It's Your Game: Keep It Real: Delaying Sexual Behavior with an Effective Middle School Program

Abstract

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.

Sexual Risk Avoidance and Sexual Risk Reduction Interventions for Middle School Youth: A Randomized Controlled Trial

“…This is the second randomized trial to demonstrate the efficacy of the risk reduction version of It's Your Game. [14] These findings corroborate evidence from previous studies that middle school programs emphasizing abstinence and condom skills-training can effectively delay sexual initiation [14,15] and may positively impact sexually experienced youth. [12,13,16] The RA program positively impacted Hispanic and female students.…”

“…[14] Psychosocial Measures-Impact on targeted psychosocial factors was assessed, including behavioral knowledge (STI/HIV and condom use); perceived self-efficacy (refusing sex, using condoms, negotiating condom use); behavioral beliefs (about abstinence and abstinence-until-marriage; reasons for not having sex; condom use); normative beliefs (friends' and parents' perceived beliefs about sex; friends' perceived sexual behavior); intentions (for having oral or vaginal sex; remaining abstinent through high school and untilmarriage; using condoms; getting tested for STI/HIV if at risk); environmental factors (exposure to risky situations that could lead to sex; parental communication about sexual topics); and character traits (character qualities [e.g., responsibility], and future orientation [e.g., having plans for one's future]) ( Table 1). All measures were previously utilized with urban youth.…”

Promoting Parent–Child Sexual Health Dialogue with an Intergenerational Game: Parent and Youth Perspectives

“…16,27 Computer gamebased sexual health interventions have demonstrated impact on delayed initiation of sex, risk reduction behaviors in sexually active youth, and/or improved knowledge, attitudes, and intentions regarding these behaviors. [28][29][30][31][32][33][34] However, they have primarily targeted youth. An intergenerational game (IGG) is a game that provides an inclusive and shared entertainment experience that is appealing across developmental ages from children to adults, representing a common ''meeting ground'' for families.…”

School-based HIV/AIDS education is associated with reduced risky sexual behaviors and better grades with gender and race/ethnicity differences

“…Studies have shown that school-based HIV/AIDS education programs can effectively reduce youth risky behaviors including delaying initiation of sex, frequency of sex, number of new partners, incidence of unprotected sex, STIs and pregnancy rates; and increase the use of condoms and contraception among sexually active participants [5][6][7][8][9]. However, most of the previous studies were based on a small sample size which did not allow for an assessment of school HIV/AIDS education program effectiveness by race/ethnicity and gender-specific effects.…”