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

Omorinola Adekemi Afolabi; Abel Nnamdi Chukwuemeka; Anita Mofiyinfolu Dabar; Richard Omoefe Oveh; Saheed Ademola Ibraheem; Nadia Adjoa Sam-Agudu; Maha El Tantawi; Abideen Olurotimi Salako; George Uchenna Eleje; Joanne Lusher; Oliver Ezechi; Moréniké Oluwátóyìn Foláyan

doi:10.3389/froh.2025.1592482

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

Front Oral Health. 2025 Oct 30:6:1592482. doi: 10.3389/froh.2025.1592482. eCollection 2025.

Authors

Omorinola Adekemi Afolabi¹, Abel Nnamdi Chukwuemeka², Anita Mofiyinfolu Dabar², Richard Omoefe Oveh³, Saheed Ademola Ibraheem⁴, Nadia Adjoa Sam-Agudu^{5

6

7}, Maha El Tantawi^{8

9

10

11}, Abideen Olurotimi Salako⁹, George Uchenna Eleje^{10

12}, Joanne Lusher¹³, Oliver Ezechi⁹, Moréniké Oluwátóyìn Foláyan^{9

10

14}

Affiliations

¹ Department of Social Development, Moshood Abiola Polytechnic, Abeokuta, Ogun, Nigeria.
² Department of Public Health, Lead City University, Ibadan, Oyo, Nigeria.
³ Department of Information and Communication Technology, University of Delta, Agbor, Delta, Nigeria.
⁴ Scientific and Industrial Research Department, National Research Institute for Chemical Technology, Zaira, Nigeria.
⁵ International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria.
⁶ Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana.
⁷ Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States.
⁸ Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
⁹ Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.
¹⁰ Africa Oral Health Network, Alexandria University, Alexandria, Egypt.
¹¹ Faculty of Dental Medicine, Alamein International University, New Alamein City, Egypt.
¹² Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria.
¹³ Provost's Group, Regent's University London, London, United Kingdom.
¹⁴ Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: adolescents; assessment tool; health screening; mental health; oral health; sexual and reproductive health.