Muhammad Zakaria* Md. Belal Hossain**
Abstract: The present study aims at examining the impact of television viewing as well as Internet usage on transmitting accurate information regarding menstruation by mothers to their adolescent daughters. Data were collected from 1031girls attending grade nine and ten from five schools in Chittagong through a structuredand self-administered questionnaire. Chi-square (χ2) test was performed to find the association between TV viewing as well as Internet usage and the level of accuracy of the period-related contents conveyed by the mothers during the discussion with their adolescent daughters.
P-values of bivariate analyses of this study found significant differences in all variables. In other words, mothers who viewed TV regularly and used the Internet were more likely to disseminate correct knowledge about menstruation to their daughter.
Keywords: Television Viewing, Internet Use, Menstruation, Communication, Mothers, Adolescent Daughters.
Introduction
By the 1960s, television had become the medium of the day and represents for many the first choice to convey a message (Thomas, 2006). Television, both a
“news and entertainment medium” (Gamble & Gamble, 1986, p. 192), disseminates information; increases knowledge; influences attitudes, beliefs, and behaviors, and transmits values to its viewers (Adams & Fuchs, 1989). It has various advantages (Ramalingam et al., 2006) over other media, including
“creativity and impact, coverage and cost-effectiveness, captivity and attention, and selectivity and flexibility” (Belch et al., 2013, p. 447). Since the invention of television, it is a “powerful, intrusive, attractive, and ubiquitous medium” (Stelin, 1986). Besides, it has become the dominant force in shaping modern society.
Television provides similar opportunities to the radio but with the advantage of sound, special effects, light, and so on (Thomas, 2006). With the introduction of cable television, this medium provides a platform for accessing an audience as broad or as small as desired. Television programming usually includes news shows, and healthcare is certainly a significant subject today, as are other health- related services and public service announcements (PSAs) (Thomas, 2006).
* Muhammad Zakaria, Associate Professor, Department of Communication and Journalism University of Chittagong, Bangladesh, Email: [email protected]
** Md. Belal Hossain, Assistant Professor, Department of Mass Communication and Journalism, Comilla University, Bangladesh, Email: [email protected]
Do TV Viewing and Internet Usage Contribute to Information Accuracy?
Internet is a “multipurpose tool with numerous potentials”(Devi & Roy, 2012, p. 183) and studies in many countries suggest that Internet use is the highest among urban, middle and upper-class groups and the Internet usage is a way of life for young people (Sokol&Sisler, 2010). Also, Owens(1999) forecasted that
“through digitalization, the Internet will be all, and television, telephone, and computers will converge on the Internet” (Cited in Holmes, 2009). The Internet has emerged as the ubiquitous technology of the current century.
In many ways, the Internet is becoming the vehicle of choice for accessing health-related information (Thomas, 2006). As such, it becomes an increasingly common channel for health communicators. The Internet supports the facility to disseminate information in various ways, including informative websites, email transmission, chat rooms, and newsgroups. Paid advertising is found on many websites, and some carry public service announcements relating to healthcare.
Thisis why the role of media and Internet use on the accuracy of the information transmitted through mother-daughter communication regarding period is important enough to be chosen as a research topic.
Literature Review
Different studies show that Interpersonal communication between mother- adolescent daughters on reproductive health (RH) is a very useful means of transmitting reproductive information and promoting healthy behavior among adolescent girls globally during the adolescent period (Ayalew et al., 2014;
DiClemente et al., 2001; Eisenberg et al., 2006; Jerman & Constantine, 2010;
Phetla et al., 2008; Wamoyi et al., 2010).
A variety of factors have been identified as causes of mother-to-daughter communication. Amongst these are television campaigns, behavioral changes, and perceived risk behavior in young people, or health-related problems (Bastien et al., 2011; Davis et al., 2013). The studies found that while parents understand the value of parent-child communication on sexually sensitive topics, they are still at times ambivalent and unprepared for such discussions because they have never had these discussions. The integration of technology is, therefore, a means of conducting such conversations.
