| Background and Objective:At present,many problems that were related to the lack of youth health education were prescenced in China's adolescents growing.Such as increased incidence of HIV infection and STD caused by frequent unprotected behavior,sexual harassment/sexual assault and school bullying due to gender and sexual orientation,intimate relationship misconducted and high abortion rate due to accidental pregnancy that cannot be ignored.Therefore,effective youth health education has become an urgent need.The existing models of youth health education mainly include mass media education,professional education,and peer education,etc.,which were related to social education,school education,family education,and peer education,but each model has certain limitations.The systematic school youth health education curriculum was still considered to be the best education model,but no attempts have been able to break through the predicament of health education in existing school curriculum,and there was also a lack of reliable evaluation of the effects of these models.To understand the current needs of adolescents for youth health education,and to try to construct a youth health education model suitable for the current education system,the project has been carrying out for five years.As well as an effective comprehensive evaluation system was structuring to comprehensively evaluate the model and provide suggestions.Methods:Through literature review and systematic evaluation,the existing literature was integrated to analyze the current situation of middle school students'sexual heath knowledge.The self-designed“Middle School Students Health Education Questionnaire”was used to investigate and analyze the situation of Jiangsu middle school students.Based on the above research,combined with the experience of actual intervention activities,the adolescent“self-participating”youth health education model was constructed,and the intervention effect was preliminarily evaluated in practical application.The framework of comprehensive evaluation system was constructed by Analytic Hierarchy Process.Through the Delphi method to collect expert opinions,and use cluster analysis to merge,obtain the indicators and corresponding weights of the comprehensive evaluation system;the information required for the comprehensive evaluation was collected by used the class test method and semi-structured interview and handled by use the propensity score.The fuzzy comprehensive evaluation method was performed to finish the evaluation.SPSS22.0,epidata3.1,Excel2013 and other software were performed to process data.The quantitative data was expressed in the form of mean±standard deviation.The difference between the two group was compared by t test.The comparison between qualitative data was analyzed by?~2.Inspection level is 0.05.RESULTS:(1)40 independent studies from 2012 to 2017 were included by literature search and screening in the Meta-analysis.The results showed that the awareness rate of sexual transmission of AIDS among middle school students was as high as 87.8%(95%CI was81.9%-92.6%).The awareness rate of effective prevention of AIDS by wearing condoms and single sexual partners was about 60%which decreased with time;5.8%of middle school students have sexual behavior.(2)The awareness rate of AIDS transmission routes among middle school students in Jiangsu was over 90%and the rate of non-transmission routes such as“mosquito bites,shared bathrooms and swimming pools”is not high,ranging from 30%to 60%in Jiangsu.More than60%of students have acquired relevant knowledge through the network or relatives and friends.(3)Taking the needs of middle school students as the leading factor,aiming at realizing the improvement of adolescents'sexual health awareness and the reduction of the incidence of sexual crisis,through the efforts of college student volunteers or NGO,the youth“self-participating”youth health education model was constructed.The model was divided into two parts.The first part is the core intervention system,focusing on the basic youth health knowledge dissemination through participatory training and the online communication platform.The second part is the peripheral support system,through inspiring core interventions and continuous environmental improvement to carry out youth health education activities.Social resources such as society,government,and professionals will be introduced to integrate with the current teaching system,and cultivate interest groups or associations in the school.The two systems complement each other to provide the school with a full-scale health education-related resources and activities to enhance participants'understanding of youth health and AIDS prevention,and to develop their ability to face sexual crisis.(4)After preliminary intervention,in the mastery of knowledge,the middle school students in Jiangsu Province have improved the knowledge of the role of condoms and the harm of unsafe sex,and the awareness rate has increased from 60%to 80%.The difference is statistically significant(P<0.05).There has also been a certain improvement in the identification of self-rightness.In the self-assessment of“the mastery of sexual and AIDS knowledge”,the scores range from 5.99±2.65 to 7.01±2.40,and 5.61±2.97 to 7.60±2.46.The difference is statistically significant(P<0.05).Huai'an students have a wider change of knowledge,and Wuxi students have made greater changes in their attitudes.In the visual evaluation of participants'intervention mode,the scores of each evaluation are about 8 points,and the score of the host is as high as 9.5 points,which proves that the model has certain attraction and effect on middle school students.(5)16 professionals in related fields such as AIDS prevention,health education,social work,were invited to determine the basic framework and indicators of the comprehensive evaluation system for youth health education,with“efficiency level,audience level and implementation level”as the criteria layer has a weight of 29.06,40.635,and 30.31,respectively.There are 17 program layers under it,The weights of the benefit level are 17.88%covering the general understanding,22.18%of the people affected by the investment per10,000 yuan,29.81%effective for the target problem,30.13%of the promotion,and the weight of the behavior change at the audience level.The highest is 20.06%,and the rest is 14.49%in knowledge,11.47%in feeling,14.42%in attitude,14.36%in overall content,14.26%in willingness to participate,12.82%will be satisfied,or 12.37%in demand.At the implementation level,the weights are 15.58%for the basic program,16.60%for easy operation,15.45%for a good feedback system,19.49%for self-sustaining operations,17.56%for local conditions,and 15.32%for related personnel.The reliability evaluation was carried out,and Kendall W=0.323 was obtained.The opinions of various experts tend to be consistent.(6)The youth self-participating youth health education model was evaluated based on the comprehensive evaluation system constructed.At the level of effectiveness,20 relevant professionals were invited,and the general evaluation was relatively good.At the audience level,two middle school students'and two vocational middle school were surveyed,and 100pairs of participants were selected to match,and the audience was found at the level of“knowing the letter”.The change presents a large polarization,with about 35%of the excellent and 40%of the poor.From the participating students,200 participants were randomly selected to conduct a qualitative evaluation of the model,40%of them rated excellent,30%rated the general;Executive level,performed on 20 performers and supporters of the project Interviews,at the operational level,65%of people rated well,accounting for the main.The ratio of excellent feedback and adaptability is about 60%.After the fuzzy comprehensive analysis method,the“excellent”evaluation has the highest degree of membership,about 0.42,which proves that the evaluation of the education model is excellent.Conclusions and Suggestions:(1)With the development of social economy,the knowledge of AIDS prevention and control among middle school students has not risen but fallen.Combined with the survey results of middle school students freshmen in some areas,and the HIV infection status of cities in Jiangsu Province can be found,some students have little knowledge of AIDS,but they are in a crisis of potential sexually transmitted diseases.(2)The youth“self-participating”youth health education model which was constructed by combined with literature research and field research was in good agreement with the characteristics of middle school students who are more willing to acquire relevant knowledge through peers,networks and video media.The preliminary evaluation results were good.Make up for the vacancy in the current education system.(3)The comprehensive evaluation system was used to evaluate the youth self-participating youth health education model.It was found that the model's benefit level was highly evaluated,and the breadth of knowledge coverage and high promotion ability were recognized.At the audience level,the change in the level of“knowledge and trust”is low,and the measurement of behavior change is yet to be evaluated,but it is very popular from the perspective of middle school students.At the implementation level,the model has also received a high evaluation and has good adaptability,but at the operational level,there are still problems such as unfamiliarity and slow start.(4)The implementation of the youth“self-participating”youth health education model should be based on the needs of middle school students,and based on the characteristics of the school itself,strive to introduce multiple resources.This model needs to be improved in further practical application and application,and more relevant youth health education related content will be introduced to make it more suitable for the needs of youth health education in schools,thus contributing to the comprehensive and healthy realization of adolescents. |
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