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Impact of Life Skills Training to Improve Cognition on Risk of Sexual Behavior and Contraceptive Use among Vocational School Students in Shanghai,China

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Journal of Reproduction and Contraception 2008年第4期19卷 239-251页

作者： chao-hua lou xiao-jin wang xiao-wen tu er-sheng gao Shanghai Institute of Planned Parenthood Research National Population and Family Planning Key Laboratory of Contraceptive Drugs & Devices Shanghai 200032 China

Objective To evaluate the impact of life skills training that uses participatory teaching method on improving reproductive health cognition of vocational school students of metropolitan, China.Methods Three vocational schools of an urban district in Shanghai were selected as the research sites, with two schools as the intervention groups（group A and group B） and the other as the control（group C）. Group A was provided life skills training with core of reproductive health plus peer education, while group B only provided life skills training. All the second grade students were recruited as the subjects. Baseline surveys were conducted in three schools before the implementation of the intervention, and similar surveys were conducted after two terms of the intervention to test the effectiveness of the intervention. In total, 1 612 subjects, including 810 males and 802 females, were recruited. The effects of the intervention on subjects＇ cognitions on sexual behavior and condom/contraceptive use were analyzed using mixed model with repeated measures.Results From pretest to posttest, there were significant increase of the proportions of perceiving risks in getting pregnant, infecting STDs and HIV, benefits by learning and using condom, and self-efficacy in contraceptive use, and decrease of the proportions of perceiving barriers for condom use in two intervention groups; while few similar changes in the control group. In mixed modeling analysis, interaction effects of group A × time and group B × time were found on the scores of perceived risks （P〈0.000 1）, perceived benefits （P〈0.000 1）, perceived barriers （P=0.001 2for group A and P=0.003 4 for group B）,and perceived self-efficacy （P〈0.000 1）. The significant difference of the effects between two interventions was only observed on perceived benefits （P 〈0.000 1）.Conclusion Life skills training using participatory approaches is effective in improving students＇ reproductive health cognition and could be used as an im

关键词： life skill training participatory method reproductive health cognition vocational school students China

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Relationship between Contraceptive Knowledge,Cognition and Behaviors among Vocational High School Students

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Journal of Reproduction and Contraception 2006年第4期17卷 239-248页

作者： xiao-jin wang chao-hua lou xiaowen tu er-sheng gao Bio-statistics Department of Jiaotong University Shanghai 200025 China Epidemiology and Social Science Department of Shanghai Institute of Planned Parenthood Research Shanghai 200032 China

Objective To study the relationship between contraceptive knowledge, cognition and behaviors among vocational high school students. Methods A cross-sectional survey was anonymously self-administrated by way of computer to all the 1st graders＇ among three vocational high schools in a district of Shanghai. Four cognition indicators, including perceived benefits, perceived barriers, perceived risks and self eJficacy were applied according to Health Belief Model. Results The percentage of respondents who reported ever sexual practices and contraceptives use at first sex was 7.01% and 56.64% respectively. Condom （58. 70%） and oral contraceptive pills （27.78%） were used by the majority. Main reasons for non-use were ＂shy to buy it＂（26.53%） and ＂partner don＇t want to use any＂（18.37%）. Proportion of respondents who ever had sex regarded withdrawal and rhythm as effective were 68.35% and 68.42% respectively. Proportion of respondents having sex knew ＂If a person was infected with STDs, he/she might not have noticeable symptoms＂ were 22.86%. Proportion of respondents who reported non-use of contraceptives at first sex considered that ＂infrequent intercourse could not cause a girl pregnant even she had experienced her menstruation＂ were 40.63%. Proportion of respondents who had ever used condom got full score of knowledge on ＂how to correctly use condom＂ were 23,26%. Perceived risks were poorest among four cognition indicators. High level of contraceptive knowledge was connected with high rate of contraceptives use at first sex, whereas high level contraceptive cognition was connected with high rate of contraceptive use both at first and recent sex. Conclusions It is important to provide youth-friendly services as well as message on contraceptives among vocational school students.

