Serowoky Mary L, George Nancy, Yarandi Hossein
Assistant Clinical Professor, Nurse Practitioner, College of Health Professions, University of Detroit Mercy & Henry Ford Health System, Detroit, MI.
Associate Clinical Professor, Assistant Director for the DNP Program, College of Nursing, Wayne State University, Detroit, MI.
Worldviews Evid Based Nurs. 2015 Oct;12(5):297-305. doi: 10.1111/wvn.12110. Epub 2015 Sep 30.
Addressing the disparities in pregnancy and sexually transmitted infection (STI) rates for Latino youth in the United States requires an evidence-based approach. Although randomized controlled trials for sexual risk reduction interventions have shown promise in improving short-term outcomes, program sustainability has not been extensively examined in school settings where teens spend time. Latina teen pregnancy rates are nearly twice the national average. Adolescents comprise only 17% of the U.S. population, yet they account for 50% of STIs. ¡Cuídate! is a high-impact sexual health group program endorsed by the Centers for Disease Control and Prevention that has not been replicated in a real-world setting.
The program logic model (PLM) was used as the systematic approach to plan, implement, and evaluate a sustainable model of sexual health group programing (¡Cuídate!) in a U.S. high school with a large Latino student population.
The PLM provided the framework for the evaluation of outputs, outcome, and impact. A multivariate repeated measures analysis of variance was used as the means to evaluate the participant outcomes immediately postprogram and at 8-12 weeks.
¡Cuídate! was executed within an existing school structure and time constraints, below cost projections, and with high participant retention (95.8%). Three cohorts (N = 24) of female teens demonstrated significant increases in STI or HIV knowledge, self-efficacy, and intention to use condoms (p < .01). Condom use increased postprogram. No participants initiated sexual behavior, nor were there any reported pregnancies or STIs.
An evidence-based intervention previously tested in randomized controlled trials can be sustained in a school-based health center with similar results of efficacy.
Our success served as a platform for a sustainable program. We continue to extend the impact of the program by delivering ¡Cuídate! in the school setting using a community health worker.
解决美国拉丁裔青少年怀孕率和性传播感染（STI）率方面的差异需要基于证据的方法。尽管降低性风险干预措施的随机对照试验已显示出改善短期结果的前景，但项目可持续性在青少年所在的学校环境中尚未得到广泛研究。拉丁裔青少年怀孕率几乎是全国平均水平的两倍。青少年仅占美国人口的17%，但却占性传播感染病例的50%。“关爱自己！”是一项由疾病控制与预防中心认可的具有重大影响的性健康团体项目，尚未在现实环境中得到复制。
项目逻辑模型（PLM）被用作一种系统方法，用于规划、实施和评估在美国一所拥有大量拉丁裔学生的高中开展的性健康团体项目（“关爱自己！”）的可持续模式。
PLM为产出、结果和影响的评估提供了框架。使用多变量重复测量方差分析来评估项目结束后即刻以及8至12周时参与者的结果。
“关爱自己！”在现有的学校结构和时间限制内实施，成本低于预期，且参与者保留率高（95.8%）。三组（N = 24）女性青少年在性传播感染或艾滋病毒知识、自我效能以及使用避孕套意愿方面均有显著提高（p < .01）。项目结束后避孕套使用有所增加。没有参与者开始性行为，也没有报告怀孕或性传播感染病例。
一项先前在随机对照试验中测试过的基于证据的干预措施能够在学校健康中心持续开展，并取得类似的疗效结果。
我们的成功为一个可持续项目搭建了平台。我们通过利用社区卫生工作者在学校环境中开展“关爱自己！”项目，继续扩大该项目的影响。
