1
|
Ramalepa TN, Netangaheni TR. A scoping review of strategies for adolescents' sexual and reproductive health role modelling. S Afr Fam Pract (2004) 2024; 66:e1-e9. [PMID: 38708753 PMCID: PMC11151353 DOI: 10.4102/safp.v66i1.5859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/22/2023] [Accepted: 01/24/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Individuals strive to maintain their sexual and reproductive health (SRH) by being exposed to correct information, having access to contraceptives, and promoting safe sex practices. Adolescent SRH promotion efforts should consider the influence of role models. This review explored the availability and nature of strategies and programmes on adolescents' SRH role modelling and described them using a scoping review. METHODS Studies were retrieved from four databases and grey literature through a search of 223 studies. The databases included EBSCO-host, Medline, Sabinet, and Pubmed. Data extraction was guided by a data-extraction tool adapted from the JBI Manual for Evidence Synthesis. The characteristics of the selected studies were recorded in a Microsoft spreadsheet. Eleven studies published between 2014 and 2022 were included for the final review and analysed using thematic analysis. RESULTS Selected articles focused on adolescents' SRH; however, only two studies focused particularly on role modelling. Nonetheless, some aspects of the findings and recommendations presented could be extrapolated to adolescents' SRH role modelling. This includes adolescent-parent communication on SRH, community engagement, mentoring, positive role modelling, and information sharing through media campaigns. CONCLUSION There is a lack of literature on SRH role modelling because most studies did not focus on role modelling as an aspect of SRH. Therefore, research needs to be conducted on strategies and programmes focusing on SRH modelling.Contribution: The findings of this scoping review may encourage the development and implementation of strategies and programmes targeting adolescents' SRH throughout diverse communities to promote adolescent SRH.
Collapse
Affiliation(s)
- Tshiamo N Ramalepa
- Department of Nursing Science, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Tshwane.
| | | |
Collapse
|
2
|
Dimitrova E, Kotzeva T. Adolescent risk behaviours and family settings in Bulgaria: An evidence-based approach to effective family support policies. JOURNAL OF MOTHER AND CHILD 2022; 25:139-150. [PMID: 35143718 PMCID: PMC9097663 DOI: 10.34763/jmotherandchild.20212503si.d-21-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/22/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND The paper focuses on Bulgarian adolescents' behaviours that put their health at risk and their relationship to family-related characteristics: structure of family and material status, family support, communication with parents, parental monitoring and school-related parental support. It also discusses intervention programs with a focus on parent support gradient. MATERIAL AND METHODS The analysis is based on the Bulgarian sample of Health Behaviour in School-Aged Children survey, the 2018 round. Logistic regression models of current cigarette smoking, regular alcohol consumption, sexual debut and current cannabis use are applied. Main national programs on adolescent health and the parental involvement component in them are also discussed. RESULTS The statistical analyses reveal significant gender and age differences in Bulgarian adolescents' health risk behaviours. Girls have significantly higher odds of smoking and are less likely to report an early start of sexual life. Odds of cigarette smoking and regular alcohol consumption increase with age. Children living with one parent have significantly higher odds of smoking, regular alcohol consumption and current cannabis use. Interactions between FAS and family support reveal that students who report low family support, regardless of the material status of the family, have significantly higher odds of health risk behaviours. CONCLUSION The main contribution of the analysis reveals the alleviating effect of family support on socio-economic inequalities between families. An evidence-based approach delineating a preventive potential of family support on Bulgarian adolescents' health risk behaviours despite the level of family affluence provides solid arguments for increasing national family support programs.
Collapse
Affiliation(s)
- Elitsa Dimitrova
- Institute for Population and Human Studies – Bulgarian Academy of Sciences & Plovdiv University Paisii HilendarskiPlovdivBulgaria, E-mail:
| | - Tatyana Kotzeva
- Burgas Free University & Institute for Population and Human Studies – Bulgarian Academy of SciencesBurgasBulgaria
| |
Collapse
|
3
|
Farah D, Andrade TRM, Di Bella ZIKDJ, Girão MJBC, Fonseca MCM. Current evidence of contraceptive uptake, pregnancy and continuation rates in young women: a systematic review and Meta-analysis. EUR J CONTRACEP REPR 2021; 25:492-501. [PMID: 33140990 DOI: 10.1080/13625187.2020.1833187] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Half of all pregnancies worldwide are unintended, and the rate is even higher in women aged ≤25 years. We sought to identify which method of contraception was the most effective option to prevent unintended pregnancy in young women and adolescents. METHODS Systematic searches, without language restrictions, were carried out of the PubMed, Embase, Lilacs and Cochrane databases from inception to July 2020. Abstracts and full-text articles of observational studies and randomised controlled trials comparing the use of multiple methods of long-acting reversible contraception (LARC) and short-acting reversible contraception (SARC) in young women and adolescents were screened and reviewed. Risk ratios (RRs) and mean differences with their 95% confidence interval (CI) were derived using a random-effects meta-analytical model. Meta-analyses provided pooled estimates for adverse events, continuation rates and efficacy of LARC methods in young women and adolescents. Nine of the 25 included studies compared LARC with SARC, and 16 compared LARC methods only. RESULTS At 12 months, young women had better adherence with LARC compared with SARC (n = 1606; RR 1.60; 95% CI 1.21, 2.12; I 2 = 88%), which suggests a better unintended pregnancy prevention outcome for young women. However, more young women chose SARC (n = 2835; RR 0.37; 95% CI 0.17, 0.80; I 2 = 99%). Pregnancy during LARC use was rare. CONCLUSION LARC methods are the most efficacious in preventing pregnancy, and women should be informed of this if pregnancy prevention is their priority. The evidence, however, is of low quality. PROSPERO REGISTRATION NUMBER CRD42017055452.
