Online Program

Fidelity and Implementation Outcomes of a Combined 14-Session Sexual Activity Risk Prevention Education Curriculum and a Healthy Relationship Education Curriculum For HIgh Risk Seventh Graders In an Urban Setting

Tuesday, November 3, 2015 : 3:30 p.m. - 3:50 p.m.

Harry Piotrowski, MS, ITMESA, LLC (Inquiry Through Measurement Evaluation and Statistical Analysis), Oak Park, IL
Don Hedeker, PhD, Department of Public Health Studies - Department of Medicine, The University of Chicago Biological Sciences, Chicago, IL
Purpose: Evaluate fidelity and implementation of an innovative combination curriculum for high risk minority 7thgraders in an urban setting: 14-session combined (1) 8 abstinence-only Evidence-Based (Promoting Health Among Teens) sessions,  (2) evidence-promising healthy relationship (5 selected from The Dibble Institute Love U 2 Relationship Skills for Teens) sessions, and (3) 1 CDC/OPA session on contraception and reducing risk for STD’s and Pregnancy. The study is a quasi-experimental design with a comparison lagged grade 8 (usual instruction) group and treatment group with questionnaire responses comparison in 8th grade. It is a post-test only non-equivalent groups design to examine impacts. At this time we report on the fidelity and implementation outcomes (pre-immediate post) for treatment group.

Methods:  11 schools participated in the treatment and comparison group design.  To date over 3000 students have enrolled in the program. Consents/assents were obtained for the 1180 students whose responses are analyzed at this time. Students completed a baseline questionnaire one week before instruction and a post questionnaire after instruction. In addition to demographic items (age, gender, race, ethnicity), items were adapted from the relationship curriculum and the sexual activity research literature. The Likert items were empirically constructed into scales with a range of 0 to 100%, with 100% as the target. Pre-post significant differences examined implementation with.05 probability. Attendance, student survey with items about instruction, materials and the two facilitators and facilitator self-assessment provided fidelity data.

Analysis: Demographics: 53% female, 90% between 12-13, 51% African American, 34% Hispanic, all living in NW Indiana.  With intent-to-treat analysis, separate three-level mixed effects repeated (two-time periods)  regression models, adjusted for lack of independence among schools and classroom and for control of baseline demographic differences to maintain equivalence, were examined with school and student level covariates.

Results: Estimates from multiple analyses indicated modest to moderate effect sizes that demonstrated positive changes in (1) managing relationship skills, (2) knowledge about positive peer relationships, (3) attitudes about positive peer relationships, behavioral intentions to develop positive peer relationships and (5) behavioral intentions to abstain from sexual activity.  High fidelity was determined from student participation rates (>75% attended >80% sessions) and feedback ratings

Conclusion:  The combined curricula for 7th graders was found to be evidence-promising with high fidelity.

Learning Areas:

Implementation of health education strategies, interventions and programs
Public health or related education
Social and behavioral sciences

Learning Objectives:
Describe results of a 14-session middle school curriculum on psychosocial measures of positive healthy relationships and risk reduction and risk avoidance. Describe how the results are evidence-promising with a high risk urban primarily African American and Hispanic 7th grade student population. Describe how an evidence-based curriculum to reduce sexual activity and a peer youth relationship education curriculum has positive outcomes in both areas

Keyword(s): Adolescents, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the primary evaluator for the quasi-experimental evaluation three-year project. I am also the primary evaluator for a cluster randomized trial of a longitudinal curriculum. I have taught research methods and supervised research projects of family medicine and internal medicine residents for over 20 years. I have coauthored a number of research studies in public health. I have done research in the area of adolescent health for the last 10 years.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
PATH, Inc Children and Teens Consultant

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.