Assessing the impact of an educational intervention program on sexual abstinence based on the health belief model amongst adolescent girls in Northern Ghana, a cluster randomised control trial

Effect of social support on fetal movement self-monitoring behavior in Chinese women: a moderated mediation model of health beliefs

OBJECTIVE

Strengthening the management of women's self-monitoring during pregnancy is important to reduce fetal death in utero and improve maternal and infant outcomes. However, due to the lack of awareness among pregnant women about the importance of self-monitoring fetal movement, resulting in low behavioral compliance, adverse pregnancy outcomes remain common in China. This study aimed to investigate the relationship between social support and health beliefs and the self-monitoring behavior of fetal movement. In addition, we examined the moderating and mediating effects of health beliefs on fetal movement self-monitoring.

METHODS

This cross-sectional study was conducted on 200 postpartum mothers in a tertiary hospital in China. The mothers were asked to complete a socio-demographic questionnaire, the fetal movement self-monitoring behavior questionnaire, the fetal movement self-monitoring health beliefs questionnaire, and the social support rating scale. Data from the questionnaires were analyzed and compared using SPSS 24.0 and PROCESS 3.2.

RESULTS

The results of this study showed that the total scores of social supports, health beliefs, fetal movement self-monitoring were 42.98 ± 11.65, 78.605 ± 13.73, and 11.635 ± 2.86, respectively. The study found that when social support and health beliefs were included in the regression equation, both social support and health beliefs showed a positive correlation with fetal movement self-monitoring. Health beliefs partially mediated the effect of social support on fetal movement self-monitoring, accounting for 37.5% of the total effect.

CONCLUSION

Social support and health beliefs play a crucial role in influencing the self-monitoring behavior of fetal movements. Therefore, strengthening social support and health beliefs during pregnancy has the potential to improve compliance with fetal movement self-monitoring behaviors for pregnant women.

Gender-transformative school-based sexual health intervention: study protocol for a randomized controlled trial

BACKGROUND

There is general agreement that sexuality is a central aspect of human development; it is key in sexual health and reproductive education during adolescence. However, in spite of the existing interventions on this topic and the evidence generated, the inclusion of a gender focus in sexuality is relatively recent and there is little evidence available, thus structured and corroborated interventions with a gender-transforming perspective in sexuality are required.

METHODS

We will use a mixed method experimental design with a parallel cluster-randomized trial (GRTs) that will evaluate the effectiveness of a comprehensive gender-transformative intervention of sexual education (ENFOCATE -Focus-on-), which will be complemented with qualitative studies to understand the implementation process. The participants will be 609 10th and 11th-grade students. The randomization will be by grade, and the data will be collected at three moments (pre-intervention, post-intervention, and a 3-month follow-up).

DISCUSSION

Comprehensive, gender-focused, and culturally pertinent interventions in sexuality are needed for adolescents of countries with high, middle, and low incomes. These produce better results in terms of sexual health, and including a gender-transformative focus contributes to equity in health. Focus-on is unique since it uses a comprehensive gender-transformative intervention in sexual education that will allow putting into practice a program based both on international evidence and that which arises from the object population. It also uses a culturally-sensitive focus, since it is designed based on the characteristics of the object population; it will allow adapting some activities to the needs of the context in which it is developed.

TRIAL REGISTRATION

The study was prospectively registered on June 6, 2023, at ClinicalTrials.gov ID: NCT05896540. Protocol version number 1.0. May 22, 2023.

Impact of sexual and reproductive health interventions among young people in sub-Saharan Africa: a scoping review

Objectives

The aim of this scoping review was to identify and provide an overview of the impact of sexual and reproductive health (SRH) interventions on reproductive health outcomes among young people in sub-Saharan Africa.

Methods

Searches were carried out in five data bases. The databases were searched using variations and combinations of the following keywords: contraception, family planning, birth control, young people and adolescents. The Cochrane risk-of-bias 2 and Risk of Bias in Non-Randomized Studies-of-Interventions tools were used to assess risk of bias for articles included.

