Science and Success, Second Edition: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV and Sexually Transmitted Infections

Full Study Report [HTML] [PDF]
Executive Summary [HTML] [PDF]

Program Components

• Health promotion curriculum
• Forty lessons per year in each of two years, each lesson lasting one class period
• Three hours per week of community service in assigned placements
• Reflection and activities to help students learn from their community experiences
• Educator training recommended

For Use With

• Seventh and eighth graders / middle school students
• Urban youth
• Black and Hispanic youth
• Economically disadvantaged youth

Evaluation Methodology

• Quasi-experimental and experimental designs, including treatment and comparison groups, in two large, public middle schools in New York, New York
• Urban youth (n=1,157 at baseline; n=1,061 at spring follow-up); average age at baseline, 12.2 for seventh graders and 13.3 for eighth graders
• Pretest and follow-up nine months later; longitudinal follow-up after a further 24 months

Evaluation Findings

• Delayed initiation of sexual intercourse
• Reduced frequency of sex
• Increased condom use
• Increased use of contraception
• Long-term: Sustained reduction in rates of initiation of sexual intercourse
• Long-term: Sustained reduction in frequency of sex

Evaluators' comments: A service learning intervention that combines community involvement with [sexual] health instruction can have a long-term benefit by reducing sexual risk-taking among urban adolescents.
Source: O’Donnell, Steuve, O’Donnell et al, 2002

Program Description

The Reach for Health Community Youth Service (CYS+) program builds upon community-based service learning. It includes a health promotion curriculum (Reach for Health) that is based upon Teenage Health Teaching Modules. The curriculum includes information regarding human sexuality and is delivered to seventh and eighth graders by educators trained specifically in the curriculum. The health curriculum consists of 40 core lessons that focus on three primary health risks faced by urban youth: 1) drug and alcohol use; 2) violence; and 3) sexual behaviors that may result in pregnancy or infection with HIV and other STIs.[10]

Students spend about three hours each week providing service in community settings, such as nursing homes, senior centers, full-service clinics, and child day care centers. Under the guidance of their health teachers as well as staff from placement sites, students perform such tasks as reading to elders, assisting with meals, and helping with exercise, recreation, and arts. Students prepare for their service activities by learning more about the organization to which they are assigned and by setting personal goals for their service learning.[10]

The program is based on the health belief model and theories of social learning. As such, the program expects students to learn both by doing and by reflecting on their experiences.[10]

Evaluation Methodology

The evaluation was designed to compare the impact of receiving CYS+ (Reach for Health curriculum plus service learning) to that of receiving the health curriculum only and of receiving no intervention. The study sites included two large, urban middle schools. One school served as the intervention school and one as the comparison. Classes in the intervention school were randomly assigned to receive:

• Health curriculum only (Reach for Health, including information about human sexuality) or
• Health curriculum plus the service-learning component (CYS+).

All students in grades seven and eight at the two school sites were eligible to participate in the evaluation study if they had written parental consent. Ninety-four percent of eligible students participated. Forty-eight percent of the students who completed surveys at both baseline and follow-up were eighth graders.[10]

Among participants in the study, 47 percent were male. At baseline, the average age of seventh graders was 12.2. Average age of eighth graders was 13.3. Sixteen percent of students self-identified as Hispanic and 79 percent as non-Hispanic black. Five percent self-identified as ‘other’. Of 1,061 students completing both fall and spring surveys, 255 participated in the CYS+ intervention; 222 participated in the curriculum only intervention; and 584 served as comparisons. At baseline, 68 percent of the sample had never had sex while 23 percent reported having had sex in the three months prior to the survey. Among those reporting recent sex at baseline, 40 percent reported no use or inconsistent use of condoms.[10]

Outcomes

• Behaviors—
  • Delayed initiation of sexual intercourse—Rates of sexual initiation increased by eight percentage points among comparison youth. Rates increased less among curriculum-only and CYS+ youth (three and four percentage points, respectively).[10]
  • Reduced frequency of sex—Rates of recent sex increased five percentage points among comparison youth and by three percentage points among curriculum-only youth. Rates decreased by nearly half a percentage point among CYS+ youth. The difference between comparison and CYS+ youth was statistically significant.[10]
  • Increased condom use—Comparison students reported an increase of three percentage points in recent sex without a condom. Rates among curriculum-only and CYS+ youth decreased by 13 and 16 percentage points, respectively.[10]
  • Increased use of contraception—Comparison students reported an increase of nine percentage points in recent sex without birth control pills. Rates decreased by five and eight percentage points, respectively, among curriculum-only and CYS+ youth.[10]
• Behavioral changes among special education students—Although the number of special education students in this study was small and findings must be used with caution, this group appeared to experience some of the greatest benefits of the curriculum alone.[10]
  • Among special education students, comparison youth reported a 26 percentage point increase in ever having had sex and CYS+ youth reported a four percentage point increase. The rate decreased by 13 percentage points among curriculum-only youth.[10]
  • Among special education students, comparison and CYS+ youth reported an increase of 31 and three percentage points, respectively, in recent sex. The rate decreased 11 percentage points among curriculum-only youth.[10]
  • Rates of recent sex without a condom decreased by eight, 100, and 27 percentage points, respectively, among comparison, CYS+, and curriculum-only groups of special education students.[10]
  • Special education comparison youth reported an increase of 22 percentage points in recent sex without birth control pills. Rates decreased by 50 and 22 percentage points, respectively, among CYS+ and curriculum-only youth.[10]

Long-Term Impact

• Delayed initiation of sexual intercourse—Follow-up when youth had reached 10th grade found that CYS+ youth were less likely than youth who received the health curriculum only to report having initiated sex or to report recent sex. Among those who had not had sex at baseline, 44 percent of male and 57 percent of female CYS+ youth had not initiated sex by 10th grade, compared to 27 percent of males and 47 percent of females who received the curriculum only.[11]
• Reduced frequency of sex—Similarly, sexually experienced curriculum-only youth were more likely to report recent sex than were sexually experienced CYS+ youth. Among sexually experienced curriculum-only youth, 69 percent of males and 47 percent of females reported recent sex versus 45 percent of sexually experienced CYS+ males and 38 percent of sexually experienced CYS+ females.[11]

For More Information, Contact

• Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com