Collapse
Affiliation(s)
- Daniela Farah
- Health Technologies Assessment Centre, Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Teresa Raquel Moraes Andrade
- Health Technologies Assessment Centre, Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Manoel João Batista Castello Girão
- Health Technologies Assessment Centre, Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Marcelo Cunio Machado Fonseca
- Health Technologies Assessment Centre, Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Gynaecology, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
4
|
Bourdeau B, Miller BA, Byrnes HF, Woodall WG, Buller DB, Grube JW. Efficacy of a Web-Based Intervention (Smart Choices 4 Teens) for Facilitating Parent-Adolescent Communication About Relationships and Sexuality: Randomized Controlled Trial. JMIR Pediatr Parent 2021; 4:e19114. [PMID: 34128818 PMCID: PMC8277347 DOI: 10.2196/19114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/04/2020] [Accepted: 04/18/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND There is a need for interventions that promote healthy decision making among adolescents and leverage the ongoing impact of parental relationships through older adolescence and young adulthood. These interventions should maximize adolescent engagement and be easily accessible to families in terms of cost, duration, and logistics related to participation. OBJECTIVE This study aims to test the efficacy of the healthy relationships and sexual decision-making component of a web-based intervention for older adolescents and their parents, ascertain whether the efficacy varies by gender, and assess its efficacy over time. METHODS A randomized controlled trial was conducted for the web-based, self-paced intervention Smart Choices 4 Teens from 2014 to 2015. Families (N=411) with adolescents aged 16-17 years were randomly assigned to the intervention or control condition. Surveys assessing aspects of sexual communication were administered at baseline and at 6, 12, and 18 months. Generalized estimating equations were used to determine the impact of exposure to the relationships component of the intervention on sexual communication by parents, as reported by adolescents. RESULTS Less than half (88/206, 42.7%) of the intervention group participated in the third and final intervention component, which was focused on relationships and sexual decision making. Participation in the relationships component increased the frequency of parental sexual communication and increased the number of dating rules after accounting for other significant adolescent characteristics. The impact of the intervention varied little by gender, although it did demonstrate an impact on communication reports over the follow-up survey administrations. CONCLUSIONS Smart Choices 4 Teens demonstrated efficacy in increasing the frequency of sexual communication between parents and adolescents in the long term. TRIAL REGISTRATION ClinicalTrials.gov NCT03521115; https://clinicaltrials.gov/ct2/show/NCT03521115.
Collapse
Affiliation(s)
- Beth Bourdeau
- Division of Prevention Science, University of California San Francisco, San Francisco, CA, United States
| | - Brenda A Miller
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, United States
| | - Hilary F Byrnes
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, United States
| | | | | | - Joel W Grube
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, United States
| |
Collapse
|
5
|
Trauma exposure and adolescent attitudes toward having a baby: An exploratory survey. Contracept X 2021; 3:100058. [PMID: 33665605 PMCID: PMC7907236 DOI: 10.1016/j.conx.2021.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives To examine the association between childhood trauma exposure (i.e., extent of interpersonal trauma experienced in childhood) and attitudes toward teen parenthood. Study design We used a cross-sectional sample of 416 urban middle and high school male and female students from Tulsa, OK recruited through a local public school district mailing list. Multinomial logistic regression analyses were used to examine odds of reporting having a baby would make life worse, better, or cause no change according to childhood trauma score. Results Approximately 8% of students and their guardians responded to the mailed survey invitation. Among the students, 67% reported having a baby would make their lives worse; 17% reported it would not change their lives much, and 16% reported having a baby would make their lives better. Each increase in trauma score was associated with a 9% increase in reporting an indifferent attitude (p < 0.001) and a 15% increase in reporting a positive attitude toward having a baby (p < 0.01). After controlling for a wide range of sociodemographic, attitudinal, and sexual history variables, childhood trauma remained associated with a positive attitude toward having a baby (p<.01), but not an indifferent attitude toward having a baby. Conclusions Greater childhood trauma exposure is associated with indifferent and positive attitudes toward having a baby during adolescence. Implications Screening for childhood trauma and utilizing interventions designed to reduce the harmful effects of trauma exposure in childhood may offer a more targeted approach to adolescent pregnancy prevention strategies.
Collapse
|
6
|
Fair CD, Albright JN, Varney O. US Provider Perceptions of Differences in the Sexual and Reproductive Health Needs of Adolescents with Perinatally Acquired and Behaviorally Acquired HIV: A Mixed Methods Study. AIDS Patient Care STDS 2019; 33:440-448. [PMID: 31524504 DOI: 10.1089/apc.2019.0108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study explores health care providers' perceptions of similarities and differences in the sexual and reproductive needs of adolescents with perinatally acquired HIV (PHIV) and behaviorally acquired HIV (BHIV). Interviews (n = 13) and online surveys (n = 46) were completed by medical and social service providers (n = 30, n = 29, respectively) who care for adolescents with HIV. Eligible providers were recruited using snowball sampling. Responses to open-ended questions were coded for emergent themes. Sixty-eight percent of participants perceived differences in the sexual and reproductive health needs of adolescents with PHIV and BHIV. Differences included factors related to psychosocial, sexual, and medical needs. Providers believed adolescents with PHIV had integrated their diagnosis into their identity, were more adept at communicating with providers, and were more sexually cautious than youth with BHIV. Providers perceived adolescents with BHIV as more comfortable discussing sex-related issues, and suggested youth with PHIV were more comfortable accessing health care. Adolescents with PHIV were thought to have complex medical histories/treatment and greater knowledge of illness/medications. Existing research on adolescent-reported sexual and reproductive health knowledge and experiences in care suggests that provider and adolescent perspectives do not always align. Mode of transmission may provide some information about psychosocial functioning and sexual behavior. However, assumptions about sexual and reproductive health needs based solely on mode of transmission may contribute to gaps in sexual and reproductive health care. Future research is needed to examine whether these differing perspectives indeed lead to discrepancies in the care provided to adolescents with HIV.
