Evaluation of Big Decisions in Three South Texas School Districts
Condition: Teen Pregnancy Prevention
Study type: Interventional

Summary: 
      An evaluation of a promising Teen Pregnancy Prevention Curriculum, Big Decisions, in ninth
      grade students in three high schools in South Texas.
    

Detailed description: 
      Intervention Description Big Decisions is a promising teen pregnancy prevention intervention
      that consists primarily of abstinence-plus sexual health education curriculum. The intended
      dosage for students is 10 classroom-based sexual health lessons.

      Classroom teachers, who receive three days of training on the curriculum as well as ongoing
      technical assistance, deliver Big Decisions lessons to 9th grade students. The lessons take
      place during normally scheduled classes over the course of three to five weeks. Classes
      include health, biology, and English. The curriculum focuses on helping youth make good
      decisions about their sexual health. There are three key messages: (1) having sex with
      someone is a big decision, (2) abstinence is the most effective way to avoid both pregnancy
      and sexually transmitted infections, and (3) teens who have sex need to use latex condoms
      correctly every time to reduce the risk of HIV and sexually transmitted infections and use
      contraception to prevent pregnancy.

      In addition to a classroom curriculum, Big Decisions also includes a parent component offered
      to all families. This includes two parent workshops, a parent workbook, and homework for
      parents and children. The parent workshop meets twice during the period of time when students
      receive the classroom curriculum. The workshops last for 90 minutes, are offered in both
      English and Spanish, and are facilitated by district coordinators and grantee staff.

      Comparison Condition Youth Voices Comparison Condition Description Youth Voices is a benign
      comparison intervention that meets for two class sessions over three to five weeks. Classroom
      teachers deliver Youth Voices to 9th grade students. Teachers deliver sessions during
      regularly scheduled classes similar to Big Decisions. Students in Youth Voices participate in
      facilitated discussions about two of seven potential discussion topics (nutrition, physical
      fitness and exercise, tobacco and e-cigarettes, participation in sports, driver safety,
      environmental health, and safety at work). Students take a vote, and they discuss the two
      topics with the most votes during the sessions. Classroom teachers facilitate Youth Voices.
      Teachers are trained to deliver both Youth Voices and Big Decisions and can deliver both
      programs to different classes during the same implementation period.

      Behavioral Outcomes Sexual initiation, condom use at last sex, birth control use at last sex,
      ever pregnant or gotten someone pregnant, sex in the past three months, sex without a condom
      in the past three months, sex without birth control in the past three months Non-behavioral
      Outcomes Intentions to have sex, intentions to use a condom, intentions to use birth control
      Sample and Setting HealthyFutures of Texas staff recruited four high schools from three rural
      and semi-rural school districts in Texas for participation in the study. The program targets
      9th-grade students in each district for participation. Each high school identified one course
      required for 9th grade students for program delivery (for example, health, biology, English).
      To be eligible for participation, students must (1) be in 9th grade, (2) be enrolled in one
      of the courses identified for program delivery, (3) have parental consent, and (4) provide
      student assent. The evaluation expects to enroll 2,596 students from 178 classrooms.

      Research Design and Data Collection This evaluation is a cluster randomized controlled trial.
      Classrooms are the unit of randomization. Two of the three school districts are implementing
      the program and evaluation once a year and the third school district, with two high schools,
      is implementing each quarter of the academic year. At the beginning of each round of
      implementation, parents provide consent for participation. Two weeks before implementation,
      students provide assent and take the baseline survey. The evaluator randomizes the
      participating classes the week before implementation.

      Youth will be surveyed at baseline, immediately post-intervention, and at 12-month follow-up.
      Baseline and immediate post-test surveys will be given in the classroom. Surveys will be
      collected using a survey link or using paper versions of the survey. The 12-month follow-up
      survey will take place in small group settings at the school. Absent students will be
      surveyed in-person individually by the district coordinator, by phone, or over the web.
      Teachers, district coordinators, and research staff will collect data.

      Data for an implementation study designed to assess fidelity, attendance, and quality will be
      collected through fidelity logs, observations, and attendance sheets.
    

Intervention name(s): Big Decisions
Intervention type(s): Behavioral
Intervention description(s): Big Decisions is a promising teen pregnancy prevention intervention that consists primarily of abstinence-plus sexual health education curriculum. The intended dosage for students is 10 classroom-based sexual health lessons.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention