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Replicating Reducing the Risk: 12-Month Impacts of a Cluster Randomized Controlled Trial.

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The "Reducing the Risk" sexual health program did not change adolescent sexual behaviors overall. However, it improved knowledge and attitudes, with some positive behavioral impacts at one site.

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Area of Science:

  • Public Health
  • Adolescent Health
  • Sexual Health Education

Background:

  • Adolescent pregnancy and sexually transmitted infections (STIs) remain significant public health concerns.
  • Evidence-based sexual health curricula are crucial for preventing negative sexual health outcomes in youth.
  • Understanding the impact of such programs on behavior and intermediate outcomes is vital.

Purpose of the Study:

  • To evaluate the effectiveness of the "Reducing the Risk" sexual health curriculum.
  • To assess the program's impact on adolescent sexual behaviors.
  • To examine the influence on intermediate outcomes, such as knowledge and attitudes, related to sexual health.

Main Methods:

  • A randomized controlled trial was conducted across schools in three US cities.
  • Participants were assigned to either the "Reducing the Risk" program or a control group ("business as usual").
  • Web-based surveys were administered at baseline and 12-month follow-up, with intent-to-treat analyses performed.

Main Results:

  • The program demonstrated no overall significant impact on adolescent sexual behaviors after 12 months.
  • A positive impact on sexual intercourse rates was observed at one of the study sites.
  • Significant improvements were noted in intermediate outcomes, including sexual knowledge and attitudes.

Conclusions:

  • The "Reducing the Risk" curriculum did not achieve widespread behavioral change in sexual risk behaviors within 12 months.
  • Mixed results suggest potential for longer-term or more targeted behavioral impacts.
  • Positive effects on knowledge and attitudes, alongside site-specific behavioral improvements, offer a promising foundation for future interventions.