Collapse
Affiliation(s)
- Cynthia D. Fair
- Department of Public Health Studies, Elon University, Elon, North Carolina
| | - Jamie N. Albright
- Clinical Psychology, University of Virginia, Charlottesville, Virginia
| | - Olivia Varney
- School-Based Outpatient Therapy, T.W. Ponessa and Associates, Mountville, Pennsylvania
| |
Collapse
|
7
|
Yakubu I, Garmaroudi G, Sadeghi R, Tol A, Yekaninejad MS, Yidana A. 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. Reprod Health 2019; 16:124. [PMID: 31416450 PMCID: PMC6694566 DOI: 10.1186/s12978-019-0784-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 07/29/2019] [Indexed: 12/28/2022] Open
Abstract
Background Adolescent pregnancy is a worldwide problem because of its health, social, economic and political repercussions on the globe. Even though the rates of adolescent pregnancy have declined over the decade, there is still unacceptably high rates especially in lower and middle-income countries including Ghana. Although the problem has been widely investigated, there is little information on the effectiveness of different methods to improve adolescent sexual abstinence based on theoretical models. This study is aimed to assess an educational intervention program on sexual abstinence based on the Health Belief Model (HBM) among adolescent girls in Northern Ghana. Methods A cluster randomized control trial was conducted in Ghana from April to August 2018. Participants within the ages of 13–19 years were enrolled voluntarily from six randomly selected Senior High Schools (3 for intervention and 3 for control). A total of 363 adolescent were enrolled. A self-structured questionnaire was administered to both groups of participants at baseline and endpoint of the study. Control participants received their normal classes whiles the intervention group additionally received comprehensive sexuality education for 1 month. Qualified midwives conducted the health education program. At least two sessions were conducted for each participating class weekly. The lessons focused on perceived susceptibility, perceived severity of adolescent pregnancy, perceived benefits, perceived barriers to adolescent pregnancy prevention, personal and family values, perceived self-efficacy and knowledge of contraceptives. Educational strategies such as discussions, demonstrations, role-play and problem solving techniques were used to deliver the lessons. Sexual abstinence was the outcome variable of the study and it was measured after 3 months of the intervention. Binary logistic regression was used to assess the impact of the intervention on sexual abstinence practice. Results At baseline, there was no difference between control and intervention groups. The mean score of Knowledge and attitude for control were (58.17 and 139.42) and intervention (60.49 and 141.36) respectively. Abstinence practice was 69.4% for control and 71.6% in the intervention group. However, after the intervention, the mean score of knowledge and attitude for control were (87.58 and 194.12) respectively. Sexual abstinence in the control was 84.4% and intervention was 97.3% respectively. The educational interventions resulted in a significant difference in sexual abstinence between intervention and control groups (OR = 13.89, 95% Confidence Interval (2.46–78.18, P < 0.003). Conclusion Educational intervention, which was guided by HBM, significantly improved sexual abstinence and the knowledge of adolescents on pregnancy prevention among the intervention group. Provision of comprehensive sex education guided by behavioural theories to adolescents at Senior High Schools in Ghana is recommended. Trial registration This trial was retrospectively registered in Protocol Registration and Results System (PRS) with trial number NCT03384251.
Collapse
Affiliation(s)
- Ibrahim Yakubu
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran. .,Department of Nursing, Nursing and Midwifery Training College, Gushegu, Ghana.
| | - Gholamreza Garmaroudi
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Azar Tol
- Department of Health Education And Promotion, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health Tehran University of Medical Sciences, Tehran, Iran
| | - Adadow Yidana
- Department of Community Health and Family Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
| |
Collapse
|
8
|
Crocker BCS, Pit SW, Hansen V, John-Leader F, Wright ML. A positive approach to adolescent sexual health promotion: a qualitative evaluation of key stakeholder perceptions of the Australian Positive Adolescent Sexual Health (PASH) Conference. BMC Public Health 2019; 19:681. [PMID: 31159767 PMCID: PMC6547521 DOI: 10.1186/s12889-019-6993-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 05/16/2019] [Indexed: 06/10/2024] Open
Abstract
Background Positive youth development (PYD) models are effective in improving adolescent sexual health. Adolescent programs including peer educators, parents and the wider community also demonstrate effectiveness in improving sexual health outcomes. An innovative Positive Adolescent Sexual Health (PASH) Conference model has been introduced in Northern NSW, Australia. It is run by the North Coast PASH Consortium, which is based on a health promotion framework. It takes a positive and holistic approach to sexual health education, and incorporates peer educators, parents, community workers and teachers. This study provides an introductory evaluation of the PASH Conference and identifies areas for increased effectiveness. It is intended as an early piece of research to inform future evaluations and to provide introductory information for public health educators. Methods Data collection included semi-structured interviews with 13 key stakeholders of the PASH Conference. Interviews were recorded, transcribed verbatim and analysed using deductive thematic analysis. Results Subjects included 2 teachers, 2 parents, 2 youth conference workers, 2 organisers, 2 presenters and 3 Peer Educators engaging Peers (PEEPs). Stakeholders perceived that young people were engaged to strengthen their sexual health and wellbeing due to many factors. These followed 3 themes: a safe and open learning environment, empowerment of young people and involvement of the support system and broader community. Multiple recommendations were identified across 2 themes: changes to conference format and planning, and enhancing stakeholder engagement. Discussion The PASH Conference is a promising new youth development design promoting positive adolescent sexual health, which may provide a feasible model for public health educators to trial. Elements of the conference identified as engaging to youth align well with those in PYD research literature. This study provides an early piece of research to inform the design of future research on the PASH Conference including evaluation of behavioural outcomes. It provides introductory information to inform PASH Conference development to further increase its effectiveness. Electronic supplementary material The online version of this article (10.1186/s12889-019-6993-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | - Sabrina W Pit
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, POBox 3074, Lismore, NSW, 2480, Australia. .,Sydney School of Public Health, University Of Sydney, Sydney, Australia.
