在大型城市学区加强对性健康教育的支持后，学生知识和保护行为的增加

Increases in Student Knowledge and Protective Behaviors Following Enhanced Supports for Sexual Health Education in a Large, Urban School District

——原载美国《青少年健康杂志》，2022年第70卷第4期——

<Journal of Adolescent Health>, 2022, 70 (4)

    【摘要】目的：基于学校的性健康教育 (SHE) 可以教授学生重要的知识和技能。对于有效的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交付支持后学生性健康知识和性行为的变化。方法：在一个大型城市学区（n=7,555名学生）中，在初中和高中健康教育课程的开始和结束时评估了性健康知识。使用来自该地区（2015年和2017年）和州（2017年）的青年风险行为调查数据评估性行为。分析探讨了2015年（n=2,596）到2017年（n=3,371）干预区学生的行为差异，并将干预区学生（n=3,371）与同一州的其他学生（n=1,978）进行了比较。结果：分层线性模型回归分析揭示了学生的显著知识增益。 Logistic回归结果显示，在干预区的学生中，2015年至2017年，16名被检查的行为中有6名朝着预期方向移动；1名朝着意想不到的方向移动。2017年数据的逻辑回归结果显示，在干预区学生与该州其他学生的比较中，干预区学生报告最后一次性行为时使用安全套的几率显着更高（调整后的优势比 [AOR] = 1.36，95% 置信区间 [ CI] = 1.07–1.72)，并且报告与4人以上发生性关系 (AOR = .72, 95% CI = .55–.94) 或在上一次性行为前使用酒精或药物的几率显着降低 (AOR = .63, 95% CI = .42–.94)。结论：调查结果表明，该学区的SHE在增加年轻人的知识和改善行为和经验方面有潜在的影响。

    【关键词】 性健康教育；性教育；艾滋病毒预防； 性病; 性传播感染； 青少年; 怀孕预防

    [Abstract] Purpose: 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. Methods: 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). Results: 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). Conclusions: Findings suggest potential effects of the district’s SHE in increasing knowledge and improving behaviors and experiences among youth.

    [Key words] Sexual health education; Sexuality education; HIV prevention; Sexually transmitted disease; Sexually transmitted infections; Adolescent; Pregnancy prevention

  论文原文：Catherine N. Rasberry, Emily Young, Leigh E. Szucs, Colleen Murray, Ganna Sheremenko, James Terry Parker, Georgi Roberts, Catherine A. Lesesne (2022). Increases in Student Knowledge and Protective Behaviors Following Enhanced Supports for Sexual Health Education in a Large, Urban School District. Journal of Adolescent Health, 70 (4) :588-597.  https://doi.org/10.1016/j.jadohealth.2021.05.015 

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