The impact of the Postponing Sexual Involvement curriculum among youths in California. Evaluating the outcomes of parent-child family life education. Effects of a parent-child communications intervention on young adolescents' risk for early onset of sexual intercourse. Adult identity mentoring: reducing sexual risk for African-American seventh grade students.
Postponing Sexual Involvement (PSI) is a widely implemented middle school curriculum designed to delay the onset of sexual intercourse. In an evaluation of its effectiveness among seventh and eighth graders in California, 10,600 youths from schools and community-based organizations statewide were recruited and participated in randomly assigned intervention or control groups; the curriculum was implemented by either adult or youth leaders. Survey data were collected before the program was implemented, and at three months and 17 months afterward. At three months, small but statistically significant changes were found in fewer than half of the measured attitudes, behaviors and intentions related to sexual activity; at 17 months, none of these significant positive effects of the PSI program had been sustained. At neither follow-up were there significant positive changes in sexual behavior; Youths in treatment and control groups were equally likely to have become sexually active, and youths in treatment groups were not less likely than youths in control groups to report a pregnancy or a sexually transmitted infection. The evaluation suggests that PSI may be too modest in length and scope to have an impact on youths' sexual behavior. Conducted in diverse sociocultural communities in Los Angeles County, the project implemented and evaluated a family life education program designed to prevent the negative outcomes of risky sexual behavior. A sample of 251 male and female early adolescents 9 through 14 years of age participated with their parents in this abstinence-based adolescent pregnancy prevention program. The project sought to improve parent-child communications and delay the onset of sex-related behaviors through direct involvement of parents in the education process. Naturally occurring community groups were randomly assigned by site to treatment or delayed treatment conditions in a longitudinal quasi-experimental evaluation design. The evaluation demonstrated significant improvements in communication between parents and children immediately following the intervention; however, these improvements were no longer present 12 months postintervention. The process and outcome evaluation methods employed in the study triangulated qualitative and quantitative data collection and analysis procedures. This combination provided other sources of data than the traditional outcome measures used in most evaluation studies, thus addressing some of the gaps in present program evaluations. Descriptions of the process evaluation, integrated with the outcome data, are intended to heighten nurses' awareness of the importance of this component of research and the rich qualitative data it may yield. The qualitative process components in the project captured the experience of the investigators when they encountered many of the complex challenges that confront researchers who implement and evaluate family life education programs among early adolescents. This experience provided the basis for suggested strategies that nurse clinicians and researchers can use in their work with early adolescents and their parents in clinical-, school-, and community-based settings. The quality of parent-child communications about sex and sexuality appears to be a strong determinant of adolescents' sexual behavior. Evaluations of interventions aimed at improving such communications can help identify strategies for preventing early onset of sexual behavior.
                A school-based abstinence-only curriculum was implemented among 351 middle school students, who were randomly assigned to receive either the classroom instruction alone or the classroom instruction enhanced by five homework assignments designed to be completed by the students and their parents. An experimental design involving pretest and posttest surveys was used to assess the relative efficacy of the curriculum delivered with and without the parent-child homework assignments.
                In analyses of covariance controlling for baseline scores, immediately after the intervention, adolescents who received the enhanced curriculum reported greater self-efficacy for refusing high-risk behaviors than did those who received the classroom instruction only (mean scores, 16.8 vs. 15.8). They also reported less intention to have sex before finishing high school (0.4 vs. 0.5), and more frequent parent-child communications about prevention (1.6 vs. 1.0) and sexual consequences (1.6 vs. 1.1). In all significant comparisons, the direction of the findings favored adolescents who received the enhanced curriculum. Dose-response relationships supported the findings.
                Parent-child homework assignments designed to reinforce and support school-based prevention curricula can have an immediate impact on several key determinants of sexual behavior among middle school adolescents. This study was undertaken to determine whether the Adult Identity Mentoring (AIM) project successfully promotes abstinence, delays initiation of sex, and decreases intention to engage in sex.
                Twenty middle school classes of African-American seventh graders were randomly assigned to receive either the AIM intervention or a standard health education control curriculum. The AIM is a 10-session curriculum based on the theory of possible selves. Class exercises encourage students to articulate a possible future self-identity and to develop self-promotion skills. Surveys about sexual activity were conducted before the intervention, 19 weeks after baseline, and again at 1 year after the intervention.
                Hierarchical logistic regression analyses showed significant effects for the intervention on sexual intentions, abstinence, and a trend toward fewer virgins initiating intercourse for the first time, 19 weeks after baseline. Specifically, students who received the intervention showed decreased intention to engage in sex and increased abstinence compared with students not receiving the intervention. Effects for 1-year follow-up, with smaller sample size, showed only that AIM male participants maintained the significant abstinence effect.
                A new intervention, AIM was evaluated among African-American seventh graders. This program, by focusing students on positive future selves, effectively modified sexual risk without directly providing instruction on sexually explicit topics.