| | - Vibeke Hansen
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, POBox 3074, Lismore, NSW, 2480, Australia
| | - Franklin John-Leader
- Harm Reduction and Health Promotion Programs, HIV and Related Programs (HARP), North Coast Public Health, Mid-North Coast Local Health District, Lismore, Australia
| | | |
Collapse
|
9
|
Havaei M, Salehi L, Akbari-Kamrani M, Rahimzadeh M, Esmaelzadeh-Saeieh S. Effect of education based on protection motivation theory on adolescents' reproductive health self-care: a randomized controlled trial. Int J Adolesc Med Health 2019; 33:/j/ijamh.ahead-of-print/ijamh-2018-0195/ijamh-2018-0195.xml. [PMID: 30753161 DOI: 10.1515/ijamh-2018-0195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 09/06/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adolescents should be empowered to improve their reproductive and sexual health needs. The present study aimed to investigate effects of protection motivation theory-based education on student girls' reproductive and sexual health self-care. METHODS This randomized controlled trial was conducted in parallel on 90 female students living in dormitories of the Alborz University of Medical Sciences in Iran. The data collection lasted from January 2017 to May 2018. Convenience sampling was performed, and samples were put into intervention and control groups by block randomization. The intervention group received six educational sessions based on the protection motivation theory(PMT). The data collection tool of this research consisted of the protection motivation theory and reproductive health self-care questionnaires. RESULTS There was no significant difference between control and intervention groups in demographic characteristics. The results of the repeated measures test indicated that the reproductive health self-care variable had a significant change (p = 0.000), and there was a significant difference between groups (p = 0.000). The total score of the Protection Motivation Theory Questionnaire was not changed over time (p = 0.54) and there was no significant difference between groups (p = 0.51) according to results of the repeated measures test. CONCLUSION According to effects of an educational intervention based on the protection motivation theory, it is suggested to utilize this model as an educational framework for adolescents' reproductive and sexual health by healthcare providers, schools and universities as well as holding periodic courses educating adolescents within short-term intervals in order to achieve the higher sustainability of the educational results.
Collapse
Affiliation(s)
- Marjan Havaei
- Student research committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Leili Salehi
- School of Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Akbari-Kamrani
- School of Medical Sciences, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mitra Rahimzadeh
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Sara Esmaelzadeh-Saeieh
- School of Medical Sciences, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| |
Collapse
|
10
|
Diamant-Wilson R, Blakey JM. "Strap up:" Sexual socialization and safer sex practices among African American youth in foster care. CHILD ABUSE & NEGLECT 2019; 88:466-477. [PMID: 30420293 DOI: 10.1016/j.chiabu.2018.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 06/09/2023]
Abstract
Adolescent sexual health is often reflected through a problem-oriented lens. This serves to reinforce prevailing sexual scripts and cultural images of disenfranchised youth. Very little is known about the support young people in foster care, particularly youth of color, need to stay sexually healthy and safe. This article presents data on the sources and types of sexual socialization experiences that supported African American transitional age youth in foster care to protect against sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Eighteen African American participants (18 to 21-years old) who reported condom use in two quantitative interviews were selected to participate in a qualitative interview. A mapping exercise and thematic analyses were used to identify the participants' sources of support and sexual socialization experiences. The study's findings indicated the youth had a combination of informal and formal sources that conveyed four types of STI/HIV prevention messages: Effective, Affective, Affinity, & Tangible. The majority of the participants (83%) received all four types of STI/HIV prevention messages from adult, partner and/or peer sources. Sources who motivated the participants the most to protect against STIs/HIV had a strong relationship with the youth and communicated openly about safer sex practices. Results of this study provide implications for future research as well as indications for practice that may be incorporated into training for child welfare practitioners, foster parents, kinship caregivers, and others who encounter youth in foster care.
Collapse
Affiliation(s)
- Roni Diamant-Wilson
- University of Wisconsin-Milwaukee Helen Bader School of Social Welfare, 2400 E. Hartford Avenue, 1165 Enderis Hall, Milwaukee, WI, 53211, USA.
| | - Joan M Blakey
- Tulane University School of Social Work, 127 Elk Place, New Orleans, LA, 70112, USA.
| |
Collapse
|
11
|
Smith S, Platt JM, Clifford D, Preston M, Satterwhite C, Kelly PJ, Ramaswamy M. A State-Level Examination of School Nurses' Perceptions of Condom Availability Accompanied by Sex Education. J Sch Nurs 2019; 36:386-393. [PMID: 30669935 DOI: 10.1177/1059840518824728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
School nurses are often sources of health-care support for teens with sexually transmitted infections (STIs) and unintended pregnancies. However, providing prevention (e.g., condoms) and teaching technical skills (e.g., condom use) needed to reduce high-risk sexual behavior may require a change in perceptions and policies. This study used a cross-sectional study design to assess nurses' perceptions of condom availability accompanied by sex education programs among high school nurses (n = 87) in Kansas. Results showed that school nurses in this study supported condom availability, were comfortable providing condoms, and felt condom availability was within the scope of their job but were less likely to provide condoms because of external barriers. Common barriers include administration, parents, cost, community support, and policies. School nurses, by virtue of their access to the majority of Kansas' adolescents, have the potential to provide sex education and tools such as condoms, so young people can prevent STIs and unintended pregnancies.
