Constantine Norman A, Jerman Petra, Berglas Nancy F, Angulo-Olaiz Francisca, Chou Chih-Ping, Rohrbach Louise A
Center for Research on Adolescent Health and Development, Public Health Institute, 555 12th Street, 10th Floor, 94607, Oakland, CA, USA.
Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, 50 University Hall, 94720, Berkeley, CA, USA.
BMC Public Health. 2015 Mar 26;15:293. doi: 10.1186/s12889-015-1625-5.
BACKGROUND: An emerging model for sexuality education is the rights-based approach, which unifies discussions of sexuality, gender norms, and sexual rights to promote the healthy sexual development of adolescents. A rigorous evaluation of a rights-based intervention for a broad population of adolescents in the U.S. has not previously been published. This paper evaluates the immediate effects of the Sexuality Education Initiative (SEI) on hypothesized psychosocial determinants of sexual behavior. METHODS: A cluster-randomized trial was conducted with ninth-grade students at 10 high schools in Los Angeles. Classrooms at each school were randomized to receive either a rights-based curriculum or basic sex education (control) curriculum. Surveys were completed by 1,750 students (N = 934 intervention, N = 816 control) at pretest and immediate posttest. Multilevel regression models examined the short-term effects of the intervention on nine psychosocial outcomes, which were hypothesized to be mediators of students' sexual behaviors. RESULTS: Compared with students who received the control curriculum, students receiving the rights-based curriculum demonstrated significantly greater knowledge about sexual health and sexual health services, more positive attitudes about sexual relationship rights, greater communication about sex and relationships with parents, and greater self-efficacy to manage risky situations at immediate posttest. There were no significant differences between the two groups for two outcomes, communication with sexual partners and intentions to use condoms. CONCLUSIONS: Participation in the rights-based classroom curriculum resulted in positive, statistically significant effects on seven of nine psychosocial outcomes, relative to a basic sex education curriculum. Longer-term effects on students' sexual behaviors will be tested in subsequent analyses. TRIAL REGISTRATION: ClinicalTrials.gov NCT02009046.
背景:一种新兴的性教育模式是基于权利的方法,该方法将性、性别规范和性权利的讨论统一起来,以促进青少年的健康性发展。此前尚未发表过对美国广大青少年群体进行的基于权利干预的严格评估。本文评估了性教育倡议(SEI)对性行为假设心理社会决定因素的即时影响。 方法:在洛杉矶的10所高中对九年级学生进行了一项整群随机试验。每所学校的教室被随机分配接受基于权利的课程或基础性教育(对照)课程。1750名学生(干预组N = 934,对照组N = 816)在预测试和即时后测试时完成了调查。多层次回归模型研究了干预对九个心理社会结果的短期影响,这些结果被假设为学生性行为的中介因素。 结果:与接受对照课程的学生相比,接受基于权利课程的学生在即时后测试时表现出对性健康和性健康服务的了解明显更多,对性关系权利的态度更积极,与父母就性和关系的沟通更多,以及在管理危险情况方面的自我效能感更强。两组在与性伴侣沟通和使用避孕套的意图这两个结果上没有显著差异。 结论:相对于基础性教育课程,参与基于权利的课堂课程对九个心理社会结果中的七个产生了积极的、具有统计学意义的影响。对学生性行为的长期影响将在后续分析中进行测试。 试验注册:ClinicalTrials.gov NCT02009046。
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