Robin Leah, Dittus Patricia, Whitaker Daniel, Crosby Richard, Ethier Kathleen, Mezoff Jane, Miller Kim, Pappas-Deluca Katina
Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-33, Atlanta, GA 30341, USA.
J Adolesc Health. 2004 Jan;34(1):3-26. doi: 10.1016/s1054-139x(03)00244-1.
To review adolescent sexual risk-reduction programs that were evaluated using quasi-experimental or experimental methods and published in the 1990s. We describe evaluated programs and identify program and evaluation issues for health educators and researchers.
We systematically searched seven electronic databases and hand-searched journals to identify evaluations of behavioral interventions to reduce sexual risk behaviors among adolescents. Articles were included if they were published in the 1990s, provided a theoretical basis for the program, information about the interventions, clear aims, and quasi-experimental or experimental evaluation methods. We identified 101 articles, and 24 met our criteria for inclusion.
We reviewed these evaluations to assess their research and program characteristics. The majority of studies included randomized controlled designs and employed delayed follow-up measures. The most commonly measured outcomes were delay of initiation of sexual intercourse, condom use, contraceptive use, and frequency of sexual intercourse. Programs ranged from 1 to 80 sessions, most had adult facilitators, and commonly included skills-building activities about sexual communication, decision-making, and problem solving. The programs included a wide range of strategies for content delivery such as arts and crafts, school councils, and community service learning.
Analysis of these programs suggest four overall factors that may impact program effectiveness including the extent to which programs focus on specific skills for reducing sexual risk behaviors; program duration and intensity; what constitutes the content of a total evaluated program including researchers' assumptions of participants' exposure to prior and concurrent programs; and what kind of training is available for facilitators.
回顾20世纪90年代使用准实验或实验方法进行评估的青少年性风险降低项目。我们描述了经过评估的项目，并为健康教育工作者和研究人员确定项目及评估问题。
我们系统地搜索了七个电子数据库，并手工检索期刊，以确定减少青少年性风险行为的行为干预评估。如果文章发表于20世纪90年代，提供了项目的理论基础、干预措施信息、明确目标以及准实验或实验评估方法，则纳入研究。我们共识别出101篇文章，其中24篇符合纳入标准。
我们对这些评估进行了审查，以评估其研究和项目特征。大多数研究采用随机对照设计，并采用延迟随访措施。最常测量的结果包括首次性交的延迟、避孕套使用、避孕措施使用以及性交频率。项目时长从1节到80节不等，大多数有成人辅导员，通常包括关于性沟通、决策和问题解决的技能培养活动。这些项目包括多种内容传递策略，如艺术和手工艺、学校议会以及社区服务学习。
对这些项目的分析表明，有四个总体因素可能影响项目效果，包括项目关注减少性风险行为的特定技能的程度；项目时长和强度；一个完整评估项目的内容构成，包括研究人员对参与者接触先前和同期项目的假设；以及为辅导员提供何种培训。
