# Evaluation of the contextualized sexual and reproductive health educational strategy “Rurankapak”: a mixed-methods quasi-experimental study among adolescents and young people in Ecuador

## TL;DR

This study evaluates and adapts a participatory sexual and reproductive health education strategy for Ecuadorian adolescents, improving its cultural relevance and acceptability.

## Contribution

The paper introduces a culturally adapted version of the Rurankapak methodology with peer facilitators to enhance SRH education in diverse settings.

## Key findings

- Adapted Rurankapak showed high acceptability among adolescents and young people.
- Peer facilitators improved communication skills and intercultural competence.
- Parents showed lower acceptance of the adapted intervention.

## Abstract

Sexual and reproductive health (SRH) educational interventions in Ecuador show uneven effectiveness, particularly among adolescents and young people in socioculturally diverse settings. Although the “Rurankapak” methodology has been implemented as a participatory SRH education strategy, its standardized application has limited cultural relevance, acceptability, and sustainability.

To collaboratively adapt the Rurankapak methodology for SRH education to diverse sociocultural contexts and to preliminarily assess its applicability and acceptability among adolescents and young people in Ecuador.

A mixed-methods quasi-experimental study was conducted in three phases. The qualitative phase included semi-structured interviews with key informants experienced in Rurankapak implementation, analyzed using thematic coding. Findings informed a participatory redesign process involving Obstetrics students trained as peer facilitators. The quantitative phase followed a before–after design, applying the adapted intervention to four population groups and administering pre–post knowledge assessments (Cronbach's α = 0.81) and satisfaction surveys.

Qualitative findings identified the need to strengthen pre-workshop planning, referral pathways, and the management of complex topics. An adapted version of Rurankapak was developed, structured into seven educational stations with culturally tailored materials. Quantitative results showed high acceptability among adolescents and young people, with lower acceptance among parents. Peer facilitators demonstrated strong pedagogical performance and reported improvements in communication skills, empathy, and intercultural competence.

Contextual adaptation and participatory redesign enhance the cultural relevance and feasibility of SRH educational strategies. The use of peer facilitators supports adolescent engagement and contributes to the comprehensive training of future SRH professionals.