TY - JOUR
T1 - Sexual risk avoidance and sexual risk reduction interventions for middle school youth
T2 - A randomized controlled trial
AU - Markham, Christine M.
AU - Tortolero, Susan R.
AU - Peskin, Melissa Fleschler
AU - Shegog, Ross
AU - Thiel, Melanie
AU - Baumler, Elizabeth R.
AU - Addy, Robert C.
AU - Escobar-Chaves, Soledad Liliana
AU - Reininger, Belinda
AU - Robin, Leah
N1 - Funding Information:
All authors contributed to the concept and design of the study and the process of drafting and revising the manuscript. No authors have any potential conflicts of interest. This study was funded by the Centers for Disease Control and Prevention (CDC) ( #5U48DP000057 ). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. The study is registered at www.clinicaltrials.gov (#U48/DP000057). The authors thank our Expert Advisory Group, including Mary Adam, Marilyn Ammon, Elaine Borawski, Karin Coyle, Ralph DiClemente, Patricia Goodson, Gale Grant, Doug Kirby, Joneen Mackenzie, Rebecca Maynard, Anita Smith, Shepherd Smith, Freya Sonenstein, Kate Walters and Gina Wingood for their input and support throughout the study; Stacey Ladd, Mary Ann Mosack, and Peggy Pecchio for their input and guidance in developing the risk avoidance curriculum; school district personnel and students for their participation; and Jennifer Torres, M.P.H., for her editorial assistance.
PY - 2012/3
Y1 - 2012/3
N2 - Purpose: To evaluate the efficacy of two, theory-based, multimedia, middle school sexual education programs in delaying sexual initiation. Methods: Three-armed, randomized controlled trial comprising 15 urban middle schools; 1,258 predominantly African American and Hispanic seventh grade students followed into ninth grade. Both programs included group and individualized, computer-based activities addressing psychosocial variables. The risk avoidance (RA) program met federal abstinence education guidelines; the risk reduction (RR) program emphasized abstinence and included computer-based condom skills-training. The primary outcome assessed program impact on delayed sexual initiation; secondary outcomes assessed other sexual behaviors and psychosocial outcomes. Results: Participants were 59.8% females (mean age: 12.6 years). Relative to controls, the RR program delayed any type of sexual initiation (oral, vaginal, or anal sex) in the overall sample (adjusted odds ratio [AOR]:.65, 95% CI:.54.77), among females (AOR:.43, 95% CI:.31.60), and among African Americans (AOR:.38, 95% CI:.18.79). RR students also reduced unprotected sex at last intercourse (AOR:.67, 95% CI:.47.96), frequency of anal sex in the past 3 months (AOR:.53, 95% CI:.33.84), and unprotected vaginal sex (AOR:.59, 95% CI:.36.95). The RA program delayed any sexual initiation among Hispanics (AOR:.40, 95% CI:.19.86), reduced unprotected sex at last intercourse (AOR:.70, 95% CI:.52.93), but increased the number of recent vaginal sex partners (AOR: 1.69, 95% CI: 1.012.82). Both programs positively affected psychosocial outcomes. Conclusions: The RR program positively affected sexually inexperienced and experienced youth, whereas the RA program delayed initiation among Hispanics and had mixed effects among sexually experienced youth.
AB - Purpose: To evaluate the efficacy of two, theory-based, multimedia, middle school sexual education programs in delaying sexual initiation. Methods: Three-armed, randomized controlled trial comprising 15 urban middle schools; 1,258 predominantly African American and Hispanic seventh grade students followed into ninth grade. Both programs included group and individualized, computer-based activities addressing psychosocial variables. The risk avoidance (RA) program met federal abstinence education guidelines; the risk reduction (RR) program emphasized abstinence and included computer-based condom skills-training. The primary outcome assessed program impact on delayed sexual initiation; secondary outcomes assessed other sexual behaviors and psychosocial outcomes. Results: Participants were 59.8% females (mean age: 12.6 years). Relative to controls, the RR program delayed any type of sexual initiation (oral, vaginal, or anal sex) in the overall sample (adjusted odds ratio [AOR]:.65, 95% CI:.54.77), among females (AOR:.43, 95% CI:.31.60), and among African Americans (AOR:.38, 95% CI:.18.79). RR students also reduced unprotected sex at last intercourse (AOR:.67, 95% CI:.47.96), frequency of anal sex in the past 3 months (AOR:.53, 95% CI:.33.84), and unprotected vaginal sex (AOR:.59, 95% CI:.36.95). The RA program delayed any sexual initiation among Hispanics (AOR:.40, 95% CI:.19.86), reduced unprotected sex at last intercourse (AOR:.70, 95% CI:.52.93), but increased the number of recent vaginal sex partners (AOR: 1.69, 95% CI: 1.012.82). Both programs positively affected psychosocial outcomes. Conclusions: The RR program positively affected sexually inexperienced and experienced youth, whereas the RA program delayed initiation among Hispanics and had mixed effects among sexually experienced youth.
KW - Adolescents
KW - Educational technology
KW - Health education
KW - Intervention studies
KW - Pregnancy
KW - Sexual behavior
KW - Sexually transmitted infection
KW - Urban populations
UR - http://www.scopus.com/inward/record.url?scp=84857048618&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857048618&partnerID=8YFLogxK
U2 - 10.1016/j.jadohealth.2011.07.010
DO - 10.1016/j.jadohealth.2011.07.010
M3 - Article
C2 - 22325134
AN - SCOPUS:84857048618
SN - 1054-139X
VL - 50
SP - 279
EP - 288
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 3
ER -