Effects on attitudes, knowledge, intentions and behaviour of an AIDS prevention programme targeting secondary school adolescents

Spanish Translation, Adaptation, and Validation of the Multidimensional Condom Attitudes Scale with Young Colombian Men and Women

Infection by HIV/AIDS or other STIs and unplanned pregnancies are sexual health problems of considerable impact around the world. Condoms are the only method that prevents all those risks, and attitudes toward the use of condoms are among the best predictors of their consistent use. The purpose of the present study was to translate, adapt, and validate a Spanish-language version of the Multidimensional Condom Attitudes Scale (MCAS) using a sample of young people from Colombia. A total of 1441 young people between the ages of 18 and 26 years responded to a web-based survey conducted between January 2018 and February 2018. The dimensionality of the scale was explored and confirmed to replicate the original five-factor structure (alphas ranged from .65 to .86). Criterion validity was adequate. Women had more positive attitudes toward identity stigma associated with condom use, while men had more positive attitudes toward reliability and effectiveness of condoms and were less embarrassed with condom negotiation and use. The Spanish-language MCAS is suitable for measuring condom-related attitudes among Colombian youth. Future research is needed to validate the Spanish version of the MCAS with other Spanish-speaking populations.

Implementation fidelity for promoting the effectiveness of an adolescent sexual health program

The goal of the present study was to examine COMPAS program (Competencies for adolescents with a healthy sexuality) outcomes based on implementation fidelity: dose, adherence, and acceptance. Participants were 716 adolescents aged 14-16 years (46.5% boys). Two fidelity groups were established: high (n=83) and low (n=312), with the remaining sample serving as a non-program control group (n=321). Knowledge about sexually transmitted infections (STIs), attitudes towards HIV, intention to use condoms, and sexual behavior were evaluated. Results indicated that adolescents receiving the intervention displayed improved STI knowledge (p<0.001) and improved attitudes toward HIV (p<0.05) as compared to the control group. Between the two intervention groups, a high-fidelity group intended to engage more in safe sex behaviors (p=0.05) and displayed greater STI knowledge (p=0.05) as compared to the low-fidelity group. The present study revealed improved efficiency when applying prevention programs with implementation fidelity.

Educación sexual: opiniones y propuestas del alumnado y profesorado de los institutos de secundaria de Asturias, España

Introducción:

La educación sexual en las escuelas es clave para la formación de los jóvenes y hay evidencia de que los programas integrales tienen resultados en mejorar la salud. Sin embargo, a pesar de las numerosas propuestas puestas en marcha en nuestro país, no hay una incorporación efectiva. Este estudio plantea recoger la opinión del alumnado y profesorado de secundaria, así como sus propuestas para la acción.

Métodos:

Se recogió información con grupos focales de alumnado de Secundaria y Bachillerato, y de profesorado, en siete centros educativos, organizados en función de la zona educativa (rural o urbana). En el caso del alumnado, también se tuvo en cuenta el sexo, con grupos de chicos, chicas y mixtos. Se realizó un análisis del discurso y se clasificó la información en actividades realizadas, valoración de las mismas, temas de interés (para el alumnado), dificultades (para el profesorado) y propuestas.

Resultados:

El alumnado había participado en diferentes actividades de educación sexual, como sesiones del profesorado, talleres externos y charlas. La valoración de las mismas fue positiva. Propusieron que la educación sexual se abordase en los centros educativos, ya que en casa sigue siendo un tema tabú, y priorizaron diferentes temas relacionados con la afectividad y las relaciones sexuales. El profesorado destacó numerosas dificultades, entre ellas la falta de tiempo y de formación. Entre sus propuestas está la incorporación curricular desde la Educación Primaria.

Conclusiones:

Las propuestas del alumnado y profesorado recogen parte de los elementos clave para incorporar de forma efectiva educación sexual. Asimismo, apuntan en una dirección clara: el compromiso de las autoridades sanitarias y educativas, proporcionando recursos humanos, materiales y económicos.