Results

Community-based programs, mHealth, SRH education, counselling, community health workers, youth friendly health services, economic support and mass media interventions generally had a positive effect on childbirth spacing, modern contraceptive knowledge, modern contraceptive use/uptake, adolescent sexual abstinence, pregnancy and myths and misperceptions about modern contraception.

Conclusion

Sexual and reproductive health interventions have a positive impact on sexual and reproductive health outcomes. With the increasing popularity of mHealth coupled with the effectiveness of youth friendly health services, future youth SRH interventions could integrate both strategies to improve SRH services access and utilization.

Effects of the Momentum project on postpartum family planning norms and behaviors among married and unmarried adolescent and young first-time mothers in Kinshasa: A quasi-experimental study

This study evaluated the effect of Momentum-an integrated family planning, maternal and newborn health, and nutrition intervention-on postpartum family planning norms and behaviors among ever married and never-married first-time mothers age 15-24 in Kinshasa, Democratic Republic of the Congo. Using data collected in 2018 and 2020, we conducted an intent-to-treat analysis among 1,927 first-time mothers who were about six-months pregnant at enrollment. Difference-in-differences models were run for panel data and treatment effects models with inverse-probability weighting for endline-only outcomes. Average treatment effects (ATE) were estimated. Momentum had positive effects on partner discussion of family planning in the early postpartum period (ever married 15-19: ATE = 0.179, 95% CI = 0.098, 0.261; never married 15-19: ATE = 0.131, 95% CI = 0.029, 0.232; ever married 20-24: ATE = 0.233, 95% CI = 0.164, 0.302; never married 20-24: ATE = 0.241, 95% CI = 0.121, 0.362) and discussion with a health worker, and on obtaining a contraceptive method in the early postpartum period, except among never married adolescents. Among adolescents, intervention effects on modern contraceptive use within 12 months of childbirth/pregnancy loss were larger for the never married (ATE = 0.251, 95% CI = 0.122, 0.380) than the ever married (ATE = 0.114, 95% CI = 0.020, 0.208). Full intervention exposure had consistently larger effects on contraceptive behaviors than partial exposure, except among ever married adolescents. Momentum had no effect on normative expectations about postpartum family planning use among adolescents, and on descriptive norms and personal agency among those who were never married. Results for normative outcomes and personal agency underscored the intersectionality between young maternal age and marital status. Future programs should improve personal agency and foster normative change in support of postpartum family planning uptake and tailor interventions to different age and marital status subsets of first-time mothers.

Predictors of sexual and reproductive health knowledge and utilization of services among adolescents in Ghana's Adaklu district

Objective

To explore factors associated with adolescents' sexual and reproductive health (SRH) knowledge and their engagement with educational and clinical services.

Design

Regression analysis of secondary data collected during a community survey.

Setting

Adaklu district, Volta Region, Ghana.

Participants

221 adolescent caregiver pairs.

Main outcome measures

The study employed three main outcome measures: (1) adolescents' level of SRH knowledge (assessed via questionnaire), (2) membership in district-sponsored adolescent health clubs (AHCs), and (3) ever-utilization of clinical SRH services.

Results

Greater SRH knowledge was significantly associated with older age, AHC membership, and relying primarily on teachers or friends for SRH information. Increased odds of AHC membership were observed among females (AOR = 2.38, 95% CI 1.14-4.95); those who had communicated with one parent about sexual issues (OR 2.70, 95% CI 1.17-6.21); and those with a history of transactional sex (OR 5.53, 95% CI 1.04-29.37). Decreased odds were observed among adolescents whose caregivers were educated to the primary level (AOR = 0.24, 95% CI = 0.07-0.79). Overall, utilization of clinical SRH services was low, but higher odds were detected among individuals reporting a history of forced sex (AOR = 117.07, 95% CI 3.82-3588.52) and those who had discussed sexual issues with both of their parents (AOR = 13.11, 95% CI 1.85-92.93).

