An implementation and outcome evaluation of a multicomponent sexuality education programme for high school students

Abstract

Numerous classroom-based interventions have aimed to improve sexual health outcomes for young people, yet few have shown strong, lasting effects. Ecological approaches that address multiple levels of a young person’s environment offer largely untapped potential to positively change sexual behaviour. This paper presents results of a cluster-randomised trial of a multicomponent sexuality education intervention that integrated a classroom curriculum, parent education workshops and materials, peer advocate programme, and sexual health services at 10 urban high schools. An implementation evaluation, employing quantitative and qualitative instruments, was conducted to examine whether the individual components of the intervention were delivered as planned and how they were received by the target populations. Multilevel modelling was used to evaluate the effect of the multicomponent intervention on outcomes at one-year follow-up. Results showed that the intervention components were successfully implemented with and well received by target populations. Students receiving the multicomponent intervention reported greater increases in the use of sexual health services (odds ratio [OR] = 1.73, 95% CI = 1.09–2.75) and the likelihood of carrying a condom (OR = 2.71, 95% CI = 1.44–5.09) relative to those receiving a control condition. No effects were found for other behaviours, possibly due to low prevalence of sexual activity in the sample and the small number of schools randomised.

Keywords:

• Young people
• adolescents
• sexuality education
• ecological framework
• school-based intervention
• evaluation
• cluster-randomised trial

Acknowledgements

We thank Gaylene Gunning for data collection management, Sara Marques and Jennifer Tsai for analysis support, and the Planned Parenthood Los Angeles staff and leadership for following the rigorous study protocol.

Funding

This study was supported by Planned Parenthood Los Angeles (contract number 04975 to the Public Health Institute, subcontract number 1020682 to the University of Southern California), with additional support from the Ford Foundation [grant number 1120-2773] and the William and Flora Hewlett Foundation [grant number 2013-9222]. The funders had no control over the analyses conducted, the results reported, or any other aspect of this paper.

Notes

1. The survey contained the following definition of sex: ‘In this survey, we use the word sex to mean vaginal sex (penis in the vagina) or anal sex (penis in the anus, or butt).’

2. The survey contained the following definition of oral sex: ‘Sometimes this is called “going down” or “giving head,” and it involves putting your mouth on someone else’s private parts or having someone put their mouth on your private parts.’