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Chapter Five: Review of Relationship Education Programs for Adolescents
Thus far, the chapters of this report have reviewed theory and empirical research relevant to understanding the role of adolescent romantic relationships in the development of healthy adult marriages, with the explicit goal of informing programs and curricula targeting adolescents. To what extent are existing programs that address adolescents’ romantic relationships informed by this literature? How well do the programs currently being administered to adolescents map onto the issues and topics that research indicates should be important?
To address these questions, this chapter surveys the current landscape of relationship education programs for adolescents, with a particular emphasis on materials likely to be directed toward low-income adolescents. These programs have typically been delivered in one of five formats. The first, Relationship and Marriage Education (RME), explicitly and more or less exclusively addresses interpersonal and romantic relationships and their implications. The other four programs include RME as a component of a broader curriculum. These broader formats include Family and Consumer Sciences (FACS) classes, character education (CE) programs, abstinence education (AE) programs, and community-based initiatives. Although the focus of this chapter is relationship education within community-based settings serving low-income adolescents (as opposed to schools), FACS classes are included in this discussion because they may be the program that routinely covers RME-related topics to which the largest number of low-income and other adolescents are exposed.
After reviewing the content and delivery of programs falling into each of these categories, we summarize the sparse evidence on the effectiveness of RME. Because the limited evidence is promising but still inconclusive, the analyses presented here, organized according to the integrative framework derived in Chapter Three, go one step further by comparing the content of examples of each type of curriculum with the content that the literature suggests might produce a potentially modifiable precursor to successful relationships. The results of this comparison can be used by policymakers and program implementers to identify, adapt, or develop new curricula targeting precursors to healthy relationships.
Reflecting the interest of the federal government and other policymakers in improving adult marital outcomes through interventions targeting adolescents, the chapter concludes with a review of the community-based organizations that provide relationship education to adolescents, using either an established curriculum described in this chapter, another of the available curricula, or a home-grown curriculum. The discussion highlights ways that community efforts to implement these curricula can be best supported.
In preparing this chapter, we relied heavily on conversations with decisionmakers, curriculum developers and distributors, and practitioners who are delivering relationship curricula to low-income adolescents. We spoke with a combination of FACS representatives and directors of organizations that currently or in the past were ACF grantees and are currently or have expressed an interest in offering relationship education to low-income or minority adolescents or young adults. Most of the practitioners are directors or executive directors of programs that are currently being funded by DHHS to implement relationship or marriage education curricula for low-income or minority youth (e.g., as part of the African-American Healthy Marriage Initiative). To ensure that these informants and others who receive funding in part from federal resources were comfortable discussing the issues and concerns they face in their practice, we promised to maintain confidentiality concerning their names and affiliations. However, all practitioners we spoke with represented a single program or coalition of programs targeting low-income or minority adolescents in community settings, including faith-based institutions and small and large community-based organizations serving different groups, including Hispanics, blacks, and fathers. Together, these organizations represented the four regions of the country, but they should not be considered representative of a larger universe of organizations.
In selecting particular relationship education curricula to review, our intent was to identify those that were most widely known and respected in their particular genre. Thus, the specific curricula and programs reviewed here cover the leading materials but do not represent a comprehensive list.
The Goals of Relationship Education for Adolescents and Youth
Marriage education programs designed for and mostly serving middle-class couples have been around for several decades. The broad objectives of these programs are to influence attitudes and beliefs and to teach skills and behaviors that are believed to contribute to positive relationships (Ooms, 2005). Relationship and marriage education programs for adolescents are generally similar. As with marriage education programs for couples, the objectives of RME curricula are to impart some combination of knowledge, values, and skills believed necessary to establish healthy romantic relationships. Drawing from each curriculum’s Web site, Table 5.1 summarizes the objectives of the subset of curricula examined in this chapter that are entirely or largely focused on relationship education. Although each curriculum touches on the importance of a healthy marriage, only the two abstinence programs explicitly note healthy marriage as an objective. For the other curricula, no tangible short- or long-term measures of relationship outcomes are immediately apparent in the stated objectives. Others (e.g., Connections) aim to impart skills necessary to maintain a healthy marriage or relationship more generally but do not describe marriage itself as an objective.