Conclusions

Awareness of the predictors of knowledge, AHC involvement, and clinical service utilization can empower adolescent SRH initiatives-both present and future-to enhance their teaching, develop targeted outreach to underserved groups, and promote engagement with key clinical resources.

Funding

This work has been supported by grants from the International Development Research Centre [108936] (IDRC), Canada.

Efficacy of mobile-based educational intervention using Instructional Systems Design in promoting preventive behaviors for sexually transmitted infections among Iranian women: a randomized controlled trial

BACKGROUND

Women who are sexually active are at risk of sexually transmitted infections (STIs), which can cause serious difficulties for their reproductive health. However, despite the high global burden of STIs, most infections are preventable with education for behavioral change. The purpose of this study is to investigate the Efficacy of Mobile-Based Educational Intervention Using Instructional Systems Design in Promoting Preventive Behaviors for Sexually Transmitted Infections among Iranian Women.

METHODS

This randomized controlled trial aimed at promoting preventive behaviors related to STIs in Iranian women with an educational intervention based on the Instructional Systems Design (ISD) in 2022. The participants in this study were recruited from a single center, specifically the Health House No. 3 located in District 11 of Tehran Municipality. Two instruments were used in the present study: a) a valid scale titled: "Four-Scale of STI Preventive Behaviors", and b) a researcher-made Questionnaire titled: "Social perception affecting sexually transmitted infections (SOPESTI)". These tools contain 8 demographic items and specific questions with a total of 68 five-point Likert scales. The intervention comprised three phases: a pre-test (baseline), a training program, and two follow-up assessments (4 and 12 weeks after the start of the training program). The experimental group received education through a mobile app, while the control group received no intervention. SPSS v.26 was used, with a significance level of P < 0.05. The chi-square test, Fisher's exact test, independent t-tests, analysis of covariance (ANCOVA), and repeated measures ANOVA were used to analyze the data.

RESULTS

A total of 80 women, with a mean age of 36.524 ± 6.91 (experiment group) and 34.78 ± 8.20 (control group), respectively, participated in the trial. The study revealed a statistically significant difference in the mean score for eight domains, including STIs Knowledge, STIs Vulnerability, STIs Preventive Self-efficacy, STIs Prevention intentions, STIs Perceived social exclusion, STIs Perceived cognitive barriers, STIs Perceived social support, and STIs Perceived risks in the experiment group following the intervention compared to before the intervention (p < 0.05).

CONCLUSION

The results of this study showed that a mobile-based educational intervention based on the ISD model had a significant effect on the preventive behaviors of STIs in Iranian women. These results highlight the potential benefit of mobile health in enhancing reproductive health.

TRIAL REGISTRATION

ClinicalTrials.gov IRCT20200602047638N1. Registered on 22 May 2021 with the IRCTID, V1.0. https://www.irct.ir/trial/55632.

Reaching young people living with HIV & AIDS and young people in detention with comprehensive sexuality education (CSE): a preparatory formative study in Ghana

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted.

The male-focused marital relationship enrichment and sexual well-being interventions: A scoping review

Background

There is an increasing need for sexual well-being and health promotion strategies that effectively engage men. Researchers have evaluated the efficacy of sexual and reproductive health-related and marital enhancement interventions in male-dominated societies. However, few have focused on culturally appropriate and gender-specific program effects.

Objective

This review aims to evaluate evidence of existing interventions aimed at enriching marital relationships and sexual well-being in adult men.

Materials and Methods

This scoping review was conducted by searching various databases (CINAHL, PsycINFO, EMBASE, Google Scholar, PubMed, Scopus, SID, and Noormags), and other available resources in both English and Persian languages. We located all publications up to January 2023 with no time restriction. Inclusion criteria were studies targeting men in the enrichment of marital and sexual relationships, which focus on marital/sexual enrichment, sexual and reproductive health (SRH) program, passionate relationship, or sexual satisfaction as the main outcomes. PRISMA guidelines were utilized in this review.

