| Objective:To discuss and compare the feasibility and effectiveness of 2 kinds of intervention package.Specific objective:1. To know the implementation of the intervention activities in each intervention group;2. To know the changes of the reproductive health information providing and the accessibility of reproductive health service after giving intervention and compare the differences between the minimal intervention group and extended intervention group;3. To know the changes of the knowledge and attitude and practice of the floating population after giving intervention and compare the differences between the minimal intervention group and extended intervention group;MethodIt is cluster-randomized experimental study. We will improve the connection between the health facilities and the worksites, so that the reproductive health status of the floating population can be improved.1. study designWe sampled 10 worksites purposively among the worksites which meet the including criteria. After matching them in pairs, there will be 5 pairs of worksites. In each pair, one worksite is selected at random (by tossing a coin) and assigned to arm A (minimal intervention group). The other worksite of the pair is assigned to arm B (extended intervention group).150 unmarried and 150 married whose age is between 18 years old to 29 years old in each worksite will be surveyed, and 3000 female will be included in our study in 10 worksites.2. intervention methodWe develop 2 kinds of intervention package:minimal intervention package and extended intervention package. And the activities of minimal intervention include:providing IEC materials and sexual and reproductive Health posters and free condoms in worksites to the floating population. The activities of extended intervention include:Providing IEC material, posters and free condom to all workers in worksites, providing hotline service, giving lectures on reproductive health, giving peer education and providing referral card and playing the video about reproductive health in the worksites. Both of the two intervention package will be carried out for 6 months and the intervention activities will be implement by the health team.3. content of the studyIt is an experimental epidemiological study. The contents of pre-intervention survey include:the demographic characteristics, such as birthday, education level and marital status and so on; status of receiving reproductive health information and service; knowledge, attitude and practice on reproductive health. We will collect the following contents in the post-intervention survey:the demographic characteristics, such as birthday, education level and marital status and so on; the implementation of the intervention activities; status of receiving reproductive health information and service; knowledge, attitude and practice on reproductive health.Results:Analysis method:The assessment concludes two parts:assessment of the intervention process and the effectiveness of the intervention. The assessment of the intervention process contains the implementation of the intervention and the changes of the connection between health facilities and the worksites and the changes of the reproductive health information receiving and the accessibility of the RH service. And we will find out the changes of knowledge level and attitude level and practice level of the floating population to assess the intervention effectiveness. The difference on KAP is large between the married and the unmarried, so we will describe them respectively. The minimal intervention group and the extended group is comparability in pre-intervention, because we have matched them. We call them the pre-intervention group. We will compare the difference among the following group:pre-intervention group VS minimal post-intervention group; pre-intervention group VS extended post-intervention group; minimal post-intervention group and VS extended post-intervention group.10 worksites have been given 6 month intervention activities from 15th July to 15th December,2008.1757 unmarried have been surveyed in the base-line survey.814 (66.1%took part in the base-line survey) and 806 (87.3% took part in the base-line survey) unmarried are surveyed in minimal and extended intervention group at the end of the study.1764 married have been involved in the pre-intervention survey. And in the post-intervention,767 (78.4% took part in the base-line survey) and 760 (87.1% took part in the base-line survey) married are surveyed our survey in minimal intervention group and extended intervention group respectively.1.1 assessment of the intervention process1.1.1 Implementation of the intervention73.7% and 92.2% of the respondents said they had ever received the IEC material of YOLAMI project in minimal intervention group and extended intervention group respectively in the unmarried.86.5% and 96.8% of the respondents have noticed the posters of RH in minimal intervention group and extended intervention group respectively in the unmarried.71.2% and 75.6% of the respondents have received the free condom provided by the health team in minimal intervention group and extended intervention group respectively in the unmarried. And 94.7% of the respondents have token part in the lecture and 89.5% of them involved in the peer education in extended intervention group in the unmarried.88.0% and 98.9% of the respondents had ever received the IEC material of YOLAMI project in minimal intervention group and extended intervention group respectively in the married.85.1% and 98.3% of the respondents have noticed the posters of RH in minimal intervention group and extended intervention group respectively in the married.74.2% and 86.8% of the respondents have received the free condom provided by the health team in minimal intervention group and extended intervention group respectively in the married. And 93.3% of the respondents have token part in the lecture and 94.6% of them involved in the peer education in the extended intervention group in the married.1.1.2 Connection between the health facilities and worksitesThe connection between the health facilities and the worksites has been improved by the construction of the health team both in the unmarried and the married.1.1.3 Changes of the RH information receiving and the accessibility of the RH serviceIn the unmarried population,44.6% of the respondents have ever received the RH information in the base line, after giving the minimal intervention,79.4% of them said they have ever received the information(X2=272.822,P=0.000), and the rate reached to 97.2% in extended intervention group(X2=639.457,P=0.000).11.6% in the pre-intervention group have ever received the RH service, and after giving the intervention,15.5% and 42.7% of the respondents have ever received the RH service in minimal intervention group and extended intervention group respectively in the unmarried population (pre-intervention VS minimal intervention group: X2=7.411,P=0.006; pre-intervention VS extended intervention group:X2=317.011, P=0.000).In the married population,74.9% of the respondents have ever received the RH information before giving intervention, after giving the minimal intervention,97.4% have ever received the information(X2=228.034,P=0.000), and the rate reached to 99.9% in extended intervention group(X2=228.034,P=0.000) in the married population. 