Background: Adolescence is a pivotal period for establishing lifelong reproductive health; nevertheless, in many underserved Iranian schools, limited access to youth‑friendly counseling and persistent cultural barriers hinder open communication and service delivery. The present study investigated the stakeholders’ acceptance of School‑Based Tele–Reproductive Health Counseling (SBTRHC) with a focus on counseling priorities and perceived usability.
Method: A cross‑sectional survey was conducted in 2022 in Garmdareh County, Alborz Province, Iran, involving 175 secondary‑school stakeholders. Using a multistage sampling technique, two schools were randomly selected, followed by convenience recruitment of students and their mothers. Data collection included demographic characteristics, a stakeholder checklist of tele‑counseling topics, and a validated acceptance scale. Group differences across acceptance domains were examined using the Kruskal–Wallis test in SPSS version 23.
Results: The mean age of the students was 15.1±1.6 years old. Counseling priorities varied among the groups. Students primarily emphasized high-risk behaviors (92.4%). Mothers highly prioritized life skills, physical activity, mental and social health, and substance use prevention (93.9%). Meanwhile, school staff rated most topics as highly important but assigned the lowest priority to sexually transmitted diseases (88.4%). Acceptance indicators were consistently high across all groups. Perceived usefulness was endorsed by 87.9% of students, 91.0% of mothers, and 93.0% of school staff; ease of use by 86.4%, 75.8%, and 88.4%; and trust by 80.3%, 84.8%, and 86.1%, respectively. Furthermore, a strong intention to use the service was reported across all groups. Although overall acceptance did not differ significantly (P=0.227), ease of use varied across groups (χ²=7.681, P=0.021), with mothers reporting lower usability.
Conclusions: Stakeholders demonstrated strong acceptance of school‑based tele‑counseling, supporting its feasibility for adolescent reproductive health promotion. Variations in counseling priorities and usability highlight the importance of tailored implementation strategies.