Multidisciplinary peer-led sexual and reproductive well being training programme in France, a potential controlled-study | BMC Public Well being

Description of the programme

The SeSa programme for healthcare college students extends over one educational 12 months and consists of 20 hours of world well being prevention programs, 31 hours of particular prevention (dependancy, dental hygiene, diet and sexual training) and one to 4 subject interventions throughout which healthcare college students talk their data to the youngsters. Gynaecologists, SRH training consultants, and governmental and nongovernmental organizations specializing in reproductive well being and well being training lead the 31 hours lengthy SRH-specific programme and lined STIs (physiopathology of chlamydia, gonococcus, HPV) and HIV/AIDS info and prevention (8 hours), contraception (hormonal, non hormonal, emergency contraception, pharmaceutical points and technical use, 4 hours), abortion procedures (3 hours), rights and legal guidelines (4 hours), sexual and gender minority consciousness (4 hours), authorized points in addition to issues of respect and consent (4 hours), sexual training communication (4 hours). 5 healthcare college students per group, one from every well being department (dentist, medical physician, midwife, pharmacist and physiotherapist), lead the sector interventions. The logistical points, length and particular targets of those interventions are determined and arranged by the colleges taking part within the SeSa programme. Interventions final for one to 4 hours for one class on at some point. The taking part healthcare college students must switch their data in an tailored approach so as to attain the precise targets set by the related college.

The traditional French public secondary college curriculum consists of reproductive well being training through the penultimate 12 months, and faculty attendance is necessary till 16 years of age. These two grades represented probably the most related teams of scholars to review.

Research design

The Mediterranean Perinatology Community led this multicentric observational potential quasi-experimental analysis examine [23] from November 2018 to June 2019 in Aix-Marseille and Good Sophia-Antipolis Universities. Two populations have been studied: the primary inhabitants included healthcare college students (peer-educators) taking part within the SRH a part of the SeSa programme (SRH peer-educators) who have been in comparison with healthcare college students taking part in different modules (diet, dependancy, and dental hygiene) (different peer-educators), and the second inhabitants included 13–15 year-old college college students (youngsters) taking part within the SeSa SRH programme (SeSa-intervention youngsters) who have been in comparison with 13–15 year-old college college students receiving the traditional public college programme (no-intervention youngsters). Ranges of data, danger notion and dangerous behaviour have been studied earlier than and after the SeSa programme amongst these populations (Fig. 1). We included all college students of all healthcare branches taking part within the SeSa programme, as required by regulation, learning on the Universities of Aix-Marseille and Good Sophia Antipolis as follows: the primary 12 months college students for dental and midwifery faculties, second 12 months college students for pharmacy and physiotherapy faculties and third 12 months college students for medical faculties. Healthcare college students have been randomly assigned by alphabetical order to at least one module of the programme, aside from midwives in Good who have been assigned to the SRH module for organizational functions. Every healthcare scholar taking part within the SeSa programme was invited to reply a questionnaire in November 2018 earlier than taking part in any course. On the finish of the educational 12 months, in Could 2019, the identical questionnaire was supplied once more. Data on age, gender and sort of research (dentistry, medication, midwifery, physiotherapy, and pharmacy) was collected.

Fig. 1
figure 1

For youngsters, we included voluntary secondary faculties in Marseille and chosen college students of their penultimate and final 12 months of secondary college (13–15 years outdated). Investigators invited faculties included within the SeSa programme to take part within the examine. After agreeing to take part, faculties have been assigned to the SHR group if the category participated within the SHR module and to the management group if the category participated in one other module. Youngsters have been invited to finish a questionnaire earlier than the interventions in February 2019. The identical questionnaire was supplied three months after the top of the programme. Faculties not taking part within the SeSa programme obtained the primary questionnaire in February or March 2019 and the postintervention questionnaires in Could or June 2019 to respect a 3-month delay between the 2 questionnaires. Data on age, class, college and gender have been collected.

