Intervention
A literature search was done for the preparation of an intervention package on SRH education. The intervention package consisted of handbooks covering the following topics.Handbook Part 1—Adolescent health statistics, Female reproductive system, Puberty, and Menstrual HealthHandbook Part 2—Pregnancy, Contraception, STIs/RTIs, and HIV/AIDSThe principal investigator has done a literature search through various websites of WHO and UNICEF, which focused on adolescent health. The relevant documents were then downloaded. The content required as per need has been retrieved from the documents and has been included in handbooks. Also, various Indian documents and modules pertaining to adolescent health, textbooks of school, and Obstetrics and Gynaecology, were referred for handbook preparation. The handbooks were developed in the English language. Since the vernacular language is Odia, the handbooks were translated into Odia by a professional Odia translator. The translated handbooks were given to two medico-social workers (MSWs) separately to verify comprehension of the language. The intervention was given in the months of November and December 2021 for the schools in the intervention arm. Owing to the COVID-19 pandemic, schools were running only half—a day, and accordingly, intervention timing was fixed. The author (AG) visited all the four schools in the intervention arm to provide SRH education to school-going adolescent girls. In each school, the intervention included three sessions. Three sessions were done on 3 consecutive days in each school. Each session lasted for about 2 h. The intervention was given to adolescent girls studying in ninth and tenth classes separately. In the first session, education was given on topics such as the female reproductive system, puberty, and menstrual health with the help of the first part of the handbook. The second session included the topics of part 2 of the handbook, i.e., pregnancy, contraception, STIs/RTIs, and HIV/AIDS. The intervention included a PowerPoint presentation with the help of a projector, brainstorming sessions, and a discussion of case scenarios. The third session was an interactive session between the students and teachers, and various doubts were cleared.Following the intervention, an endline assessment was conducted 3 months later among all eight schools using online Google forms. The assessment of each school was done on 8 different days between the months of February and March 2022. Once the endline assessment was completed, the same intervention was provided to students in the control arm. The flow of the study design is depicted in Fig. CONSORT flow diagram