Publications
Reducing the Risk Print

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

  • Sex education curriculum, including information on abstinence and contraception
  • Sixteen sessions, each lasting 45 minutes and expandable to 90 minutes, if desired
  • Experiential activities included to build skills in refusal, negotiation, and communication
  • Educator training recommended

For Use With

  • High school students, especially those in grades nine and 10
  • Low risk youth[*]
  • Sexually inexperienced youth
  • Multi-ethnic populations – white, Latino, Asian, and black youth
  • Urban, suburban, and rural youth

Evaluation Methodology

  • Quasi-experimental design, including treatment and comparison conditions, in 13 California high schools
  • Urban and rural high school students (n=1,033 at baseline; n=758 at 18 month follow-up); mean age at baseline, 15.3 years
  • Pretest and post-test at program exit, with six- and 18-month follow-up

Evaluation Findings

  • Increased parent-child communication – especially among Latino youth
  • Delayed initiation of sexual intercourse
  • Reduced incidence of unprotected sex – among lower risk youth

Replication Evaluation Methodology & Findings

  • Quasi-experimental design, including treatment and comparison conditions, in five school districts in Arkansas
  • Rural and urban, mostly white youth (n=512 at baseline; n=212 at 18-month follow-up); average age 15 to 16
  • Pretest and 18-month follow-up
  • Achieved knowledge and behavior changes similar to those of original evaluation and also achieved increased use of contraception among sexually active youth

Evaluators' comments: The curriculum…reduced the chance that a student would initiate intercourse, possibly by as much as 24 percent. Moreover, it did not increase the frequency of intercourse among students who had already initiated intercourse.
Source: Kirby, Barth, Leland et al, 1991

Program Description

Reducing the Risk is a sex education curriculum for grades nine through 12, but especially recommended for grades nine and 10. Lasting 16 class periods and instructor-led, it focuses on the overall behavioral goal of encouraging youth to avoid unprotected sex by:

  • Practicing abstinence or
  • Using contraception.

Nearly every activity supports this goal, by assisting teens to personalize information on the risks of unprotected sex and by teaching them how to avoid unprotected sex. As such, Reducing the Risk addresses sexual risk-taking related to both pregnancy and HIV/STI prevention.[12,13]

Through experiential activities, participants learn to recognize and resist peer pressure, make decisions, and negotiate safer sex behaviors. The curriculum is based on social learning theory, social inoculation (social influence) theory, and cognitive behavioral theory. Reducing the Risk also encourages students to talk to their parents about abstinence and birth control.[12,13]

Evaluation Methodology

Reducing the Risk was implemented in 13 high schools in urban and rural California school districts. Although 1,033 students took the pretest, 758 completed all surveys and were included in the evaluation. The treatment participants (n=429) and comparison youth (n=329) were surveyed at four points—prior to their exposure to the curriculum, immediately afterwards, and at six and 18 months after receiving the curriculum. Students were mostly in ninth (27 percent) or 10th (56 percent) grade and female (53 percent). Youth were mostly white (62 percent) or Latino (20 percent). Nine percent were Asian; two percent were black; and two percent, Native American; five percent checked ‘other’. The average age at baseline was 15.3. Seventy percent of students lived with both their parents; 24 percent lived with a single parent. Seven percent lived in other situations.[12]

At pretest, there were no significant differences between students assigned to participate in Reducing the Risk (treatment condition) or to comparison groups that received whatever sexual health education teachers were already providing (comparison condition). In evaluation, 46 classrooms of students taking a mandatory health education class were randomly assigned to either the treatment or the comparison condition. Thus, the evaluation measured the impact of Reducing the Risk relative to other sex education curricula.[12]

Outcomes

  • Knowledge—Participating and comparison students' knowledge of contraception increased substantially over time. However, knowledge increased significantly more among participants than among comparison youth.[12]
  • Attitudes and perceptions—The curriculum significantly affected students' perceptions of the proportion of their peers who had ever had sexual intercourse. The two groups' perceptions were similar at pretest (all respondents believed that about one-half of their peers had initiated sex). By the six-month post-test, comparison group members believed that more than half of their peers had initiated sex, while no such change was apparent in the perceptions of the treatment group.[12]
  • Behaviors
    • Increased parent-child communication about abstinence and contraception—Participating students, particularly Latinos, significantly increased their discussions with parents about abstinence and contraception at six-months post-intervention.[12]
    • Delayed initiation of sexual intercourse—Among youth who had not initiated sex at the time of receiving Reducing the Risk, a significantly smaller percentage (29 percent) had initiated sex 18 months later versus comparison youth (38 percent). This amounted to a 24 percent reduction in the initiation of sex among participants as opposed to that among comparison youth.[12]
    • Reduced incidence of unprotected sex among lower risk youth—Among all lower risk youth, regardless of sexual experience at pretest, there were significant differences in unprotected sexual intercourse (as measured by comparing those who delayed initiating sexual intercourse and those who had sex but used contraception at most recent sexual intercourse with those who had sex and did not use contraception at most recent intercourse). At pretest, 11 percent of both comparison and treatment groups had engaged in unprotected sexual intercourse. At 18 months follow-up, only 13 percent of the treatment group had engaged in unprotected sex; but 23 percent of the comparison group had done so.[12]

Replication Evaluation Methodology

Reducing the Risk was replicated in Arkansas. Participants and comparison youth (n=212) were white (85 percent) and black (14 percent); 52 percent were female; 49 percent were in grade 10, and 31 percent in grade 11. The comparison group consisted of five school districts matched to five treatment school districts based on geographic location, racial / ethnic distribution, and average per capita income. Comparison classes received a one-semester health education program that included whatever sexuality education was provided in that school district. One classroom in each treatment and comparison school district was randomly selected for testing.[13]

Replication Outcomes

  • Behaviors
    • Increased parent-child communicationReducing the Risk resulted in a significantly higher proportion of participants than comparison youth talking with their parents about birth control and about protection from HIV/STI.[13]
    • Delayed initiation of sexual intercourse—Evaluation showed that a significantly smaller percentage of participants than comparison youth who were sexually inexperienced at pretest had initiated sex after 18 months (28 and 43 percent, respectively).[13]
    • Increased use of contraception—Significantly more participants than comparison youth who initiated sexual intercourse after baseline also reported using effective methods to prevent pregnancy and HIV/STI (89 and 46 percent, respectively).[13]

For More Information or to Order, 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
  • ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://www.etr.org/

* Evaluators defined low risk youth as those who were not higher risk. Higher risk students were any who did not live with both parents, whose mother did not finish high school, whose high school grades were mostly Ds or lower, who drank alcohol one or more times during the preceding month, and/or who normally drank five or more drinks on each drinking occasion.

 
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