Research Article
Evaluation of a Collegiate Women's Sexual Health Promotion and Education Program
School of Nursing and Health Professions, Murray State University, Murray, KY 42071, USA
*Corresponding author: Jessica Naber, Assistant Professor, School of Nursing and Health Professions, Murray State University, Murray, KY 42071, USA, Tel. 502-541-3011, E-mail: jnaber@murraystate.edu
Received: March 1, 2016 Accepted: May 21, 2016 Published: January 5, 2017
Citation: Baumann C, Naber J, Perlow M. Evaluation of a Collegiate Womenʼs Sexual Health Promotion and Education Program. Madridge J Womens Health Emancipation. 2017; 1(1): 1-3.doi: 10.18689/mjwh-1000101
Copyright: © 2017 The Author(s). This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
The purpose of this study was to provide a Women's Sexual Health Promotion and
Education program to teach female college students about gynecology, the menstrual
cycle, the female reproductive system, Sexually Transmitted Infections (STIs), and
pregnancy prevention. The program's success was measured using a pre-test and a
post-test. A t-test analysis confirmed a significant increase in participant knowledge of
women's sexual health as a result of the program. This program may serve as a guideline
for future women's sexual health programs and adds to current research supporting the
need for more sexual health education programs.
Keywords: Women's sexual health; Education program; Self-awareness; Sexual partners
Abbreviations: STIs: Sexually Transmitted Infections; ACHA-NCHA: American College
Health Association National College Health Assessment; HPV: Human Papillomavirus;
IUD: Intrauterine device
Introduction
In order to protect themselves from select health care issues, college age females
need to possess knowledge about themselves, their bodies, and their behavior. Research
indicates an overall need for an increase in this knowledge, as discussed in the literature
review. To better understand the effect of education on self-awareness, a study was
conducted offering a women's sexual health promotion and education program on
campus at a mid-size regional public university to all interested female students. This
article describes the need for programs such as this one at other universities and among
this population of females.
Literature Review
According to the American College Health Association National College Health
Assessment (ACHA-NCHA, 2006) [1] sexually active female participants had an average
of 1.8 sexual partners. When male and female students were asked about their use of
pregnancy protection methods 4% used nothing, 15% used the withdrawal technique,
35% used birth control pills, 36% used condoms, and 28% said they had not had
intercourse.
The fall 2009 ACHA-NCHA [2] survey reveals, 48.7% of female college students had
not seen a gynecologist in the past year. In the past 30 days 60.9% had not performed a
breast self-exam. As reported by both males and females, 51.3% had not received
information about STIs and 63.7% about pregnancy at their school. Thirty percent
reported an interest in receiving pregnancy prevention information and 38.1% in
receiving STI information (ACHA-NCHA, 2009). Paul, McManus, and Hayes (2000) surveyed sexually risky behaviors of college students [3]. Of
the 555 participants, 169 participants had "hooked-up" with a
partner at least once.
The fall 2015 ACHA-NCHA [4] survey shows continued
trends in sexual health education needs. Only 48.2% of female
college students received the vaccination against Human
Papillomavirus (HPV). 37.4% of females reported performing a
breast self exam in the last 30 days, and 42.4% had a routine
gynecological exam in the last 12 months. In terms of
pregnancy protection used by females or their partners, 57.2%
used birth control pills, 4.1% used birth control shots, 5.2%
used implants, 9.0% used intrauterine devices, 8.5% used the
calendar method or other methods of fertility awareness,
34.8% used withdrawal, and 59% used male condoms. Other
lesser used methods included birth control patches, female
condoms, diaphragms, cervical caps, contraceptive sponges,
and spermicides.
According to Calco (2014), nearly 50% of STI's occur
between the ages of 15 and 24, putting traditional
undergraduate college students in the ideal age range for
receiving sexual health education. However, 42% of
participants did not consider themselves knowledgeable
about STIs [5-8]. Oster (2015) discussed high risk behaviors of
college students [9]. These included inconsistent condom use
during vaginal or anal sex, multiple partners, alcohol and drug
use before and during sexual activity. These behaviors increase
the risk for HIV and other STIs and unintended pregnancy.
Methods
This study used a pre-experimental pre-test, post-test design. The 19 participants were 18 to 25 year old female students who attended the two hour program at a mid-size, regional public university. Approval of human subjects protection was granted by the home institution's IRB. All participants signed informed consent forms before the program began. A pre-test and post-test included fifteen multiple choice questions that surveyed participant knowledge in the topics of STIs, pregnancy prevention, gynecology, female reproductive anatomy, and the menstrual cycle. The questionnaires also examined sexual protective habits and an understanding of women's health. After the pre-test, the researcher presented an hour-long program that included information about the topics from the pre-test. The program was a combination lecture-discussion style. Immediately following the program, the post-test was administered, and the post-test also provided an opportunity for evaluation of the program. A T-test analysis of the pre-test and post-test scores evaluated if the student's educational needs were met. Finally, participant opinions regarding the program were sought.
