Abstract:
Unintended pregnancies are found in university students with insufficient health literacy on preventing pregnancy. Thus, the objective of the current two-phase study was to analyze the situation of health literacy concerning contraception among female university students and to evaluate the effects of the “Sex Must Safe” program on health literacy intention and practice regarding condom and emergency contraceptive pill uses among female university students in Chon Buri province, Thailand. A cross-sectional study design was used in phase 1. Data was collected between February and May 2017. A self-administered questionnaire, developed by the Ministry of Public Health based on evolving concept of health literacy, was used to collect data from 418 university students. Descriptive statistical analysis was used for the data analysis. A quasi-experimental study design was used in phase 2. Multistage sampling was conducted to collect data from 73 selected university students (36 intervention group and 37 comparison group) between September 2017 and January 2018. The intervention group participated in an 8 week “Sex Must Safe” program and follow up period at week 20. Once again, a self-administered questionnaire was used. Descriptive statistics, the chi-square test, Fisher’s exact test, paired samples t-test, independent samples t-test, Mann-Whitney U test, and generalized estimating equations were used for the data analysis. The results showed that majority of the students did not have sufficient knowledge related to health (78.2%), mainly knowledge on health and health services, knowledge and understanding about health and communicating to improve expertise. The data collected were used to improve the ‘Sex Must Safe’ program. Whereas, the results indicated the health literacy mean scores of the intervention group were found significantly higher than the control group (p-value = 0.002, 95% confidence interval [CI]: 3.43–15.47) following the intervention, a mean difference between the two groups for intentions regarding condom and emergency contraceptive pill use was not statistically significant (p-value = 0.111, 95% CI = -2.22–2.15). Analysis of the practice scores was only conducted on university students who had sexual intercourse. The reported mean difference, is in favor of the intervention group, which was statistically significant (p-value = 0.004, 95% CI = 0.27– 1.45). The intervention was demonstrated to increase health literacy and practice among the female university students. The finding of this study would be able to offer a new practical program to prevent unintended pregnancy. .