Promoting STI testing among senior vocational students in Rotterdam, the Netherlands effects of a cluster randomized study 英文参考文献.docVIP

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Promoting STI testing among senior vocational students in Rotterdam, the Netherlands effects of a cluster randomized study 英文参考文献.doc

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Promoting STI testing among senior vocational students in Rotterdam, the Netherlands effects of a cluster randomized study 英文参考文献

Wolfersetal.BMCPublicHealth2011,11:937 /1471-2458/11/937 RESEARCH ARTICLE OpenAccess PromotingSTItestingamongseniorvocational studentsinRotterdam,theNetherlands:effectsof aclusterrandomizedstudy MireilleWolfers1,3*,GerjoKok2,CasparLooman3,OnnodeZwart4andJohanMackenbach5 Abstract Background:Adolescentsareariskgroupforacquiringsexuallytransmittedinfections(STIs).IntheNetherlands, seniorvocationalschoolstudentsareparticularatrisk.However,STItestratesamongadolescentsarelowand interventionsthatpromotetestingarescarce.ToenhancevoluntarySTItesting,aninterventionwasdesignedand evaluatedinseniorvocationalschools.Theinterventioncombinedclassroomhealtheducationwithsexualhealth servicesattheschoolsite.ThepurposeofthisstudywastoassessthecombinedandsingleeffectsonSTItesting ofhealtheducationandschool-basedsexualhealthservices. Methods:Inacluster-randomizedstudytheinterventionwasevaluatedin24schools,usingthreeexperimental conditions:1)healtheducation,2)sexualhealthservices;3)bothcomponents;andacontrolgroup.STItestingwas assessedbyselfreportedbehaviorandregistrationsatregionalsexualhealthservices.Follow-upmeasurements wereperformedat1,3,and6-9months.Of1302studentspresentatbaseline,739(57%)completedatleast1 follow-upmeasurement,ofthesestudents472(64%)weresexuallyexperienced,andconsideredtobesusceptible fortheintervention.Multi-levelanalyseswereconducted.Toperformanalysesaccordingtotheprincipleof intention-to-treat,missingobservationsatfollow-upontheoutcomemeasurewereimputedwithmultiple imputationtechniques.Resultswerecomparedwiththecompletecasesanalysis. Results:Sexuallyexperiencedstudentsthatreceivedthecombinedinterventionofhealtheducationandsexual healthservicesreportedmoreSTItesting(29%)thanstudentsinthecontrolgroup(4%)(OR=4.3,p0.05).Test ratesinthegroupthatreceivededucationorsexualhealthservicesonlywere5.7%and19.9%,notreaching statisticalsignificanceinmultilevelanalyses.Femalestudentsweremoreoftentestedthenmalestudents:21.5% versus5.4%.TheSTI-prevalenceinthestudygroupwaslowwi