Collapse
Affiliation(s)
- Sharla Smith
- Department of Preventive Medicine and Public Health, 8586University of Kansas, Wichita, KS, USA
| | - Joey M Platt
- Montefiore Medical Center, 2006Albert Einstein College of Medicine, Bronx, NY, USA
| | - Daniel Clifford
- Public Health Performance Division, Sedgwick County Division of Health, Wichita, KS, USA
| | - Michael Preston
- Department of Surgery, College of Medicine, 155638University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Catherine Satterwhite
- Department of Preventive Medicine and Public Health, 12251University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Megha Ramaswamy
- Department of Preventive Medicine and Public Health, 12251University of Kansas Medical Center, Kansas City, KS, USA
| |
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW In recent years, pregnancy and birth rates among adolescents in the United States have declined to all-time lows, although adolescents in the United States continue to have the highest rate of unintended pregnancy among developed countries. Contraception is a key component in the prevention of unintended pregnancy. In this review, we outline unique barriers to reproductive healthcare for adolescents and strategies to optimally address the contraceptive needs of adolescents. RECENT FINDINGS Adolescents face barriers such as confidentiality, cost, and access when seeking contraception. Counseling about options for contraception may involve parents or guardians when appropriate, but an adolescent's autonomy should be respected in the decision-making process. Contraceptive counseling for adolescents must not be coercive in nature. Adolescents are at an increased risk for acquisition of sexually transmitted infections, and dual use, the use of condoms and an additional method of contraception, is highly recommended. Initiatives that remove the common barriers of cost and access have demonstrated significant success in increasing the use of long-acting reversible contraceptive methods and reducing the rates of unintended pregnancy among adolescents. SUMMARY Counseling adolescents about contraception requires acknowledgement of the unique barriers that adolescents face and facilitating decision-making about contraceptive methods in a manner that prioritizes the adolescent's autonomy.
Collapse
|
13
|
Glick P, Al-Khammash U, Shaheen M, Brown R, Goutam P, Karam R, Linnemayr S, Massad S. Health risk behaviours of Palestinian youth: findings from a representative survey. EASTERN MEDITERRANEAN HEALTH JOURNAL 2018; 24:127-136. [PMID: 29748941 PMCID: PMC9206082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 05/15/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is little systematic information about health risk behaviours among youth in Middle Eastern countries, leaving public health authorities unprepared to deal with emerging public health threats at a time of major social change. AIM The Palestinian Youth Health Risk study investigates patterns of risk behaviours among Palestinian youth, their perceptions of the risks and benefits of such behaviours, and the relationship of exposure to violence with mental health and engagement in risk behaviours. METHODS We conducted a representative survey among 2500 individuals aged 15-24 years in the West Bank and East Jerusalem, permitting reliable comparison across sex and rural-urban divisions. A stratified 2-stage random sample was drawn from the 2007 population census, with strata formed by crossing the 12 governorates with urban, rural and refugee camp locations. Within strata, 208 survey clusters were sampled with probability proportional to size. Within each cluster, 14 households with youth of the appropriate age were sampled. RESULTS Among youth aged 20-24 years, 22.4% of males and 11.6% of females reported trying alcohol; 10.5% of males and 4.3% of females reported trying drugs. Almost one quarter of unmarried youth aged 20-24 years reported any sexual experience. Tobacco use is high, even among younger youth (45.4% of males and 21.2% of females aged 15-19 smoke). Risk behaviours are higher among males, older youth and in urban areas and refugee camps. CONCLUSION While smoking is of particular concern, prevention outreach for all behaviours should be directed at subgroups and areas identified as highest risk.
Collapse
Affiliation(s)
- Peter Glick
- RAND Corporation, Santa. Monica, California, United States of America
| | - Umaiyeh Al-Khammash
- Juzoor for Health and Social Development, Ramallah, West Bank.,United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), East Jerusalem, Palestine
| | | | - Ryan Brown
- RAND Corporation, Santa. Monica, California, United States of America
| | - Prodyumna Goutam
- RAND Corporation, Santa. Monica, California, United States of America
| | - Rita Karam
- RAND Corporation, Santa. Monica, California, United States of America
| | | | - Salwa Massad
- United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), East Jerusalem, Palestine.,Palestinian National Institute of Public Health, West Bank
| |
Collapse
|
14
|
Rojas R, Castro FD, Villalobos A, Allen-Leigh B, Romero M, Braverman-Bronstein A, Uribe P. [Comprehensive sexual education in Mexico: an analysis of coverage, comprehensiveness and continuity of contents in Mexican public and private schools]. SALUD PUBLICA DE MEXICO 2018; 59:19-27. [PMID: 28423106 DOI: 10.21149/8411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 06/24/2016] [Indexed: 11/06/2022] Open
Abstract
Objective: To analyze coverage of comprehensive sex education (CSE) in high schools in Mexico and describe whether it is comprehensive, homogeneous and has continuity based on student reports of exposure to topics in three dimensions: reproductive and sexual health, self-efficacy and rights and relations. Materials and methods: Within a probabilistic, cross-sectional survey with stratified, cluster sampling, a nationally representative sample of 3 824 adolescents attending 45 public and private high-schools in urban and rural areas completed questionnaires on CSE. Results: The proportion of adolescents reporting having received sex education from school personnel varies depending on topics and grade level. Topics most frequently covered are those related to sexual and reproductive health while rights and relations are least frequently dealt with. Most sex education topics are covered during junior high school and much less frequently in elementary or high school. Conclusions: CSE needs to be comprehensive and homogenous in terms of content, ensure inclusion of priority topics, meet national and international recommendations, ensure continuity and adapt contents to student age through all education levels.
