Title: Presentaci
1Universidad de los Andes Santiago, Chile
ADOLESCENT PREGNANCY PREVENTION AN
ABSTINENCE-CENTERED INTERVENTION WITH A
COGNITIVE-BEHAVIOURAL PROGRAM IN A PUBLIC HIGH
SCHOOL IN CHILE
Dr. Carlos Cabezón G. Dept. Obstetrics and
Gynecology Faculty of Medicine Universidad de
los Andes
2 Introduction
- Experience in one school starting in 1997
- Liceo A 128 Elvira Brady
- San Bernardo (peripheral, low income
neighborhood) - Dept Ob/Gin Universidad de los Andes
- Journal of Adolescent Health 36 (2005)64-69
3LOCAL DESCRIPTION
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7 Liceo A 128 Elvira Brady San Bernardo
- Only Girls
- 4 grades high school
- 10 classes (30 40 students each) per grade
- Approx. 1,500 students
- Age 15 19 years old
8 Background Pregnancies during 1996 Liceo A 128
9 Adolescent risky behaviour triad
- Sexual activity (disordered)
- Tobacco / Alcohol / Drugs
- Violence, delinquency
- Strongly related focusing on sexuality can help
in the other problems
10THE PROGRAM
11 The TeenSTAR Program (www.teenstar.org)
- Developmental curriculum
- Learning fertility pattern
- Self-understanding / self-esteem
- Responsible decision making
- Communication skills in the area of sexual
behaviour - Abstinence
12TeenSTAR Program
- One class a week through 2 semesters
- Teachers training one week workshop (40
hours) - Personal monitoring for students
- Parental informed consent
- Voluntary participation of students
13The program 14 units
- Initial session
- Differences between genders
- Prejudices, complement
- Anatomy and Physiology of human reproductive
organs - Fertility awareness observation and registration
of fertility records. - Fertility awareness interpretation
- Knowing emotions and controlling behaviour
14- 8. The manipulation of sexuality in media
- 9. Self-assurance and maintaining decisions
- 10. Marriage and family
- 11. Beginning of life, value of human life
- 12. Family planning methods, contraception and
STD - 13. Pregnancy, delivery and breastfeeding
- 14. Final session
15STUDY DESIGN
16 Prospective, randomized, controlled
- Three cohorts
- 1996 cohort (n 425)
- 1997 cohort (n 423)
- 1998 cohort (n 411)
- Follow up 4 years (each cohort)
- Outcome pregnancies occurring during the 4 year
period in each cohort
17 Randomization (1997 1998 cohorts)
- 1997 cohort 5 teachers/ 10 classes
- 5 classes received the program (n 210)
- 5 classes control group (n 213)
- 1998 cohort 8 teachers/ 10 classes
- 8 classes received the program (n 328)
- 2 classes control group (n 83)
18RESULTS
19 Pregnancy rates 1997 cohort (1997 2000)
20 Pregnancy rates 1998 cohort (1998 2001)
21 Pregnancy rates 1997 1998 cohorts
22Teachers involvement
23DISCUSSION
24 (1)
- A long term cognitive-behavioural intervention
proposing abstinence has been effective in
prevention of unintended pregnancies among
female high school students. - Measured outcome
- Control group
- Prospective intervention
25 Limitations (1)
- No record of abortions
- No record of STD
- No information (facts) about sexual activity
among students - Further investigation is being done
26 (2)
- School teachers get involved and cooperate with
this program - Improves educational environment
27 Limitations (2)
- Persistence in time
- Cost ( 5 vs. 500)
- Entertaining, interesting (not tedious)
- Parental involvement (must be improved)
-
28 Conclusions
- Starting point for our group
- Further research has to be done
- Age of sexual initiation
- Attitude towards sexuality
- Biological facts
- Parents involvement
- Importance of the central message proposed to
adolescents
29Thank you!