1 Touro College of Osteopathic Medicine , New York, New York.
J Womens Health (Larchmt). 2014 Apr;23(4):358-64. doi: 10.1089/jwh.2013.4523.
Rates of sexually transmitted infections (STIs) and unplanned pregnancy are high in Kenya, and limited reproductive health education exists in schools.
We designed and implemented a 6-week reproductive health curriculum in Laikipia District, Kenya, in 2011, which included didactic sessions, educational games, and open discussions. We applied a mixed quantitative and qualitative methods to evaluate this curriculum including a comprehensive 35-item survey to assess pre- and post-training knowledge, attitudes, and practices of female teenagers regarding STIs/HIV and family planning using paired t-test as well as complementary focus groups (n=42) and individual interviews (n=20).
Average age for 42 female teenagers was 16.5 (± 1.31) years. Pre-test questionnaires revealed lack of knowledge about different types of STIs, specifically chlamydia, but adequate knowledge of basic contraception including abstinence and condom use. By the conclusion of the study, we observed improvement in following educational domains: general knowledge of HIV/AIDS (85% ± 7.5% to 94% ± 5.6%) (p<0.001); general knowledge of teen pregnancy and STIs (57% ± 19% to 82% ± 13%) (p<0.001); and overall scores of knowledge, attitude, and self-efficacy (81% ± 6.6% to 90% ± 5%) (p<0.001). Focus group discussions, however, revealed persistent misconceptions and knowledge gaps with themes regarding HIV transmission risk factors, perceived difficulty negotiating condom use, masturbation and its perceived consequences, and issues surrounding female circumcision.
Important misconceptions and gaps in reproductive practices were identified and addressed using a mixed methods approach. Despite prior basic knowledge and positive attitudes on STI prevention and family planning, complementary teaching approaches were instrumental in improving overall knowledge of STIs other than HIV as well as family planning. The curriculum was feasible, well received, and achieved its educational goals.
肯尼亚的性传播感染（STI）和意外怀孕率很高，学校的生殖健康教育有限。
我们于 2011 年在肯尼亚的莱基皮亚地区设计并实施了一项为期 6 周的生殖健康教育课程，其中包括课堂教学、教育游戏和公开讨论。我们采用了混合定量和定性方法来评估该课程，包括一项综合的 35 项调查，以评估女青少年在性传播感染/艾滋病毒和计划生育方面的知识、态度和实践，使用配对 t 检验评估培训前后的知识、态度和实践，以及补充焦点小组（n=42）和个人访谈（n=20）。
42 名女青少年的平均年龄为 16.5（±1.31）岁。预测试卷显示，她们对不同类型的 STI 缺乏了解，特别是衣原体，但对基本避孕方法，包括禁欲和使用避孕套有足够的了解。研究结束时，我们观察到以下教育领域的知识有所提高：艾滋病病毒/艾滋病的一般知识（85%±7.5%至 94%±5.6%）（p<0.001）；青少年怀孕和性传播感染的一般知识（57%±19%至 82%±13%）（p<0.001）；以及知识、态度和自我效能的综合评分（81%±6.6%至 90%±5%）（p<0.001）。然而，焦点小组讨论揭示了一些持续存在的误解和知识差距，主题包括艾滋病毒传播风险因素、对使用避孕套的协商难度、自慰及其感知后果，以及围绕女性割礼的问题。
使用混合方法确定并解决了生殖实践中的重要误解和差距。尽管在预防性传播感染和计划生育方面有基本的知识和积极的态度，但补充教学方法对于提高除艾滋病毒以外的性传播感染和计划生育的整体知识是至关重要的。该课程是可行的，受到了欢迎，并实现了其教育目标。
