Students in the southwestern region of Uganda were assigned to three study arms: control (n = 16 schools, n = 408 students) receiving usual care comprising of sexual and reproductive health curriculum; and two active treatment arms: Treatment 1 (n = 16 schools, n = 471 students) received everything the control arm received plus a savings led intervention. Treatment 2 (n = 15 schools, n = 381 students) received everything the control and treatment arms received plus a family strengthening intervention. We used multilevel models to assess the relationship between peer pressure and risk-taking behaviors. We ran structural equation models for mediation analysis.
Using baseline data, we found that direct peer pressure was significantly associated with substance use risk behaviors, (β = 0.044, 95% CI = 0.008, 0.079). We also found a statistically significant effect of the intervention on acquiring STIs through the mediating effect of sexual risk-taking significant (β = -0.025, 95% CI: -0.049, -0.001, p = .045) and total indirect (β = -0.042, 95% CI: -0.081, -0.002, p = .037) effects. Also, there was a significant mediation effect of the intervention on substance use through peer pressure (β = -0.030, 95% CI: -0.057, -0.002, p = .033).
Overall, the study points to the role of peer pressure on adolescent girls\' risk-taking behaviors; and a need to address peer pressure at an early stage.
方法:乌干达西南地区的学生被分配到三个研究组:对照(n=16所学校,n=408名学生)接受包括性健康和生殖健康课程在内的常规护理;和两个积极治疗组:治疗1(n=16所学校,n=471名学生)获得了控制臂所获得的一切,加上储蓄导致的干预。治疗2(n=15所学校,n=381名学生)接受了所有控制和治疗武器以及家庭加强干预。我们使用多层次模型来评估同伴压力和冒险行为之间的关系。我们运行了结构方程模型进行中介分析。
结果:使用基线数据,我们发现,直接的同伴压力与物质使用风险行为显著相关,(β=0.044,95%CI=0.008,0.079)。我们还发现,干预措施通过性冒险行为的中介效应对性传播感染的影响具有统计学意义(β=-0.025,95%CI:-0.049,-0.001,p=0.045)和总间接效应(β=-0.042,95%CI:-0.081,-0.002,p=.037)。此外,通过同伴压力干预对物质使用有显著的中介效应(β=-0.030,95%CI:-0.057,-0.002,p=.033).
结论:总体而言,该研究指出了同伴压力对青春期女孩冒险行为的作用;以及在早期阶段解决同伴压力的必要性。