关键词： vocational high school students contraceptive behaviors contraception cognition health belief model (HBM) computer-administrated

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Association of Sexual Intercourse with Psychological Suppression and Copying Modes for Vocational School Students

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Journal of Reproduction and Contraception 2009年第2期20卷 101-112页

作者： Li wang xiao-jin wang xiao-wen tu chao-hua lou er-shenggao School of Public Health Fudan university Shanghai 200032 China Department of Epidemiology and Social Science Research on Reproductive Health Shanghai Institute ofPlanned Parenthood Research Shanghai 200032 China Department of Biostatistics Shanghai Jiaotong University School of Medicine Shanghai 200025 China

Objective To evaluate the association of sex behavior with sexual related psychological suppression and coping modes among students in three vocational schools in Shanghai. Methods A cross-sectional survey was conducted among 1 368 grade one students from three vocational schools in a district of Shanghai, with Computer Assisted Self- Interview （CASI）. The field work began in the April 2003 for a baseline survey, and completed in the December, 2003. Data on students＇ sexual intercourse, sexual related psychological suppression and psychological coping modes, and communication with parents were collected and analyzed. Binary logistic regression was used to adjust the potential confounding factors. Results After controlling for demographic factors, adolescents with middle or high scores of active psychological coping strategies on sexual related events were less likely to have sexual intercourse （ORadj=0.48, 95%CI=0.30-0. 77 and ORadj=0.49, 95%CI=0.30-0.83, respectively）, while association between psychological suppression on sex related events and sexual intercourse was not statistically significant （ORadj= 0.93, 95%CI=0.63-1.37）; sexual related psychological suppression and active coping modes were positively associated with adolescents＇ communicating with parents for 2-7 h/week about school things, but negatively associated with parents＇ open attitudes towards heterosexual contacts and talking sex related things with others. Conclusion Vocational school students with active psychological coping strategies on sexual related events were less likely to engage in sexual intercourse, so interventions focus on reducing unprotected sexual behaviors should target on psychological coping modes skills training.

关键词： psychological suppression psychological coping modes sexual intercourse

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Evaluation of Family Sex Education on Middle School Students in Shanghai

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Journal of Reproduction and Contraception 2006年第4期17卷 260-269页

作者： Xia-yun ZUO xiao-wen tu chao-hua lou er-sheng gao Shanghai Institute of Planned Parenthood Research Shanghai 200032 China

Objective To evaluate the impact of family-school combined sex education among middle school students. Methods This is a school-based intervention study. Four junior middle schools and two senior middle schools in Xuhui District, Shanghai, were selected as study sites involving parents, two junior middle schools and one senior middle school as the intervention group and others as control group. The intervention group was provided with both school and family education which contained giving lectures, distributing leaflets, organizing group discussions and parent-adolescent communicating activities to parents. Data were collected through anonymous and self-administered questionnaires before and after one-year intervention to evaluate the effect of the intervention. Results The average score of parents in the intervention group was higher than that in the control group after intervention. Particularly, the mean score of AIDS knowledge in the intervention group was increased by 10.5, which was more than that of control group （5.3）. The intervention increased the parents＇ intention to family sex education. The percentage of parents in the intervention group approving ＂sex education should be provided by parents＂ had increased, much higher than that in the control group. Intervention also promoted parent-adolescent communication about sex. The percentage of parents reporting ＂they actively talked with their children about sex or their teens asked them questions related to sex＂ had increased, much higher than that in the control group. Conclusion Family-school combined sex education significantly increased sexual knowledge and sex education intention of parents, promoted the parent-adolescent communication about sex as well.

关键词： family sex education middle school students parent intervention

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Survey on Attitude of Middle School Educators for Sex and Reproductive Health Education

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Journal of Reproduction and Contraception 2006年第4期17卷 270-274页

作者： Qi-guo LIAN chao-hua lou xiao-wen tu er-sheng gao Shanghai Institute of Planned Parenthood Research Shanghai 200032 China Fudan School of Public Health Shanghai 200032 China

Objective To get a general picture of the attitudes of middle school educators on sex and reproductive health education. Methods A cross-sectional survey was carried out among 144 middle school educators in three districts of Shanghai from September to October 2005 using anonymous self-administered questionnaire. Results The majority of the educators thought that it was necessary to launch the sex and reproductive health education in all of the middle schools in Shanghai （97. 02%）. They were aware that the age of the students＇puberty were earlier now than before （94.41%）, but the reproductive health knowledge of students was neither sufficient nor correct （78.34%）. The sex and reproductive health education had been involved in the curriculum of many middle schools （66.11%）. Lacking of qualified education staffs contributed most （90. 71%） in the schools which had not launched the sex and reproductive health education. Lacking of qualified education staffs （90.91%） challenged most in the schools which had carried the education. Conclusion The middle school educators thought it was necessary to carry the sex and reproductive health education in all of the middle schools in Shanghai while the major challenges were lacking of qualified education staffs and sufficient teaching time.