Results
Results from the paired t-test analysis revealed a
statistically significant difference between pre-test and posttest
scores (t=10.88; DF=18; =3; Sx=1.2; and p<0.001). The mean score of the fifteen question test was 0.57 (=8.5/15) on
the pre-test and 0.77 (=11.5/15) in the post-test. Participants'
self-report rating of their understanding of the menstrual
cycle and female reproductive anatomy improved from pretest
to post-test.
The pre-test and post-test were used to obtain information
regarding participant sexual habits and attitudes. Ten of 19
participants reported being sexually active on the pre-test
and nine reported being sexually active on the post-test. No
participants reported feeling at risk for acquiring STIs and two
reported feeling at risk for pregnancy on the pre-test and
post-test. One participant reported an unwanted or unplanned
pregnancy, and one reported being diagnosed with an STI.
Thirteen participants, who could respond to more than one
choice, reported previously being to the gynecologist; ten
went for well-woman check-ups, two for suspected pregnancy,
two for a suspected STI, eight to be get birth control, and two
for other purposes. When asked about plans to see the
gynecologist within the year, 14 participants responded yes
on the pre-test and 15 responded yes and one responded
may be on the post-test.
The participants were questioned about sexual protective
habits regarding pregnancy and STI prevention. Concerning
pregnancy prevention methods, 7 participants reported use
of abstinence, 10 used oral contraceptives, 7 used condoms, 3
used the "pulling out" technique, and two reported using no
method. Regarding STI prevention, 8 reported abstinence, 4
used oral contraceptives, 8 used condoms, 1 used the "pulling
out" technique, and 3 used no method. Five participants also
reported the use of abstinence for medicinal purposes, 9 used
the pill for medicinal purposes, and 6 reported no method for
medicinal purposes. According to Oster (2015), college
students are likely to take part in the same risky behaviors
such as using the pulling out technique, lack of condom use,
and using no contraceptive method.
In addition, the participants were queried regarding their
opinions of the program. Participant ratings confirmed overall
positive opinions. The identified strengths of the program
were information about pregnancy prevention and
gynecology while the weakness was students' comfort level
with the topic during the program. Participants expressed a
desire for a similar program in the future. Participants also
rated benefits of the program as follows; the ease of
understanding the information about STIs, the female
reproductive system, and the menstrual cycle.
Discussion
The Women's Sexual Health Promotion and Education
Program was effective in increasing the knowledge of the
participants. Every participant's score improved an average of
three questions. The results supported that women's sexual
health education could be an effective means of increasing
the population's knowledge of women's health issues.
The participants' scores revealed an awareness of STI
prevention, breast self-examinations, the ovaries, and factors affecting the menstrual cycle. Calco's (2014) participants, on
the other hand, expressed a feeling of a lack of knowledge
about STIs. Topics that were less well known before the
program were oral contraceptives, internal bimanual
examinations, the uterine wall, and the female reproductive
system [4]. Questions most often answered incorrectly on the
post-test concerned Intrauterine device IUDs, ovulation
cervical changes, and the menstrual cycles feedback system.
The presentation of these topics should be improved.
Knowledge of IUDs may be poor in part due to their
uncommon use (ACHA, 2015).
According to the ACHA-NCHA (2009), 72% of participants
reported they were sexually active. The participants of this
study's program, however, were less sexually active, with only
52.6% reporting sexually activity. Concerning gynecology,
thirteen of the nineteen (68.2%) educational program
participants had been to the gynecologist. This result was
slightly higher than the NCHA (2015) participants, as 42.4% of
those participants had been to the gynecologist. The reason
for these differences between the two study samples is
undetermined [10].
Limitations and Recommendations
The use of convenience sampling and a small sample size
were limitations. The study may have been improved with a
control group and this is advised for future research studies.
Healthcare providers may use this study to provide effective
women's sexual health programs to the population. Most
certainly additional research should be undertaken to identify
the optimal methods for educating college age students as to
their reproductive health.
Summary
Results of this descriptive design reinforced the
understanding that this particular population was not as
aware of the nuances of women's health care as would be
desirable. In order to provide the self-care necessary, these
students need to know more about themselves and the
available health care options. Educational programs such as
the program described need to be available to optimize the
health of this group.
Conflicts of Interest: The author(s) report(s) no conflicts of
interest.
Consent: No consent is required to our article publication.
References
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