Abstract Study question Can we enhance fertility awareness among young individuals through targeted health education? Summary answer The initiative, led by senior human reproduction nurses, demonstrated a remarkable increase of 23.78% in fertility knowledge among adolescents. What is known already Understanding factors impacting fertility is key to making informed reproductive decisions. However, a pervasive gap exists in evidence-based fertility knowledge within Western societies, underscoring the need for specialized health education. Young adults often overlook fertility considerations until they encounter challenges in conceiving. Interestingly, recent findings indicate that although fertility awareness is valued amongst young people, it can also lead to stress and anxiety. Therefore to foster early and impactful learning, introducing fertility education to high school curriculums is recommended. Study design, size, duration The reproductive health and fertility awareness initiative was conducted across five public high schools in Catalonia, Spain, during the 2022-2023 academic year. The training consisted of 45-minute presentations delivered by 2 senior human reproduction nurses and focused on modifiable factors influencing fertility. To assess the success of the initiative, we compared teenagers’ knowledge before and after the educational sessions. Participants/materials, setting, methods During the academic year, presentations reached 157 high school students. Assessment was carried out through the virtual platform “Kahoot”, employing 10 multiple-choice questions with 4 response options. The responses before and after the intervention were recorded and analyzed using a paired Fisher’s exact test. P-values <0.05 were considered significant. Main results and the role of chance Prior to the initiative, the correct response rates to the fertility questions varied, with averages ranging from 47.6% and 73.8%. Following the fertility awareness presentation, when students were asked the same questions, there was a marked improvement in student performance. Average scores improved to 89.0%, 90.2%, 88.1%, 84.5%, and 89.5% across the respective schools. These improved scores were significant across all five high schools (p-values: 0.0074, 0.0229, 0.0221, 0.0006, 0.0163), emphasizing the effectiveness of the initiative in varying educational environments. The overall average of correct answers initially stood at 64.5%, and significantly increased to to 88.3% (p < 0,0001) post-intervention, reflecting a relative improvement of 23.8%. The consistent increase in knowledge across diverse student demographics suggests that the program’s content was well-received and comprehensible, contributing to its success. Limitations, reasons for caution The initiative only included participants from Catalonia, which may introduce regional biases, limiting broader applicability. Translating increased knowledge into sustained behavior change remains a challenge. A longer-term follow-up period would provide insights into the retention and application of fertility knowledge over time Wider implications of the findings The positive reception and rapid knowledge assimilation among students underscores the potential of targeted health education, extending empowerment beyond classrooms to influence their future reproductive health decisions. This initiative also lays groundwork for addressing potential disparities in fertility knowledge, which has implications for promoting equitable access to reproductive health information Trial registration number not applicable
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