Results

Of records 34,405 retrieved by searching, after removing duplicate articles, 8 articles were included based on the inclusion criteria. SRH program was the main focus of 6 articles. Marital and sexual enhancement were common areas of focus in 2 studies. Research methods included 2 semi-experimental, 3 clinical trials, 1 systematic review, 1 content analysis, and a mixed method. According to the assessment result, 4 articles were moderate and 4 were of high quality.

Conclusion

Our findings reveal that a small number of interventions specifically offering SRH or marital and sexual enhancement programs to men should be conducted. As the majority were heterosexual couples, we recommend male-focused programs recognizing men's sexuality.

A Meta-Analysis of the Effects of Comprehensive Sexuality Education Programs on Children and Adolescents

Childhood and adolescence are crucial periods for developing one's awareness of sexuality. Comprehensive Sexuality Education (CSE) during these stages is essential for overall growth, fostering healthy self-concepts, and addressing diverse sexual issues among children and adolescents globally. A meta-analysis was conducted to analyze the effectiveness of CSE programs. A literature search was performed on EMBASE, PubMed, CINAHL, Cochrane Library, and PsycInfo for studies published before 14 June 2023, and based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We used the Comprehensive Meta-Analysis (CMA, V4) software version 4.0 for the analysis and interpreted the effect sizes according to Cohen's definition. Between 2011 and 2020, 21 studies on CSE were published, with the United States having the most publications (17). Of the 34 studies reviewed, 20 were randomized controlled trials. The primary population for CSE was middle/high school students (15), with the most frequent age range being 10-19 years (26). The overall effect size of CSE was significant (effect size = 1.31, p < 0.001), with cognition (effect size = 5.76, p < 0.001) being the most significant. CSE is an effective educational tool for children and adolescents with a significant impact on variables such as cognition and abstinence. It should be incremental from childhood and adolescence to adulthood.

Shared Components of Worldwide Successful Sexuality Education Interventions for Adolescents: A Systematic Review of Randomized Trials

A crucial aspect of human development is sexuality which has implications for health, particularly in adolescence, since unfavorable sexual experiences may result in physical and mental problems. Sexuality education interventions (SEI) are one of the most used actions to promote sexual health in adolescents. Nevertheless, there is variability across their components; therefore, key elements for an effective SEI targeted at adolescents (A-SEI) are not well known. Based on this background, this study aims to identify the shared components of successful A-SEI through a systematic review of randomized controlled trials (RCT). This study followed the preferred reporting items for systematic reviews and meta-analyses statement. A search was conducted in CINAHL, PsycInfo, PubMed, and Web of Science between November and December 2021. A total of 21 studies passed the inclusion test after the review of 8318 reports. A total of 18 A-SEIs were identified in these studies. The components analyzed were the intervention's approach, dose, type of intervention, theoretical framework, facilitators' training, and intervention methodology. The results established that components that should be present in the design of an effective A-SEI are behavior change theoretical models, the use of participatory methodology, be targeted at mixed-sex groups, facilitators' training, and at least ten hours of weekly intervention.

Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, substance use history, and family environment

Background

University students are known to have risky sexual behaviours (RSBs). The severity of the RSB is influenced by many factors, including the family environment, exposure to adverse childhood events (ACEs), and the use of addictive substances. However, there is limited information about the influence of ACEs and the family environment of these students in low-and medium-income countries (LMICs). Therefore, a pilot study was conducted among university students from a LMIC, Uganda.

Methods

The present study comprised a cross-sectional online survey among Ugandan students at a public university (N = 316; 75% male; 52.2% aged between 18–22 years). The survey included questions relating to socio-demographic information, family environmental information, the Sexual Risk Survey (SRS), and the Adverse Childhood Experiences-International Questionnaire (ACE-IQ).

