Components Study of REAL Essentials
Condition: Components of REAL Essentials
Study type: Observational

Summary: 
      The Components Study of REAL Essentials (REA) is a descriptive implementation and outcome
      study. This study aims to identify the components that matter most for promoting positive
      health behaviors and outcomes among adolescents. The study will examine a variety of
      components to determine which are most influential in predicting participant outcomes. In
      addition, the study will measure youth engagement in programming from various perspectives
      and examine the role of engagement as an intermediary factor to achieving youth outcomes.
    

Detailed description: 
      Sites participating in the study used the REA relationship education curriculum, a popular
      program among federal Teen Pregnancy Prevention (TPP) and Sexual Risk Avoidance Education
      (SRAE) grantees. The program is intentionally flexible, and each participating school
      selected a subset of the 87available lessons to meet the needs of the population it serves;
      the selected lessons comprised the site-specific scope and implementation sequence. Schools
      offered different lessons and total dosage, and facilitators had various levels of experience
      with the curriculum, and various backgrounds and facilitation quality. The variation in
      program delivery, coupled with diverse participant backgrounds, created different REA
      experiences for participating youth. The study capitalized on this variation to examine which
      program components were most predictive of variation in participant outcomes.

      The study enrolled 1,301 youth across 27 schools in Spring 2022 and Fall 2022. The study
      collected youth outcome surveys at baseline and at program exit. The immediate follow-up
      survey enabled the study to explore how variation in components influences outcomes proximal
      to the REA content, which largely included antecedents to sexual behavior and optimal health.
      A six-month follow-up survey enabled the study to explore how program components influenced
      distal behavioral and optimal health outcomes.

      In addition to the outcome data, the study collected extensive implementation data. Program
      facilitators completed logs after delivering each class to enable the study to determine
      whether facilitators delivered program content and activities, whether they adapted lessons,
      and the extent to which youth appeared engaged in the lesson. Facilitators also documented
      attendance at each class session to provide detailed dosage data for youth. Study staff
      independently observed a subset of classes and REA trainings and interviewed and hold focus
      groups with facilitators and youth.

      The study measured youth engagement through brief exit tickets with youth (surveys
      administered after each class); facilitators' reports of perceived engagement; independent
      in-person observations; and in a small number of sites, video recordings of youth faces coded
      with artificial intelligence to determine how strongly the measures of youth engagement
      correlate with each other and which was most predictive of youth outcomes.
    

Intervention name(s): REAL Essentials Advance
Intervention type(s): Other
Intervention description(s): REA is a relationship education curriculum developed by the Center for Relationship Education for high school-age youth. REA teaches youth critical relationship skills and practical approaches for navigating the social dynamics of friendship and love. The curriculum draws on several theories of behavior change, including social cognitive theory, theory of planned behavior, social inoculation theory, social norms theory, and behavior change theory.
REA includes 87 lessons organized into 10 units. The units cover topics such as healthy relationships, effective communication, commitment, planning for the future, job readiness, and sexual health.
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Youth enrolled in schools where REA is offered through the study. Youth must have active
        parental consent for data collection to be included in the study.
      
Keywords: Components; Relationship education; Content; Dosage; Delivery mechanism