Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Departamento de Historia y Ciencias Sociales, Facultad de Artes Liberales, Universidad Adolfo Ibáñez, Santiago, Chile.
PLoS One. 2022 Mar 23;17(3):e0265309. doi: 10.1371/journal.pone.0265309. eCollection 2022.
Adolescent sexual and reproductive health services in Chile have been primarily provided through health centers. Although some school-based initiatives have been implemented, to date, these have not been assessed. This study aims to identify strengths and challenges of the affectivity and sexuality component of the school-based 3A Program, a health program which seeks to prevent risk behaviors and promote healthy lifestyle habits within public schools (addressing health topics which in Spanish begin with the letter 'A', hence '3A'), implemented in the municipality of Lo Prado, city of Santiago.
We carried out a qualitative study with a descriptive-interpretative approach in three schools. We conducted in-depth interviews with students, teachers, health professionals, and school principals (N = 44); and focus groups with students (N = 3), teachers and health personnel (N = 3). The interviews were analyzed using thematic analysis.
Participants highlight the integrative approach to health and to sexual and reproductive health promoted in the 3A Program, which is enhanced by the collaboration of interdisciplinary health teams. Permanent and expedited student access to sexual and reproductive health care is achieved, and affectional bonds are developed between students and the Program's health staff. The Program assists female participants to imagine and form identities that are not inherently tied to motherhood. It also assists boys and LGBTQ+ adolescents in feeling included as relevant actors in sexual and reproductive health and decision making. The delivery of contraception in schools is highly valued. The most significant challenge identified is ensuring effective and ongoing collaboration between health staff and teachers.
Participants value the effectivity and sexuality component of the 3A Program as an initiative to improve adolescents' access to sexual and reproductive health care. Our findings suggest that this Program could be replicated throughout the region and the country to improve the quality and accessibility of health services for adolescents.
智利的青少年性健康和生殖健康服务主要通过健康中心提供。虽然已经实施了一些基于学校的举措，但迄今为止，这些举措尚未得到评估。本研究旨在确定 3A 计划中以学校为基础的影响和性部分的优势和挑战，该健康计划旨在预防公立学校内的风险行为并促进健康的生活方式习惯（涉及西班牙语中以字母 'A' 开头的健康主题，因此称为'3A'），在圣地亚哥市的 Lo Prado 市实施。
我们在三所学校进行了一项定性研究，采用描述性解释方法。我们对学生、教师、卫生专业人员和校长（N = 44）进行了深入访谈；并对学生（N = 3）、教师和卫生人员（N = 3）进行了焦点小组讨论。使用主题分析对访谈进行分析。
参与者强调了 3A 计划中促进的健康和性健康的综合方法，这得益于跨学科卫生团队的合作。学生可以获得永久性和快速获得性健康和生殖健康护理，学生和计划的卫生工作人员之间建立了感情联系。该计划帮助女参与者想象并形成不与母亲身份固有相关的身份。它还帮助男孩和 LGBTQ+青少年感受到包括在性健康和决策中作为相关行为者。在学校提供避孕措施受到高度重视。确定的最大挑战是确保卫生人员和教师之间的有效和持续合作。
参与者重视 3A 计划的效果和性部分，认为这是改善青少年获得性健康和生殖健康护理的举措。我们的研究结果表明，该计划可以在该地区和全国范围内复制，以提高青少年健康服务的质量和可及性。
