Efectividad de un programa de educación sexual en adolescentes acerca de la adquisición de conocimientos y cambios de actitud ante el empleo de métodos anticonceptivos

[Effectiveness of structural interventions to promote condom use in adolescents and young people: Systematic Review]

OBJECTIVE

Evaluate the effectiveness of structural or multicomponent interventions aimed at increasing the use of condoms in adolescents and young adults, identifying the strategies that form the interventions evaluated, and recognizing the theoretical models that support these interventions.

METHODOLOGY

Design: Systematic review of literature. Data source: MEDLINE databases were consulted via OVID, Embase, and CENTRAL in order to search for studies on interventions aimed at increasing the use of condoms in adolescents and young adults. Selection of studies: A total of 7 primary investigations were selected, in which the effect of a structured or multicomponent intervention to increase the use of condoms in adolescents and young adults was evaluated. The quality of the studies was evaluated using the Cochrane bias risk assessment.

RESULTS

Five investigations show changes in the percentages of condom use with values between 53% and 68%. The interventions targeted guided their actions more at individual level with strategies such as sexual health education, reproductive health counseling, knowledge about the condom, knowledge about STIs / HIV, than at organizational and environ-mental levels, which were aimed at the provision of condoms. The theoretical models proposed in the studies are focused on human behavior, individual behavior, and social learning.

CONCLUSION

Structural interventions that aim to increase the use of condoms in adolescents and young adults seem to show significant changes at individual level, but possible changes generated at both organization and environment levels are unknown.

Knowledge of Sexuality and Contraception in Students at a Spanish University: A Descriptive Study

Youth is a period characterized by impulsiveness and risk-taking. This population often feels invulnerable and has a strong motivation to seek out their identity. These characteristics make it a risky age period for an unwanted pregnancy. This study aimed to investigate the level of knowledge about sexuality and contraception among nursing students at the University of Jaen. The students completed a 16-item questionnaire assessing their knowledge level about sexuality and contraception. A bivariate analysis was performed using the Kruskal–Wallis H and Mann–Whitney U tests. Later, an ordinal logistic regression model was generated. The sample consisted of 130 participants, with an average age of 20.36 years. The level of knowledge about sexuality and contraception was moderately high, 10.38 points out of 16. The factors associated with the probability of accordingly presenting a high level of knowledge were being a woman, having studied in a public institution, not having used any contraceptive method in the first sexual experience, and wishing to use a contraceptive pill in future sexual relations. In conclusion, the knowledge level about sexuality and contraception is high, although it is necessary to assess whether this level of high knowledge translates to the use of contraceptive methods in future sexual experiences.

The Integration of Gender Perspective into Young People's Sexuality Education in Spain and Portugal: Legislation and Educational Models

Throughout history, Sexuality Education (SE) has undergone many changes in formal education curricula. The education systems should incorporate SE and promote an understanding of sexuality from the critical perspective of gender. Objectives: To examine the approach to SE in young people in Spain and Portugal, considering the incorporation of the gender perspective, and analyze the legislation in both countries. A scoping review was conducted considering studies with SE programs, gender perspective, and legislation in Spanish, Portuguese, and English, without any time limits. The population consisted of young people aged 10 to 18 years who did not attend higher education. Databases used: CINAHL Complete, ERIC, LILACS, SciELO, MEDLINE, Psychology and Behavioral Sciences Collection, Scopus, Open Access Scientific Repository of Portugal, Base de Datos de Tesis Doctorales, Theses and Dissertations Online, and governmental websites. Thirty-two studies were found, including intervention, diagnosis, and documental programs. Eight of the studies adopted the gender perspective. Legislation in both countries is vast, with 23 main references. Although SE is legislated in both countries, the social-health and educational programs are insufficient. The relevance of the gender perspective is not incorporated into SE.

[Effectiveness of educational interventions for the prevention of pregnancy in adolescents]

Objetivo

Evaluar la efectividad de las intervenciones educativas dirigidas a prevenir el embarazo en la adolescencia.