Collapse
Affiliation(s)
- Rosalba Rojas
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. México
| | - Filipa de Castro
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. México
| | - Aremis Villalobos
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. México
| | - Betania Allen-Leigh
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. México
| | - Martin Romero
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. México
| | | | - Patricia Uribe
- Centro Nacional para la Prevención y el Control del VIH y el Sida. México
| |
Collapse
|
15
|
de Castro F, Rojas-Martínez R, Villalobos-Hernández A, Allen-Leigh B, Breverman-Bronstein A, Billings DL, Uribe-Zúñiga P. Sexual and reproductive health outcomes are positively associated with comprehensive sexual education exposure in Mexican high-school students. PLoS One 2018; 13:e0193780. [PMID: 29554152 PMCID: PMC5858848 DOI: 10.1371/journal.pone.0193780] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/16/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives To describe the comprehensive sex education (CSE) coverage and to evaluate a set of indicators related to knowledge, attitudes, and practices associated with the seven components of the CSE framework among Mexican high-school students. Methods We conducted a cross-sectional survey of a nationally representative sample of students in public and private high schools in Mexico. Questions about CSE coverage and about knowledge, attitudes, and practices related to sexual health were included. We present descriptive statistics for demographic characteristics, exposure to CSE, and sexual health outcomes. We fitted a series of multivariate logistic regression models to examine the association between each CSE component exposure and sexual health outcomes, adjusting for age and sex. Results There were significant associations between being exposed to each CSE components and the related sexual health outcomes. The strongest one was for identifying effective contraceptives among those exposed to the Sexual and Reproductive Health component (SRH) (OR 4.10; 95%CI[2.93,5.75]). Also, students exposed to the relationships component had 20% higher odds of affirming they could convince their partner to use condoms (OR 1.20; 95%CI[1.05,1.36]). Conclusions This paper provides evidence of the potential beneficial effects of CSE on attitudes, knowledge, and behaviors regarding sexual and reproductive health among adolescents. In addition, it identifies areas that should be strengthened to increase the positive impact of CSE.
Collapse
Affiliation(s)
- Filipa de Castro
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Rosalba Rojas-Martínez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
- * E-mail: (RRM); (ABB)
| | | | - Betania Allen-Leigh
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Ariela Breverman-Bronstein
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
- * E-mail: (RRM); (ABB)
| | | | | |
Collapse
|
16
|
Abstract
Abortion is common. Data on abortion rates are inexact but can be used to explore trends. Globally, the estimated rate in the period 2010-2014 was 35 abortions per 1000 women (aged 15-44 years), five points less than the rate of 40 for the period 1990-1994. Abortion laws vary around the world but are generally more restrictive in developing countries. Restrictive laws do not necessarily deter women from seeking abortion but often lead to unsafe practice with significant mortality and morbidity. While a legal framework for abortion is a prerequisite for availability, many laws, which are not evidence based, restrict availability and delay access. Abortion should be available in the interests of public health and any legal framework should be as permissive as possible in order to promote access. In the absence of legal access, harm reduction strategies are needed to reduce abortion-related mortality and morbidity. Abortion can be performed surgically (in the first trimester, by manual or electric vacuum aspiration) or with medication: both are safe and effective. Cervical priming facilitates surgery and reduces the risk of incomplete abortion. Diagnosis of incomplete abortion should be made on clinical grounds, not by ultrasound. Septic abortion is a common cause of maternal death almost always following unsafe abortion and thus largely preventable. While routine follow-up after abortion is unnecessary, all women should be offered a contraceptive method immediately after the abortion. This, together with improved education and other interventions, may succeed in reducing unintended pregnancy.
Collapse
MESH Headings
- Abortion, Criminal/adverse effects
- Abortion, Criminal/mortality
- Abortion, Criminal/prevention & control
- Abortion, Incomplete/diagnosis
- Abortion, Incomplete/mortality
- Abortion, Incomplete/therapy
- Abortion, Induced/adverse effects
- Abortion, Induced/legislation & jurisprudence
- Abortion, Induced/mortality
- Abortion, Induced/trends
- Abortion, Septic/diagnosis
- Abortion, Septic/mortality
- Abortion, Septic/prevention & control
- Abortion, Septic/therapy
- Adolescent
- Adult
- Congresses as Topic
- Female
- Global Health
- Harm Reduction
- Health Services Accessibility
- Humans
- International Agencies
- Maternal Mortality
- Pregnancy
- Pregnancy, Unplanned
- Reproductive Medicine/methods
- Reproductive Medicine/trends
- Young Adult
Collapse
|
17
|
Bowring AL, Wright CJC, Douglass C, Gold J, Lim MSC. Features of successful sexual health promotion programs for young people: findings from a review of systematic reviews. Health Promot J Austr 2018; 29:46-57. [PMID: 29700941 DOI: 10.1002/hpja.3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/22/2017] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED Young people have a high burden of sexual and reproductive health (SRH) problems, and it is important to reach this group through health promotion initiatives. We conducted a systematic review of reviews to identify successful elements of health promotion programs for improving SRH of young people. METHODS We identified and collated systematic reviews published in 2005-2015 which focused on young people (10-24 years), reported on SRH outcomes (pregnancy, sexually transmissible infections, condoms/contraceptive use, risky sexual behaviour, sexual healthcare access or intimate partner violence), and included primary studies predominantly conducted in high-income countries. This report focuses on features of successful SRH programs identified in the interpretation and discussion of included systematic reviews. RESULTS We identified 66 systematic reviews, of which 37 reported on program features which were anecdotally or statistically associated with improved program effectiveness and success. Common features of effective interventions were: longer term or repeated implementation; multi-setting and multi-component; parental involvement; culturally/gender/age appropriate; and inclusion of skills-building. SO WHAT?: There is marked consistency of features improving SRH program effectiveness for young people despite the wide variation in interventions reviewed. There is a need to better implement this knowledge in future programs, and our findings provide useful guidance for optimising the design of SRH interventions for young people.