Evaluación de proceso del programa de educación afectivo-sexual Ni ogros ni princesas

Resumen

Fundamento: En 2008, se puso en marcha el programa Ni ogros ni princesas en 12 centros de secundaria de Asturias (España) para incorporar la educación afectivo-sexual. El programa proponía 14 actividades, dirigidas a alumnado, profesorado y familias. Este estudio recoge la evaluación de proceso de esta intervención, en relación a la ejecución de las actividades, participación, satisfacción, utilidad percibida y propuestas de mejora. Métodos: La población de estudio fueron los 12 centros que participaron en el programa, y su alumnado, profesorado y familias. Se obtuvo información sobre la ejecución de actividades mediante un cuestionario de seguimiento; se recogió la satisfacción y utilidad percibida con cuestionarios auto-administrados para alumnado y profesorado; también se recogieron sus propuestas de mejora, y las de las familias, en grupos focales. Resultados: El número medio de actividades realizadas por los 12 centros fue 11,6. Se implicaron 185 docentes (26%), que impartieron sesiones al 81% del alumnado en estos 12 centros. El número medio de sesiones impartidas fue 6 en cada nivel de la ESO. El 79% del profesorado se sintió bastante/muy satisfecho con su actuación y al 65% del alumnado le gustaron bastante/mucho estas sesiones. Más del 60% de estudiantes y docentes consideraron que estas sesiones servían bastante/mucho para aumentar conocimientos, reflexionar, mejorar la igualdad, conocer otras opiniones y favorecer el respeto a la diversidad sexual. Entre las propuestas de mejora, más horas para la educación sexual, liberación horaria para el profesorado, y más actividades para familias. Conclusiones: El programa fue una intervención novedosa y percibida como útil para incorporar la educación sexual en los centros de secundaria, ya que contó con un gran nivel de ejecución, así como una alta participación, satisfacción y utilidad percibida por el alumnado y profesorado.

[Process evaluation in relation to effectiveness assessment: experiences with school-based programs]

Evaluation of public health interventions usually focus on the quality of design and research methods, and less on the quality of the intervention or process evaluation. In process evaluation of school-based interventions, key issues are how completely the intervention is carried out and adherence to the protocol. In addition, exploration of intermediate variables, such as those that influence (and often predict) preventable behavior, is highly useful. This article describes the basic concepts in this topic, using examples of the effectiveness of some preventive interventions carried out in schools. The interventions discussed were mainly quasi-experimental studies, based on data from programs promoted by public health teams in the city of Barcelona. Data from process evaluation of preventive programs in secondary schools that underwent formal assessment of their effectiveness is provided. The examples are drawn from preventive programs of HIV infection or unprotected sexual intercourse (PRESSEC program) and drug consumption prevention (the PASE, PASE.bcn and x kpts programs). These examples show why the intervention process influences the impact of the programs and their results. Thorough planning of process evaluation is essential to obtain valid indicators that will identify, in the effectiveness evaluation of the intervention, the most efficacious strategies to obtain positive outcomes.

Systematic review of interventions to prevent the spread of sexually transmitted infections, including HIV, among young people in Europe

AIM

To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STIs), including HIV, among young people in the European Union.

METHODS

For this systematic review, we examined interventions that aimed at STI risk reduction and health promotion conducted in schools, clinics, and in the community for reported effectiveness (in changing sexual behavior and/or knowledge) between 1995 and 2005. We also reviewed study design and intervention methodology to discover how these factors affected the results, and we compiled a list of characteristics associated with successful and unsuccessful programs. Studies were eligible if they employed a randomized control design or intervention-only design that examined change over time and measured behavioral, biologic, or certain psychosocial outcomes.

RESULTS

Of the 19 studies that satisfied our review criteria, 11 reported improvements in the sexual health knowledge and/or attitudes of young people. Ten of the 19 studies aimed to change sexual risk behavior and 3 studies reported a significant reduction in a specific aspect of sexual risk behavior. Two of the interventions that led to behavioral change were peer-led and the other was teacher-led. Only 1 of the 8 randomized controlled trials reported any statistically significant change in sexual behavior, and then only for young females.

CONCLUSION

The young people studied were more accepting of peer-led than teacher-led interventions. Peer-led interventions were also more successful in improving sexual knowledge, though there was no clear difference in their effectiveness in changing behavior. The improvement in sexual health knowledge does not necessarily lead to behavioral change. While knowledge may help improve health-seeking behavior, additional interventions are needed to reduce STIs among young people.

Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world

This paper reviews 83 studies that measure the impact of curriculum-based sex and HIV education programs on sexual behavior and mediating factors among youth under 25 years anywhere in the world. Two thirds of the programs significantly improved one or more sexual behaviors. The evidence is strong that programs do not hasten or increase sexual behavior but, instead, some programs delay or decrease sexual behaviors or increase condom or contraceptive use. Effective curricula commonly incorporated 17 characteristics that describe the curricula development; the goals, objectives, and teaching strategies of the curricula themselves; and their implementation. Programs were effective across a wide variety of countries, cultures, and groups of youth. Replications of studies also indicate that programs remain effective when implemented by others in different communities, provided all the activities are implemented as intended in similar settings.