a healthy relationships program for vulnerable youth

Conditions: Pregnancy, Unplanned; Sexually Transmitted Diseases

Summary: developed from a piloted intervention and based on scientific evidence, about us is an innovative healthy relationships intervention that promotes positive adolescent romantic relationships and use of condoms and highly effective contraceptives if having sex. the program includes 10 lessons (2 that are between 30-45 minutes long 8 that are 50 minutes long) that blend group-based activities with online activities implemented in a small group format with students in grades 9 or 10 who have parental consent and provide assent to take part. the program will be implemented in school-based health centers (sbhcs). primary research question: 1. nine months following the end of the program, what is the impact of about us relative to the standard of care on: 1.1. rates of vaginal or anal sex without condoms in the past three months? secondary research questions: 2. three and nine months following the end of the program, what is the impact of about us relative to the standard of care on: 2.1. rates of abstinence from vaginal or anal sex in the past three months? 2.2. frequency of communicating without abuse? 2.3. utilization of school-based health center services? 2.4. rates of behavioral willingness and attitudes toward birth control? exploratory research questions: 3. three and nine months following the end of the program, what is the impact of about us relative to the standard of care on: 3.1. the psychosocial variables stemming from the theoretical framework (e.g., attitudes toward condom and contraceptive use, normative beliefs, perceived self-efficacy to use condoms or have difficult conversations) and enumerated in the logic model. 3.2. outcomes listed above within key sub-groups including those defined by sex (male/female), race/ethnicity, and exposure to violence; 4. among those receiving about us, how do effect sizes for the primary and secondary behavioral outcomes vary by dosage?

students will be screened for eligibility through each school-based health center (sbhc) by sbhc staff, and those participants meeting the screening eligibility requirements (previous exposure to violence and/or previous or current involvement in a romantic relationship) will be offered a parental consent form and informational packet. consent forms will be available in english and spanish. pending parental consent and youth assent, students will be randomized into either the intervention or control group.

Eligibility criteria:
inclusion criteria: * the target population includes 9th or 10th grade students from participating schools who meet at least one of the following inclusion criteria based on their responses to a school-wide health assessment: 1. prior exposure to violence; 2. prior or current experience with a romantic relationship. any student answering "yes" to either criteria would be eligible to take part in the study. only those who have parent consent and assent would be enrolled. exclusion criteria: * those students without parental consent; * if siblings are eligible to participate, the sibling who returns the signed consent form first will be admitted into the study. any other eligible siblings will be excluded.

Keywords: youth adolescents teens healthy relationships unintended pregnancy teen pregnancy sexually transmitted infections sexually transmitted diseases sexual health education school-based health center randomized controlled trial