Addressing Sexual Behavior Among Disadvantaged Youth

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DESCRIPTION (provided by investigator): This project is designed to reduce the risk of HIV, other sexually transmitted disease (STD), and unplanned pregnancy among high school-aged youth attending district alternative (i.e., continuation) schools. This study involves three key activities: (1) developing and implementing a theoretically-based intervention that integrates two program strategies drawn from evidenced-based prevention programs; (2) conducting a rigorous outcome and process evaluation; and (3) disseminating the study findings and materials to the field. The outcome data from this study also will provide an opportunity to better understand the sexual behavior patterns and related norms and values among youth in alternative settings, an under-studied population at great risk for HIV, other STDs, and unplanned pregnancy. The proposed study will assess the individual and combined effects of two theoretically based intervention components: (1) a skills- and norm-based HIV, other STD, and pregnancy prevention curriculum; and, (2) community involvement and service learning. The curriculum component will address essential skills, norms, and knowledge supporting behavior change and provide ample opportunities for acquisition and practice of key skill and risk reduction strategies. The service learning component will help enhance students' sense of purpose and future and provide opportunities for positive connection, both potential motivational influences to avoid risk-taking behaviors. These components stem from several effective interventions/studies, including Making Proud Choices (Jemmott, Jemmott, & Fong, 1998), Safer Choices (Coyle et al., 1999, 2001), Teen Outreach Program (TOP) (Philliber & Allen, 1992), and Reach for Health Community Youth Service (CYS) (O'Donnell et al., 2002). The intervention effects will be tested using a 2 x 2 experimental pretest-posttest-delayed posttest design involving 84 classrooms (1,512 youth). Classrooms will be randomly assigned to one of four intervention conditions: skills- and norms-based curriculum, service learning, skills and norms curriculum plus service learning, or an attention control curriculum. Students will be assessed at baseline and at 6- and 18-months after program entry. Multilevel analyses will be used to account for the clustering of students within classrooms. Few studies have examined the effects of HIV/STD/pregnancy prevention interventions with youth in alternative settings. Additionally, no published study has examined both the individual and combined effects of a skills- and norm-based curriculum and service learning. Thus, this project will advance existing research on sexual risk behavior as well as provide new data on an important youth population.