Table 1 The hypothesized LIFES framework to understand the local adolescents’ religio-cultural menstrual practices in far-western Nepal

Category	Sub-category	Operational definition
Family subsystem	Individual	Nature and characteristics of the caregivers (e.g., grandmother and mother), which have implications on the adolescent girls’ development and performance of religio-cultural menstrual practices.
	Interpersonal	Nature and characteristics of the caregiver-child interactions (e.g., mother-child, grandmother-child), which have implications on the adolescent girls’ development and performance of religio-cultural menstrual practices.
	Family-as-a-whole	Nature and characteristics of the local family, which have implications on the adolescent girls’ religio-cultural menstrual practices.
Level of influence	Immediate	Manifested behavioural strategies pertinent to menstrual practices.
	Proximal	Cognitive, motivational, volitional or affective factors that affect the menstrual practices or pertaining interactions.
	Distal	Contextual factors that are supposed to have indirect impacts on religio-cultural menstrual practices or pertaining interactions as a high-level moderators.

LIFES, Levels of Interacting Family Environmental Subsystems.