Short‐Term Impact of Safer Choices: A Multicomponent, School‐Based HIV, Other STD, and Pregnancy Prevention Program

Abstract

This study evaluated the effectiveness of the first year of Safer Choices, a theoretically based, multicomponent HIV, STD, and pregnancy prevention program for high school youth. The study featured a randomized trial involving 20 schools in California and Texas, with a cohort of 3,869 ninth-grade students. Students who completed both the baseline and the first follow-up survey approximately seven months later were included in the analysis (n = 3,677). Safer Choices enhanced 9 of 13 psychosocial variables including knowledge, self efficacy for condom use, normative beliefs and attitudes regarding condom use, perceived barriers to condom use, risk perceptions, and parent-child communication. Safer Choices also reduced selected risk behaviors. Specifically, Safer Choices reduced the frequency of intercourse without a condom in the three months prior to the survey, increased use of condoms at last intercourse, and increased use of selected contraceptives at last intercourse.

The effectiveness and cost-effectiveness of behavioural interventions for the prevention of sexually transmitted infections in young people aged 13–19: a systematic review and economic evaluation

“…43,50,58,[61][62][63]65,66,69,71 The ethnicity of the samples was largely a function of either the country or the aim of the study. In North American studies, the young people were generally ethnically diverse.…”

“…50,51,58,62,63,65,69,70 Typically, these samples were either representative of the general population (white, middle class, but including some young people of lower SES, for example studies by Borgia and colleagues 51 and Wight and colleagues, 70 or they specifically targeted young people of lower SES, for example studies by Jemmott and colleagues, 62 and Levy and colleagues 65 ). In four studies, low SES was implicit.…”

“…Five were delivered by both teachers and peers (not shown in Table 22). 51,58,63,68,71 Two of the studies, Levy and colleagues 65 and Coyle and colleagues, 61 which fell into the 'Other' category, used specially trained health educators. One study, Jemmott and colleagues, 43 used a specially trained 'adult facilitator'.…”

“…For example, 'Safer Choices', reported by Coyle and colleagues, 58 was based on an intervention, in the USA, entitled 'Reducing the Risk' (originally evaluated by Kirby and colleagues, 83 but did not meet the inclusion criteria for this systematic review). 'Reducing the Risk' was one of the Centers for Disease Control's 'programmes that work' 84 and was subsequently replicated and modified by Zimmerman and colleagues 71 (included in this systematic review) for 'high sensation seeking and impulsive youth'.…”

“…However, at least one study which was subsequently included in the systematic review is known to have undergone economic evaluation. 58 The publication describing this economic evaluation was included in our systematic review of cost-effectiveness studies 59,60 (see Chapter 6). Table 13 shows the sexual health topics covered by the interventions.…”