青少年生殖健康服务促进对中学生家长的干预效果分析

Effect of adolescent reproductive health service promotion on middle school students' parents

目的观察多部门合作促进青少年生殖健康服务提供和利用的干预中,中学生家长在青少年生殖健康教育方面的作用及变化,为进一步探索促进家长开展青少年生殖健康教育的相关策略提供线索。方法以已经建立青少年保健门诊的广东惠州市惠城区、重庆渝中区、贵州凯里市,作为"多部门合作促进青少年友好服务提供和利用的行动方案"(简称"方案")干预地区,选择同样建立了青少年友好服务门诊且国内生产总值相当的黑龙江穆棱市、山东即墨市、江苏盐城市作为方案实施对照地区,干预时间为1.5年。干预前后,对中学生及其家长分别开展问卷调查和专题小组讨论。结果干预后,接受过家长关于生殖健康教育的男、女青少年中,认为家长的生殖健康知识"水平高"的比例分别由6.2%和5.9%增加至13.0%和13.4%,差异均有统计学意义(P值均<0.05)。干预和对照地区的家长都存在对青少年生殖健康问题关注不足、对自身在青少年生殖健康教育的重要作用认识不足、关于青少年生殖健康教育的知识和技能不足的情况。但对于获得青少年生殖健康知识和技能具有积极态度。结论促进家长在青少年生殖健康教育方面的参与和认知水平应得到充分重视,需专门制订相关策略和工具。

Objective To investigate the role and its change of parents（ or caregivers） of middle school students in adolescent reproductive health（ ARH） education in the intervention about multi-sectoral cooperation to promote the delivery and utilization of ARH services. Methods Action Plan for Multi-Sectoral Cooperation to Promote the Delivery and Utilization of Youth Friendly Service was implemented for 1.5 years in Chinese 3 counties/districts of 3 provinces where Youth Friendly Service（ YFS） Clinics had been established. Another 3 counties/districts where YFS Clinics had also been established from 3 other provinces were selected as control areas. The Gross Domestic Products of intervention areas were similar with those of control areas respectively. Questionnaires and focus group discussions were conducted among middle school students and their parents respectively. Percentages were used to describe each variable in interventional and control, male and female adolescents respectively. χ^2 test was used to analyze the differences between before and after intervention in interventional areas, and those between interventional and control areas after the interventional period. Basing on this, multiple factor analysis was conducted by binary Logistic regression. Thematic Framework method was used in qualitative data analysis. Results The percentages of boys and girls who could receive ARH education from their parents（ or caregivers） decreased from 50.5% and 68.0% to 38.2% and 61.5% respectively with statistical significance after the intervention（ OR = 0.67, 95% CI = 0. 51-0. 87）（ P〈0. 05）. The proportions of boys and girls who had received ARH education from their parents（ or caregivers） and thought that their parents（ or caregivers） had a high level of ARH knowledge increased from6.2% and 5.9% to 3.0% and 13.4% respectively（ OR = 2.48, 95%CI = 1.61-3.84）（ P〈0.05）. Lack of attention to ARH problems,weak awareness of their own important role in ARH education, lack of knowledge and skills on ARH were three common issues in parents（ or caregivers）. But parents（ or caregivers） interviewed possessed a positive attitude towards acquiring ARH knowledge and skills. Conclusion It should be given full attention to promote parents（ or caregivers） ＇ participation and enhance their ARH education capacity. Special related strategy and tool are needed.