高中同儕性教育介入成效之探討

本研究目的為探討同儕性教育介入對某高中一年級學生在避免性行為自我效能、避免性行為決定衡量、避免性行為改變過程及避免性行為改變階段之影響效果。採用「不對等實驗組、對照組」之準實驗設計，於高雄市選取高中學校各三所，其中以甲學校194位一年級學生為研究介入對象之實驗組，乙及丙兩所高中學校共174位一年級學生為校外對照組。在計畫介入前先對兩組學生進行個人特性資料、避免性行為改變階段、避免性行為自我效能、避免性行為決定衡量、避免性行為改變過程、同儕討論避免性行為現況及同儕對避免性行為支持情形之前測，之後實驗組學校採自願或老師推薦方式，招募同儕性教育種子學生共11名，給予為期4個月的性教育活動訓練，訓練結束後再由同儕性教育種子學生對其同儕進行為期8個月的性教育活動介入，對照組學生則不予任何特別介入，並於介入結束後第二週同時對實驗組及對照組進行後測。以百分率、獨立樣本t檢定、卡方檢定、配對樣本t檢定及共變數分析等統計方法進行資料分析及檢定。研究結果顯示經由同儕性教育介入後，實驗組無性行為學生的避免性行為改變階段顯著趨於正向，有性行為學生的避免性行為改變階段前後測則無顯著差異。對照組無性行為學生其避免性行為改變階段則有顯著負向改變，而有性行為之對照組學生其避免性行為改變階段前後測亦無顯著改變。實驗組學生介入後在避免性行為自我效能、避免性行為決定衡量、避免性行為利益衡量、避免性行為障礙衡量、避免性行為改變過程、同儕討論避免性行為現況的提升顯著高於對照組，但在同儕對避免性行為支持情形與對照組則無顯著差異。整體而言，實驗組學生有八成以上對闖關活動介入，表示喜歡及有幫助。本研究結果可作為學校及衛生行政單位推行高中生性教育之參考。

關鍵字

同儕性教育介入；避免性行為自我效能；避免性行為決定衡量；避免性行為改變過程；避免性行為改變階段

並列摘要

The main purpose of this research is to explore the effectiveness of peer sexual education on self-efficacy, decisional balance, process of change, and stage of change for sexual abstinence among first-grade students in vocational senior high schools. Under the quasi-design of “experiment and control groups” with non-equivalence, the students were sampled from three vocational senior high schools. Among them, students in school A (n=194) were assigned to the experimental group. In addition, 174 students were sampled from schools B and C as the controls, and then a pre-test by constructed questionnaire based on our sexuality program was carried out. All participants completed a constructed questionnaire including self-efficacy, decisional balance, process of change, stage of change, peer discussion about abstinent behavior, and perceptions of support from peers concerning sexual abstinence. 11 students were selected from the experimental group as "peer sexual educators", and they were trained in sexual education over a four-monthly period. After course completion, these peer sexual educators were given sexual education intervention for students of the experimental group over a period of 8 months. Conversely, students in the control group did not receive any peer sexual education. Two weeks after sexual education intervention, the post-test was carried out for experimental and control group. Independent t-test, Chi-square test, paired t-test, and analysis of covariance（ANCOVA）were used to examine the effect. Overall, the findings showed that the stage of change for sexual abstinence with sexually inexperienced students positively changed in the experimental group, however, there was no significant change for already sexual experienced students. Furthermore, there was significant difference between experimental and control groups in terms of self-efficacy, decisional balance, process of change and peer discussion about abstinent behavior, but no significant change for perceptions of support from peers about sexual abstinence. More than 80％ of the students in the experimental group favored such an sexual education program, and fully thought that it was a helpful program. Overall, the results of this research could be used as a reference for school nurses or government policymakers to promote peer sexual education for adolescents.