health.

Relevance to clinical practice.  This study reveals that sexuality, particularly romantic relationships during puberty, may be perceived negatively in the local society. There is a need for school nurses to help all relevant people to understand and respond to sexuality-related concerns in a cultural appropriate way.