All About Youth: Evaluation of Sexual Risk Avoidance and Risk Reduction Programs for Middle School Students
Condition: Sexually Transmitted Diseases; Pregnancy; HIV Infections
MeSH terms: Sexually Transmitted Diseases
Study type: Interventional

Summary: 
      This study will evaluate the efficacy of two curricula relative to standard care. The first
      is a sexual risk avoidance curriculum for middle school students that included abstinence
      until marriage and complies with Title V Section 510 A-H abstinence education requirements.
      The second is a sexual risk reduction curriculum for middle school students that included
      abstinence and condom/contraceptive information and skills. Each intervention consists of an
      age-appropriate classroom curriculum and a CD-ROM-based tailored intervention delivered in
      7th and 8th grade. The overall goal of the study is to identify common elements of effective
      sexuality education curricula that will be of benefit to youth.
    

Detailed description: 
      This study will evaluate the efficacy of a risk avoidance program for middle school students
      and a theoretically-comparable risk reduction program relative to standard care. The study
      design is a randomized controlled trial conducted in fifteen inner-city middle schools in
      Houston, Texas. Five schools were randomly assigned to a risk avoidance intervention, five to
      a risk reduction intervention, and five to a comparison (standard care) condition.
      Approximately, 1,800 7th grade students were recruited into the study and will be followed
      over a three-year period. Based on a formative study, a pilot study, and input from community
      groups and a national panel of experts, two comparable curricula were developed. The risk
      avoidance curriculum emphasizes sexual abstinence until marriage and includes the
      requirements for abstinence education as defined in Title V, Section 510. The risk reduction
      curriculum emphasizes abstinence and addresses condom and contraceptive use. The risk
      avoidance and risk reduction interventions each consist of an age-appropriate classroom
      curriculum and a CD-ROM-based tailored intervention delivered in 7th and 8th grade. Each
      intervention was delivered by trained facilitators. The effect of the interventions will be
      evaluated by assessing sexual risk-taking behaviors of participants in each intervention
      (proportion of students initiating sexual intercourse, proportion that are sexually active,
      number of times of unprotected sex, number of sexual partners) relative to the comparison
      group. Risk assessment data from students was collected by using an audio computer-assisted
      self-interview (ACASI) approach for the collection of baseline, 6-, 18-, and 24-month data.
      Parental permission and child assent were required prior to participation. In addition, we
      will conduct a 36-month follow-up survey and a one-time urine-based test for chlamydia,
      gonorrhea, and trichomonas which will provide additional longitudinal data to assess the
      impact of each curriculum, relative to standard care.
    

Intervention name(s): Risk Avoidance Intervention; Risk Reduction Intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The risk avoidance intervention is a Title V compliant curriculum emphasizing abstinence until marriage and strong character development. The curriculum includes 12 classroom and CD-ROM based lessons delivered in the 7th and 8th grade. Lessons include topics such as puberty, reproduction, healthy relationships, consequences of sex, and refusal skills.; The risk reduction intervention is a curriculum providing skills for abstinence and condom and other contraceptive use. The curriculum includes 12 classroom and CD-ROM based lessons delivered in the 7th and 8th grade. Lessons include topics such as puberty, reproduction, healthy relationships, consequences of sex, and refusal skills.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: adolescents; sexual health; HIV; STD; pregnancy prevention; abstinence education; HIV Seronegativity; human immunodeficiency virus