Improving girls' health through gender integrated health promotion interventions: The Philadelphia ujima experience

Sex and gender disparities in health continue to persist. Gender is an important social determinant of health because it influences social roles, responsibilities, norms and access to resources. However, a critical assessment of the role of gender in health is often omitted from many studies, undermining women and girls' health promotion efforts. The Philadelphia Ujima Coalition for a Healthier Community funded by the Office on Women's Health, employs a gender integrated health promotion school based intervention focusing on nutrition, sexual health and healthy relationships in high schools students. The intervention uses a gender analysis framework to assess understanding of the role of gender in health and promotes behavior change. Methods: A quasi experimental design was used in which intervention groups (2 schools) received a 10 hour health promotion workshop series on targeted objective areas and were compared with a control group (1 school) not receiving the intervention. Baseline and post intervention questionnaires were completed. Results: Sex differences exist in attitudes and behaviors associated with accessing care, nutrition and eating practices, sexual health and healthy relationships. Intervention participants have an increased understanding of the role of gender norms and expectations in their health behaviors. There were also observed changes in their perceptions of personal attributes associated with masculinity and femininity. Conclusions: Health promotion interventions must consider the role of gender in disparate health outcomes and integrate attention to gender in programming for girls. Important lessons learned were identified to enhance assessment and inclusion of gender in youth health promotion programming globally.