Results

Over half (53.8%) reported having had sexual intercourse. Males reported over two times higher mean total SRS score compared to females (χ2 = 4.06, p = 0.044). Approximately one-sixth of the sample had drunk alcohol or used illicit psychoactive substances in the past six months (16.1%). Among four regression analysis models, sociodemographic variables predicted the highest variance (13%), followed by family environment variables (10%), and both psychoactive substance use history (past six months) and ACEs individually explained approximately 5% variance in total SRS score, with the final model predicting 33% of the variance in RSB.

Conclusions

The present study demonstrated a gender disparity with males involved in more RSB than females, as has been reported in most previous RSB studies. Family environment, sociodemographic factors, substance use, and ACEs all appear to contribute to RSB among university students. These findings will benefit other researchers exploring factors associated with RSB among university students and will help develop interventions to reduce RSB to protect students from unwanted pregnancies, sexually transmitted diseases, and HIV/AIDS.

Socio-cultural factors influencing adolescent pregnancy in Ghana: a scoping review

Background

Adolescent pregnancy is a public health challenge that has well-defined causes, associated health risks, and social and economic consequences for adolescent, their families, communities, and society. The purpose of this scoping review is to summarize studies published on socio-cultural determinants of adolescent pregnancy in Ghana.

Methods

Search for records was done in four major databases, including PubMed CENTRAL, Science Direct and JSTOR. Records from Google and Google Scholar were also added, and results and findings from published and unpublished studies were included. All the 22 studies that met the eligibility criteria, were critically appraised. The guidelines for conducting scoping reviews by Arksey and O’Malley were followed.

Results

The result revealed that poverty, peer influence, low level of education, dysfunctional family, lack of communication between parents and their daughters, lack of sexual and reproductive health education, child marriage, coerced sex, misconception and non-usage of contraceptives, and decline in cultural values such as puberty rites and virginity inspection are some of the determinants of adolescent pregnancy in Ghana. The study also showed that there is a lack of high-quality observational studies that adjust for confounding variables.

Conclusion

Interventions and policies should be designed to take into consideration the needs, context, and background of adolescents. Programmes to enhance adolescent reproductive health need to consider multilevel factors such as person, family, community, institutions, national, and global issues that affect such programmes.

Determinants of adolescents' contraceptive uptake in Ethiopia: a systematic review of literature

Introduction

Various studies have identified different factors that affect adolescent contraceptive uptake in different parts of Ethiopia. However, varying results were reported across primary studies and those results need to be systematically collated to inform policies. Therefore, this systematic review aimed to synthesize the findings of those primary studies to obtain more robust and representative evidence about adolescent contraceptive uptake in Ethiopia.

Methods

Five databases (MEDLINE via PubMed, Google Scholar, Scopus, Science Direct and CINAHL) were searched for papers published from January 2000 up to June 2021 in English. We limited our search to start on January 2000 as the health of adolescents have been given more attention after this period and to avoid time-lapsed biases. Seven studies were included in this systematic review. We used the Newcastle-Ottawa Scale and the Mixed Methods Appraisal Tool for quality assessment of the selected studies.

Results

Determinants of adolescent contraceptive utilization were focused on four levels: individual, socio-cultural, healthcare service and knowledge related factors. Individual-related factors that influence adolescents’ contraceptive uptake include; being in the age group of 10–15 years, not currently enrolled in school and being from low-income families, while socio-cultural factors include: lack of discussion with family members, arranged marriage, pressure from a partner, harmful traditional practices, discussion with peer groups and sexual partners. Healthcare service-related factors include; lack of information about contraceptives during health facility visits, lack of privacy during service provision and inconvenient service hours at health facilities, and not visiting health facilities, whereas, knowledge related factors include; having knowledge of contraceptive methods and being heard about contraceptives from media. Also, the proportion of adolescent contraceptive uptake ranged from 12 to 79%.

