Swedish adolescents’ experiences of educational sessions at Youth Clinics

https://doi.org/10.1016/j.srhc.2011.05.003Get rights and content

Abstract

Planning sex and relationship health education suitable for adolescents is a pedagogical challenge.

Objective

To describe how secondary school pupils in Sweden experience health educational sessions at Youth Clinics.

Methods

Data were collected from six focus groups within 2 weeks of an educational session. The groups consisted of pupils aged 14–16 years from three cities. The participants were 29 adolescents divided into groups of girls (n = 15) and boys (n = 14) and the interviews were audio taped. Data were analysed using qualitative content analysis.

Findings

Five categories were identified: Impact of the educational session, The desirable educator, Didactic setup, Gender inequalities and Suitable age for the educational session. The adolescents were satisfied with the content of the education and the session was evaluated as a complement to school education. The educators were seen as competent with an ability to create a comfortable atmosphere which made it easier for participants to discuss the subject and ask questions. The session was experienced as secure which was appropriate for the intimate and personal subject and gender aspects were seen as influencing the conversation.

Conclusion

This study can give an understanding of the needs and demands of adolescents which can be useful when planning and conducting sex and relationship health education.

Introduction

Adolescence, as defined by WHO, is the period spanning 10–19 years of age [1].

It covers the transition from childhood to adulthood and includes the reaching of sexual maturity [2]. Adolescents’ needs regarding sexual and reproductive health issues vary according to their stages of development and personal circumstances [1]. The mean age for coital debut varies between 14.9 and 16.4 years in five European countries [3], [4]. Sexually transmitted infections (STIs) are a health risk for adolescents with Chlamydia continuing to be the most frequently reported STI in Europe [5] and the United States [6], primarily affecting young people aged between 15 and 24 [5], [6].

Many adolescents consider themselves to have inadequate education and advice regarding sex and relationships [3], [7], [8], [9], [10]. According to the World Health Organization (WHO), various sectors must work together to meet the needs of adolescents and each country has to consider its own cultural, social and economic circumstances [1]. Efforts made to meet these needs vary around the world, ranging from conventional sex education in schools to multi-component community-based programmes [1], [11], [12]. In many developed countries, contraceptive services and supplies are available free of charge or at low cost to all teenagers [13].

Sex and relationship education in British secondary schools has been criticised for the variation of topics covered, the extent of the education and for teaching methods used [14]. Around 50 per cent of British secondary school pupils do not feel that they could ask all the questions they wanted to during sex and relationship health education [15]. There was an expressed desire for skilled people such as midwives to work with teaching sexual and reproductive health [5], [15], [16], [17], [18].

Health education regarding sex and relationships was made mandatory in Swedish schools in 1956 [19]. Nowadays pupils should be educated in the biology of sexuality, contraception and STIs by the age of 15 [20].

The overall objective of Swedish Youth Clinics (YC) is to “promote physical and mental health and to strengthen adolescents in identity development so that they can deal with their sexuality and preventing unwanted pregnancies and STIs” [21, p. 4]. The YCs offer individual counselling, investigation, treatment, group activities and outreach work. The first YC in Sweden was developed in 1970 with the aim of bringing questions about body and mind together and integrate these with sexual and relationships issues. The YCs are ideally centrally located and located away from other health services. YCs welcome all young people, mostly up to the age of 23–25 but this varies depending on local demands and resources. Many schools ask their local YC to complement their sex and relationships health education by arranging for the 14- to 15-year-old pupils to visit the YC for educational sessions. Usually, a midwife is responsible for these sessions, sometimes together with another professional such as a counsellor or psychologist. In addition to information about the aims of YCs, these sessions focus on the attitudes, norms and values of adolescents regarding sex and relationships [21]. Young people who have visited a YC have been shown to be more knowledgeable of sexual and reproductive health than those who have not visited a YC [10]. However, increased knowledge does not always result in changes of attitude and behaviour in adolescents [22].

Preventive work regarding sexual and reproductive health among young people needs to be developed and improved worldwide [1]. Collaborations between schools and, for instance, the health sector are recommended by the WHO in order to promote sexual and reproductive health among adolescents [23]. Better knowledge and improved links between youth services and schools have a positive influence on services available to youths being used [24]. The collaboration between schools and YCs has been in progress for many years in Sweden, but no studies have been conducted regarding the experiences of adolescents of these educational sessions. Hence, the aim of this study was to explore how Swedish secondary school pupils experience health educational sessions at Youth Clinics.

Section snippets

Methods

Due to a lack of studies conducted on pupils’ experiences of health educational sessions at the YC, an exploratory qualitative approach with semi-structured focus group (FG) interviews was chosen. This is a method where data is produced through the interaction of the group, which generates an understanding of the experiences and attitudes of the participants. By using FGs instead of individual interviews more voices could be heard and a variety of perspectives could be identified [25], [26].

Results

The FG participants consisted of 15 girls and 14 boys in secondary schools aged 14–16 (median: 14 years). Eleven girls and 13 boys had heard of the YC before the educational session, including one girl and two boys who had visited the YC before. For five of the adolescents the YC was a new experience.

The analysis developed into five categories: Impact of the educational session, The desirable educator, Didactic setup, Gender inequalities and Suitable age for the educational session. Verbatim

Discussion

This study was conducted to explore how Swedish secondary school pupils experience health educational sessions at YCs. The opinions regarding the impact of the health educational session at the YCs varied among the participants, possibly due to the different amounts and varying quality of sex and relationship education at school. Shifting levels of sexual maturity and experiences could also explain the difficulties for the pupils to estimate the importance of the educational session. However,

Conclusion

The overall picture showed that the pupils appreciated the educational sessions at the YCs as a complement to the health education they had received in school. The findings stress the importance of having competent and motivated educators who can create an atmosphere where everyone can comfortably discuss the subject and ask questions. It is a didactic challenge to form a learning situation including aspects of security appropriate for the intimate and personal subject as well as the gender

Funding

No foundations have been involved in the study.

Conflict of interest statement

None declared.

Acknowledgements

The authors thank the focus group participants and the interest from the staff members at the different schools.

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