Abstract
Background
Existing sexual health programs have not significantly reduced teen pregnancies or sexually transmitted diseases. A more creative approach is needed.
Methods
An assessment of 539 teens in one Ontario city was conducted to identify knowledge about and use of birth control, comfort in discussing sexual health, and preferred sites, providers and methods of service delivery.
Results
Knowledge of, and comfort discussing, birth control was not associated with frequency of use but was associated with grade. Adolescents were less comfortable discussing sexual health with teachers than health professionals. Over time, comfort increased with health professionals, but not teachers. Sexually active teens reported willingness to attend mall-based clinics.
Conclusions
Using birth control appears to be maturational given its association with grade. Since teens were consistently less comfortable with teachers, providing sexual health services in schools is likely ineffective. Teens may respond to clinics in creative settings such as malls.
Résumé
Contexte
Les programmes de santé sexuelle existants n’ont pas réduit de façon importante la grossesse chez les adolescentes et les maladies transmises sexuellement, d’où la nécessité de trouver des approches novatrices.
Méthode
Nous avons sondé 539 adolescents d’une ville ontarienne pour déterminer leurs connaissances et leur emploi des méthodes anticonceptionnelles, leur aisance à parler de santé sexuelle et leurs préférences quant aux lieux où obtenir des services de santé sexuelle, aux prestateurs de ces services et aux méthodes de prestation.
Résultats
Les connaissances et l’aisance n’étaient pas associées à la fréquence d’utilisation des méthodes anticonceptionnelles, mais au niveau de scolarité. Les adolescents étaient moins enclins à discuter de santé sexuelle avec des enseignants qu’avec des professionnels de la santé. Ils devenaient graduellement plus à l’aise avec les professionnels de la santé, mais pas avec les enseignants. Les adolescents actifs sexuellement étaient disposés à visiter des cliniques de centres commerciaux.
Conclusions
L’emploi des méthodes anticonceptionnelles étant associé au niveau de scolarité, il pourrait être lié à la maturation. Comme les adolescents sont uniformément moins à l’aise avec les enseignants, il n’est sans doute pas efficace d’offrir des services de santé sexuelle à l’école. Il serait préférable de créer des cliniques dans des endroits moins conventionnels, comme les centres commerciaux.
References
- 1.Wolk L. The benefits of school-based condom availability: Cross-sectional analysis of a comprehensive high school-based program. J Adolesc Health. 1995;17:.184–88. doi: 10.1016/1054-139X(95)00031-M. [DOI] [PubMed] [Google Scholar]
- 2.Middlesex-London Health Unit. Reproductive Health Report: Middlesex County and the City of London. London, Ontario: author; 1998. [Google Scholar]
- 3.Hanvey L, Avard D, Graham I, Underwood K, Campbell J, Kelly C. The Health of Canada’s Children: A CICH Profile. 2nd. Ottawa: Canadian Institute of Child Health; 1994. [Google Scholar]
- 4.Middlesex-London Health Unit. Communicable Disease Report for Middlesex-London: 1990–1998. London, Ontario: author; 2000. [Google Scholar]
- 5.Starr C. Beyond the birds and the bees: Talking to teens about sex. Patient Care. 1997;31(7):.102–12. [Google Scholar]
- 6.Hingson RW, Strunin L, Berlin BM. Acquired immunodeficiency syndrome transmission: Changes in knowledge and behaviors among teenagers. Pediatrics. 1990;85:.24–29. [PubMed] [Google Scholar]
- 7.Johnson LS, Rozmus C, Edmission K. Adolescent sexuality and sexually transmitted diseases: Attitudes, beliefs, knowledge, and values. J Pediatr Nurs. 1999;14:.177–85. doi: 10.1016/S0882-5963(99)80006-2. [DOI] [PubMed] [Google Scholar]
- 8.Kirby D. School-based programs to reduce sexual risk-taking. J Sch Health. 1992;62:.280–87. doi: 10.1111/j.1746-1561.1992.tb01244.x. [DOI] [PubMed] [Google Scholar]
- 9.van Visser AP, Bilsen P. Effectiveness of sex education provided to adolescents. Patient Educ Couns. 1994;23:.147–60. doi: 10.1016/0738-3991(94)90031-0. [DOI] [PubMed] [Google Scholar]
- 10.Haignere CS, Culhane JF, Balsley CM, Legos P. Teachers’ receptiveness and comfort teaching sexuality education and using non-traditional teaching strategies. J Sch Health. 1996;66(4):.140–44. doi: 10.1111/j.1746-1561.1996.tb08234.x. [DOI] [PubMed] [Google Scholar]
- 11.Middlesex-London Health Unit. Teen Panel Summary Report: 1998–1999 School Year. London, Ontario: Author; 1999. [Google Scholar]
- 12.Shrier LA, Goodman E, Emans SJ. Partner condom use among adolescent girls with sexually transmitted diseases. J Adolesc Health. 1999;24:.357–61. doi: 10.1016/S1054-139X(98)00133-5. [DOI] [PubMed] [Google Scholar]
- 13.Brindis C, Bogess J, Katsuranis F, Mantell M, McCarter V, Wolfe A. A profile of the adolescent male family planning clinic client. Fam Plann Perspect. 1998;30(2):.63–66. doi: 10.2307/2991661. [DOI] [PubMed] [Google Scholar]
- 14.O’Donnell L, Stiueve A, San Dorval A, Duran R, Haber D, Atnafou R, et al. The effectiveness of the Reach for Health community youth service learning program in reducing early and unprotected sex among urban middle school students. Am J Public Health. 1999;89:.176–81. doi: 10.2105/AJPH.89.2.176. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Stout JW, Kirby D. The effects of sexuality education on adolescent sexual activity. Pediatr Ann. 1993;22:.120–26. doi: 10.3928/0090-4481-19930201-09. [DOI] [PubMed] [Google Scholar]
- 16.Neuman B. The Neuman Systems Model. 3rd. Norwalk: Appleton & Lange; 1995. [Google Scholar]
- 17.Ministry of Health, Public Health Branch. Mandatory Health Programs and Services Guidelines. Toronto, Ontario: author; 1997. [Google Scholar]
- 18.Crosse EA. Inter-area variation in low birth-weight rates within the City of London, Ontario, 1984–1988. London, Ontario: University of Western Ontario; 1994. [Google Scholar]
- 19.Polit DF, Hungler BP. Nursing Research: Principles and Methods. 6th. Philadelphia: Lippincott; 1999. [Google Scholar]