Developing and evaluating the Teen-Strong life skills programme in Southern Thailand

Risk sexual behaviours are known as a threat to health and wellbeing of adolescents. Although there are standard sexual education curriculums in Thai schools, most schools use traditional teaching methods rather than participatory teaching activities. This study aimed to (i) develop 'Teen-Strong' programme by combining the concept of the World Health Organization's life skills programme with Thai sexual education curriculum and (ii) investigate the association of Teen-Strong programme with knowledge and decision-making regarding risky sexual behaviours and teenage pregnancy in Thai adolescents. The Teen-Strong programme was developed by means of experts review and cognitive interviewing process and evaluated in 66 adolescents in Grades 7-9 from six schools in southern Thailand. Twenty-six students were assigned to the experimental group (attended Teen-Strong programme and standard sexual education) and 40 to the control group (attended only the standard sexual education). A pre-post-test quasi-experimental design was used and the Teen-Strong questionnaire (TSQ) was administered to measure knowledge and decision-making at three time points: before (T1), immediately after (T2) and 1 month after (T3) attending the programme. A 2 x 3 mixed-design ANOVA was used to analyse the data. TSQ scores in the experimental and control groups were higher at T2 and T3 as compared with T1. Mean increase in TSQ scores at T2 and T3 compared with T1 were significantly higher in the experiment than the control group [T2 vs. T1: t (64) = 4.07, p-values < 0.0001; T3 vs. T1: t (64) = 3.32, p-values = 0.017]. This study showed that Teen-Strong programme could increase adolescent's knowledge and decision-making skills regarding risk sexual behaviours. Lay Summary Sexual practices during adolescence are shown to cause teenage pregnancy and other threats to the health and wellbeing of adolescents in Thailand. Adolescent sexual education that considers the culture and environment where adolescents grow up is essential. Although there are sexual education programmes in Thai schools, most schools use traditional teaching methods (i.e. learning through memorization) rather than participatory teaching activities (i.e. learning through activities and sharing experiences from and with peers). We developed a programme called 'Teen-Strong' by combining participatory learning technique proposed by the World Health Organization with the Thai sexual education programme and evaluate whether this hybrid programme helped Thai adolescents in Grades 7-9 to better understand and avoid risky sexual behaviours. We found that adolescents who were involved in the Teen-Strong programme showed better knowledge and decision-making skills at avoiding risky sexual practices than adolescents who were not involved in the programme. Our findings show participatory sexual education programme could enhance adolescents' understanding of risky sexual practices and strategies to avoid these risky practices.