As described below, the few efforts to evaluate the effectiveness of these programs have focused on different attitudinal and some behavioral outcomes, but choice of outcome is idiosyncratic to the specific program or preferences of the evaluation team. The field could benefit from a discussion about whether these programs should be targeting adolescent outcomes only (based on a model, perhaps, that says that establishing solid relationships in adolescence naturally paves the way for establishment of solid relationships later) or if these programs need to try to affect longer-term relationship decisions directly. The field is at the point that stakeholders and program developers need to consider, prioritize, and select among a number of potential program goals, including promoting positive attitudes toward marriage; promoting greater rates of abstinence; promoting lower rates of date rape and abuse; promoting greater satisfaction with romantic relationships; increasing the chances of later healthy, stable marriage; lowering eventual divorce rates; lowering rates of conflict; and enhancing the ability to communicate to romantic partners and other people. An important direction for future development of these programs is to carefully think through the desired goals of these programs and try to link these goals to clear behavioral or attitudinal adolescent and/or adult outcomes. Greater clarity about program goals will help policymakers and others interested in investing in services for adolescents as a means to promoting later healthy marriage.
| Relationship and Marriage Education Curriculum | Objective |
|---|---|
| Connections (Kamper, 2004) |
Teaches teens the skills that are essential for success in their dating relationships and in preparing for marriage. For younger teens, Connections includes a variety of exercises to teach teens how relationships develop, how to communicate effectively, how to recognize destructive patterns, how to deal with emotions, and other essential skills. For older teens, it teaches self-awareness, relationships, communication, conflict, and a Marriage Game. |
| The Art of Loving Well (Boston University School of Education, 1993) |
Designed to help teenagers learn responsible sexual and social values through good literature, which reveals the complexity of life and love relationships. Additional goals include promoting literacy, critical thinking, and habits of reflection; resisting peer pressure; and reducing premature sexual activity, adolescent pregnancy, AIDS, other sexually transmitted diseases, and substance abuse; as well as countering school and family violence by providing positive models of conflict resolution. |
| Choosing the Best Soul Mate: A Relationship and Abstinence Curriculum (Cook, 2004) |
Intended to inspire students to develop the communication skills and personal qualities essential for successful relationships of all kinds—with parents, peers, coworkers, teachers—and ultimately, for a lasting marriage. |
| A.C. Green’s Game Plan Abstinence Program (Gray and Phelps, 2001) |
The curriculum as a whole is intended to promote abstinence. Two secondary objectives are (1) to help students understand the importance of choosing friends wisely and to assist students in establishing guidelines for healthy dating relationships, and (2) to give students information on the positive benefits of marriage and to help them to consider this information for themselves and for their future. |
The Formats of Relationship Education
Based on our conversations with decisionmakers and program developers and distributors, we identified five formats in which relationship education is typically delivered. Although some may have been developed for a single setting, such as a school, these curricula, with the exception of the two textbooks reviewed here, are usually offered in a wide range of settings, including schools, the juvenile justice system, foster care programs, independent living facilities, programs for pregnant and parenting teens, camps, retreats, group homes, and after-school programs. For each of the five formats, Table 5.2 briefly describes the content of at least one curriculum nominated by our informants for inclusion in this report. Another commonality among most of the curricula reviewed (with the exception of abstinence education) is that the emphasis is on healthy relationships generally, which may include heterosexual or same-sex relationships. It is worth noting, however, that none of the curricula reviewed here explicitly mention same-sex relationships in the written materials. Rather, program developers mention that they discuss same-sex relationships when implementing the curricula.
Relationship and Marital Education (RME) Curricula
RME curricula are typically implemented in schools, faith-based settings, youth-serving organizations, and community-based organizations. In recent years, however, as part of welfare reform efforts, there has been an emphasis on supporting marriage and healthy relationships among welfare recipients, and most recently, as part of the African-American Healthy Marriage Initiative, on enhancing short- and long-term romantic and marriage outcomes for adolescents (Ooms, 2005). Typically, RME curricula contain some mix of intervention orientation and educational orientation. Love U2, for example, developed by Marline Pearson, contains content and structure that is similar to those used in marital education programs guided by behavioral or social learning theory, such as the Prevention and Relationship Enhancement Program (PREP; see, for example, Markman, Stanley, and Blumberg, 1994). This curriculum introduces a lot of background information for the instructor, and many activities for role-playing and practice skills. Other curricula, such as Connections (developed by Charlene Kamper), provide a mix of interactive activities and lessons, with less background information for instructors. There are now several registries of RME for adolescents, including Smart Marriages (Coalition for Marriage, Family and Couples Education, undated), and the National Healthy Marriage Resource Center (NHMRC, 2007).
Two RME curricula are described in Table 5.2. One of these, Love U2, is currently being revised. At the time this report was drafted, the lesson plan for only one of what will eventually be four revised modules was available, Relationship Smarts. The three other Love U2 modules are Baby Smarts, which seeks to link marriage/relationships and childbearing by encouraging adolescents to assume a child’s perspective; Communication Smarts, a version of PREP for adolescents aimed at preventing dating violence; and Becoming Sex Smart, a curriculum designed for sex education classes. Current versions of all Love U2 modules are available from the Dibble Fund (Dibble Fund, 2007).
