Program

Apr 11, 2007

OVERVIEW

Postponing Sexual Involvement (PSI) is a middle school sex education curriculum that focuses on delaying sexual activity.

A large, diverse sample of 7th and 8th graders from California took part in an evaluation of the effectiveness of PSI.  In conjunction with a brief course in human sexuality, the program was not found to have any lasting impact on student sexual beliefs, attitudes, intentions, or behaviors.  Compared with students who did not receive the PSI curriculum, those students who did were just as likely to become sexually active, had sex no less frequently, had no fewer sexual partners, were no more likely to use condoms or oral contraception, and were no less likely to report a pregnancy or sexually transmitted infection.  Researchers blamed PSI’s failure on its modest length and the lack of opportunities it provides for students to practice new skills.

Researchers in Washington, D.C. also implemented PSI in conjunction with a brief course in human sexuality.  In an attempt to increase PSI’s effectiveness, these researchers supplemented their implementation with “booster” activities that took place the year after the PSI curriculum was taught.  This implementation of PSI remained ineffective in impacting the sexual beliefs, attitudes, intentions, and behaviors of males.  The revised program did have a positive impact on females, however.  Compared with females who did not receive the PSI curriculum, those who did were less likely to become sexually active and were more likely to use contraception if sexually active.  Researchers were encouraged by these results, but remained unconvinced that PSI was a successful program overall.

Another evaluation evaluated the impact of PSI plus an additional program called Sex Can Wait. More information can be found here.

DESCRIPTION OF PROGRAM

Target population: Middle school students

The Postponing Sexual Involvement curriculum is aimed at supporting adolescents in delaying sexual activity. The program consists of five sessions, each 45-60 minutes in length. These sessions familiarize students with the various social pressures that encourage adolescent sexual activity and teach skills such as setting limits, resisting peer pressure, assertiveness in saying “no” to sex, and non-sexual expression of feelings. Session activities include class discussions, group work, video-watching, and role-playing. The program can be led by an adult or a trained teenager and can serve as a stand-alone sexuality education curriculum or can exist as part of a larger sex education program. The program is manualized and the manual is available for purchase at $149.

EVALUATION(S) OF PROGRAM

Kirby, D., Korpi, M., Barth, R. P., & Cagampang, H. H. (1997).The impact of the Postponing Sexual Involvement curriculum among youths in California. Family Planning Perspectives, 29(3), 100-108.

Evaluated population: In the early 1990s, 10,600 7th and 8th grade students from all over California received parental consent to participate in this study, and 7,340 of these students completed baseline and follow-up surveys (a 75% response rate). The sample was ethnically diverse; Hispanics, Caucasians, African Americans, Asian/Pacific Islanders, and American Indians were all well-represented. Over one-third of the participants came from households without a father.

Approach: Three research designs were employed in this study. In the first design, students within selected schools were randomly assigned by classroom to take part in either a youth-led PSI program, an adult-led PSI program, or no PSI program. In the second design, entire schools were randomly assigned to take part in either the adult-led PSI program or no PSI program. Schools taking part in the program also took part in school and community-wide activities designed to promote healthy alternatives to sexual activity. In the third design, students were recruited from community-based agencies and individual students were randomly assigned to take part in either an adult-led PSI program or no PSI program.

All students were surveyed on their beliefs, attitudes, and intentions regarding sex. They also reported on their past sexual behavior and their sexual health. Following the baseline survey, students assigned to treatment conditions took part in the PSI program. As part of this implementation of the program, students received instruction in human sexuality before participating in PSI. Students assigned to the control condition received whatever sex education (or lack thereof) was regularly offered by their schools, but did not receive the PSI curriculum.

Students in the first research design were surveyed again after three months, and all students were surveyed again after 17 months. Attrition analyses did not identify any significant differences between students in the treatment groups and students in the control group.

Results: No significant differences were found that would indicate that the PSI program had any impact on sexual behaviors overall or among subgroups. Among students who reported never having had sex before the study began, students who received the PSI curriculum were just as likely to initiate intercourse as were those students who did not receive the curriculum. Among sexually active students, those students who received the PSI curriculum had sex just as frequently and with as many different partners as did those students who did not receive the curriculum. Moreover, the program had no positive impact on condom use, contraceptive use, pregnancy rate, or acquisition of sexually transmitted infections.

The PSI program had some short-term impacts on some beliefs, attitudes, and intentions related to sex at three months, but had no lasting impacts at 17 months. Program participation had no impact on whether or not students communicated with their parents about sex.

Aarons, S. J., Jenkins, R. R., Raine, T. R., El-Khorazaty, M. N., Woodward, K. M., Williams, R. L., Clark, M. C., & Wingrove, B. K. (2000). Postponing Sexual Intercourse Among Urban Junior High School Students – a Randomized Controlled Evaluation. Journal of Adolescent Health, 27, 236-247.

Evaluated population: 812 7th grade students from six DC public schools were eligible for participation in this study. In 1996, 582 (72%) of these students received parental consent to participate, and 522 (64%) completed the baseline survey. (Response rates on all subsequent surveys were above 50%.) African Americans made up 84% of the sample and Hispanics accounted for another 13%. Nearly two-thirds of the participants were economically disadvantaged, and less than half of them lived with both of their parents.

Approach: Schools were put into matched pairs and were then randomly assigned to either a treatment or a control condition. Treatment schools were assigned a full-time health professional who led 7th graders in three classroom sessions on reproductive health. After receiving this instruction, students took part in a youth-led version of the PSI curriculum. The next year, as 8th graders, students were again led in three classroom sessions on reproductive health and were encouraged to take part in “booster” activities. Booster activities included voluntary small group discussions on matters of pertinence to adolescent health, an assembly on sexually transmitted diseases, and a student contest.

All students were surveyed on their sexual beliefs, attitudes, intentions, and behaviors at baseline and then again at the end of 7th grade, the beginning of 8th grade, and the end of 8th grade.

Results: Females who received the PSI curriculum were significantly less likely to become sexually active and were significantly more likely to use contraception if sexually active than were females who did not receive the curriculum. The program did not have these impacts on males.

The PSI program had some short-term impacts on some beliefs, attitudes, and intentions related to sex (primarily among females), but had no lasting impacts. Program participation had no impact on whether or not students of either sex communicated with their parents about sex.

Participation in the program did lead to an increase in knowledge of reproductive health services among females and in information about birth control among males. (This finding can be attributed to the human sexuality classes that supplemented PSI, in that PSI has no informational components on birth control or reproductive health services.)

SOURCES FOR MORE INFORMATION

References

Aarons, S. J., Jenkins, R. R., Raine, T. R., El-Khorazaty, M. N., Woodward, K. M., Williams, R. L., Clark, M. C., & Wingrove, B. K. (2000). Postponing Sexual Intercourse Among Urban Junior High School Students – a Randomized Controlled Evaluation. Journal of Adolescent Health, 27, 236-247.

Kirby, D., Korpi, M., Barth, R. P., & Cagampang, H. H. (1997). The impact of the Postponing Sexual Involvement curriculum among youths in California. Family Planning Perspectives, 29(3), 100-108.

Link to program curriculum: http://www.siecus.org/index.cfm

KEYWORDS: Adolescence (12-17), School-based, Education, Reproductive Health, Teen Pregnancy, Risky Sex, Sexual Initiation, STD/HIV/AIDS, Middle School, White or Caucasian, Black or African-American, Hispanic, Asian, Hawaiian or Other Pacific Islander, American Indian or Alaska Native, Urban, Rural.

Program information last updated 4/11/07

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