Department of Epidemiology and Biostatistics, University of California, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California; Bixby Center for Global Reproductive Health, University of California, San Francisco, California.
California Department of Public Health, Maternal, Child and Adolescent Health Division, Sacramento, California.
J Adolesc Health. 2023 Jan;72(1):138-146. doi: 10.1016/j.jadohealth.2022.09.001. Epub 2022 Oct 23.
This study examines whether comprehensive sexual health education that provides information on clinical services can change adolescents' perceptions of barriers, facilitators, and intention to use services and whether changes in perceptions differ by participant characteristics.
Adolescent participants in a statewide sexual health education program in California were surveyed at baseline and at exit about their perceptions of barriers, facilitators, and intention to use clinical services. Linked baseline and exit surveys (n = 7,460) assessed change in perceptions after program completion. Logistic regression analyses that accounted for the clustered data structure assessed associations between participant characteristics and improvement in perceptions.
After the program, there were significant reductions in two perceived barriers (worry about cost and judgment by staff), but there were also small but significant increases in perceptions of two barriers (worry about confidentiality of services and test results). There were significant increases in all three perceived facilitators and intention to use sexual and reproductive health services, which rose from 90.6% at baseline to 96.2% at exit. Younger youth were more likely than older youth to show improvement in all perceived facilitators and intentions. Girls and Black youth were more likely than boys and Hispanic youth to show improvement in two facilitators (knowing what to expect and access). No sociodemographic characteristics were consistently associated with reductions in perceived barriers.
Comprehensive sexual health education that addresses adolescents' questions and concerns regarding clinical services can help to reduce perceived barriers, increase facilitators, and increase intention to use services if needed.
本研究旨在探讨综合性性健康教育（为青少年提供临床服务信息）是否能够改变青少年对服务使用障碍、促进因素和意向的认知，以及认知变化是否因参与者特征而异。
参与加利福尼亚州全州性健康教育计划的青少年在基线和结业时接受了关于他们对临床服务使用的障碍、促进因素和意向的认知调查。基线和结业时的关联调查（n=7460）评估了项目完成后认知的变化。考虑到聚类数据结构的逻辑回归分析评估了参与者特征与认知改善之间的关联。
项目实施后，两种感知障碍（担心费用和担心受到工作人员的评判）显著降低，但两种感知障碍（担心服务和测试结果的保密性）也略有增加。所有三种感知促进因素和性与生殖健康服务的使用意向均显著增加，从基线时的 90.6%上升到结业时的 96.2%。年轻的青少年比年长的青少年更有可能在所有感知促进因素和意图方面有所改善。女孩和黑人青少年比男孩和西班牙裔青少年更有可能在两个促进因素（了解预期和获得途径）方面有所改善。没有任何社会人口特征与感知障碍的减少始终相关。
综合性性健康教育如果能够解决青少年对临床服务的问题和担忧，那么可以帮助减少感知障碍、增加促进因素并增加对服务的使用意向。
