Stephenson J M, Oakley A, Charleston S, Brodala A, Fenton K, Petruckevitch A, Johnson A M
Department of Sexually Transmitted Diseases, UCL Medical School, London.
Sex Transm Infect. 1998 Dec;74(6):405-8. doi: 10.1136/sti.74.6.405.
To assess the feasibility of conducting a large randomised controlled trial (RCT) of peer led intervention in schools to reduce the risk of HIV/STD and promote sexual health.
Four secondary schools in Greater London were randomly assigned to receive peer led intervention (two experimental schools) or to act as control schools. In the experimental schools, trained volunteers aged 16-17 years (year 12) delivered the peer led intervention to 13-14 year old pupils (year 9). In the control schools, year 9 pupils received the usual teacher led sex education. Questionnaire data collected from year 9 pupils at baseline included views on the quality of sex education/intervention received, and knowledge and attitudes about HIV/AIDS and other sexual matters. Focus groups were also conducted with peer educators and year 9 pupils. Data on the process of delivering sex education/intervention and on attitudes to the RCT were collected for each of the schools. Analysis focused on the acceptability of a randomised trial to schools, parents, and pupils.
Nearly 500 parents were informed about the research and invited to examine the study questionnaire; only nine raised questions and only one pupil was withdrawn from the study. Questionnaire completion rates were around 90% in all schools. At baseline, the majority of year 9 pupils wanted more information about a wide range of sexual matters. Focus group work indicated considerable enthusiasm for peer led education, among peer educators and year 9 pupils. Class discipline was the most frequently noted problem with the delivery of the peer led intervention.
Evaluation of a peer led behavioural intervention through an RCT can be acceptable to schools, pupils, and parents and is feasible in practice. In general, pupils who received the peer led intervention responded more positively than those in control schools. A large RCT of the long term (5-7 year) effects of this novel intervention on sexual health outcomes is now under way.
评估在学校开展由同龄人主导的干预措施以降低艾滋病毒/性传播感染风险并促进性健康的大型随机对照试验（RCT）的可行性。
大伦敦地区的四所中学被随机分配接受由同龄人主导的干预措施（两所实验学校）或作为对照学校。在实验学校，16 - 17岁（12年级）的经过培训的志愿者向13 - 14岁的学生（9年级）提供由同龄人主导的干预措施。在对照学校，9年级学生接受常规的教师主导的性教育。从9年级学生基线时收集的问卷数据包括对所接受的性教育/干预质量的看法，以及对艾滋病毒/艾滋病和其他性问题的知识与态度。还与同伴教育者和9年级学生进行了焦点小组访谈。收集了每所学校关于提供性教育/干预过程以及对随机对照试验态度的数据。分析重点在于随机试验对学校、家长和学生的可接受性。
近500名家长得知了这项研究并受邀查看研究问卷；只有9人提出问题，只有1名学生退出了研究。所有学校的问卷完成率约为90%。在基线时，大多数9年级学生希望获得更多关于广泛性问题的信息。焦点小组访谈表明，同伴教育者和9年级学生对同龄人主导的教育表现出极大热情。课堂纪律是实施同龄人主导干预措施时最常提到的问题。
通过随机对照试验对同龄人主导的行为干预措施进行评估，学校、学生和家长是可以接受的，并且在实践中是可行的。总体而言，接受同龄人主导干预措施的学生比对照学校的学生反应更积极。目前正在开展一项关于这种新型干预措施对性健康结果的长期（5 - 7年）影响的大型随机对照试验。