Collapse
Affiliation(s)
| | - Cassandra J C Wright
- Burnet Institute, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Caitlin Douglass
- Burnet Institute, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Judy Gold
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
18
|
Green J, Oman RF, Vesely SK, Cheney M, Carroll L. Beyond the Effects of Comprehensive Sexuality Education: The Significant Prospective Effects of Youth Assets on Contraceptive Behaviors. J Adolesc Health 2017; 61:678-684. [PMID: 28974359 DOI: 10.1016/j.jadohealth.2017.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/30/2017] [Accepted: 06/30/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the study was to prospectively determine if youth assets were significantly associated with contraception use after accounting for the effects of youths' exposure to comprehensive sexuality education programming. METHODS Prospective associations between youth asset scores, comprehensive sexuality education topics received, type of contraceptive used, and consistent contraceptive use were analyzed using multinomial and binomial logistic regression in a sample of 757 sexually active youth. RESULTS Higher youth asset scores were associated with condom use (adjusted odds ratio [AOR] = 1.51, 95% CI = 1.01-2.28), hormonal birth control use (AOR = 2.71, 95% CI = 1.69-4.35), dual method use (AOR = 2.35, 95% CI = 1.44-3.82), and consistent contraceptive use (AOR = 1.97, 95% CI = 1.38-2.82). After controlling for youths' experience with comprehensive sexuality education, higher youth asset scores remained a significant predictor of hormonal birth control use (AOR = 2.09, 95% CI = 1.28-3.42), dual method use (AOR = 2.58, 95% CI = 1.61-4.15), and consistent contraceptive use (AOR = 1.95, 95% CI = 1.36-2.80). CONCLUSIONS Youth serving organizations that are interested in preventing teen pregnancy should consider widespread implementation of evidence-based youth development programs that focus on building and strengthening specific youth assets.
Collapse
Affiliation(s)
| | - Roy F Oman
- School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada.
| | - Sara K Vesely
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Marshall Cheney
- Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma
| | - Leslie Carroll
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center/OU-Tulsa, Tulsa, Oklahoma
| |
Collapse
|
19
|
Layzer C, Rosapep L, Barr S. Student Voices: Perspectives on Peer-to-Peer Sexual Health Education. THE JOURNAL OF SCHOOL HEALTH 2017; 87:513-523. [PMID: 28580671 DOI: 10.1111/josh.12519] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/03/2016] [Accepted: 01/28/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND This process study is a companion to a randomized evaluation of a school-based, peer-led comprehensive sexual health education program, Teen Prevention Education Program (Teen PEP), in which 11th- and 12th-grade students are trained by school health educators to conduct informative workshops with ninth-grade peers in schools in North Carolina. The process study was designed to understand youth participants' perspectives on the program in order to gain insight into program effectiveness. METHODS This is a mixed-methods study in 7 schools, with online surveys (N = 88) and 8 focus groups with peer educators (N = 116), end-of-program surveys (N = 1122), 8 focus groups with ninth-grade workshop participants (N = 89), and observations of the Teen PEP class and workshops during the semester of implementation in each school, 2012-2014. RESULTS Both peer educators and ninth graders perceived benefits of participating in Teen PEP across a range of domains, including intentions, skills, and knowledge and that the peer education modality was important in their valuation of the experience. CONCLUSIONS Our findings suggest that the peer-led comprehensive sexual health education approach embodied in Teen PEP can be an important educational mechanism for teaching students information and skills to promote sexual health.
Collapse
Affiliation(s)
- Carolyn Layzer
- Social and Economic Policy Division, Abt Associates Inc., 55 Wheeler Street, Cambridge, MA 02138
| | - Lauren Rosapep
- International Health Division, Abt Associates Inc, 4550 Montgomery Avenue, Bethesda, MD 20814
| | - Sherry Barr
- Center for Supportive Schools, 822 South White Street, Suite 100, Wake Forest, NC 27587
| |
Collapse
|
20
|
Green J, Oman RF, Lu M, Clements-Nolle KD. Long-Term Improvements in Knowledge and Psychosocial Factors of a Teen Pregnancy Prevention Intervention Implemented in Group Homes. J Adolesc Health 2017; 60:698-705. [PMID: 28259621 DOI: 10.1016/j.jadohealth.2017.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/23/2016] [Accepted: 01/11/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Youth in out-of-home care have higher rates of sexual risk behaviors and pregnancy than youth nationally. This study aimed to determine if Power Through Choices (PTC), a teen pregnancy prevention program developed for youth in out-of-home care, significantly improves knowledge and psychosocial outcomes regarding HIV and sexually transmitted infections (STIs), sexual activity and contraception methods, long term. METHODS A cluster randomized controlled trial was conducted with 1,036 ethnically diverse youths (aged 13-18 years) recruited from 44 residential group homes in three states. Intervention participants received the 10-session PTC intervention; control participants received usual care. Participants were administered self-report surveys at baseline, after intervention, 6 and 12 months after the intervention. Survey items assessed knowledge, attitudes, self-efficacy, and behavioral intentions regarding HIV and STIs, sexual activity and contraception methods. Random intercept logistic regression analyses were used to assess differences between the intervention and control groups. RESULTS Compared with youth in the control group, youth in the PTC intervention demonstrated significant improvements in knowledge about anatomy and fertility (adjusted odds ratio [AOR] = 1.07, 95% confidence interval [CI] = 1.03-1.11), HIV and STIs (AOR = 1.03, 95% CI = 1.002-1.07), and methods of protection (AOR = 1.06, 95% CI = 1.03-1.09), as well as self-efficacy regarding self-efficacy to communicate with a partner (AOR = 1.14, 95% CI = 1.04-1.26), plan for protected sex and avoid unprotected sex (AOR = 1.16, 95% CI = 1.04-1.28), and where to get methods of birth control (AOR = 1.13, 95% CI = 1.01-1.26) 12 months after the intervention. CONCLUSIONS Findings suggest that the PTC intervention can have positive long-term knowledge and psychosocial effects regarding contraception methods on youth in out-of-home care.
