Short-term Effects Of A Sexual And Reproductive Health Education Program For Adolescents

ObjectivesThis study intended to develop a sexual and reproductive health education program for adolescents based on social cognition theory and to assess the effects of the sexual and reproductive health education program on sexual knowledge,sexual attitudes and reject self-efficacy,which would improve the related knowledge and self-protection ability of adolescents.MethodsTwo middle schools were conveniently selected in a city of Shandong Province.Then,two classes in grade 7 and grade 8 were selected from these two middle schools respectively using an online randomizer and classes in the same grade were randomly assigned to intervention group(233 cases)and control group(236 cases)using a coin toss.The intervention group received a sexual and reproductive health education including topical lecture,knowledge game,group discussion and video-watching,while the control group only received basic health education including the distribution of health education materials and video-watching without interpersonal interaction.The background information sheet,Pubertal Development Scale and Adolescent Reproductive Health Environment Questionnaire were used to evaluate basic information.Instruments assessing sexual knowledge(Sexual Knowledge Scale,HIV/AIDS Knowledge Questionnaire),sexual attitudes(Sexual Attitudes Questionnaire)and reject self-efficacy(Reject Self-efficacy Scale)were administered before the intervention(To),immediately after intervention(Ti)and one month after intervention(T2).The SPSS 22.0 for Windows(SPSS Inc.Chicago)was used for statistical analysis including independent sample t-test,chi-square test,Fisher exact test and repeated measures analysis of variance(ANOVA).Results1.After the intervention,9 cases were lost to follow-up;one month after intervention,12 cases were lost to follow-up.Finally,223 were in the intervention group and 225 were in the control group.2.The status of pubertal development and sexual and reproductive health education among adolescentsA majority of adolescents(86.6%)entered puberty.52.1%of boys were in mid-puberty,while 78.1%of girls were in late puberty.17.1%and 49.5%of the adolescents received sexual knowledge education from father and mother respectively.None of the adolescents had received sexual and reproductive health education in middle school.44.3%discussed sex-related topics with their peers and 56.1%indicated that there are regular sexual and reproductive health service settings in their neighborhood.36%paid attention to the sex-related topics in social media.In addition,the sources of sexual knowledge are parents,traditional media,internet,classmates/friends and teachers.3.Sexual knowledge,sexual attitudes and reject self-efficacy among adolescentsBefore the intervention,the basic sexual knowledge score of adolescents was 12.84 ± 6.31,STD/AIDS knowledge score was 4.15 ± 3.10,sexual attitude score was 26.00 ± 3.25,and reject self-efficacy score was 4.41 ± 0.94.4.Effects of the sexual and reproductive health education programRepeated measure analysis of variance showed that the main effect of intervention and time on sexual knowledge,sexual attitudes and reject self-efficacy was significant(P<0.05),and there was significant interaction between time and group on all the outcome measures(P<0.05).The results of t-test at different time points in two groups indicated that there were significant differences on sexual knowledge,sexual attitudes and reject self-efficacy at T1 and T2(P<0.05).The comparison of the outcome measures in intervention group showed that there were no significant differences on the scores of basic sexual knowledge,sexual attitudes and reject self-efficacy at T1?T2(P>0.05),and the differences weresignificant at the other two time points(P<0.05).There were significant differences on the scores of STD/AIDS knowledge at T0?T1,T1?T2,and T0?T2(P<0.05).ConclusionAdolescents' sexual knowledge was in a low level and sexual attitude was relatively open.In addition,reject self-efficacy of adolescents was not enough.The sexual and reproductive health education program for adolescents based on social cognition theory was effective at improving adolescents' sexual knowledge,sexual attitudes and reject self-efficacy.