Universal Family-Focused Intervention with Young Adolescents: Effects on Health-Risking Sexual Behaviors and STDs Among Young Adults

Abstract

Considering the prevalence and consequences of health-risking sexual behaviors (HRSBs) and STDs among young adults, their prevention is a public health priority. Emerging etiological and prevention outcome literatures suggested study of the long-term effects of universal family-focused interventions on young adult HRSBs and STDs. Although earlier studies have demonstrated intervention impact on adolescent substance misuse, no study has examined universal family-focused intervention effects on young adult HRSBs and STDs via reductions in adolescent misuse. Sixth grade students and their families enrolled in 33 rural Midwestern schools were randomly assigned to experimental conditions. Self-report questionnaires provided data at pretest (Ns=238, 221, and 208 for the Iowa Strengthening Families Program [ISFP], Preparing for the Drug Free Years [PDFY], and control groups, respectively), with seven data points through young adulthood (age 21). In latent growth modeling, three young adult HRSB measures (number of sexual partners, condom use, substance use with sex) and lifetime STDs were specified as distal outcomes mediated by adolescent substance initiation growth factors (average level and rate of change). Results showed that the models fit the data and, except for condom use, there were significant indirect effects, with a higher frequency of significant findings for ISFP. The model additions of direct intervention effects on young adult outcomes generally were not supported, consistent with a model positing that long-term intervention effects on young adult HRSBs and STDs outcomes are indirect. As an indication of the practical significance of long-term effects, analyses revealed relative reduction rates ranging from 6 % to 46 % for significant outcomes.

PROSPER delivery of universal preventive interventions with young adolescents: long-term effects on emerging adult substance misuse and associated risk behaviors

“…The current findings add to a growing literature addressing this gap and indicate the potential benefits of developmentally well-timed interventions in early adolescence for substance-related outcomes during emerging adulthood, further substantiating results concerning substance misuse presented in our earlier reports from other projects (Spoth et al 2009 b , 2014 a , 2014 b ), and from other research groups that have reported results into young adulthood (Oesterle et al 2015). …”

“…To illustrate, the RRR for lifetime non-prescribed narcotics use (25.8%) suggests that, for every 100 general population young adults (i.e., from non-PROSPER communities/school districts) who have ever misused narcotics, approximately 74 young adults from PROSPER sites would have misused narcotics. The combination of positive outcomes and cost-efficiency of the PROSPER partnership model (Spoth & Greenberg, 2011; Crowley et al 2012) suggests its potential public health benefit, particularly in light of the likely long-term effects of reduced young adult substance misuse (e.g., Hawkins et al 2005, 2008 b ; Spoth et al 2014 a ;Trudeau et al 2016). The National Research Council and Institute of Medicine Report (2009) and the recent US Surgeon General Report (2016), along with other literature (Hawkins et al 2008 a; 2012), note the practical benefits of community-based prevention delivery systems for EBIs, particularly those embedded in national delivery systems and/or those supporting practitioner-scientist partnerships (Grumbach & Mold, 2009; Spoth & Greenberg, 2011).…”

“…A number of randomized controlled trials have demonstrated long-term crossover effects on emerging adult HRSBs (Botvin & Griffin, 2014 b ; Kellam et al 2014; Spoth et al 2014 a; Perrino et al 2016). …”

Toward the Development of Preventive Interventions to Reduce HRSB, HIV/AIDS, and Multiple Problem Behaviors

“…Despite these notable differences and without any direct focus on sexual behavior, four of these long-term studies found significant (direct or indirect) reductions in HRSB for some or all of participants (Caruthers et al 2014;Hill et al 2014;Kellam et al 2014;Spoth et al 2014). Although the remaining two studies did not find intervention effects, they did provide etiologic data supporting the general thesis of this Supplemental Issue (Conduct Problems Prevention Research Group 2014; Skinner et al 2014).…”

“…One paper focuses on a school-based intervention targeting early aggressive behavior in children (Kellam et al 2014). Two papers focus on universal interventions targeting drug use and associated risk factors using either a combined school-and family-based intervention implemented during childhood (Hill et al 2014) or a familybased intervention implemented during early adolescence (Spoth et al 2014). One paper focuses on universal and targeted interventions implemented during childhood to address conduct problems using both school-and family-based approaches (Conduct Problems Prevention Research Group 2014).…”