Program

Jun 13, 2012

OVERVIEW

The All4You program was designed to reduce the frequency of unprotected sex among students in alternative high schools.  The program included classroom curriculum as well as service-learning activities.  In a random assignment study, students at alternative schools assigned to implement the All4You program were compared with students at alternative schools assigned to a control group.  At the 6-month follow-up, All4You students were significantly more likely than control students to have a used a condom at last intercourse.  All4You students also reported having had less frequent sex and less frequent sex without a condom over the past three months.  These impacts were no longer significant at the 12-month or 18-month follow-up, however.  At no time point did the program have an impact on number of sexual partners, use of effective contraception at last intercourse, or pregnancies.

DESCRIPTION OF PROGRAM

Target population: students in alternative high schools

All4You features two components: a skills-base curriculum and service-learning activities. All4You’s nine classroom lessons, completed in about 13.5 hours, were drawn from the Be Proud! Be Responsible! curriculum and the Safer Choices curriculum.  Lessons address HIV, STD, and pregnancy prevention; vulnerability to HIV, STDs, and pregnancy; negotiation skills; and condom-use skills.  All lessons are highly interactive and include activities such as role plays, demonstrations, discussions, and games.

All4You’s service-learning component includes five visits to volunteer sites, including schools, senior centers, and service organizations.  These visits total about 12.5 hours. At these sites, students participate in a variety of service activities.  Students are provided with exercises to prepare for their service activities and are given opportunities to reflect on their service.

The program is delivered by experienced health educators. In most treatment schools, All4You was the only form of sex education provided to students.

EVALUATION(S) OF PROGRAM

Coyle, K.K., Kirby, D.B., Robin, L.E., Banspach, S.W., Baumler, E., & Glassman, J.R.  (2006).  All4You! A randomized trial of an HIV, other STDs, and pregnancy prevention intervention for alternative school students.  AIDS Education and Prevention, 18, 187-203.

Evaluated population: A total of 988 students from 24 alternative schools in northern California urban counties served as the study sample for this investigation.  In general, students had been referred to these schools because of severe discipline issues, substance use, and/or chronic absenteeism.  Students ranged in age from 14 to 18, and the majority were male (61.2% of intervention and 65.0% percent of control group were males). The sample was comprised of 28% African American adolescents; 15% Asian American adolescents; 29% Hispanic adolescents; 12% white adolescents; and 16% of other ethnicities.  At baseline, the majority of students (83%) reported already having had sexual intercourse.

Approach: Schools were matched into two groups according to seven school-level variables. One group was randomly assigned to the treatment group and the other to the control group.  Schools assigned to the treatment group implemented the All4You curriculum. Sessions occurred two or three times a week for five or seven weeks. Schools assigned to the control group continued offering their usual sex education activities, which typically consisted of presentations by local speakers.

The only difference at baseline was age, with adolescents in the intervention group being significantly older than participants in the control group. Data were collected in the form of a 131 item questionnaire that delved into demographics, sexual risk behaviors, psychosocial antecedents, and program exposure. All students provided baseline data before the study began.  Follow-up data were collected 6, 12, and 18 months after baseline.  Follow-up data were difficult to collect, as students at alternative schools are extremely transient.  That said, approximately 76% of students who provided baseline data responded to at least one follow-up survey.

Results: At the 6-month follow-up, students attending schools implementing the All4You program were more likely than students attending control schools to have used a condom at last intercourse.  All4You students were also significantly less likely to have had sex without a condom during the previous three months and reported having engaged in sex less frequently over those three months.  These impacts were no longer significant at the 12-month or 18-month follow-ups.

At no time point did All4You students significantly differ from control students on measures of number of sexual partners, use of effective pregnancy prevention methods, or number of pregnancies since baseline.  Among students who were sexually inexperienced at baseline, All4You students were not significantly more likely than control students to remain sexually inexperienced at the 18-month follow-up.

Three secondary outcomes were also significantly different. At the 6-month follow-up, the intervention group showed more favorable outcomes in frequency of intercourse without a condom in the previous 3 months with steady partners and more favorable outcomes for frequency of sexual intercourse in the previous 3 months. At the 18-month follow-up, the intervention group had lower frequency of sexual encounters with a non-steady partner without using a condom during the previous 3 months.

Students from All4You schools scored higher on items regarding knowledge of HIV and condoms than students from the control condition at 6 and 18 months post intervention.  The program had mixed success improving students attitudes, beliefs, and self-efficacy, however.  The control group had higher perceived self-efficacy to get and sue condoms, more positive attitudes about condoms protecting against pregnancy, and beliefs regarding using condoms when having intercourse. The program did not appear to impact condom use intentions, sense of future (i.e., optimism and fatalism), and connectedness (community orientation and connectedness to a caring adult outside of family.

Analyses took into account clustering.

SOURCES FOR MORE INFORMATION

References:

Coyle, K.K., Kirby, D.B., Robin, L.E., Banspach, S.W., Baumler, E., & Glassman, J.R.  (2006). All4You! A randomized trial of an HIV, other STDs, and pregnancy prevention intervention for alternative school students.  AIDS Education and Prevention, 18, 187-203.

Website: 

http://pub.etr.org/ProductDetails.aspx?id=100000005&itemno=Z004

Contact Information

Karin K Coyle

ETR Associates

4 Carbonero Way

Scotts Valley, CA  95066

karinc@ETR.org

KEYWORDS: High School, Service Learning, STD/HIV/AIDS, Teen Pregnancy, Life Skills, Adolescents, Youth, African American or Black, White or Caucasian, Asian American, Hispanic or Latino, School-Based, Males and Females, High Risk, Urban, Sexual Activity, Condom Use and Contraception, Manual Available

Program information last updated on 6/13/12.

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