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Purpose This study tested the effects of a theory-based middle-school HIV, STI, and pregnancy prevention program, It’s Your Game: Keep it Real (IYG), in delaying sexual behavior. We hypothesized that the IYG intervention would decrease the number of adolescents who initiated sexual activity by the 9th grade compared to those in the comparison schools. Methods The target population was English-speaking middle schoolers from a large urban predominantly African American and Hispanic school district in Southeast Texas. Ten middle schools were randomly assigned either to receive the intervention or to the comparison condition. Seventh-grade students were recruited and followed through 9th grade. The IYG intervention comprises 12 seventh-grade and 12 eighth-grade lessons that integrate group-based classroom activities with computer-based instruction and personal journaling. Ninth-grade follow-up surveys were completed by 907 students (92% of the defined cohort). The primary hypothesis tested was that the intervention would decrease the number of adolescents who initiated sexual activity by the 9th grade compared to those in the comparison schools. Results Almost one-third (29.9%, n=509) of those in the comparison condition initiated sex by 9th grade compared to almost one-quarter (23.4%, n=308) of those in the intervention condition. After adjusting for covariates, students in the comparison condition were 1.29 times more likely to initiate sex by the 9th grade than those in the intervention condition. Conclusions A theory-driven multi-component, curriculum-based intervention can delay sexual initiation up to 24 months; can have impact on specific types of sexual behavior such as initiation of oral and anal sex; and may be especially effective with females. Future research must explore the generalizabilty of these results.

While research has explored adolescents’ use of technology to perpetrate dating violence, little is known about how traditional in-person and cyber abuse are linked, and no studies have examined their relationship over time. Using our sample of 780 diverse adolescents (58% female), we found that traditional and cyber abuse were positively associated, and cyber abuse perpetration and victimization were correlated at each time point. Cyber abuse perpetration in the previous year (spring 2013) predicted cyber abuse perpetration one year later (spring 2014), while controlling for traditional abuse and demographic variables. In addition, physical violence victimization and cyber abuse perpetration and victimization predicted cyber abuse victimization the following year. These findings highlight the reciprocal nature of cyber abuse and suggest that victims may experience abuse in multiple contexts.

Purpose-To evaluate the efficacy of two, theory-based, multi-media, middle school sexual education programs in delaying sexual initiation.Methods-Three-armed, randomized controlled trial comprising fifteen urban middle schools; 1,258 predominantly African-American and Hispanic 7 th grade students followed into 9 th grade. Both programs included group and individualized, computer-based activities addressing psychosocial variables. The risk avoidance (RA) program met federal abstinence education guidelines; the risk reduction (RR) program emphasized abstinence and included computer-based condom skills-training. The primary outcome assessed program impact on delayed sexual initiation; secondary outcomes assessed other sexual behaviors and psychosocial outcomes.Results-Participants were 59.8% female, mean age 12.6 years. Relative to controls, the RR program delayed any type of sexual initiation (oral, vaginal or anal sex) in the overall sample (adjusted odds ratio [AOR]: 0.65, 95% CI: 0.54-0.77), among females (AOR: 0.43, 95% CI: 0.31-0.60) and African-Americans (AOR: 0.38, 95% CI: 0.18-0.79). RR students also reduced unprotected sex at last intercourse (AOR: 0.67, 95% CI: 0.47-0.96), past three months' frequency of anal sex (AOR: 0.53, 95% CI: 0.33-0.84) and unprotected vaginal sex (AOR: 0.59, 95% CI: 0.36-0.95). The RA program delayed any sexual initiation among Hispanics (AOR: 0.40, 95% CI: 0.19-0.86), reduced unprotected sex at last intercourse (AOR: 0.70, 95% CI: 0.52-0.93) but increased the number of recent vaginal sex partners (AOR: 1.69, 95% CI: 1.01-2.82). Both programs positively impacted psychosocial outcomes. program, comparable in duration, delivery, and theoretical framework, to further examine how both approaches impact middle school students. The primary hypothesis tested whether students, who received either the RR or the RA intervention, would delay sexual initiation into 9 th grade relative to controls. Secondary hypotheses tested intervention effects on other sexual behaviors and psychosocial factors. Conclusions-The METHODS Study Design and ParticipantsA randomized controlled trial was conducted from 2006-2010 in fifteen urban middle schools in a large south-central US school district. Seventy-eight percent of students were classified as economically disadvantaged. Assignment of schools to one of three conditions (5 to the RA condition, 5 to the RR condition, and 5 to a control condition) was conducted prior to baseline assessment using a multi-attribute randomization protocol, accounting for school size, racial/ethnic composition (percent of African-American and Hispanic students), and geographic location.[18]Assuming 15% of controls would initiate any type of sex by 9 th grade, 25% attrition, intraschool correlations=0.005, and α=0.05 (two-tailed), an initial sample size of 1,500 7 th grade students was estimated to provide 80% power to detect 10% pairwise differences in sexual Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript initiation between intervention and co...