53.4% in the pre-intervention group have ever received the RH service, and 53.8% and 63.7% of the respondents have ever received the RH service in minimal intervention group and extended intervention group respectively in the married population (pre-intervention VS minimal intervention group:X2=0.042,P=0.838; pre-intervention VS extended intervention group:X2=22.827,P=0.000).1.2 assessment of the intervention effectiveness1.2.1 Changes of the RH knowledge levelThere are 18 items of the RH knowledge, if the respondent gives a correct answer plus 1 point, if he gives a wrong answer or chooses "I do not know" plus 0 point. The total of the RH knowledge is 18 point. Both in minimal intervention group(median:12.500, Z=-17.359,P=0.000) and extended intervention group(median:15.00, Z=-35.164,P=0.000) the RH knowledge level are higher than pre-intervention group(median:7.00) in the unmarried population. And the effectiveness of extended intervention is better than minimal intervention group (Z=-23.676, P=0.000) in the unmarried.Both in minimal intervention group(median:3.000, Z=-10.976, P=0.000) and extended intervention group(median:16.000, Z=-31.682, P=0.000) the RH knowledge level are higher than pre-intervention group(median:12.00) in the married population. And the effectiveness of extended intervention is better than minimal intervention group (Z=-17.083, P=0.000) in the married population.1.2.2 Changes of the RH attitude levelThere are 7 items relative to RH attitude. If the respondent's attitude is positive plus 1 point, otherwise plus 0 point. The total is 7 point.The score is 4.0 in the pre-intervention group, and the scores of positive attitude both in minimal intervention group(meidan:5.0, Z=-7.735, P=0.000) and extended intervention group are higher than pre-intervention group(median:6.0, Z=-20.184, P=0.000) in the unmarried population. The effectiveness of extended intervention is better than minimal intervention (Z=-11.131, P=0.000) in the unmarried population.In the married population, the score is 5.0 in the pre-intervention group, and the scores of positive attitude both in minimal intervention group(median:6.000, Z=-13.056,P=0.000) and extended intervention group are higher than pre-intervention group(median:6.000, Z=-7.035,P=0.000).1.2.3 Changes of the RH relative practice1) Changes of healthy sexual behaviorNeither the minimal intervention nor the extended intervention is effective on changing safety sexual behavior and unwanted sex in unmarried population. The rate of unhealthy sexual behavior is 23.7% in the pre-intervention group, and this rates are lower both in minimal intervention group in the married (P=16.8%, X2=14.507, P=0.000) and extended intervention group (P=16.4%, X2=15.181, P=0.000).2) Changes of contraceptive behaviorAfter giving the minimal intervention, the rate of using contraception insistently (P=68.0%) is higher than pre-intervention group (P=56.0%)(X2=4.715, P=0.030) in the unmarried. The rates of using condom insistently and correctly and using modern contraception have not been enhanced neither in minimal intervention group nor extended intervention group in the unmarried.The rates of using contraception insistently, using condom insistently and correctly and using modern contraception have not been enhanced neither in minimal intervention group nor extended intervention group in the married.3) Changes of health seeking behavior16.7% of the respondents in the pre-intervention group have ever consulted to the health service provider about RH in the unmarried. The rates increase obviously both in minimal intervention group(P=23.3%, X2=16.198, P=0.000) and extended intervention group((P=48.0%, X2=278.394, P=0.000) and the effect in minimal intervention group is better than that in extended intervention group (X2=107.514, P=0.000) in the unmarried. 50.9% of the respondents in the pre-intervention group have ever consulted to the health service provider about RH in the married. The rates increase to 63.3% in extended intervention group (X2=33.139, P=0.000) in the married.31.8% have ever had gynecological symptom in the pre-intervention group in the unmarried. After giving the intervention activities, this rates have increased obviously both in minimal intervention group(P=53.6%, X2=18.153, P=0.000) and extended intervention group(P=82.4%, X2=65.554, P=0.000), especially in the extended intervention group(X2=8.783, P=0.003) in the unmarried.55.8% have ever had gynecological symptom in the pre-intervention group in the married. This rates have increased obviously both in minimal intervention group in the married (P=71.0%, X2=20.837,P=0.000) and extended intervention group(P=74.8% X2=24.512,P=0.000). Conclusion:1. changes of RH information receiving and RH service accessibility Both the minimal intervention package and extended intervention package improve RH information receiving and RH service accessibility in both the unmarried and the married floating population, and the extended intervention package is better than minimal intervention package.2. effectiveness of interventionThe unmarried:1)Both the minimal intervention package and the extended intervention package work, and the effectiveness of extended intervention package are better:to raise the level of the reproductive health and positive attitude, the rate of consulting to the health service provider about RH, the rate of seeking doctor after having gynecological symptom.2) Neither the minimal intervention package nor the extended intervention package work: to raise the rate of healthy sexual behavior and the rate of conceptive usingThe married:1) Both the minimal intervention package and the extended intervention package work, and the effectiveness of extended intervention package are better:to raise the level of the reproductive health and positive attitude.2) Both the minimal intervention package and the extended intervention package work, but there is no difference between these two intervention packages:to raise the rate of health sexual behavior and the rate to seeking doctor after having gynecological symptom.3) The minimal intervention package does not work, and the extended intervention package work:to raise the rate of consulting to the health service provider about RH4) Neither the minimal intervention package nor the extended intervention package work: to raise the rate of contraceptive using...
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