This review strongly concurs with the recommendations of others to use biological outcomes as a measure of efficacy when applicable and feasible, and to provide greater detail in reporting of interventions and control conditions. METHODS To explore whether the inclusion of content on gender and power matters for program efficacy, electronic and hand searches were conducted to identify rigorous sexuality and HIV education evaluations from developed and developing countries published between and It's been proven time and time again. Clinic-based programs were far more likely to reduce adverse health outcomes than programs implemented in other settings, with four out of five clinic-based programs proving effective. Multicomponent interventions have been hypothesized to be more effective than single-component interventions.
Most—20 out of 22 programs—described their theory or model of behavior change. Two significantly reduced pregnancy or STI rates 94, and two did not. Possible explanatory variables such as program duration, study design, pedagogical approach or inclusion of additional program components do not seem to be confounding the effects observed. AIDS, , 24 Suppl. Some also provide explicit instructions for handling subtle, and not so subtle, sexual or homophobic harassment. Postintervention follow-up was six months or less in five studies; one evaluation showed a significant decrease in pregnancy risk 84 and four had no effect on pregnancy or STIs. Rogow D and Haberland N, Sexuality and relationships education: Among the eight programs that addressed gender and power and demonstrated significant decreases in pregnancy or STIs, all eight also found significant, independent beneficial effects on reported behavior, attitudes, or other desirable health or social outcomes. Tan JY et al. DiClemente RJ et al. Silverman JG et al. Eight were multicomponent, that is, they included at least one other type of program element, such as service learning, 84,88 community awareness raising, 86, health services or vouchers for services, 86,90,99—, or activities or support in nonhealth areas e. Haberland N and Rogow D, Sexuality education: Depending on the local context, this element may include critically examining and analyzing images of females in visual media and music, 89,90, harmful practices such as early marriage, 94 power disparities in relationships caused by economic or age differ- ences, 91,94 or how some of the differences in the ways males and females express their sexuality are the result of gender stereotypes. Opening Doors with Young People: Finally, the possibility of including chance findings was reduced by examining effects on the range of indicators that evaluations measured. These include explanatory and outcome variables that measure gender attitudes, agency, power in relationships, critical thinking skills, intimate partner violence, advocacy or civic participation, school environment and safety, schooling outcomes, and school connectedness. Of the 22 programs, all but one explicitly described using interactive, participatory, learner-centered or critical thinking pedagogy. Also, so that other potential influences on outcome could be considered, additional information was extracted about each program and study, including the study design, the theoretical basis and general description of the intervention, the duration of the intervention, and the pedagogical approach. Specifically, it can increase the chances that young people will have relationships characterized by equality, respect and nonviolence, and incur the benefits that such characteristics bring for a host of other outcomes. Miller E et al. Harmful gender norms have been correlated with a number of adverse sexual and reproductive health outcomes and risk behaviors, even after other variables have been controlled for. Pallitto CC et al. It is therefore likely that most, if not all, eligible studies were identified. These were also the only two school-based programs that addressed gender or power.
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