BACKGROUND Adolescent pregnancy is a worldwide problem because of its health, social, economic and political repercussions on the globe. Even though the rates of adolescent pregnancy have declined over the decade, there is still unacceptably high rates especially in lower and middle-income countries including Ghana. Although the problem has been widely investigated, there is little information on the effectiveness of different methods to improve adolescent sexual abstinence based on theoretical models. This study is aimed to assess an educational intervention program on sexual abstinence based on the Health Belief Model (HBM) among adolescent girls in Northern Ghana. METHODS A cluster randomized control trial was conducted in Ghana from April to August 2018. Participants within the ages of 13-19 years were enrolled voluntarily from six randomly selected Senior High Schools (3 for intervention and 3 for control). A total of 363 adolescent were enrolled. A self-structured questionnaire was administered to both groups of participants at baseline and endpoint of the study. Control participants received their normal classes whiles the intervention group additionally received comprehensive sexuality education for 1 month. Qualified midwives conducted the health education program. At least two sessions were conducted for each participating class weekly. The lessons focused on perceived susceptibility, perceived severity of adolescent pregnancy, perceived benefits, perceived barriers to adolescent pregnancy prevention, personal and family values, perceived self-efficacy and knowledge of contraceptives. Educational strategies such as discussions, demonstrations, role-play and problem solving techniques were used to deliver the lessons. Sexual abstinence was the outcome variable of the study and it was measured after 3 months of the intervention. Binary logistic regression was used to assess the impact of the intervention on sexual abstinence practice. RESULTS At baseline, there was no difference between control and intervention groups. The mean score of Knowledge and attitude for control were (58.17 and 139.42) and intervention (60.49 and 141.36) respectively. Abstinence practice was 69.4% for control and 71.6% in the intervention group. However, after the intervention, the mean score of knowledge and attitude for control were (87.58 and 194.12) respectively. Sexual abstinence in the control was 84.4% and intervention was 97.3% respectively. The educational interventions resulted in a significant difference in sexual abstinence between intervention and control groups (OR = 13.89, 95% Confidence Interval (2.46-78.18, P < 0.003). CONCLUSION Educational intervention, which was guided by HBM, significantly improved sexual abstinence and the knowledge of adolescents on pregnancy prevention among the intervention group. Provision of comprehensive sex education guided by behavioural theories to adolescents at Senior High Schools in Ghana is recommended. TRIAL REGISTRATION This trial was retrospectively registered in Protocol Registration and Results System (PRS) with trial number NCT03384251 .

中文翻译：

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根据健康信念模型，在加纳北部的少女中评估一项教育干预计划对性节制的影响，这是一项随机对照试验。

背景技术由于全球范围内的健康，社会，经济和政治影响，青春期怀孕是一个世界性的问题。尽管十年来青春期怀孕率下降了，但仍然有令人无法接受的高比率，特别是在包括加纳在内的中低收入国家中。尽管已经对该问题进行了广泛研究，但基于理论模型，关于提高青少年性禁欲的各种方法的有效性的信息很少。这项研究旨在评估基于健康信念模型（HBM）的加纳北部少女的性节欲教育干预计划。方法2018年4月至2018年8月在加纳进行了整群随机对照试验。随机选择了六所高级中学（13名干预者和3名对照者）自愿参加了13-19岁年龄段的参与者。总共363名青少年入组。在研究的基线和终点，对两组参与者进行了自我结构化的问卷调查。对照组的参与者接受了正常的课程，而干预组还接受了为期1个月的全面性教育。合格的助产士进行了健康教育计划。每个参与课程每周至少进行两次会议。这些课程侧重于感知的易感性，感知的青春期严重程度，感知的益处，感知的预防青春期怀孕的障碍，个人和家庭价值观，感知的自我效能感和避孕知识。讨论，示范，角色扮演和解决问题的技术等教育策略均用于授课。性禁欲是该研究的结果变量，在干预3个月后进行了测量。二元逻辑回归用于评估干预对性禁欲行为的影响。结果在基线时，对照组和干预组之间没有差异。知识和控制态度的平均得分分别为（58.17和139.42）和干预（60.49和141.36）。对照的节制率是69.4％，干预组的节欲率是71.6％。但是，干预后，知识和控制态度的平均得分分别为（87.58和194.12）。对照组的性节制分别为84.4％和97.3％。结论在HBM的指导下进行的教育干预措施显着改善了干预组的性禁欲和青少年预防妊娠的知识。建议在加纳的高中向青少年提供以行为理论为指导的全面性教育。试验注册该试验已在方案注册和结果系统（PRS）中进行了回顾性注册，试验编号为NCT03384251。结论在HBM的指导下进行的教育干预措施显着改善了干预组的性禁欲和青少年预防妊娠的知识。建议在加纳的高中向青少年提供以行为理论为指导的全面性教育。试验注册该试验已在方案注册和结果系统（PRS）中进行了回顾性注册，试验编号为NCT03384251。