Evaluation of a Need to Know (N2K): A New Sex Education Program for High School Students
Condition: Teen Pregnancy
Study type: Interventional

Summary: 
      This trial evaluated the impact of N2K, a three-year quasi-experimental study to delay sexual
      initiation and increase condom and contraception use among high school students. The program
      was administered to treatment students beginning in the fall of 2012 (9th grade) and
      continued through the spring of 2015 (11th grade). The purpose of this study was to measure:
      1) the impact of N2K on sexual initiation at the end of the three-year program and 2) the
      impact of N2K on condom or contraception non-use at the end of the program.
    

Detailed description: 
      Need to Know is based on a framework of positive youth development intended to delay sexual
      initiation and reduce the rate of teenage pregnancy. The N2K curriculum is designed to
      support the treatment participants throughout their high school career with consecutive
      dosage for three years from 9th through 11th grade. The intended dosage for treatment
      participants is 16 lessons (25 minutes each) each year of the program (8 in the fall and 8 in
      the spring). The program consists of 3 years (48 lessons) of curriculum to be delivered in a
      group or classroom setting of up to 32 students. There are 16 lessons in each year of the
      curriculum. Eight lessons are intended to be taught in the fall semester and eight in the
      spring. Each lesson is 25 minutes long, and can be taught in any class period that allows for
      25 minutes of content instruction.

      The 9th grade course is N2K: Basics and consists of lessons that encourage self-discovery and
      goal setting, discuss human growth and development, adolescent risk behaviors, communication,
      STDs, abstinence, contraceptives, teen dating violence, legal issues, responsible media use,
      refusal skills, and role-playing. The 10th grade N2K: Decisions consists of lessons that
      increase decision making skills, clarify values, promote healthy relationships and the
      benefits of delaying sex, and review of anatomy, contraceptives, STDs, and legal issues. It
      promotes the development of critical thinking skills and application of the facts to real
      life situations. N2K: Decisions includes an original webisode series of 11 episodes, the
      first of which is viewed in class, and the others can be viewed online outside of class. The
      webisode series adds narrative to the basic facts being presented in class. The series runs,
      in conjunction with the 10th grade curriculum lessons 3-8. The 11th grade N2K: Relationships
      reinforces basic themes taught in prior years. It emphasizes healthy relationships, healthy
      living, and taking responsibility for personal health as an adolescent matures into adult
      life. The last three lessons are a culminating activity that allows participants to express
      what they have learned and present it to others. About 35% of the 48 sessions focuses on
      abstinence, 27% highlight positive youth development (PYD), 13% discuss risky behaviors, 12%
      address STDs, 8% cover contraceptives, and 5% discuss anatomy and puberty in the cumulative
      three years of the N2K Curriculum.

      A paper and pencil survey was administered in school to assess program impacts. Treatment and
      comparison students were surveyed at baseline (fall 2011 for comparison and fall 2012 for
      treatment), and for the treatment group, surveying took place before the intervention began.
      Surveys were administered at the end of each year of programming (end of 9th grade, end of
      10th grade, and end of 11th grade), which for the treatment students was after the N2K
      programming was completed for the year.
    

Intervention name(s): The Need to Know students received the N2K curriculum as described previously
Intervention type(s): Behavioral
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: High school; Longitudnal; Sexual initiation; Contraception; Adolescents; Pregnancy prevention; Sexual health