The effect of educational intervention on sexual health literacy and contraceptive method preferences among individuals applying to Family Health Centers for marriage reports

Objective: Knowledge and effective use of contraceptive methods contribute positively to maternal and child health by preventing unintended pregnancies. Family physicians, as in many other areas, should also utilize educational opportunities to provide individuals with sufficient knowledge and foster appropriate attitudes regarding sexual health. The aim of this study was to evaluate the knowledge and attitudes of individuals applying for premarital medical reports at a family health center regarding contraceptive methods, their sexual health literacy levels, and the effect of an educational intervention on these outcomes. Methods: This cross-sectional and prospective study was conducted between 16.12.2024 and 15.06.2025 at Ertuğrulgazi Family Health Center (FHC) in Eyyübiye district of Şanlıurfa, a region with low socioeconomic status. Data were collected through a questionnaire prepared by the researchers, which assessed sociodemographic characteristics and knowledge/attitudes towards contraceptive methods, as well as the Sexual Health Literacy Scale (CİSÖY). The survey was administered face-to-face after informing participants and obtaining informed consent. Following the baseline survey, each participant received a 30-minute face-to-face educational session delivered by the researcher, using written and visual materials. Two months later, participants who returned for follow-up were re-administered the same questionnaire and scale. Data analysis was performed using IBM SPSS 25. The Mann–Whitney U test was used for continuous variables, and the McNemar test for paired categorical variables. A significance level of p<0.05 was accepted. Results: A total of 203 individuals participated in the study. The majority were aged 18–25 years (89.2%), female (68.5%), and middle school graduates (40.9%). Of the participants, 62.6% reported having no prior knowledge of contraceptive methods, while 77.8% reported having no prior knowledge of sexually transmitted infections (STIs). Among those who had received information, the most common sources were friends (27.1% for contraception; 14.3% for STIs) and the internet (24.6% for contraception; 17.7% for STIs). Before the intervention, women had significantly lower sexual knowledge scores than men (p<.001), while their sexual attitude scores were significantly higher (p<.001). After the intervention, there was no significant difference between genders in either sexual knowledge (p=0.774) or sexual attitudes (p=0.151). Overall, knowledge about all contraceptive methods increased significantly following the intervention (p<0.001). The proportion of participants who recognized condoms as protective against STIs rose from 13.3% to 64.0% (p<0.001). Although the proportion of individuals considering contraceptive use increased after training, the difference was not statistically significant (p>0.05). Post-intervention, participants reported that they would prefer to receive sexual health education primarily from family physicians (69.5%) and nurses (54.7%). Conclusion: The findings of this study revealed that individuals at the premarital stage had insufficient knowledge, awareness, and attitudes regarding contraceptive methods and sexual health. A single-session educational intervention significantly improved knowledge levels but had no meaningful effect on attitudes, suggesting that cultural, religious, and social factors continue to play an influential role. The significant increase in awareness of condoms as protective against STIs highlights the importance of such educational interventions. Based on these findings, sexual health education should be initiated at earlier ages, delivered continuously and in repeated sessions, and structured with culturally sensitive content that incorporates family and partner participation.