Jerman and Constantine (2010) suggest that the demographic characteristics of mother and children can promote or retard parents-children puberty related discussion. In research conducted in Tanzania and South Africa, the higher socioeconomic status, including educational level, was associated with more frequency in communication between parents and their children (Namisi et al., 2008). Some evidence of associations between adolescents’ grade level and sexual communication has been found (Ayalew et al., 2014; Fanta et al., 2016; Shiferaw et al., 2014).
The lack of knowledge is known as affecting the initiation of conversations.
Families discuss how, whenever they speak to their children, specific questions are posed by their children, and this makes them aware that their children have a lack of understanding and are not aware of other things. Jerman & Constantine (2010) further argue that parental perceptions of sexual knowledge and level of comfort are also indicators for the initiation of sexual conversations.
Comilla University Journal of Social Sciences
53
Overall, several mother-to-child communication studies have had similar findings in terms of communication barriers. The reluctance of mothers to engage in contact with their daughters was attributed to the uncertainty of their ability to deal with their daughters’ questions, the timing of interactions, and the lack of communication skills and information on sexual issues (Afifi et al., 2008).
Specific considerations included shame, anxiety, not being taken seriously, and the fear of their children not being honest with them (Afifi et al., 2008).
Personal style is the biggest obstacle to communication between mothers and daughters in a study in South Africa (Phetla et al., 2008). Parents prefer to judge psychologically, proscriptively, use imprecise language, and use reminders and threats to prevent sexual behavior (Phetla et al., 2008). This is also found in the USA, where daughters report that because of the way the mother reacts and delivers those messages, they avoid such problems. So, they do not want to offend their mothers, they do not want to overthink their mothers, and they are afraid their mothers will get frustrated and angry (Crohn, 2010).So, the Interpersonal communication between mothers and their adolescent daughters about reproductive health in Bangladesh needs careful assessment, and this study is to investigate the consequence of TV viewing as well as Internet usage on transmitting accurate information regarding menstruation by mothers to their adolescent daughters in Bangladesh.
Objective
The objective of this study is to investigate the effect of TV viewing as well as Internet usage on transmitting accurate information regarding menstruation by mothers to their adolescent daughters in Bangladesh.
Methods Study Design
In an attempt to achieve the desired research outcomes, the present study used a quantitative research approach designed with a school-based cross-sectional survey.
Study Population
The study population was all female students aged 14-16 years attending grade 9 and grade 10 in high schools in Chittagong during the study period.
Inclusion Criteria
Female students attending at grade 9 and grade 10 in the high schools
The adolescent girls aged 14-16 living with their mothers in the family
The girls who had got menstruation at least one year preceding the survey Exclusion Criteria
The girls whose mothers were not alive
Adolescents who were not willing to participate in the study
Do TV Viewing and Internet Usage Contribute to Information Accuracy?
Study Setting and Sample Size
For conducting this school-based cross-sectional study, five schools were selected for the study. For taking urban participants, one city corporation run (autonomous) high school named Krishnakumari City Corporation School and one private high school named Bangladesh Women’s Association School and College were randomly selected from Chittagong City. For collecting data from rural respondents, two schools named Satkania Girls High School located at Satkania Upazila from the south part and Shobuj Shikkhyaton High School situated at Sitakunda Upazila from the north part of Chittagong District were finalized. One school named Moanoghar School was taken from Rangamati District to include the ethnic minority and non-Muslim group of respondents in the study. In this way, five schools were selected for the institution-based cross- sectional survey. Study participants were drawn from each school using a systematic sampling method according to the proportion.
The sample size was determined using single population proportion formula considering the following assumption: p = 50%, significance level 5% (α
= 0.05), Z = 1.96, margin of error 3% (d = 0.03).
n = Z P(1 − P) d =1.96 × 0.50 × 0.50
0.03 n = 1067
Afterward, 36 cases were removed in the analysis according to the case wise listing of residuals to identify outliers outside 2 std. dev. cases with ZResid values above 2.5 (or less than -2.5). So the final sample size was 1031. The mean age of the respondents was 14.92 years (SD = .870), while the mean age of the respondents' mothers was 38 years (SD = 5.172).
