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Universidad de los Andes Santiago, Chile

Universidad 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

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Universidad de los Andes Santiago, Chile

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  1. Universidad 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

  3. LOCAL DESCRIPTION

  4. 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

  5. Background: Pregnancies during 1996 Liceo A 128

  6. Adolescent risky behaviour: triad • Sexual activity (disordered) • Tobacco / Alcohol / Drugs • Violence, delinquency • Strongly related: focusing on sexuality can help in the other problems

  7. THE PROGRAM

  8. 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

  9. TeenSTAR 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

  10. The 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

  11. 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

  12. STUDY DESIGN

  13. 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

  14. 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)

  15. RESULTS

  16. Pregnancy rates 1997 cohort (1997 – 2000)

  17. Pregnancy rates 1998 cohort (1998 – 2001)

  18. Pregnancy rates: 1997 – 1998 cohorts

  19. Teachers’ involvement

  20. DISCUSSION

  21. (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

  22. Limitations (1) • No record of abortions • No record of STD • No information (facts) about sexual activity among students • Further investigation is being done

  23. (2) • School teachers get involved and cooperate with this program • Improves educational environment

  24. Limitations (2) • Persistence in time • Cost (“$ 5 vs. $ 500”) • Entertaining, interesting (not tedious) • Parental involvement (must be improved)

  25. 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

  26. Thank you!

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