Open Access Research article

Improving awareness of preconception health among adolescents: experience of a school-based intervention in Lebanon

Lama Charafeddine15, Rym El Rafei15, Sophie Azizi1, Durriyah Sinno5, Kawthar Alamiddine15, Christopher P Howson3, Salimah R Walani3, Walid Ammar4, Anwar Nassar12 and Khalid Yunis15*

Author Affiliations

1 the National Collaborative Perinatal Neonatal Network, American University of Beirut Medical Center, Beirut, Lebanon

2 American University of Beirut Medical Center, Beirut, Lebanon

3 March of Dimes Foundation, White Plains, New York, U.S

4 Director General of the Ministry of Public Health of Lebanon, Beirut, Lebanon

5 Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon

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BMC Public Health 2014, 14:774  doi:10.1186/1471-2458-14-774

Published: 31 July 2014



Maternal behavior before and after conception affects maternal and child health. Limited awareness of adolescents in preconception health may be addressed through school education. The aim of this intervention is to assess preconception health awareness among adolescents in Lebanese high schools and to test the effectiveness of a one-time educational session in improving preconception knowledge.


The intervention consisted of a 30-minute educational session about good practices in preconception health, developed by the National Collaborative Perinatal Neonatal Network’s (NCPNN) research team. A convenience sample of high school Lebanese students in grades 10 to 12, aged 14 to 26 years old, from 70 private and public schools in all six Lebanese provinces, participated in the intervention in 2011 and 2012. A multiple-choice questionnaire administered prior to and 2 months after the session was used to assess knowledge improvement among the students.


A total of 7,290 students were enrolled. After the session, mean scores of correct answers increased from 4.36 to 6.42 out of 10, representing a 47.2% improvement (p < 0.001). The percent of correct answers increased for all the questions regarding health practices (p < 0.001). The greatest improvement was observed for questions about Trisomy 21, folic acid intake and toxoplasmosis with percentages improvement of 96%, 172% and 83% respectively. Being female or in private school was a significant predictor of higher scores in both pre-test and post-test (p < 0.001).


Awareness campaigns in schools increased the preconception health knowledge among high school students. We recommend expanding the scope of this intervention into universities in Lebanon.

Preconception; Adolescents; Awareness campaign; Health education program; Health information