Data Collection
Study data were obtained using a pretested, structured, and self-administered questionnaire.The questions included in the questionnaire were designed on the basis of the literature review. Afterward, a brainstorming session was conducted to finalize the questionnaire. The female graduate students who were recruited for data collection were present in the brainstorming session. Then, it was checked by a female faculty member of the University of Chittagong to review the terminology, language, and cultural issues used in the questionnaire. Finally, before getting the questionnaire for conducting a pilot study, the sensitivity of the words and language were verified by an applied psychologist who was working as an Associate Professor in the Department of Psychology at the University of Chittagong. The questionnaire was modified, and few questions had been excluded from the questionnaire being ready for pilot study through these series of processes. The survey was led by ten female facilitators who were graduate
Comilla University Journal of Social Sciences
55
students at Chittagong University, and who was well acquainted with social science study. Based on prior expertise in data collection, the research team was hired. Until the questionnaire was given to the research participants, the data collectors explained the significance and purpose of this study to them.The field data collection procedure was supervised by the researchers. The classroom was used in break time for distributing and filling up a self-administered questionnaire with the permission of the school authority to ensure privacy in the data collection process. Students of grade 9 and grade 10 completed the questionnaire in separate classrooms. Data collectors have checked the filled questionnaire.
Data Quality Control Issue
Ten female data collectors have been provided with sufficient preparation for a day concentrating interview methodology, queries, ethical concerns and confidentiality. The training was in the form of a workshop. The questionnaire was clearly clarified during the training session and was later pretested. Pilot study was then performed to test the comprehensibility and to ensure its wholeness and accuracy in supplying the appropriate details for the analysis.
Thirty high school girls from a city school and thirty from a rural school were randomly chosen to pretest the questionnaire. Equal numbers of respondents from grade 9 and grade 10 were taken. They had not been included in the final survey.
Copy of the final draft of the survey was created after pretesting and revising the questionnaire and made ready for data collection.
Measure of Outcome (Dependent) Variables
The accuracy of the information transmitted through mother-daughter communication on reproductive health was assessed following four questions based on some misconceptions and malpractice those were mentioned in some literate. These four questions were: 1. Has your mother ever asked you not to go to school and outside during the period?; 2. Has your mother ever told that period was a disease?; 3. Has your mother ever forbidden you not to touch anyone during the period?; 4. Has your mother asked you to use cloths or cotton instead of the sanitary pad during period?. Each question was dichotomized using as ‘yes’ (0), implying that the mother disseminated wrong information or ‘no’ (1), indicating that the mother provided correct knowledge and guidelines.
Data Analysis
The data, which were gathered using a structured questionnaire, was coded and entered into IBM SPSS version 24.0. Descriptive statistics using cross-tabulation was used to see the overall percentage distribution of the study for four outcome variables regarding the accuracy of the information transmitted through mother- daughter communication on menstruation and mothers' television viewing and Internet use. Secondly, chi-square (χ2) test was also used to examine the relationship between independent and main outcome variables.
Do TV Viewing and Internet Usage Contribute to Information Accuracy?
Ethical Considerations
Permission was obtained from the school authority, which conducted the questionnaire survey. The intent and confidentiality of the study had been discussed to the respondents before the questionnaires were distributed. After clarification, the informed verbal consent was obtained from each of the participants to participate in the study. The facilitators ensured the information gathered was confidential and anonymous. Study participants had the right to opt- out of the surveyanytime they would desire.
Results
Socio-demographic Characteristics
Table 1 shows the socio-demographic and media related characteristics of the participants and their parents. Of the respondents’ mothers, 327 (31.7%) had attained the secondary level of education followed by 254 (24.6%) completed primary, 235 (22.8%) attained bachelor, and 214 (20.8%) had a higher secondary level. Of the respondents’ fathers, 346 (33.6%) had attained bachelor whereas 281 (27.3%), 222 (21.5%), and 181 (17.6%) had attained secondary, primary, and higher secondary, respectively. Of the respondents, 557 (54%) were attending grade ten, while 474 (46%) were the students of grade nine in the high schools.
Regards to group 385 (37.3%), 365 (35.4%) and 281 (27.3%) were from Commerce, Science, and Arts, respectively.
Regardingthe area of residence, more than half of the respondents (53.6%) were from rural areas, and the rest of them (46.4%) were from urban areas.
Regards to religion, the majority of the respondents (71.8%) were Muslim, while (28.2%) were non-Muslim.