Conclusions

In this systematic, individual, socio-cultural, health-care-related, and knowledge-related characteristics have all been identified as influencing adolescents’ contraceptive uptake in Ethiopia. Hence, integrated interventions aimed at overcoming barriers to adolescent contraceptive uptake would be beneficial to improving adolescent contraceptive utilization in Ethiopia.

Adolescents’ Contraceptive Uptake in Ethiopia: A Meta-Analysis

Introduction. Ethiopia has made significant efforts to enhance family planning services despite variations in the community’s use of modern contraception in different parts of the country. Various studies have reported the proportion and determinant factors of adolescents’ contraceptive uptake in Ethiopia. These studies are not consistent in terms of size, scope, and geographic coverage, and the results need to be systematically collated to inform policies. Therefore, this review was aimed at analyzing the findings of those primary studies to obtain more representative evidence of adolescents’ contraceptive uptake in Ethiopia. Methods. Five databases (MEDLINE via PubMed, Google Scholar, Scopus, ScienceDirect, and CINAHL) were searched for papers published from January 2000 up to June 2022 in English. Of thirty eligible studies, eight papers were included in this meta-analysis. Between-study heterogeneity was evaluated by the forest plot and inconsistency index ( $I^2$ ). A random-effects model was used to calculate the pooled estimates of adolescents’ contraceptive uptake. Results. The overall pooled proportion of adolescents’ contraceptive uptake was 40% ( $I^2=99.70$ , $p\le 0.001$ ; $95\%\text{CI}=19,61$ ). Adolescents’ usage of contraception was influenced by a number of factors: individual-, sociocultural-, knowledge- (about contraceptive methods), and healthcare service-related factors. Individual-related factors include the educational status of adolescents, being of young age, and the income status of adolescents’ families. Sociocultural-related factors comprise discussion with the family/relatives, parent disapproval and pressure from partners, and being married or having a partner. Healthcare service-related factors include the availability of youth clubs and inconvenient service hours for SRH services. Knowing contraceptive methods and SRH services was also positively associated with adolescents’ contraceptive utilization. Conclusions. The proportion of adolescents who used contraception in Ethiopia was 40%. Adolescents’ use of contraceptives was influenced by a variety of factors: individual-, sociocultural-, healthcare-, and knowledge-related factors. Hence, integrated interventions targeted at tackling barriers to contraceptive uptake may be helpful to improve adolescents’ contraceptive utilization in Ethiopia.

The Malay version of the attitudes and beliefs about cardiovascular disease (ABCD-M) risk questionnaire: a translation, reliability and validation study

BACKGROUND

Cardiovascular disease (CVD) and stroke are global public health problems and cause high mortality, especially in low- and middle-income countries. Knowledge and awareness are critical points in managing the risk in the general population. The Attitudes and Beliefs about Cardiovascular Disease (ABCD) risk questionnaire was developed to evaluate the awareness of stroke and CVD risk. Thus, the government can set up a practical risk assessment and management programme. The initiative will encourage people to seek healthcare timely and reduce the possibilities of developing complications.

OBJECTIVE

This study aimed to translate and validate the ABCD risk questionnaire into the Malay language and evaluate the psychometric properties of the Malay version in the general population in Malaysia.

METHODS

The questionnaire was translated using a standard forward-backwards translation method. The validation was perfomed by both expert panels and a potential user group. Next, the exploratory factor analysis was conducted to examine factorial validity. The respondents were selected from the government health clinics and according to the study criteria irrespective of the CVD risk. We used Cronbach's alpha and Raykov's rho to explore the internal consistency and composite reliability of the 18 items from three domains. Finally, the confirmatory factor analysis (CFA) was conducted using a robust maximum likelihood estimator.

RESULTS

The content and face validity indices were determined to be 0.94 and 0.99 respectively. Data were obtained from 179 respondents (mean age, 36.8 years; female, 68.2%; secondary level education, 51.1%). The internal consistency and composite reliability of the domains showed good results ranging from 0.643 to 0.885. The factor loadings of each item were acceptable (> 0.3), and the fit indices from the CFA resulted in a good model fit [χ² (p-value = 0.16), SRMR = 0.054, RMSEA = 0.029, CFI = 0.99, TLI = 0.99)].

