Reproductive Health Division, Centre for Population Health Research, National Institute of Public Health, Cuernavaca Morelos, Mexico.
CONACYT - National Institute of Public Health-Reproductive Health Division, Mexico, Mexico.
J Prim Prev. 2021 Aug;42(4):343-361. doi: 10.1007/s10935-020-00609-w. Epub 2020 Oct 9.
Adolescent pregnancy is considered a priority public health issue because of its implications in the lives of young mothers, their children, and the well-being of the general population. In this paper, we describe an intervention targeting adolescents (aged 11-19 years old) in a rural context and estimate its impact on key outcomes relevant to early pregnancy prevention: knowledge and self-efficacy concerning sexual and reproductive health, knowledge of sexual and reproductive rights, and attitudes toward gender roles. Our study used a quasi-experimental design comprising 747 adolescents. Three difference-in-differences models (raw, adjusted, and by exposure level) with fixed effects estimated the changes in all outcome measures. Our results showed that the intervention community had a significant improvement in all outcomes, and this improvement was larger in those who received the highest-exposure level of intervention compared to a control community. Our study provides evidence that a community-based intervention, founded on comprehensive sexual education, is a promising approach to improve key outcomes related to early pregnancy in rural contexts. Further research should be undertaken to test how similar strategies focusing on multi-layer early pregnancy determinants work on other sub-groups of vulnerable adolescents, such as school dropouts or those living in disadvantaged circumstances.
少女怀孕被视为一个优先的公共卫生问题，因为它涉及年轻母亲、她们的孩子以及整个人口的福祉。在本文中，我们描述了一项针对农村地区青少年（11-19 岁）的干预措施，并估计其对与早期妊娠预防相关的关键结果的影响：性与生殖健康方面的知识和自我效能感、性与生殖权利知识，以及对性别角色的态度。我们的研究采用了包含 747 名青少年的准实验设计。使用固定效应的三个差分模型（原始、调整和按暴露水平）估计了所有结果测量的变化。结果表明，干预社区在所有结果方面都有显著改善，而在接受最高暴露水平干预的人群中，这种改善更为明显。本研究提供了证据表明，以全面性教育为基础的基于社区的干预措施是改善农村地区与早期妊娠相关的关键结果的一种有前途的方法。应进一步开展研究，以检验针对其他弱势群体青少年（如辍学者或生活在不利环境中的青少年）的类似多层面早期妊娠决定因素的策略如何发挥作用。
