# Development of the oral, mental, and sexual reproductive health assessment tool for adolescents in Nigeria

## TL;DR

This paper presents a new 81-item tool to assess oral, mental, and sexual reproductive health in Nigerian adolescents, aiming to improve integrated health services for this group.

## Contribution

The study introduces a novel, integrated health assessment tool tailored for adolescents in Nigeria.

## Key findings

- An 81-item tool was developed covering oral, mental, and sexual reproductive health domains.
- The tool includes validated subscales for psychological distress, depression, anxiety, and sexual activity status.
- It provides a foundation for integrated health service delivery and multisectoral research.

## Abstract

Adolescence is a critical developmental stage where oral, mental, and sexual and reproductive health are closely interconnected. However, these domains are often assessed in isolation, creating a gap in holistic adolescent health understanding and intervention. This study aimed to develop an integrated tool for assessing oral, mental, and sexual and reproductive health.

A systematic literature review framework guided the study. Three dimensions—oral health, mental health, and sexual and reproductive health—were defined a priori. A structured search of PubMed and ScienceDirect identified relevant English-language articles and tools validated for use with adolescents in Nigeria. Deductive analysis was used for logical partitioning to identify items for domains and subscales. A preliminary questionnaire was drafted, organized into five sections: socio-demographics, oral health, mental health, sexual and reproductive health, and health service utilization. Items were matched with appropriate response scales.

Seventy-eight articles were identified, and 43 met the inclusion criteria. From these, domains and subscales were adopted to construct an 81-item tool. Section one contains 21 socio-demographic items. Section two covers mental health with five constructs: psychological distress (12 items), depression (nine), generalized anxiety (eight), suicide ideation (four), and risk factors (alcohol, tobacco, psychoactive substance use, and self-esteem). Section three measures sexual and reproductive health with 11 items on sexual debut and activity status. Section four assesses oral health with eight items on oral hygiene, self-reported oral problems, and oral habits. Section five includes two questions on health service utilization, covering general, dental, and psychiatric services.

This integrated 81-item tool captures three interconnected aspects of adolescent health, offering potential to strengthen service integration for this population. Beyond practice, it provides a foundation for empirical research to advance multisectoral adolescent health approaches. Future work should focus on validating the tool across diverse adolescent populations.