Diseño

Revisión sistemática.

Fuentes de datos

Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME para buscar estudios sobre intervenciones educativas para la prevención del embarazo en la adolescencia.

Selección de estudios

Se seleccionaron un total de 24 investigaciones primarias, donde se evaluaba el efecto de un programa educativo para la prevención del embarazo en la adolescencia. La calidad de los estudios seleccionados se evaluó usando la escala CASPe.

Resultados

Los programas educativos que midieron una modificación de la tasa de embarazo en la adolescencia muestran resultados poco concluyentes, ya que 2 investigaciones obtienen una reducción y otros 2 no hallan cambios significativos. Sin embargo, los programas educativos se muestran efectivos para aumentar el nivel de conocimiento sobre sexualidad y métodos anticonceptivos, y para modificar las actitudes sobre el riesgo de embarazo en la adolescencia o las actitudes hacia el uso de los métodos anticonceptivos. No se encuentran diferencias estadísticamente significativas entre los estudios que muestran un resultado positivo y los estudios con resultado negativo (p > 0,05) para ninguno de los resultados analizados en la revisión.

Conclusión

No existe una modalidad de intervención que sea la más efectiva para la prevención de un embarazo en la adolescencia. Se necesita un mayor número de investigaciones con un abordaje longitudinal que valoren no solo resultados intermedios, sino una modificación en la tasa de embarazo.

Two-Year Follow-Up of a Sexual Health Promotion Program for Spanish Adolescents

The aim is to evaluate the effects of the Competencias para adolescentes con una sexualidad saludable (COMPAS) program and compare them with an evidence-based program ( ¡Cuídate!) and a control group (CG). Eighteen public high schools were randomly assigned to one of the three experimental conditions. Initially, 1,563 Spanish adolescents between 14 and 16 years of age participated, and 24 months after their implementation, 635 of them completed a survey. Self-report measures collected data on sexual behavior, knowledge, attitudes, intention, sexual risk perception, and perceived norm. Compared to the CG, COMPAS increased the level of knowledge about sexually transmitted infections and improved the attitudes toward people living with human immunodeficiency virus at the 2-year follow-up. Neither intervention had a long-term impact on behavioral variables. Results suggest that COMPAS has a comparable impact to the other intervention on the variables predicting consistent condom use. Reinforcing the messages and skills that have the greatest impact on condom use and adding booster sessions following program completion as strategies to maintain long-term effects are necessary.

A 1-year follow-up evaluation of a sexual-health education program for Spanish adolescents compared with a well-established program

BACKGROUND

Competencies for adolescents with a healthy sexuality (COMPAS) is the only school-based sexual health promotion program in Spain that has been found to be as effective as an evidence-based intervention (¡Cuídate!) in the short term. This study's aim was to compare data from a 12-month follow-up evaluation on the effects of COMPAS on adolescents' sexual risks (knowledge, attitudes, perceived norms, sexual risk perception and intentions) and sexual behaviours (age of the first sex, consistent condom use and multiple partners) with an evidence-based intervention (¡Cuídate!) and a control group.

METHODS

Eighteen schools from five provinces of Spain were randomly assigned to one of three conditions: COMPAS, ¡Cuídate! and a control group. The adolescents (N = 1563; 34% attrition) were evaluated 1 week before and after the program, and 1 year post-program implementation.

RESULTS

We found that the COMPAS program was as effective as ¡Cuídate!, the evidence-based program, in increasing the adolescents' knowledge about sexually transmitted infections and in fostering favourable attitudes about condom use and people living with HIV/AIDS. COMPAS was more effective than ¡Cuídate! in increasing the adolescents' perceptions of their peer's consistent condom use and the age delay of their first vaginal intercourse. However, it was less effective in maintaining the adolescents' intentions to use condoms and in delaying the age of their first oral sex experience.

CONCLUSION

COMPAS was as effective as ¡Cuídate! in reducing sexual risk among adolescents.