Collapse
Affiliation(s)
| | - Roy F Oman
- School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada.
| | - Minggen Lu
- School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada
| | | |
Collapse
|
21
|
Jaramillo N, Buhi ER, Elder JP, Corliss HL. Associations Between Sex Education and Contraceptive Use Among Heterosexually Active, Adolescent Males in the United States. J Adolesc Health 2017; 60:534-540. [PMID: 28132745 DOI: 10.1016/j.jadohealth.2016.11.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/18/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE This study examined associations between reports of receiving education on topics commonly included in sex education (e.g., abstinence only, comprehensive) prior to age 18 years and contraceptive use at the last sex among heterosexually active, 15- to 20-year-old males in the United States. METHODS Cross-sectional data from 539 males participating in the 2011-2013 National Survey of Family Growth were analyzed. Bivariate and multinomial logistic regression analyses adjusting for confounding estimated associations between receipt of seven sex education topics (e.g., information on HIV/AIDS, how to say no to sex) and contraceptive use at the last sex (i.e., dual barrier and female-controlled effective methods, female-controlled effective method only, barrier method only, and no method). RESULTS Nearly, all participants (99%) reported receiving sex education on at least one topic. Education on sexually transmitted diseases (94.7%) and HIV/AIDS (92.0%) were the most commonly reported topics received; education on where to get birth control was the least common (41.6%). Instruction about birth control methods (adjusted odds ratio [AOR] = 3.01; 95% confidence interval [CI] = 1.32-6.87) and how to say no to sex (AOR = 3.39; CI = 1.33-8.64) were positively associated with dual contraception compared to no use. For each additional sex education topic respondents were exposed to, their odds of using dual methods compared to no method was 47% greater (AOR = 1.47; CI = 1.16-1.86). CONCLUSIONS Exposure to a larger number of sex education topics is associated with young men's report of dual contraception use at the last sex. Comprehensive sex education, focusing on a range of topics, may be most effective at promoting safer sex among adolescent males.
Collapse
Affiliation(s)
- Nicole Jaramillo
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, California.
| | - Eric R Buhi
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, California
| | - John P Elder
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, California
| | - Heather L Corliss
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, California
| |
Collapse
|
22
|
Committee Opinion No 699: Adolescent Pregnancy, Contraception, and Sexual Activity. Obstet Gynecol 2017; 129:e142-e149. [DOI: 10.1097/aog.0000000000002045] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
Contraceptive Knowledge Assessment: validity and reliability of a novel contraceptive research tool. Contraception 2016; 95:190-197. [PMID: 27621043 DOI: 10.1016/j.contraception.2016.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 08/30/2016] [Accepted: 09/04/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Clinicians and researchers need an accurate tool assessing contraceptive knowledge in order to understand the effectiveness of teaching efforts. However, most widely used indices are outdated. The objective of this study is to create an evidence-based assessment tool and determine its validity and reliability for measuring contraceptive knowledge. STUDY DESIGN The study team developed the 25-question multiple-choice tool entitled the Contraceptive Knowledge Assessment (CKA). Expert reviewers examined content validity and semistructured patient interviews acquired feedback on subject matter and comprehension. A two-tiered approach explored criterion validity via (1) comparison with the gold standard (Contraceptive Knowledge Inventory) and (2) comparison between groups with lower and higher contraceptive knowledge. Repeat testing after 2-4 weeks evaluated test-retest reliability. RESULTS Six experts and seven patients provided feedback on the initial CKA. One hundred two reproductive-aged male and female patients and 27 medical students completed the final CKA with an overall mean patient score of 9/25 (36%). The mean score on the CKA was higher than the mean score on the gold standard (9.1 vs. 5.8, p<.001). Patients scored lower on the CKA than did medical students (9.1 [36.4%] vs.19.4 [77.6%], p<.005). There were no differences within patients' results with repeat testing over time (p=.667). CONCLUSIONS The CKA is a valid and reliable tool to measure a patient's level of knowledge regarding contraception. This research tool may allow for the assessment of baseline knowledge, educational gaps, and improvement after an intervention. Knowledge may be lower than previous studies suggest, signifying need for improved education on contraception and better understanding of the relationship between knowledge and behavior change. IMPLICATIONS The CKA provides an evidence-based, reliable, and validated assessment of contraceptive knowledge. This modern tool may help to determine the effectiveness of interventions to improve education on contraception.
Collapse
|
24
|
Stanford JB. Population, Reproductive, and Sexual Health: Data Are Essential Where Disciplines Meet and Ideologies Conflict. Front Public Health 2016; 4:27. [PMID: 27014671 PMCID: PMC4779970 DOI: 10.3389/fpubh.2016.00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/08/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joseph B Stanford
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA; Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
25
|
Ahern NR, Bramlett T. An Update on Teen Pregnancy. J Psychosoc Nurs Ment Health Serv 2016; 54:25-8. [PMID: 27648871 DOI: 10.3928/02793695-20160119-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
After years of high teen birth rates, there is currently a decline in U.S. pregnancy and birth rates among teens. Nevertheless, these rates continue to be higher than those of most global counterparts, and psychosocial and physical adversities still occur for pregnant teens and their children. The declining birth rates may be due to teens making better choices about contraceptive use and sexual behaviors. Psychiatric-mental health nurses are in key positions to enhance pregnancy prevention for teens. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 25-28.].
Collapse
|