上海市高中、职校学生性与生殖健康行为的干预效果研究

目的评价由医学专业人员参与的对上海市高中、职校学生进行的“性与生殖健康教育”综合性干预的效果，为有效降低青少年的生殖健康风险提供依据。方法本研究选择上海市两个区的4所高级中学、2所职业学校作为研究现场，将研究对象按1：1比例分层（高中和职校）随机分配入干预组（419例）和对照组（688例），对干预组进行为期1年的“性与生殖健康教育”综合性干预，分析干预组和对照组生殖健康行为的差异。结果基线调查时干预组和对照组生殖健康行为无明显差别（P〉0．05），但干预后干预组向父亲、母亲、老师、同性朋友、医学专业人员以及其他途径求助的比例均显著高于对照组，差异具有统计学意义（均P〈0．05）。多因素分析结果显示，考虑了研究对象生殖健康知识和态度的情况下，在两性问题的求助方面，干预组较对照组更愿意寻求帮助（OR=2．881，95％CI：1．972～4．209），在求助对象和方式上，更愿意倾向父亲（OR=2．548，95％CI：1．672-3．883）、母亲（OR=2．094，95％CI：1．496～2．932）、老师（OR=2．378，95％CI：1．397～4．081）、专业人员（OR=2．247，95％CI：1．459～3．460）、热线电话（OR=2．185，95％CI：1．132～4．217）、书刊杂志（OR=1．165，95％CI：0．632～2．147）。干预组较对照组有恋爱关系或正在恋爱者，以及发生性行为可能性者较少（OR=0．628，95％CI：0．445—0．883）。结论“医教结合”的性与生殖健康教育综合性干预模式对改变学生生殖健康行为具有一定效果，值得进一步探索和推广应用。

The effectiveness of intervention on sexual and reproductive behavior in students from high and vocational schools

Objective To assess the effect of sexual and reproductive health education and service conducted by medical professionals among students from high and vocational schools in Shanghai, so as to provide evidence for reducing reproduction risk in adolescents. Methods Four high schools and two vocational schools in two districts of Shanghai were included in the study, among which two high schools and one vocational school were selected randomly as intervention group （ n = 419 ）, and the others were controls （ n = 688 ） according to 1 ： 1 ratio. The intervention group took part in one-year sexual and reproductive health education. The differences in sexual and reproductive health between two groups were analyzed. Results Although the difference was not significant between two groups in baseline investigation （P 〉 0.05 ）, there were more students in the intervention group than the controls asking for help from parents, teachers, homosexual friends, medical professionals and telephone hotline with statistical difference（ all P 〈 0.05 ）. Multivariate analysis showed that students in the intervention group were more likely to ask for help in sexual problems when sexual and reproductive knowledge and attitudes were considered （ OR = 2.881,95 % CI： 1. 972-4. 209 ）, and more likely to ask for help from fathers （ OR = 2. 548, 95 % CI： 1. 672- 3. 883 ）, mothers （ OR =2. 094, 95% CI： 1. 496-2. 932）, teachers （ OR =2. 378, 95% CI： 1. 397-4. 081 ）, medical professionals （ OR = 2.247,95% CI：1.459-3.460）, telephone hofline （OR =2. 185, 95% CI：I. 132-4. 217） and journals or books （OR = 1. 165,95% CI： 0. 632-2. 147） in help-seeking ways. Compared with the controls, the intervention group was less likely to have romantic relationship or have love affairs （OR--0. 628, 95% CI： O. 445-0. 887 ）. Conclusion The sexual and reproductive health education conducted by both medical and educational practitioners is effective to students＇ sexual and reproductive behavior, and it is worth to be complemented further.