关键词： educator middle school reproductive health sex education

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社区干预项目对未婚年轻人性行为的长期影响

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复旦学报（医学版） 2006年第2期33卷 192-196,200页

作者：涂晓雯楼超华高尔生上海市计划生育科学研究所上海200032

目的评价性与生殖健康社区干预项目对未婚年轻人性行为发生的长期影响。方法在上海市郊两个镇开展以社区为基础的干预研究,干预持续20个月,干预活动包括性与生殖健康知识教育、咨询及避孕服务。通过干预前、干预结束时及干预结束28个月... 详细信息

目的评价性与生殖健康社区干预项目对未婚年轻人性行为发生的长期影响。方法在上海市郊两个镇开展以社区为基础的干预研究,干预持续20个月,干预活动包括性与生殖健康知识教育、咨询及避孕服务。通过干预前、干预结束时及干预结束28个月后3次问卷调查评价干预项目的长期影响。结果从第3次调查所有对象性行为的发生情况看,干预组中学生性行为发生比例低于对照组,但经多因素分析调整了可能的影响因素后发现,干预对不同类别对象的性行为发生均无长期影响。从第3次调查原干预队列对象研究期间性行为的发生情况看,剔除基线调查时有过性行为的对象后,干预结束时中学生性行为的发生比例干预组低于对照组,但第3次调查两组不同类别对象性行为发生比例无统计学差别。多因素分析调整了可能的影响因素后也未发现干预对不同类别对象随访期间性行为的发生有持续作用。从新对象性行为的发生情况看,干预组不同类别对象性行为发生比例均明显低于对照组,但经多因素分析调整了可能的影响因素后发现,干预对不同类别新对象的性行为发生均无延续影响。结论干预项目对未婚年轻人性行为发生的长期影响不明显,其主要原因可能与干预结束后干预组社区性教育活动明显减弱、而对照组也在社区开展了类似活动以及当地存在订婚后同居的习俗有关。

关键词：未婚年轻人性教育生殖健康服务干预研究性行为长期效果社区

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职校生性与生殖健康教育和服务模式效果评价

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复旦学报（医学版） 2009年第3期36卷 265-269页

作者：涂晓雯应笑楼超华高尔生上海市计划生育科学研究所上海200032

目的评价职校生不同性与生殖健康教育和服务模式的效果。方法选取上海市3所职校作为研究现场,其中两所职校为干预组,分别采取由学校老师(干预1)和校外医学专业人员(干预2)开展干预活动的模式,另一所职校为对照组。干预持续2学年,通过干... 详细信息

目的评价职校生不同性与生殖健康教育和服务模式的效果。方法选取上海市3所职校作为研究现场,其中两所职校为干预组,分别采取由学校老师(干预1)和校外医学专业人员(干预2)开展干预活动的模式,另一所职校为对照组。干预持续2学年,通过干预前后2次问卷调查评价干预效果。结果两种干预模式均能有效提高职校生的性与生殖健康知识水平,增强学生的自我悦纳程度,其中干预1组和干预2组与对照组性与生殖健康知识得分增值调整均数之差分别为8.4和18.2,与对照组自我悦纳得分增值调整均数之差分别为1.0和0.6,差别具有统计学意义。干预2模式还能有效提高职校生的安全性行为意识,干预2组与对照组和干预1组安全性行为意识得分增值调整均数之差分别为0.3和0.4,差别具有统计学意义。结论与由学校老师开展的性与生殖健康教育和服务相比,由校外医学专业人员开展的教育和服务模式更有效。

关键词：职校生性教育生殖健康服务性与生殖健康知识自我悦纳安全性行为意识学校

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社区干预项目对未婚青(少)年生殖健康知识和性相关态度的影响

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复旦学报（医学版） 2004年第1期31卷 46-52页

作者：高尔生楼超华王波沈燕王筱金涂晓雯上海计划生育科学研究所上海200032

目的评价社区性与生殖健康教育和服务对未婚青(少)年生殖健康知识水平和性相关态度的影响。方法在上海市某区两个镇开展以社区为基础的干预性研究,干预组和对照组分别有15～24岁未婚青(少)年1220名和1007名。干预活动的形式包括发放... 详细信息

