Chong et al.

4

# **2. Profamilia’s Internet-Based Sex Education Course**

The online sexual education course was designed by the local NGO Profamilia.<sup>5</sup> Profamilia is Colombia’s largest organization focused on sexual health and reproductive health. With more than 40 years of presence and over 1,800 employees nationwide, Profamilia is well known and used by the local population for sexual health products and services such as contraceptives, HIV testing, and pregnancy tests.<sup>6</sup> Motivated by the stubbornly high level of some important adolescent sexual health indicators nationwide, such as teenage pregnancy rates (Demographic and Health Survey 2005), as well as legal changes, which mandated the introduction of a sexual health curriculum in Colombian public schools, Profamilia embarked on the design of a comprehensive online sexual education course designed for adolescents.

The curriculum aims to shape adolescents’ understanding and perceptions of sexuality, risks, reproductive health, sexual rights, and dating violence. The overarching theme is a human rights approach to pregnancy and teen sexuality. The course focuses on helping the students recognize themselves as endowed with rights, such as the right to say no to sex, to access basic health services, to access family planning services, and to live without sexual violence.<sup>7</sup> Profamilia’s course takes full advantage of Internet connectivity to provide an interactive experience and responsive, anonymous counseling. The modules can be potentially accessed any time of day using a password-protected account, and there is a remote tutor available to answer questions via messages and support the learning process. These features aim to create a safe social environment for adolescents to discuss sensitive topics.

Treatment consisted of five modules. Students worked on the course for a total of 11 weeks. Each group of treated students was initially given three weeks to become acquainted with the platform and complete activities in the first module. After the first three weeks, each group was given two weeks per module to complete activities in the remaining four modules. Each school dedicated one session of 1.5 hours per week to allow the students to complete the course in the school’s computer labs.

In school, each group taking the course worked with the presence of a teacher, who was tasked with helping the students resolve questions about use of and access to the platform, but not questions related to the content of the course. Students were assisted and monitored by an online tutor, who was a trained Profamilia counselor who dedicated part of his or her day to overseeing students during their completion of the course. The tutors had two main roles: answering students’ questions about the course contents and monitoring the students’ performance.<sup>8</sup> At the end of every module, the tutor provided the teacher responsible for the group with a grade for each student, based on the results of a test. To incentivize course completion, each school participating in the course included these grades as a component of the grade of one school subject, typically computer education. Each student had to complete module evaluations individually, which were the basis for his or her individual performance report. Participation in the course was mandatory for students.

# **3. Experimental Design and Estimation Strategies**

## Sample Selection

In Colombia, 13.5 percent of adolescents become sexually active by age 15, and 60 percent have sex before age 18.<sup>9</sup> Profamilia’s course targets 14–15 year olds precisely because they are close to

- 5 The organization’s website can be accessed at www.profamilia.org.co.

- 6 See Miller (2010) for a study of long-term effects of Profamilia family planning services in  Colombia.

- 7 Examples from the course modules can be accessed at www.profamiliaeduca.com/profamilia/index.php.

- 8 Records of the interactions between tutors and students are not preserved and hence were not available for analysis.

- 9 Sexual education courses must ideally be targeted at children of the appropriate age to benefit from them. Very young children may not yet be interested in sexuality issues, which points towards the benefits of targeting an older age range.