[Health promotion in adolescents in Latin America]

From “among Girl Friends” to “among Mothers”—Baseline Research Adjusts a Health Promoting Intervention in Nicaragua

Purpose.

The objective of this study is to show how baseline findings can redefine the design of an intervention.

Design.

A baseline cross-sectional study.

Setting.

The study area was a suburban community near the Nicaraguan capital, Managua.

Subjects.

A sample of 612 girls aged 10 to 14 years was selected, and 592 (97%) participated in the study.

Measures.

Using individual interviews, data were collected on sociodemographics; self-esteem and life prospects; gender; sexuality and human reproduction; knowledge of sexually transmitted diseases, human immunodeficiency virus, and acquired immunodeficiency syndrome; violence; and networking.

Analysis.

Frequency tables.

Results.

A high proportion (87.5%) of the girls lived with their mothers, and only 59% had their fathers living with the family. In 51% of the sample, the mothers made the decisions at home. For the majority of the girls, their mothers were their referent persons when they wanted to talk about sexuality and pregnancies, whereas only a few girls said they would talk with friends.

Conclusion.

The mother is the most important significant other, and thus, according to the theory of reasoned action, she would be the most important person to influence the girl. Careful investigations into which groups are forming the norms are essential for an effective intervention program in order to change behavior and enhance self-esteem.

Evaluating a Peer Intervention Strategy for the Promotion of Sexual Health-Related Knowledge and Skills in 10- to 14-Year-Old Girls. Findings from the “Entre Amigas” Project in Nicaragua

Purpose.

Report effects on knowledge of sexual health and gender from an intervention using peer methodology in Nicaragua.

Design.

A prepost nonequivalent control group design.

Setting.

Ciudad Sandino, Managua, Nicaragua.

Subjects.

A total of 599 girls were surveyed, 60% nonintervened and 40% intervened.

Intervention.

Peer methodology consisted of (1) meetings in which girls talked and worked with other girls, (2) mothers taking an active role in the peer groups, and/or (3) girls watching the soap opera “Sexto Sentido.”

Measures.

Indices measuring changes in sexual knowledge and gender vision.

Results.

Girls participating in the peer groups were twice as likely to have satisfactory sexual health-related self-esteem as those who did not participate. Eleven percent of the girls achieved satisfactory self-esteem as a result of the (peer groups × mothers) interaction and 15% due to the (peer groups × mothers × “Sexto Sentido”) interaction. Girls participating in the peer groups were three times as likely to have satisfactory gender visions; if exposed to all three components, they were almost four times as likely to develop satisfactory gender visions.

Conclusions.

Peer methodology, participation of a female family member, and an educational soap opera seem beneficial in promoting sexual health-related knowledge and gender vision in young girls.

Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial

Regular physical activity is associated with a reduced risk of all-cause mortality, and mortality due to cardiovascular disease and cancer. Among adolescents, physical activity is associated with benefits in the prevention and control of emotional distress, and improvement of self-esteem. Countries in transitional epidemiological scenarios, such as Chile, need to develop effective strategies to improve physical activity as a way to face the epidemic of chronic diseases. The objective of this study was to evaluate the effects of a school-based physical activity program on physical fitness and mental health status of adolescents living in a low socioeconomic status area in Santiago, Chile. A quasi-experimental design was used to evaluate the effects of the program over one academic year. The study included 198 students aged 15 years old. Two ninth grade classes were randomly selected as the intervention group, with two classes of the same grade as controls. A social planning approach was used to develop the intervention. The program was designed and implemented based on student preferences, teachers' expertise and local resources. Changes in physiological and mental health status were assessed. After the intervention, maximum oxygen capacity achieved a significant increase of 8.5% in the intervention versus 1.8% in the control group (p < 0.0001). Speed and jump performance scores improved significantly more in the intervention versus the control group (p > 0.01). Anxiety score decreased 13.7% in the intervention group versus 2.8% in the control group (p < 0.01), and self-esteem score increased 2.3% in the intervention group and decreased 0.1% in the control group after the end of the program (p < 0.0001). No significant change was observed in the depressive score. Student participation and compliance with the program was > 80%. To conclude, a school-based program to improve physical activity in adolescents of low socioeconomic status, obtained a high level of participation and achieved significant benefits in terms of physical fitness and mental health status.