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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel


CiteScore 2018: 0.79

SCImago Journal Rank (SJR) 2018: 0.350
Source Normalized Impact per Paper (SNIP) 2018: 0.476

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2191-0278
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Evaluation of a comprehensive sexuality education program in La Romana, Dominican Republic

Sheyla D. RichardsORCID iD: https://orcid.org/0000-0001-8082-1607 / Eva Mendelson / Gabriella Flynn
  • Columbia University Program for Global and Population Health, Vagelos College of Physicians and Surgeons, New York, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Luz Messina / Diane Bushley / Mina Halpern / Silvia Amesty
  • Columbia University Program for Global and Population Health, Vagelos College of Physicians and Surgeons, New York, NY, USA
  • Columbia University Center for Family and Community Medicine, New York, NY, USA
  • Heilbrunn Department of Population and Family Health, New York, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Samantha Stonbraker
  • Clínica de Familia, La Romana, Dominican Republic
  • Columbia University School of Nursing, New York, NY, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-06-13 | DOI: https://doi.org/10.1515/ijamh-2019-0017

Abstract

Background

The Dominican Republic (DR) has some of the highest rates of sexually transmitted infections (STI) and adolescent pregnancy in the Caribbean. Well-designed comprehensive sexuality education programs (CSEP) can reduce risky sexual behavior. This study sought to evaluate the Módulo Anexo Materno Infantil (MAMI) adolescent clinic’s CSEP in changing knowledge of STI and pregnancy and attitudes towards risky sexual behavior following implementation.

Methods

A mixed methods study was conducted among students aged 11–25 years from three schools between September 2017 and February 2018. Participants in MAMI CSEP completed questionnaires, before, immediately following, and 3 months following the CSEP. Questions assessed knowledge, attitude, and sexual experience, and obtained program feedback. There was one eight-participant focus group discussion (FGD) per school. Descriptive statistics summarized sample demographics and cross-sectional responses. McNemar’s test evaluated differences in the proportions of students selecting correct responses over time. Paired t-tests compared mean test scores across time.

Result

Overall response rate was 98.7% (1414/1432), with 486 pre-tests, 448 initial post-tests, and 480 3-month post-tests. Respondents identified as 53.5% (321/600) female and 46.5% (279/600) male with mean age of 14.2 years. More males (63.4%) reported sexual experience than females (35.8%) (p < 0.001). Increases in mean scores from pre-test to post-test and pre-test to 3-month post-test were statistically significant (p < 0.001). Three themes arose from the FGDs: (1) expanding sexual and reproductive health knowledge, (2) perception of curricular content, structure and delivery, and (3) student-health educator dynamic.

Conclusion

Improvement in test scores supports MAMI CSEP’s efficacy in educating students and reinforcing positive attitudes to reduce risky sexual behavior. Utilizing an interactive health educator model provided students with clear, accurate information in a safe environment with mutual trust. Selecting health educators employed by an adolescent clinic allows them to connect students to preventive and treatment services during the CSEP.

Keywords: adolescent; comprehensive sexuality education; Dominican Republic; program evaluation; sexually transmitted infection

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About the article

Received: 2019-01-16

Accepted: 2019-03-21

Published Online: 2019-06-13


Funding Source: National Institute of Nursing Research

Award identifier / Grant number: RHeaDI T32NR007969

Funding Source: Columbia University

Award identifier / Grant number: Friedman Funding for Scholarly Projects

National Institute of Nursing Research, National Institutes of Health, Grant Number: RHeaDI T32NR007969, Columbia University, Funder Id: http://dx.doi.org/10.13039/100006474, Grant Number: Friedman Funding for Scholarly Projects.


Citation Information: International Journal of Adolescent Medicine and Health, 20190017, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2019-0017.

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