Reproductive Health (Jul 2025)
Effectiveness of an online sexual and reproductive health educational program on knowledge, attitudes, and behaviours among senior primary school students: a cluster randomized controlled trial
Abstract
Abstract Background Sexual and reproductive health education is crucial for senior primary school students as they enter adolescence. Implementing such education in resource-limited settings faces challenges like untrained educators, cultural taboos, and lack of materials. An online sexual and reproductive health educational program may overcome these barriers, yet no research in China has assessed the effectiveness for senior primary school students. This study aims to evaluate the effectiveness of an online sexual and reproductive health education program for senior primary school students in China, focusing on their adherence to the program and comprehension of its content. Methods The efficacy of the program was evaluated through a cluster randomized controlled trial. Participants (mean age 11.21 ± 0.68 years) were recruited from two primary schools in Shangqiu, Henan, with eight classes randomly assigned to either the intervention (n = 4) or control group (n = 4). The intervention group completed a 9-week online sexual and reproductive health education program, while the control group did not receive the program. Data on knowledge, attitudes, and behaviors were collected at baseline, post-intervention, and at 16-week follow-up. The outcomes were analyzed using a generalized estimating equation model. Results At baseline, no significant differences were found between groups in sociodemographic or physical development. In the intervention group, 71.4% completed the program with an average test accuracy of 86.6%, indicating good adherence and content comprehension. Compared to the control group, the intervention group had significantly higher sexual and reproductive health knowledge (T1: β = 2.18, T2: β = 1.21, p < 0.001, p = 0.001), attitudes (T1: β = 14.73, T2: β = 6.01, p < 0.001), and behaviours (T1: β = 4.49, T2: β = 5.90, p < 0.001) scores, with improvements sustained at 16 weeks. Conclusions The online sexual and reproductive health educational program significantly improved knowledge, attitudes, and behaviours among senior primary students, providing valuable guidance for school health nurses in designing and implementing sexual and reproductive health education programs. Trial registration ChiCTR2400083843. [ www.chictr.org.cn ]. 06/05/2024.
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