Pilot RCT and implementation study of a preventive sexual and mental health program for high school students. A mixed method research of a gendertransformative intervention
Loading...
Date
2025
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Sexuality is a crucial aspect of individuals' lives, particularly during adolescence, when young people face challenges that require preventive interventions. Sexuality education programs are among the most widely used strategies to promote sexual health among adolescents. However, there is significant variability in the components of these interventions. On the other hand, comprehensive sexuality education (CSE) programs have the strongest evidence of effectiveness. Yet, many of these programs fail to adequately address gender-related issues and mental health, limiting their potential to benefit all adolescents and contributing to health inequities. Therefore, the aim of this doctoral thesis is twofold: (i) to design a gender-transformative and comprehensive sex education program for public high school students, and (ii) to evaluate the acceptability, feasibility (through a pilot randomized controlled trial), and implementation of the program, contributing to a broader evaluation of the intervention and explaining how its implementation influences gender equity in health. A mixed-methods experimental design was used across four phases: (1) program design, (2) pilot randomized controlled trial (RCT), (3) case study, and (4) integration. A total of 179 students from four public high schools were randomly assigned to either the experimental or control group. The experimental group received "Enfócate," a comprehensive, gender-transformative sexuality education program. The case study phase involved 4 individual interviews and 8 focus groups with participants from the experimental group. The second phase of the study demonstrated that the intervention was feasible and had adequate levels of acceptability. Additionally, no statistically significant differences were observed between pre- and post-intervention assessments in the experimental group compared to the control group. However, the case study revealed that both students and providers identified learning outcomes that were not captured by the assessment tools. The case study also highlighted various factors related to the program’s implementation that contributed to promoting health equity. Finally, the integration presented in the discussion section addresses the reasons for the discrepancies between the results of the different phases of the study and offers conclusions on how to ensure the acceptability, feasibility, and promotion of health equity in such interventions.
Description
Tesis (Ph.D. in Psychotherapy)--Pontificia Universidad Católica de Chile, 2025
Tesis (Ph.D. in Psychotherapy)--Universidad de Chile, 2025
Tesis (Ph.D. in Psychotherapy)--Universidad de Chile, 2025
Keywords
Sexuality, Adolescence, Comprehensive sexuality education, Health equity, Acceptability, Feasibility, Mixed-methods study