The result shows that 578 (56.1%) acknowledged their regular TV viewing, while more than half of respondents reported that their mothers had irregular TV viewing amounting to 542 (52.6). As to Internet use, one-fourth of the respondents 262 (25.4%) respondents reported about their Internet use, while only 172 (16.7%) mothers used the Internet during the survey.
Table 1: Socio-demographic and media-related characteristics of the respondents and their parents
Variable type Background Characteristics
Frequency Percentage Education Mothers’ education
No education/Primary 254 24.6
Secondary 327 31.7
Higher secondary 214 20.8
Bachelor and above 235 22.8
Fathers ‘education
No education/Primary 222 21.5
Comilla University Journal of Social Sciences
57
Secondary 281 27.3
Higher Secondary 181 17.6
Bachelor and above 346 33.6
Respondents’grade
Nine 474 46.0
Ten 557 54.0
Respondents ‘group
Arts 281 27.3
Commerce 385 37.3
Science 365 35.4
Area & Religion Area of residence
Rural 553 53.6
Urban 478 46.4
Religion
Muslim 740 71.8
Non-Muslim 291 28.2
Media Use Respondents’ TV viewing
Irregular 453 43.9
Regular 578 56.1
Mothers’ TV viewing 300 22.1
Irregular 542 52.6
Regular 489 47.4
Internet Usage Respondents’Internet usage
No 769 74.6
Yes 262 25.4
Mothers’Internet usage
No 855 83.3
Yes 172 16.7
Distribution of Items related to the Accuracy of Information regarding Menstruation Transmitted by Mothers to Daughters
Table 2 shows the accuracy of the information the mothers distributed to their adolescent daughter about different cognitive and behavioral facets of the menstruation. The answer choice ‘yes’ indicates the mothers ‘unawareness induced by a lack of adequate and accurate information about sexual and reproductive health issues. According to the study findings, about one-fourth of the mothers referred to the menstrual period as a disease, while 30% of the mothers advised them to use cloths or cotton instead of sanitary pad. Also,
Do TV Viewing and Internet Usage Contribute to Information Accuracy?
approximately 20 percent of mothers prevented their daughters from touching others during the time, and about one-third of mothers restricted their daughters going outside.
Table 2: Frequency and percentage distribution of items related to the accuracy of the information transmitted through mother-daughter communication on menstruation
Item Category Frequency Percentage
Mother referred to the menstrual cycle as a disease, not a natural process
Yes 238 23.1
No 793 76.9
Mother instructed the daughter to use cloth or cotton
Yes 314 30.5
No 717 69.5
Mother prohibited to touch anyone during menstruation
Yes 199 19.3
No 832 80.7
Mother restricted going outside during the menstrual period
Yes 321 31.1
No 710 68.9
Effects of TV and Internet on the Accuracy of Information as regards Menstruation Transmitted by Mothers to their Daughters
The bivariate analyses of the items related to the accuracy of information about menstruation transmitted by mother to adolescent daughter according to mothers’
TV viewing (regular and irregular) as well as Internet use (yes and no) were reported in Table 3, 4, 5, and 6. Results are presented as percentages of responses regarding four items relating to period those were conveyed by mothers with a comparison of the regular and irregular TV viewing as well as using the Internet or not. P-values from chi-square tests show that the status of the accuracy is highly significant in all cases by mothers’ media and Internet use.
Table 3 Distribution of the item ‘mother referred to the menstrual cycle as a disease’according to mother’s TV viewing and Internet usage
Mother referred to the menstrual cycle as a disease
Variable (N = 1031) Yes No χ2 p
TV viewing 14.68 <.001
Irregular 151 (27.9) 391 (72.1)
Regular 87 (17.8) 402 (82.2)
Internet usage 7.535 .006
No 212 (24.8) 643 (75.2)
Yes 26 (15.1) 789 (84.9)
Note: Chi-square (χ2) test was performed to find the association.
Comilla University Journal of Social Sciences
59
In particular, Table 3 demonstrates that in terms of the item stating the period as a disease instead of the natural process, a highly significant association was observed according to TV viewing (p< .001) and Internet usage (p = .006). It is clear that mothers of regular media use (82.2%) were more likely to provide their daughter with accurate information than their counterparts of irregular media use (72%). Likewise, the same result was found in the case of mothers’Internet usage depicting that respondents’ mothers who used the Internet had a higher likelihood to describe the period as a natural process than their counterparts who didnot use the Internet.