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Much is known about the prevalence and correlates of dating violence, especially the perpetration of physical dating violence, among older adolescents. However, relatively little is known about the prevalence and correlates of the perpetration of cyber dating abuse, particularly among early adolescents. In this study, using a predominantly ethnic-minority sample of sixth graders who reported ever having had a boyfriend/girlfriend (n = 424, 44.2 % female), almost 15 % reported perpetrating cyber dating abuse at least once during their lifetime. Furthermore, using a cross-sectional design, across multiple levels of the socio-ecological model, the individual-level factors of (a) norms for violence for boys against girls, (b) having a current boyfriend/girlfriend, and (c) participation in bullying perpetration were correlates of the perpetration of cyber dating abuse. Collectively, the findings suggest that dating violence interventions targeting these particular correlates in early adolescents are warranted. Future studies are needed to establish causation and to further investigate the relative importance of correlates of the perpetration of cyber dating abuse among early adolescents that have been reported among older adolescents.

Purpose Few computer-based HIV, sexually transmitted infection (STI), and pregnancy prevention programs are available, and even fewer target early adolescents. In this study, we tested the efficacy of It’s Your Game (IYG)-Tech, a completely computer-based, middle school sexual health education program. The primary hypothesis was that students who received IYG-Tech would significantly delay sexual initiation by ninth grade. Methods We evaluated IYG-Tech using a randomized, two-arm nested design among 19 schools in a large, urban school district in southeast Texas (20 schools were originally randomized). The target population was English-speaking eighth-grade students who were followed into the ninth grade. The final analytic sample included 1,374 students. Multilevel logistic regression models were used to test for differences in sexual initiation between intervention and control students, while adjusting for age, gender, ethnicity, time between measures, and family structure. Results There was no significant difference in the delay of sexual activity or in any other sexual behavior between intervention and control students. However, there were significant positive between-group differences for psychosocial variables related to STI and condom knowledge, attitudes about abstinence, condom use self-efficacy, and perceived norms about sex. Post-hoc analyses conducted among intervention students revealed some significant associations: “full exposure” (completion of all 13 lessons) and “mid-exposure” (5–8 lessons) students were less likely than “low exposure” (1–4 lessons) students to initiate sex. Conclusions Collectively, our findings indicate that IYG-Tech impacts some determinants of sexual behavior, and that additional efficacy evaluation with full intervention exposure may be warranted.

Objectives. We sought to describe the prevalence, characteristics, and mental health problems of children who experience perceived racial/ethnic discrimination. Methods. We analyzed cross-sectional data from a study of 5147 fifth-grade students and their parents from public schools in 3 US metropolitan areas. We used multivariate logistic regression (overall and stratified by race/ethnicity) to examine the associations of sociodemographic factors and mental health problems with perceived racial/ethnic discrimination. Results. Fifteen percent of children reported perceived racial/ethnic discrimination, with 80% reporting that discrimination occurred at school. A greater percentage of Black (20%), Hispanic (15%), and other (16%) children reported perceived racial/ethnic discrimination compared with White (7%) children. Children who reported perceived racial/ethnic discrimination were more likely to have symptoms of each of the 4 mental health conditions included in the analysis: depression, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. An association between perceived racial/ethnic discrimination and depressive symptoms was found for Black, Hispanic, and other children but not for White children. Conclusions. Perceived racial/ethnic discrimination is not an uncommon experience among fifth-grade students and may be associated with a variety of mental health disorders.