Evaluation of abstinence program for urban preadolescent and health outcomes

Background: Unintended pregnancy among preadolescents often imposes burdens of poor health outcomes, induce socio-economic costs, and increase health/medical costs. It is crucial to evaluate a school-based program and economic outcomes taking into account different socio-cultural characteristics and behaviors in order to allocate resources effectively.

Methods: The project employed a quasi-experimental treatment-control group evaluation design with random assignment of schools to treatment and control groups in New York. About 700 students are in the intervention and 500 students were in the treatment group in 6th and 7th grades. Health education program offered 24 weekly 45~60 minute classes. A common instrument was administered to students at baseline and at 6 month, 12 month and 24 month follow ups. Three influential factors that were related to decision-making behavior were analyzed.

Results: Application of the behavioral model demonstrated a significant difference between the treatment and control groups in attitudes toward abstinence and intent to abstain from sexual activity until marriage. The cost effective analysis shows net gain per student from the health education intervention after considering the true cost of the project. Additional findings suggest that the impact of a school-based health-education intervention for abstinence from sexual activity in preadolescents requires the integration of program components designed to enhance child-parent communication and to enhance self efficacy for preadolescents.

Conclusions: The project is feasible from a cost effectiveness point of view for society as a whole. Periodic monitoring of the program seems warranted, however, to assess program effects and enhance operating efficiency.