1874-9445/20 Send Orders for Reprints to reprints@benthamscience.net 7 DOI: 10.2174/1874944502013010007, 2020, 13, 7-13 The Open Public Health Journal Content list available at: https://openpublichealthjournal.com RESEARCH ARTICLE Educating to Say ‘no’ to Reject High-Risk Suggestions Through Roleplaying Model Among Middle School Students Fatemeh Shabani 1 , Mohtasham Ghafari 2 and Zahra Boroumandfar 3,* 1 Department of Midwifery, Medical School, Instructor, University of Medical Sciences, Arak, Iran. 2 Occupational Hazards Control Research Center, School Of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3 Midwifery & Reproductive Health Department, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Abstract: Background: As the adolescents lack necessary social and communicational skills, the present study aimed to educate to say ‘no’ to reject high-risk suggestions through the use of role play model. Methods: In a field trial, 145 female students using randomized sampling were selected in Arak. The checklist made for saying ‘no’ was completed before, immediately and two months after the intervention for students. The study was conducted based on the skill of saying ‘no’ through role-play training method. Data were analyzed by descriptive and inferential statistical tests through SPSS. Results: The mean scores of skills of saying ‘no’ to reject high risk suggestions showed a significant difference among the subjects before, immediately and two months after intervention (respectively p=0.000, p=0.009) Conclusion: The results indicate that the educational interventions of preventive behaviors are necessary for students to improve their skill of saying ‘no’. Keywords: Education, Role playing, Saying no skill, Student, Adolescence, high-risk suggestions. Article History Received: July 08, 2019 Revised: November 4, 2019 Accepted: November 22, 2019 1. INTRODUCTION Investigations show that nearly half of the world's population is composed of teenagers. About 1.5 billion people in the world were in the age range of 10-25 years by 2009 [1]. In Iran, 27% of the population, i.e., about 16 million, are adolescents. When people reach puberty, essential and important changes emerge in their appearance, social behaviors, and psychosocial status, with many healthy habits and behaviors forming at this stage of life and having a significant impact on adult health behaviors [2]. Unsuccessful marriages, high-risk pregnancies, deaths, unhealthy habits and behaviors are rooted in this period. In the world, adolescents are not adequately protected against AIDS, sexually transmit- * Address correspondence to this author at the Midwifery & reproductive health department, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; E-mail: boroumandfar@nm.mui.ac.ir -ted diseases and pregnancy, and are exposed to unhealthy and unprotected sexual relationships, drug abuse, sex without responsibility, early pregnancy, violence, failure in the course and school and so forth. In Iran, most cases of high-risk sexual behavior (55.6%) occur at the age of 16-21. The average age for starting to smoke in Iran is 16.6 years, and the highest proportion of drug addicts (45.7%) begins from the age of 17-22 years old [ 3]. Moreover, the average age of the first sexual contact is 14 years, as quoted by Rahmani from Mohammadi, and Soleimani Nia reported a 44.7% prevalence of high-risk behaviors [ 4]. The vulnerability of females, however, makes this period more sensitive for females [5]. In many countries, pregnancy during adolescence is considered as a risk factor with high rates of embryonic and maternal complications [6]. Every year, an estimated 21 million girls aged 15-19 years and 2 million girls aged under 15 years become pregnant in developing regions. Approximately 16