CONCLUSIONS

The Malay version of the ABCD risk questionnaire is a valid and reliable tool to assess the awareness of stroke and CVD risk in the general population in Malaysia.

Factors associated with preventive behaviors for COVID-19 among adolescents in South Korea

PURPOSE

COVID-19's infection rate among adolescents is increasing; hence, it is important to prevent it as it can spread in the community through transmission in schools. It is crucial to determine the extent to which adolescents follow COVID-19 preventive measures and identify factors relating to such behaviors to implement more effective health education. This study aimed to understand factors related to COVID-19 preventive behaviors using the theory of planned behavior (TPB) and the health belief model (HBM) among adolescents in South Korea.

DESIGN AND METHODS

A cross-sectional face-to-face questionnaire survey was conducted among 272 adolescents in South Korea. Structural equation modeling was used to examine the relationships between perceived susceptibility, perceived severity, attitude, subjective norms, perceived behavioral control, intention, and COVID-19 preventive behaviors.

RESULTS

Among adolescents' COVID-19 preventive behavior scores, wearing masks was the highest and distancing was the lowest. Adolescents' adherence to COVID-19 preventive behaviors was directly or indirectly associated with their perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention.

CONCLUSIONS

Attention to mitigate social isolation is important to improve compliance with COVID-19 preventive behaviors. Perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention explained 61.3% of adolescents' COVID-19 preventive behaviors, there is a need for education to promote relevant factors.

PRACTICE IMPLICATIONS

To increase adolescent awareness of COVID-19 and increase attitudes, subjective norms, and perceived behavior control, nurses need to provide education including the evidence for COVID-19 preventive behavior to increase adolescents' understanding and active implementation of those behaviors.

Interventions to Promote a Healthy Sexuality among School Adolescents: A Scoping Review

Schools are particularly suitable contexts for the implementation of interventions focused on adolescent sexual behavior. Sexual education and promotion have a multidisciplinary nature. Nurses' role and the spectrum of the carried-out interventions is not clear. We aimed to identify interventions that promote a healthy sexuality among school adolescents. Our review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and was registered in the Open Science Framework. Published articles on sexuality in adolescents in school contexts were considered. The research limitations included primary studies; access in full text in English, Spanish, or Portuguese; and no data publication limitation. Research was carried out on the EBSCOhost, PubMed, SciELO, and Web of Science platforms; gray literature and the bibliographies of selected articles were also searched. A total of 56 studies were included in the sample. The studies used a broad range of research methods, and 10 types of interventions were identified. Multi-interventional programs and socio-emotional interventions showed a greater impact on long-term behavioral changes, and continuity seemed to be a key factor. Long-term studies are needed to reach a consensus on the effectiveness of interventions. Nurses' particular role on the multidisciplinary teams was found to be a gap in the research, and must be further explored.

Nursing Scientific Production on Teenage Pregnancy: An Integrative Review

Objective: To identify, in the national and international scientific literature, the evidence produced by Nursing that provides subsidies to prevent teenage pregnancy. Material and method: An integrative literature review study, based on papers available in the PubMed, BVS, Scopus and Web of Science metabases, and in the Lilacs and BDEnf databases, in Portuguese, English and Spanish languages, published from January 2013 to March 2020. Results: According to the inclusion criteria, 13 articles were selected. The findings are presented in the categories “lower socio-economic conditions”, “knowledge, attitudes and cultural aspects” and “sexual education and specialized services”. Conclusions: Teenage pregnancy is strongly associated with poverty and other socio-economic issues. Gender relations, communication about sex education in the family and other cultural aspects were found in the discussions, which indicates their impact on this phenomenon. Interventions involving sex education are shown as an alternative to cope. The presence of the nurse at the places that assist or concentrate adolescents can be a great element to reduce pregnancy rates in this phase.