Program

Oct 18, 2014

OVERVIEW

Choosing the Best (CBT) is a classroom-based abstinence education curriculum.  The primary message of the curriculum is that abstinence from sexual activity before marriage is the best way to avoid pregnancy, disease, and possible negative emotional consequences. It is also intended to help students focus on academic and other future-oriented goals.  A randomized controlled trial among ninth-graders found statistically significant positive impacts at the end of the program on pro-abstinence beliefs and attitudes, self-efficacy, empowerment/hopefulness, commitment to abstinence, intention to delay sex, and intention to wait until marriage.  For non-virgin students, the program had a statistically significant positive impact on onset of sex.  At follow-up, the only lasting impact for students was on pro-abstinence attitudes.  For sexually active students, participation in the program had no impact on time since last sex.

DESCRIPTION OF PROGRAM

Target population: Students in grades six through twelve

Choosing the Best (CTB) is a classroom-based abstinence education curriculum that provides messages about the risks of sexual activity, including sexual intercourse.  It provides medical information to emphasize the role of abstinence in preventing pregnancy, disease, and negative emotional consequences of sexual activity prior to marriage.  It targets abstinence beliefs and attitudes, personal efficacy to maintain abstinence, and refusal skills. The program includes homework activities that encourage students to discuss curriculum topics with their parents.  The curriculum is intended to be implemented in a sequential, multi-year format from sixth through twelfth grade, and consists of up to eight 45-minute lessons each year.

EVALUATION(S) OF PROGRAM

Lieberman, L. & Su, H. (2012). Impact of the Choosing the Best Program in Communities Committed to Abstinence Education. SAGE Open 2(1).

Evaluated population: A total of 1,143 ninth-grade students attending six high schools (three in a rural school district, and three in a suburban district) in Georgia participated in the study. The average age of participants was fourteen years. Intervention students were 58% female, 37% African American, 51% Caucasian, 31% sexually active; control students were 55% female, 25% African American, 62% Caucasian, and 28% were sexually active.

Approach: All 9th-grade students attending the six high schools in the two school districts that had indicated an interest in implementing abstinence education in their schools (approximately 3,000 students) were eligible to participate; 38 percent returned parental consent to participate. All 1,143 consented students completed a pre-test.  Schools were then randomized to receive either the Choosing the Best intervention or health education as usual (control condition).    Among intervention students, 85 percent completed a post-test, and 78 percent completed a follow-up in the fall of tenth grade; 81 percent and 69 percent of control students completed a post-test and follow-up, respectively.  Assessments measured pro-abstinence attitudes; pro-abstinence beliefs; empowerment/hopefulness for the future; commitment to abstinence; parent/child communication; and self-efficacy.

Results: Overall, the study found statistically significant positive impacts on pro-abstinence attitudes (ES=-0.28) and beliefs (ES=-0.34); self-efficacy (ES=-0.19); empowerment/hopefulness (ES=0.08); commitment to abstinence (ES=-0.13); intention to delay sex (ES=-0.14); and intention to wait until marriage (ES=-0.08) for students receiving the program, compared to students in the control condition at the end of ninth grade.  At the follow-up, only changes in pro-abstinence beliefs were maintained.  Among students who had never had sex at baseline, those participating in CTB were more likely to delay sexual activity by spring of ninth grade (OR=1.43), compared with control students, but this impact was not sustained at follow-up. Among students who had already had sex at baseline, only pro-abstinence beliefs and intention to return to abstinence were significantly greater at post-test among CTB than among control students, but only changes in pro-abstinence beliefs were sustained at follow-up.  For sexually active students, the program had no impact on time since last sex.

SOURCES FOR MORE INFORMATION

References

Lieberman, L. & Su, H. (2012). Impact of the Choosing the Best Program in Communities Committed to Abstinence Education. SAGE Open 2(1).

Website: http://www.choosingthebest.com/

Keywords: Adolescents, High School, Males and Females, Black/African American, White/Caucasian, Urban, Rural, School-based, Cost, Manual, Abstinence Education, Skills Training, Sexual Activity, STD/HIV/AIDS

Program information last updated 10/18/2014

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