目的评价社区性与生殖健康教育和服务对未婚青(少)年生殖健康知识水平和性相关态度的影响。方法在上海市某区两个镇开展以社区为基础的干预性研究,干预组和对照组分别有15～24岁未婚青(少)年1220名和1007名。干预活动的形式包括发放宣教材料、播放教育录像、组织讲座和小组讨论、提供咨询和避孕服务。干预持续20个月,随访率为92％。通过干预前后的问卷调查对干预项目的效果进行评价。结果干预前干预组和对照组的性与生殖健康知识没有显著差别,干预后两组的得分分别为(72.2±10.2)和(43.6±16.9)分,干预组明显高于对照组。对有关生殖生理、避孕、性病/艾滋病的绝大部分问题,干预组的答对率较对照组有明显提高。干预对未婚青(少)年有关性相关问题的态度也有积极影响。此外,干预组对象的安全性行为和自我保护意识增强。多因素分析结果显示,在调整了其他可能的影响因素后,干预仍是影响生殖健康知识得分的一个最重要的因素。结论在社区开展对未婚青(少)年的性与生殖健康教育和服务是提高青(少)年性与生殖健康知识的一条有效途径,也可在一定程度上改变青(少)年的性观念,使他们对性相关问题持更为积极和理性的态度。

关键词：社区干预项目未婚青少年生殖健康知识性相关态度性教育健康教育

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生活技能培训对职校生生殖健康认知的影响

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生殖与避孕 2009年第1期29卷 31-37页

作者：楼超华王筱金涂晓雯高尔生上海市计划生育科研所上海200032

目的:评价生活技能培训对职校生生殖健康认知的影响。方法:上海市区3所职校为研究现场,其中2所为干预学校,1所为对照学校,研究对象为二年级的学生。干预组采取以生殖健康为核心的生活技能培训加同伴教育和单一生活技能培训2种不同的干... 详细信息

目的:评价生活技能培训对职校生生殖健康认知的影响。方法:上海市区3所职校为研究现场,其中2所为干预学校,1所为对照学校,研究对象为二年级的学生。干预组采取以生殖健康为核心的生活技能培训加同伴教育和单一生活技能培训2种不同的干预模式,干预活动持续1个学年。通过干预前后电脑问卷调查评价干预效果。结果:与基线调查时相比,干预后干预组对象的生殖健康风险(发生妊娠、感染性病和艾滋病)认知、避孕套使用的收益认知和避孕方法选择的自我效能上升,避孕套使用的障碍认知则下降,差异有统计学意义(P<0.05),而对照组的变化不明显。以基线和终线2次调查对象的生殖健康认知(即风险认知、收益认知、障碍认知和自我效能)评分为应变量,拟合重复测量资料的混合效应模型显示,在调整了其它可能的混杂因素后,组别与时间的交互作用项在4个模型中都有统计学意义(P<0.05),提示生活技能培训可提高职校生的生殖健康风险与避孕相关认知。2种干预模式(生活技能培训加同伴教育与单一生活技能培训)的作用仅在避孕套使用的收益认知上有差异。结论:生活技能培训可有效提高职校生的生殖健康认知,可以作为对年轻人进行性相关问题教育的一种重要方法。

关键词：生活技能培训生殖健康认知职校生

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社区干预项目对未婚青少年生殖健康知识的长期影响

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生殖与避孕 2005年第5期25卷 290-295页

作者：涂晓雯楼超华高尔生上海市计划生育科学研究所上海200032

目的:评价社区干预项目对未婚青少年生殖健康知识的长期影响。方法:在上海市郊两个镇开展以社区为基础的干预研究,干预持续20个月,干预项目包括性与生殖健康知识教育、咨询及避孕服务。通过干预前、干预结束时及干预结束后28个月3次问... 详细信息

目的:评价社区干预项目对未婚青少年生殖健康知识的长期影响。方法:在上海市郊两个镇开展以社区为基础的干预研究,干预持续20个月,干预项目包括性与生殖健康知识教育、咨询及避孕服务。通过干预前、干预结束时及干预结束后28个月3次问卷调查评价干预项目的长期影响。结果:干预前干预组和对照组对象的各分类知识得分及总知识得分均无统计学差别,干预后不同时点干预组对象的各分类知识得分及总知识得分均显著高于对照组,但第3次调查原干预队列对象和对照组对象知识得分增值的差值均明显低于干预结束时的调查。多因素分析结果显示,在调整了可能的影响因素后,第3次调查两组对象知识得分增值的差值为13.00,是干预结束时的50.68%。从新对象的知识得分看,除避孕知识得分两组比较无统计学差别外,其余各分类知识得分及总知识得分干预组均高于对照组。多因素分析显示,在调整了可能的影响因素后,干预效应的OR值为1.64。结论:干预项目对原干预队列对象生殖健康知识增加有较强的持续影响,对新对象生殖健康知识增加有延续影响,应继续通过社区向未婚青少年提供性与生殖健康教育和服务。

关键词：未婚青少年性教育生殖健康知识和服务干预研究长期效果社区区

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