In this study, the mean age of the group trained with the Teach-back method was 30.64 ± 5.73 and the mean age of the group provided face-to-face training was 29.83 ± 5.49, while the mean age of the non-trained group was 28.16 ± 5.09.
In the study conducted by Uçtu and Özerdoğan (2021) with the teach-back method, the mean age of women in the intervention group was 23.3 ± 4.46 years, while the mean age of women in the control group was 23.97 ± 3.59 (Kul Uçtu & Özerdoğan, 2021).
In a study conducted with pregnant women in Jamaica using the teach-back method, the mean age of women was found to be 23 years (Wilson et al., 2012).
Although the mean age of the participants in this study is similar to the literature, the differences can be said to occur due to the different sample groups.
In this study, 27 (64.3%) of the women in the group trained with the teach-back method, 31 (73.8%) of the women in the group provided face-to-face training and 29 (69%) of the non-trained women were found to be sexually active. There was no statistically significant difference between the groups (p > 0.05).
In a study conducted with university students, 20.8% of female students were found to be sexually active (Sevil et al., 2012).
In a study conducted with university students in Tanzania, 70.4% of female students were found to be sexually active (Somba et al., 2014).
In another study conducted in Turkey, 27.4% of women were found to be sexually active (Bal Yilmaz et al., 2010).
The reason why the results of this were different from other studies may be due to the fact that most of the studies in the literature were conducted with students and the questions about active sexual life were not asked in studies on women of reproductive age.
In this study, 35 (83.3%) of the women in the teach-back group, 39 (92.9%) of the women in the group provided face-to-face training and 34 (81%) of the non-trained women said that they had knowledge about STDs.
In a study examining the level of knowledge about STDs among women in different age groups, 244 (72.4%) of women reported that they had knowledge about STDs (Hafeez et al., 2021).
In a study conducted in Bangladesh including participants with STD symptoms, it was found that 71.4% of the participants said that they had knowledge about STDs (Huda et al., 2022).
The fact that all groups participating in this study said that they had knowledge about STDs may be due to their high level of education.
In this study, the sources of information about STDs were expressed to be internet-TV by 28 (66.7%), health institutions by 16 (38.1%), family friends by 15 (35.7%), magazine-book-newspaper by 14 (33.3%) and school by 13 (31%) women in the group trained with the teach-back method, respectively. The sources of information about STDs were expressed to be internet-TV by 34 (81%), family friends by 21 (50%), magazine-book-newspaper by 18 (42.9%), school by 13 (31%) and health institution by 9 (21.4%) women in the face-to-face training group, respectively. The information sources were expressed to be internet-TV by 29 (69%), health institutions by 20 (52.4%), magazines, books and newspapers by 21 (50%), family and friends by 18 (42.9%), school by 17 (40.5%) the non-trained women.
In a study conducted by Hafeez et al. (2021), the most common information sources used by women were TV 42%, internet 40%, and doctors 21% (Hafeez et al., 2021).
In a systematic review of 10 studies, the sources of information about STDs used by women were found to be friends, relatives, magazines and television, respectively (Alomair et al., 2020).
In a study carried out in Uganda, the most common sources used by women about STDs were found to be health institutions 40.4%, social media 23.9%, friends 26.8% and schools 7.5% (Nawagi et al., 2016).
In a study conducted in a student dormitory in Turkey, the students' sources of information about STDs were found to be 24.0% magazines, books, newspapers, TV, 14.0% internet, 10% friends, 8.8% school, 4.8% health institutions (Yaşar et al., 2019).
Although the results of this study are generally similar to the literature, the ranking of women's sources of information may change due to the different sample groups and demographic characteristics.
The most common STDs known were expressed to be AIDS by 38 (90.5%), Hepatitis B and Hepatitis C by 30 (71.4%), herpes by 32 (76.2%), HPV by 29 (69%), and gonorrhea by 22 (52.4%) by the women participating in this study and trained with the teach-back method. The STDs known were expressed to be AIDS by 40 (95.2%), HPV by 35 (83.3%), Hepatitis B and Hepatitis C by 32 (76.2%), herpes by 32 (76.2%), gonorrhea by 24 (57.1%) women who received face-to-face training. The STDs known were expressed to be AIDS by 33 (78.6%), Hepatitis B and Hepatitis C by 29 (69%), HPV by 29 (69%), herpes by 26 (61.9%) and gonorrhea by 18 (42.9%) non-trained women.
In a study conducted by Norbu and Mukhia (2013), participants were most aware of gonorrhea, syphilis and genital herpes, chlamydia and hepatitis infections respectively (Norbu and Mukhia, 2013).
In a study conducted in Romania, it was found that 98% of the participants knew that HIV, 75.8% gonorrhea, 61.1% chlamydia, 32.3% trichomoniasis and hepatitis B or C are STDs (Grad et al., 2018).
In a study conducted in Germany, 71.1% of the participants knew HIV/AIDS, 33.3% gonorrhea, 32.3% syphilis, 11.1% herpes, and 10.0% hepatitis B infections (Matthiesen et al., 2021).
In a study conducted in Turkey, the 4 most common STDs known by the participants were found to be gonorrhea, syphilis, AIDS, and HPV (Büyükkayacı Duman et al., 2015).
Although the results of this study are similar to the literature, the most well-known diseases in the literature and in this study were found to be the diseases that are the most studied and easy to obtain information on.
