Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee.
J Adolesc Health. 2022 Apr;70(4):588-597. doi: 10.1016/j.jadohealth.2021.05.015.
School-based sexual health education (SHE) can teach students critical knowledge and skills. For effective SHE, school districts can offer support, including strong curricula and professional development. This study assessed changes in students' sexual health knowledge and sexual behaviors following implementation of enhanced support for SHE delivery in one school district.
Sexual health knowledge was assessed at the beginning and end of middle and high school health education classes in a large, urban district (n = 7,555 students). Sexual behaviors were assessed using Youth Risk Behavior Survey data from the district (2015 and 2017) and state (2017). Analyses explored differences in behavior from 2015 (n = 2,596) to 2017 (n = 3,371) among intervention district students and compared intervention district students (n = 3,371) to other students in the same state (n = 1,978).
Hierarchical linear model regression analyses revealed significant knowledge gains among students. Logistic regression results revealed that among students in the intervention district, 6 of 16 examined behaviors moved in the intended direction from 2015 to 2017; 1 moved in the unintended direction. Logistic regression results of 2017 data revealed that in comparison of intervention district students to other students in the state, intervention district students had significantly higher odds of reporting condom use at last sex (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI] = 1.07-1.72) and significantly lower odds of reporting having had sex with 4+ persons (AOR = .72, 95% CI = .55-.94) or alcohol or drug use before last sex (AOR = .63, 95% CI = .42-.94).
Findings suggest potential effects of the district's SHE in increasing knowledge and improving behaviors and experiences among youth.
学校性健康教育（SHE）可以教授学生关键知识和技能。为了实现有效的 SHE，学区可以提供支持，包括强有力的课程和专业发展。本研究评估了在一个学区实施增强的 SHE 教学支持后，学生性健康知识和性行为的变化。
在一个大型城市学区的中学和高中健康教育课程开始和结束时，对学生的性健康知识进行评估（n=7555 名学生）。使用该学区的青少年风险行为调查数据（2015 年和 2017 年）和州数据（2017 年）评估性行为。分析探索了干预学区学生在 2015 年（n=2596）到 2017 年（n=3371）之间行为差异，并将干预学区学生（n=3371）与同一州的其他学生（n=1978）进行比较。
分层线性模型回归分析显示，学生的知识有显著提高。逻辑回归结果显示，在干预学区的学生中，16 项被检查行为中有 6 项从 2015 年到 2017 年朝着预期方向移动；1 项朝着意外方向移动。2017 年数据的逻辑回归结果显示，与该州其他学生相比，干预学区学生报告上次性行为使用安全套的可能性明显更高（调整后优势比 [AOR]=1.36，95%置信区间 [CI]=1.07-1.72），报告与 4 人以上发生性行为（AOR=0.72，95%CI=0.55-0.94）或在最后一次性行为前使用酒精或毒品（AOR=0.63，95%CI=0.42-0.94）的可能性明显更低。
研究结果表明，该学区 SHE 可能对提高青少年的知识、改善行为和体验产生影响。
