Development of the Oral, Mental, and Sexual Reproductive Health Assessment Tool for Adolescents in Nigeria

Omorinola Adekemi Afolabi^1*Abel Nnamdi Chukwuemeka²Anita Dabar²Richard Omoefe Oveh³Saheed Ademola Ibraheem⁴Nadia A Sam-Agudu⁵Maha El Tantawi⁶Abideen Salako⁷George Uchenna Eleje⁸Joanne Lusher⁹Oliver Chukwujekwu Ezechi⁷Morenike Oluwatoyin Folayan¹⁰

• ¹Moshood Abiola Polytechnic,, Abeokuta, Nigeria
• ²Lead City University, Ibadan, Nigeria
• ³University of Delta, Agbor, Delta, Nigeria
• ⁴National Research Institute for Chemical Technology, Zaria, Kaduna, Nigeria
• ⁵Medical School, University of Minnesota, Minneapolis, Minnesota, United States
• ⁶Alexandria University, Alexandria, Alexandria, Egypt
• ⁷Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
• ⁸Nnamdi Azikiwe University, Awka, Nigeria
• ⁹Regent's University London, London, United Kingdom
• ¹⁰Obafemi Awolowo University, Ife, Osun, Nigeria

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.