Nov 01, 2011


Healthy for Life is a middle-school-based program
designed to change students’ health risk behaviors in five areas, including
alcohol, tobacco and marijuana use, nutrition, and sexual behaviors. The program
also includes peer leadership, family, and community components. An experimental
evaluation shows that the program did not have an impact on condom use, and
appeared to increase sexual activity; participants by 9th and 10th grades were
more likely to have had sex than their peers who were not in the program.


Target population: Male and female middle-school students.

The Healthy for Life Project (HFL) was a program
designed to influence five areas of adolescent health, including sexuality
(Moberg & Piper, 1998). The goal of the program was for students without prior
sexual experience to remain abstinent, but if sexually experienced, to use
effective methods to avoid pregnancy and sexually transmitted diseases.
Sexuality issues were the focus of 16 of 54 core lessons, and included topics of
body image, birth control, risks associated with early sexual activity, and
understanding and communicating with parents on sexuality and values around
sexuality. Furthermore, students practiced refusal skills in lessons taught by a
trained instructor and peer leaders, and provided students with the opportunity
for active learning that focused on behavioral change. The program was designed
to include family and community components; however, these were not implemented
as planned in the evaluation described below (Moberg & Piper, 1998).


Moberg, D. P., & Piper, D. L. (1998). The Healthy for
Life Project: Sexual risk behavior outcomes. AIDS Education and Prevention,
10(2), 128-148.

Evaluated population: A total of 2,483 6th-graders at 21 middle schools in Wisconsin were in the
study. The sample was 48 percent male and 52 percent female, predominantly
white (96 percent), and most students lived with two parents (72 percent).
Sixty-nine percent of students lived in small cities, towns, or suburban areas,
27 percent lived in nonfarm country settings, and four percent lived on farms.

Approach: Cohorts
of sixth-grade students from 21 middle schools were assigned to the “intensive”
HFL condition, the “Age-Appropriate” HFL condition, or the control group through
stratified random assignment. The Age-Appropriate HFL group received the
program throughout grades six through eight, while the “intensive” HFL group
received the entire program in the seventh grade. The control group received
commonly-used prevention curricula, such as Quest, Values and Choices, or
locally developed curricula. Students self-reported annually in the fall from
sixth to tenth grade regarding sexual behavior. Surveys were administered in
the classroom using an optically scanned format. Attrition was 20 percent by
ninth grade, and 33 percent by tenth grade.

Results: HFL did
not increase condom use, or decrease the rate of intercourse, among program
participants. Program students were more likely than controls to have ever
engaged in sexual intercourse by ninth (for the intensive condition) and tenth
grades (for the Age-Appropriate condition). Students in the intensive HFL
condition reported significantly higher rates of intercourse within the past
month at eighth grade only. There was no significant difference between groups
in condom use among sexually active students at any measurement point. The rate
of intercourse was significantly different among groups at tenth grade, with the
Age-Appropriate condition reporting highest rates and control group reporting
lowest rates. Students in the HFL programs were 1.3 to 1.4 times more likely
than the control group to report ever having sexual intercourse by ninth grade.
At ninth grade, students in the intensive HFL condition believed fewer of their
peers were involved in risky sexual behavior as they had previously believed.
The perception of risky peer behavior increased for students in the
Age-Appropriate HFL condition in tenth grade.



Moberg, D. P., & Piper, D. L. (1998). The Healthy for
Life Project: Sexual risk behavior outcomes. AIDS Education and Prevention,
10(2), 128-148.

Piper, D. L., Moberg, D. P., & King, M. J. (2000). The
Healthy for Life Project: Behavioral outcomes. The Journal of Primary
21(1), 47-73.

School-based, Middle School, High School, Children (3-11), Adolescence (12-17),
Suburban, Other Reproductive Health, Sexual Activity, Condom Use and
Contraception, White or Caucasian, Males and Females, Rural.

Program information last updated 11/1/11.