Table 4 Distribution of the item ‘mother instructed the daughter to use cloth or cotton’according to mothers’ TV viewing and Internet usage
Mother told to use cloth instead of the sanitary pad during the period
Variable (N = 1031) Yes No χ2 p
TV viewing 21.14 <.001
Irregular 199 (36.7) 343 (63.3)
Regular 115 (23.5) 374 (76.5)
Internet usage 5.936 .015
No 274 (32.0) 581 (68.0)
Yes 39 (22.7) 133 (77.3)
Note: Chi-square (χ2) test was performed to find the difference.
Regarding the item of using cloths or cotton instead of the sanitary pad during the period, Table 4 depicts that mothers with regular TV viewing had a higher likelihood to suggest their daughters for using sanitary pad during period instead of cloth and cotton (76.5%, p< .001) than irregular media user mothers with 63.3%. Similarly, the mothers who used the Internet were more likely to recommend hygiene practice than their counterparts (p = .015).
Table 5 Distribution of the item ‘mother prohibited to touch anyone during menstruation’ according to mothers’ TV viewing and Internet usage
Mother forbade to touch anyone during the period
Variable (N = 1031) Yes No χ2 p
TV viewing 11.42 .001
Irregular 126 (23.2) 416 (76.8)
Regular 73 (14.9) 416 (85.1)
Internet usage 13.42 <.001
No 183 (21.4) 672 (78.6)
Yes 16 (9.3) 156 (90.7)
Note. Chi-square (χ2) test was performed to find the difference.
Do TV Viewing and Internet Usage Contribute to Information Accuracy?
In addition, Table 5 reports that 23.2 percent of mothers with irregular TV viewing told their daughters not to touch anyone during menstruation with the comparison of the counterparts of regular TV viewing (15%, p = .001). Also, the study findings found a significant association with the accuracy of information conveyed by mothers with their Internet use (p< .001).
Table 6 Distribution of the item ‘mother restricted going outside during the menstrual period’according to mothers’ TV viewing and Internet usage
Mother restricted going school and outside during the period
Variable (N = 1031) Yes No χ2 p
TV viewing 27.95 <.001
Irregular 208 (38.4) 334 (61.6)
Regular 113 (23.1) 376 (76.9)
Internet usage 14.97 <.001
No 287 (33.6) 568 (66.4)
Yes 32 (18.6) 140 (81.4)
Note. Chi-square (χ2) test was performed to find the difference.
Table 6 shows that mothers with irregular TV viewing had a higher likelihood (38.4%, p< .001) to suggest their daughter for restricting their movement during the period compared to their counterparts with regular media use (23.1%). The results depict that the number of mothers who allowed their daughters to go school and outside was significantly higher among the Internet user (81.4%, p<.001) than those with non-user (66.4%).
Discussion
In this study, mothers’ access to television as well as the Internet, appeared as the important predictors for transmitting more accurate information relating to menstruation by mothers to their adolescent daughters. In Bangladesh, television is still the most popular medium despite the rapid popularity of the Internet and social media as well. It is assumed that 130 million people have one TV set (Banglapedia, 2003, p. 86). In addition, the number of TV audiences is about 100 million, whereas 83% of people from urban areas watch TV, and 50% of those are in rural areas (DainikAmaderShomoy, 2015). Television often broadcasts the reproductivehealth-related content that may increase mothers’ knowledge as well as awareness and enable them to provide their daughters with accurate information as to period. The media has an active role in creating a favorable environment for any wellbeing. Moreover, watching programs and advertisements concerning adolescent health can alleviate the degree of the taboo of the topic that may prompt a mother to talk more about the issue.
Bangladesh has experienced an Internet boom, especially in mobile Internet connectivity during the last few years. At the end of March 2019, there were93.102 million active Internet subscribers in Bangladesh, where 87.310 million (96.64%) were using mobile Internet (BTRC, 2019).In line with other parts of the world, Facebook has gained immense popularity in Bangladesh,