The Project Connect Health Systems Intervention: Linking Sexually Experienced Youth to Sexual and Reproductive Health Care
The Project Connect Health Systems Intervention: Linking Sexually Experienced Youth to Sexual and Reproductive Health Care
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DOI：
10.1016/j.jadohealth.2014.04.005
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发表时间：
2014-10-01
影响因子：
7.6
通讯作者：
Ethier, Kathleen A.
中科院分区：
文献类型：
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作者：
Dittus, Patricia J.;De Rosa, Christine J.;Ethier, Kathleen A.
目的：评价卫生系统干预措施，以增加青少年获得优质的性和生殖保健服务。方法：准实验设计。一个大型公立学区的12所高中被配对。在每一组中，学校被分配到一定的条件，这样没有控制学校与干预学校共享地理边界。从2005年到2009年，对随机选择的9-12年级班级的学生进行了五次年度调查(T1、T2、.、T5)(N=29,823)。以社区为基础的优质性和生殖保健服务提供者被列入学校护士将青少年与护理人员联系起来的转诊指南。结果：与对照组相比，干预学校女性在三个方面的结果都有统计学意义。与T1相比，T4(调整后的优势比[AOR]=1.85；95%可信区间[CI]，1.09-3.15)和T5(调整后的优势比=2.22；95%可信区间，1.32-3.74)在过去一年接受避孕措施的人数较多。在过去的一年中，性传播疾病检测和/或治疗的增加幅度较大的是T1-T3(AOR=1.78；95%CI，1.05-3.02)、T1-T4(AOR=1.73；95%CI，1.01-2.97)、T1-T5(AOR=1.97；95%CI，1.17-3.31)和T2-T5(AOR=1.76；95%CI，1.06-2.91)。在T1-T4期间，接受过HIV检测的增加幅度更大(AOR=2.14；95%CI，1.08-4.26)。男生中未发现干预效果。结论：以学校为基础的结构性干预可以提高女性青少年接受服务的程度。爱思唯尔公司代表青少年健康和医学学会出版。
Purpose: To evaluate a health systems intervention to increase adolescents' receipt of high-quality sexual and reproductive health care services.Methods: Quasi experimental design. Twelve high schools in a large public school district were matched into pairs. Within each pair, schools were assigned to condition so that no control school shared a geographic border with an intervention school. Five yearly surveys (T1, T2,., T5) were administered from 2005 to 2009 (N = 29,823) to students in randomly selected classes in grades 9-12. Community-based providers of high-quality sexual and reproductive health care services were listed on a referral guide for use by school nurses to connect adolescents to care.Results: Statistically significant effects were found for intervention school females on three outcomes, relative to controls. Relative to T1, receipt of birth control in the past year was greater at T4 (adjusted odds ratio [AOR] = 1.85; 95% confidence interval [CI], 1.09-3.15) and T5 (AOR = 2.22; 95% CI, 1.32-3.74). Increases in sexually transmitted disease testing and/or treatment in the past year were greater in T1-T3 (AOR = 1.78; 95% CI, 1.05-3.02), T1-T4 (AOR = 1.73; 95% CI, 1.01-2.97), T1-T5 (AOR = 1.97; 95% CI, 1.17-3.31), and T2-T5 (AOR = 1.76; 95% CI, 1.06-2.91). Increases in ever receiving an HIV test were greater in T1-T4 (AOR = 2.14; 95% CI, 1.08-4.26). Among males, no intervention effects were found.Conclusions: A school-based structural intervention can improve female adolescents' receipt of services. Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine.