From leadership research to district action: Beyond the Textbook: An HBM and SCT Analysis of Adolescent Reproductive Health Education in Rural Bangladesh

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

ABSTRACT The effective delivery of adolescent and reproductive health (ARH) education in rural Bangladeshi schools is influenced by factors extending beyond curriculum content, including teacher preparedness, classroom interactions, gender norms, and the broader social environment. This qualitative study examined how teachers and students experienced the delivery and discussion of ARH topics in rural secondary schools, drawing on the Health Belief Model (HBM) and Social Cognitive Theory (SCT) as interpretive frameworks. Data were collected through 18 in‐depth interviews with teachers and nine focus group discussions involving 54 students from six secondary schools across three rural districts. Thematic analysis identified substantial variation in teachers’ confidence and instructional practices, with training and administrative support associated with greater willingness to discuss sensitive topics and use participatory teaching approaches. Students’ engagement was shaped by gendered classroom dynamics, perceived approachability of teachers, and concerns about embarrassment. When students perceived communication with teachers as difficult, they frequently sought information from peers and online sources, despite uncertainty about the reliability of such information. Teachers also described adapting their instructional practices to navigate cultural sensitivities, whereas parental concerns, community expectations, curriculum limitations, and inconsistent school‐level support continued to constrain classroom discussion. Viewed through HBM and SCT, these findings illustrate how perceived barriers, self‐efficacy, social reinforcement, modeling, and institutional conditions interact in shaping ARH education. Strengthening teacher training, school leadership support, student‐centered communication, and community engagement may improve the delivery of ARH education in rural Bangladeshi schools. Keywords: adolescent health, health communication, reproductive health education, school‐based health education, student engagement, teacher preparedness

Study methods

As the aim of this study is to capture the lived experiences of teachers and students who are engaged with ARH education in rural Bangladesh, the study employed a qualitative approach and interpretive design. Considering the RQs and purpose of this study, qualitative methods are well‐suited for exploring complex, context‐dependent phenomena [16]. The study was guided by the HBM and SCT, which informed both the development of data collection instruments and the coding framework used to address the study's RQs. In this study, a purposive sampling strategy was used to select participants who could provide diverse perspectives on ARH education in the context of rural areas. The sample comprised 18 teachers (10 female, eight male) and 54 students (29 female, 25 male) from Grades 6 to 10 across six secondary schools in three rural districts in Bangladesh. A summary of participant characteristics is presented in Table 1. Schools were selected to represent variation in type (public and private) and gender composition (coeducational and single‐gender). The primary language of instruction in the selected schools was Bangla (the native language).

Limitations

Despite its contributions, this study has several limitations. The study focused on three rural districts in Bangladesh, which may limit the transferability of the findings to other geographic and educational contexts, particularly urban schools. Although the qualitative design provided rich insights into participants’ experiences, it cannot determine the prevalence of these patterns across the broader education system. In addition, the presence of the researcher during interviews and FGDs may have introduced social desirability bias, particularly when participants discussed sensitive topics or evaluated their own practices. Future studies could employ mixed‐methods approaches and comparative rural–urban designs to further examine the factors influencing ARH education in Bangladesh.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Motasim Billah; Md Forhad Uddin. Beyond the Textbook: An HBM and SCT Analysis of Adolescent Reproductive Health Education in Rural Bangladesh. Public Health Challenges (2026-10-04). https://doi.org/10.1002/puh2.70405

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.