Growing up in Tajikistan: Students' Perceptions of the Pubertal Transition to Inform Culturally Appropriate Puberty Books Open Access

Abstract

Puberty is a momentous period in any adolescent's life as it marks the biological transition from childhood to adulthood. In order for adolescents to grow into healthy and productive adults they must successfully navigate this pubertal transition and its associated challenges, both the health and social dimensions. Yet, there is a dearth of literature on the pubertal experience for adolescents growing up in various parts of the world, such as the Central Asian context, which is necessary to construct effective interventions that address their specific challenges. We conducted qualitative research with Tajik schoolgirls and boys to explore their experiences, knowledge and perceptions of puberty in order to design culturally appropriate puberty books. We uncovered the different challenges and societal expectations that Tajik girls and boys face as they undergo the pubertal transition. These voiced concerns and shared lived experiences were then used to create relevant messaging for the puberty book program. Few academic articles detail the process of translating such important findings into evidence-based programs. Moreover, it is rare to find articles that discuss formative research - that is, research for the specific purpose of informing programmatic design. However, public health is a unique field shared by researchers and practitioners alike - a field that not only pursues invaluable research but pushes for the application of their findings. Here we provide an example of the research to program translation process through a descriptive case study set in Tajikistan. The goal of this paper is thus two-fold: (1) to present novel qualitative findings on the pubertal transition for Tajik adolescents and (2) to outline the process of how this qualitative data was used to construct the content for the puberty books.

Table of Contents

Chapter 1. Introduction 1

Research Context 1

Research Objective 4

Purpose Statement 4

Significance Statement 5

Chapter 2. Comprehensive Review of the Literature 6

Introduction 6

Adolescents in the World Today & Their Health Challenges 7

Health Implications of the Pubertal Transition 12

Puberty Education and School-Based Interventions 26

A Country in Transition - Tajikistan Context 29

Conclusion 33

Chapter 3. Manuscript 35

Contribution of Student 36

Abstract 37

Introduction 38

Methods 44

Study Setting 44

Sampling 44

Consent Process 45

Design of Focus Group Activities 45

Facilitator Team 47

Data Collection/Analysis/Application 47

Results 51

Thematic Findings - Tajik Adolescent Girls 51

Thematic Findings - Tajik Adolescent Boys 55

Translating Findings into Puberty Book Content 59

Discussion 62

Tables 67

Table 1. Description of study activities and their research aim used in each set of FGD 67

Table 2. Translation process used to apply research findings from girls' FGD to puberty book 68

Table 3. Translation process used to apply research findings from boys' FGD to puberty book 70

Chapter 4. Conclusion and Recommendations 72

Growing up in Tajikistan 72

Recommendations 73

Save the Children: Communicating Findings to the School Community 73

Research: Giving Adolescents Voice Through Participatory Methods 74

Public Health Field: Bridging the Research to Program Gap 74

References 76

Appendices 82

Appendix A: Focus Group Guides - Girls / Boys 82

Appendix B: In-Depth Interview Guides - Teachers / Girls' Councilors 95

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Education, Health Gender Studies
Keyword	Adolescence Qualitative methods Puberty Participatory methods Tajikistan
Committee Chair / Thesis Advisor	Freeman, Matthew, Emory University
Committee Members	Comeau, Dawn L, Emory University Caruso, Bethany, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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