Evaluation of a randomized intervention to delay sexual initiation among fifth-graders followed through the sixth grade

Abstract

US adolescents initiate sex at increasingly younger ages, yet few pregnancy prevention interventions for children as young as 10–12 years old have been evaluated. Sixteen Washington, DC schools were randomly assigned to intervention versus control conditions. Beginning in 2001/02 with fifth-grade students and continuing during the sixth grade, students completed pre-intervention and post-intervention surveys each school year. Each year, the intervention included 10–13 classroom sessions related to delaying sexual initiation. Linear hierarchical models compared outcome changes between intervention and control groups by gender over time. Results show the intervention significantly decreased a rise over time in the anticipation of having sex in the next 12 months among intervention boys versus control boys, but it had no other outcome effects. Among girls, the intervention had no significant outcome effects. One exception is that for both genders, compared with control students, intervention students increased their pubertal knowledge. In conclusion, a school-based curriculum to delay sexual involvement among fifth-grade and sixth-grade high-risk youths had limited impact. Additional research is necessary to outline effective interventions, and more intensive, comprehensive interventions may be required to counteract adverse circumstances in students' lives and pervasive influences toward early sex.

ClinicalTrials.gov identifier: NCT00341471

Acknowledgements

Funding was provided by Grants 3U18HD030445, 3U18HD030447, 5U18 HD31206, 3U18HD031919, and 5U18HD036104, supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the National Center on Minority Health and Health Disparities (NCMHHD). Participating institutions include Howard University, Georgetown University, George Washington University and RTI International.

Notes

^†This author has passed away after the article was submitted for publication.

^1. We slightly revised the sixth-grade questionnaire to measure the added curriculum activities; these changes did not affect any analysis variables.

^2. Altogether, 19 boys (7.6%) and nine girls (3.6%) changed from being in the intervention to the control condition; six boys (2.3%) and three girls (1.4%) made the opposite change. Nearly all of these changes occurred because of the creation of new middle schools and changes in the feeder patterns from elementary to middle schools.

^3. Details of the modeling formulations are available from the authors.

^4. We were constrained to use the attendance data only for the first seven sessions because attendance data were corrupted in the sixth grade after the seventh session, and it was necessary to create a uniform variable across the two years.

Additional information

Notes on contributors

M. Nabil El-Khorazaty

† †This author has passed away after the article was submitted for publication.