For causes associated to participation, group and anonymity, the info collected on this examine was not paired. While it had been initially deliberate to assign participant identification numbers this initiative was finally deserted given the variety of contributors and the dearth of adherence anticipated if complete anonymity was not ensured to each youngsters and healthcare college students. Since college students have been a part of a particular programme, we assumed that they might not change through the course of the programme. The investigators distributed the questionnaires. Neither the schoolteachers nor the college professors had entry to the paperwork.

To take part within the examine, peer educators (SRH and others) needed to be a part of the category of 2018 (which meant a part of the SeSa programme), converse French and be over eighteen years of age. For youngsters, participation was attainable if dad and mom or authorized guardians had given their consent to the examine, and entry to the postintervention questionnaire was not attainable if the pretest questionnaire had not been accomplished (absent and/or no authorized authorization). The distribution of participant variables is introduced in Fig. 1.

Consequence measures

The first consequence, data acquisition, was measured with 30 “true or false” questions (TFs) for healthcare college students (additionally known as peer educators) and youngsters in addition to 30 further multiple-choice questions (MCQs) for well being college students. The variety of contributors required was 1000 contributors and was decided to have 80% statistical energy and a bilateral significance of 5%, assuming a distinction of 12% between the 2 teams within the postintervention rating. The questions assessed data of contraception use, Sexually Transmitted Infections (STIs), French SRH legal guidelines (entry to abortion, free contraception, legal guidelines in opposition to homophobia, and entry to pornography) and reproductive biology.

For the secondary consequence, danger notion was measured utilizing a Likert scale [24] from 0 to five. Individuals needed to resolve in regards to the degree of danger of a scenario, between not dangerous (0) and really dangerous [5]. Eleven conditions assessed the notion of being pregnant and the transmission danger of STIs through the first intercourse, with or and not using a barrier safety technique (condom). Data on behaviour was collected utilizing an tailored model of the Youth Danger Behaviour Survey revealed by the Facilities for Illness Management and Prevention’s [25]. Individuals have been requested to document their age on the time of their first sexual activity, complete variety of sexual companions and variety of companions within the final 3 months, the contraceptive technique used, if wanted, and using alcohol or medication, and condoms throughout their final sexual activity. The time period “sexual activity” was not exactly outlined however the French time period used within the questionnaires is often understood as “first coit”. The contributors have been additionally requested whether or not they had had any “dangerous intercourse” (unprotected intercourse with out figuring out the STI standing of their accomplice) over the past 2 months. The content material of interventions in addition to gadgets listed within the questionnaires have been checked by the UNESCO’s SERAT Device [26] and adequacy of reporting was checked with the Tidier framework [27].

Evaluation

The quantitative information are reported because the imply ± normal deviation or because the median [minimum-maximum] and have been in contrast utilizing Scholar’s t-test or the Mann-Whitney assessments. The explicit information are reported as absolutely the depend (share) and have been in contrast utilizing the χ2 take a look at. Spearman’s rank correlation coefficient (ρ) was used to review the connection between steady and/or ordinal variables. The p for interplay between the timing of the questionnaire (pre- or postintervention) and the intervention (publicity or to not the SRH SeSa programme) was computed in a linear regression mannequin to check the differential modifications in quantitative outcomes amongst healthcare college students and youngsters (p [between group]). All assessments have been two-sided. Variations have been thought-about important when the p worth was lower than 0.05. Statistical analyses have been carried out utilizing IBM SPSS Statistics 20.0 (IBM Corp., Armonk, NY, USA).

Moral concerns

Healthcare college students, 13–15 year-old college college students and the authorized representatives of faculty college students gave their consent to take part within the examine. The examine obtained the approval of the French Committee for the Safety of Individuals (CPP) (nationwide quantity: 2018-A03066–49) and the French Knowledge Safety Authority (nationwide quantity: 2212148v0).

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