Effectiveness of a Mobile Application-Based Program for Enhancing Independent Menstrual Management Skills in Adolescent Girls with Mild Intellectual Disabilities: A Parallel-Group Randomized Controlled Trial

Abstract

Background: Adolescent girls with mild intellectual disabilities often face challenges in achieving independence in menstrual management, highlighting the need for structured and accessible educational interventions. This study evaluated the effectiveness of a mobile application-based education program in improving independent menstrual management skills. Methods: A parallel-group randomized controlled trial was conducted with 90 adolescent girls with mild intellectual disabilities and their mothers. Participants were randomly assigned (1:1) to the intervention or control group using a computer-generated sequence. The intervention group received a mobile application-based education program (Bağımsız Yapabilirim), which included instructional videos and interactive games for up to 30 min daily, while the control group received routine care. Outcomes (hand hygiene and pad-changing skills) were assessed at baseline and at 1, 3, and 8 months using structured Performance Record Sheets. Analyses were conducted according to the intention-to-treat principle using repeated-measures ANOVA based on multiply imputed datasets. Results: Baseline characteristics were comparable between groups. Intention-to-treat analyses based on multiply imputed datasets revealed significant time and group & times; time interaction effects for both outcomes (p < .001). Hand hygiene skills showed very large improvements (Group & times; Time: F(1.94, 171.02) = 49.31, p < .001, eta & sup2;p = 0.359; post-intervention Cohen's d = 2.39-3.99), maintained across all follow-up assessments. Pad-changing skills also improved significantly, with medium-to-large effect sizes over time (Group & times; Time: F(2.38, 206.79) = 20.34, p < .001, eta & sup2;p = 0.189; post-intervention Cohen's d = 0.75-1.39). No between-group differences were observed at baseline, whereas all follow-up assessments favored the intervention group (p <= .001). No adverse events were reported. Conclusion: The Bağımsız Yapabilirim mobile application is an effective and accessible intervention for enhancing menstrual self-management skills in adolescent girls with mild intellectual disabilities. The improvements were sustained over 8 months, demonstrating both statistical and clinical significance, and supporting the program's potential to promote independence and practical self-care competence in this population.