In this study, the symptoms of STDs were expressed to be itching by 36 (85.7%), vaginal discharge by 32 (76.2%), redness by 28 (66.7%), urinary burning by 27 (64.3%), and pain during sexual intercourse by 19 (45.2%) women in the group trained with the teach-back method. The symptoms of STDs were expressed to be itching by 38 (90.5%), vaginal discharge by 38 (90.5%), rash by 36 (85.7%), urinary burning by 33 (78.6%), pain during sexual intercourse by 24 (57.1%) and fever by 22 (52.4%) women in the face-to-face training group. The STD symptoms were expressed to be itching by 38 (90.5%), rash by 35 (83.3%), urinary burning by 32 (76.2%), and pain during intercourse by 28 (66.7%) non-trained women.
In a study, itching, rash, and pain during urination were found to be the most common STD symptoms known by the participants (Nawagi et al., 2016).
In a study conducted by Balbeesi and Mohizea (2017), it was found that women mostly knew the symptoms of genital itching, bad discharge, and painful urination (Balbeesi & Mohizea, 2017).
In a study conducted in Turkey, the most common STD symptoms known by the participants were genital wounds, vaginal discharge, menstrual irregularities, itching, urinary burning and pain during intercourse (Elkin, 2015). The results of the current research are similar to the literature.
There was no statistically significant difference between the sub-dimension and total mean scores of the Behavioral Scale for Protection from STDs of the women participating in the study pre-training (p > 0.05). The scale sub-dimension and total mean scores show similar results between the intervention and control groups pre-training.
In the study conducted by Bahri et al. (2018) to examine the effectiveness of the teach-back method in improving self-care activities in post-menopausal women, no significant difference was found in the intervention and control groups (Bahri et al., 2018).
In a randomized controlled trial using the teach-back method to improve postpartum mother-infant health in women with limited maternal health literacy in China, similar characteristics were found between intervention and control groups (Cheng et al., 2023).
In a randomized controlled trial by Uçtu and Özerdoğan (2021) on the effect of breastfeeding education given with the teach-back method on breastfeeding success, no significant difference was found between the intervention and control groups (Kul Uçtu & Özerdoğan, 2021).
Although this study is similar to the literature, the fact that there is no difference between the groups is an indication that the groups are homogeneously distributed.
In this study, the change in the sub-dimension and total scores of the Behavioral Scale for Protection from STDs pre-training, 15 days and 3 months after the training was evaluated between the groups, and the change in sub-dimension 2 (attitude) and total mean scores between the intervention and control groups did not show a statistically significant difference (p > 0.05). Sub-dimension 1 (knowledge and protection) score change had a statistically significant difference (p = 0.033) and as a result of the post-hoc comparison, there was a significant difference between the teach-back group and the non-trained group (p = 0.029). Accordingly, for the sub-dimension 1 (information and protection) score, the change in scores pre-training, 15 days and 3 months after the training was significantly less than in the teach-back group.
A systematic review found that, in general, the teach-back method showed positive effects, although not always statistically significant (Dinh et al., 2016).
Another systematic review found that the teach-back method showed positive effects on patient’s levels of knowledge (Oh et al., 2021).
Bahri et al. investigated the effectiveness of the teach-back method in improving self-care activities in post-menopausal women and found that the mean scores of knowledge and self-care in the intervention group were significantly higher than the control group one month after the intervention (Bahri et al., 2018).
In the study conducted by Cheng et al. (2023), the scores of the participants in the intervention group in which the teach-back method was applied were found to be higher and statistically significant compared to the control group (Cheng et al., 2023).
In a study aiming to improve postpartum quality of life in Iran, it was found that the intervention using the teach-back method improved women's quality of life more than the routine program and there was a statistically significant difference between the groups (Ghiasvand et al., 2017).
In a study conducted by Ahmadidarrehsima et al. (2020), the effect of self-management training with the teach-back method on uncertainty in patients with breast cancer was examined, and it was found that the uncertainty of women in the intervention group (with the teach-back method) decreased more than the control group (face-to-face) and there was a statistically significant difference between the groups (Ahmadidarrehsima et al., 2020).
In the study conducted by Abianeh et al. (2020) with the teach-back method, the scores of the participants after the intervention were found to be higher and statistically significant than before the intervention (Abianeh et al., 2020).
A study examining whether the teach-back method would increase the retention of instructions after emergency department discharge found that the participants' post-training scores increased statistically significantly (Slater et al., 2017).
Moadab et al. (2015) conducted a study to examine the effect of the teach-back method on surgical anxiety in primiparous cesarean section women. It was found that the average preoperative anxiety score of the intervention group was significantly lower than the control group that received face-to-face training (Moadab et al., 2015).
In Choi and Choi's (2021) systematic review, four quasi-experimental studies and one randomized controlled trial with cancer patients were evaluated and it was found that the teach-back method significantly affected cancer patients' intervention programs, happiness, health literacy, death-related anxiety, symptom experience, distress and self-efficacy (Choi & Choi, 2021).
In a randomized controlled study by Uçtu and Özerdoğan (2021) titled " Teach-Back Method Be Used in Breastfeeding", it was found that the education given to the intervention group with the teach-back method was more successful than the routine face-to-face education given to the control group (Kul Uçtu & Özerdoğan, 2021).
Although this study is similar to the literature, it was observed that the training given with the teach-back method provided a higher score increase compared to the face-to-face and non-trained groups.
Conclusion and Recommendations
In this study, the behaviors of the participants who were trained with the teach-back method were found to be more effective than the other groups. It is recommended to conduct further studies on the teach-back method and to use the teach-back method in trainings given to women and to evaluate its effectiveness.
Ethics Committee Approval
Ethics committee approval was received for this study from Hasan Kalyoncu University (date of meeting: July 12, 2021; number of decision: 2021-087).