Family and Consumer Sciences (FACS) Textbooks
In most states, middle schools and/or high schools can offer family and consumer sciences classes, although these courses are not a graduation requirement. Florida, for example, currently requires most graduating seniors to complete a one-semester life skills management course (generally during ninth or tenth grade), but this requirement has been eliminated for students entering high school in 2007–2008. The national standards for FACS education include Interpersonal Relationships (“understanding personal needs and characteristics and their impact on interpersonal relationships” and “effective conflict prevention and management techniques”) (National Association of State Administrators for Family and Consumer Sciences, 1998). States are free to adopt or adapt national standards according to state-specific perspectives underpinning FACS education (most states that we contacted have a standard that is very similar to Interpersonal Relationships). Because FACS classes are almost always optional, it is difficult without specific information on student enrollment to know how many and which students may be exposed to relationship education curricula within FACS courses. Limited information indicates that these classes reach females and students who are not college-bound (Jennifer Kerpelman, personal communication, April 21, 2006)—which represents at least some of the target population.
| Curriculum Developer/Distributor | Content | Target Population/Number of Sessions | |
|---|---|---|---|
| Relationship and Marital Education | Connections. Charlene R. Kamper/The Dibble Fund |
Dating and Emotions: Self-awareness and readiness to date, how relationships develop, difficulties in relationships, ending a relationship, and moving past an ended relationship. | Connections: Dating and Emotions. Grades 8–12 / 17 one-hour sessions. |
| Relationships and Marriage: Self-awareness, development of healthy friendships and dating relationships, good communication skills, and components of a healthy marriage. | Connections: Relationships and Marriage. Grades 11–14 / 18 one-hour sessions. | ||
| The materials indicate that curricula are appropriate for family life education, social studies, family consumer sciences, and health education. | |||
| Love U2. Marline Pearson/The Dibble Fund |
Relationship Smarts focuses on self-identity, peer pressure, maturity and mature love, communication, dating, models of healthy relationships, recognizing abuse, impact of healthy marriage on children, attitudes and beliefs about marriage. (At the time this report was written, only Relationship Smarts revised lessons were available.) | Curriculum was being revised at the time of this report to include Relationship Smarts (13 lessons + 1 interactive Internet booster lesson), designed for school and community settings; Baby Smarts (number of lessons to be determined), designed for school (especially FACS classes) and community settings; Becoming Sex Smart (administered over 3–4 weeks), designed specifically for health/sex education teachers; Communication Smarts, based on the communications parts of PREP, will be adapted for adolescents in schools and community settings. | |
| Family and Consumer Sciences Textbooks | Families Today. Connie R. Sasse/McGraw Hill/Glencoe |
Text includes 13 (of 34) chapters that address romantic and sexual relationships including marriage. Topics include roles and relationships, interpersonal communication, conflict resolution, work and family life balance, divorce and remarriage, mature love, sexual identity and behavior, selecting a partner, marriage, and parenting. | Secondary students enrolled in FACS courses. |
| Contemporary Living. Verdene Ryder and Marjorie B. Harter/The Goodheart-Wilcox Company, Inc. |
The text has seven parts, five of which cover much of the same material as RME, including self-concept and maturity, decision making, communication, marriage relationship, parenting, and child development. | Secondary students enrolled in FACS courses. | |
| Character Education | The Art of Loving Well. Developed by College of Communication and School of Education, Boston University/The Loving Well Project, Boston University |
A compendium of short stories and activities intended to promote student conversation and reflection about love and sexuality. Ethnically diverse stories address three broad themes: early loves and losses, romance, and commitment and marriage. | Originally field-tested with eighth and ninth graders, the curriculum is designed for grades 7–12, depending on which stories are selected by individual teachers. Contains 40 stories plus a broad spectrum of activities. |
| Abstinence Education | Choosing the Best Soul Mate: A Relationship and Abstinence Curriculum. Bruce Cook/Choosing the Best Publishing |
The curriculum uses a “teaching approach that moves students from a cognitive understanding of the facts to a personal awareness that leads to a changed behavior.” Each lesson incorporates some aspect of RME; e.g., for upper high school grades, lessons include tips on finding a good partner, self-confidence and self-awareness, developing relational skills, understanding dating, marriage and commitment. | There are four age-appropriate versions (grades 6 and 7; 7 and 8; 9 and 10; and 11 and 12). Each version has 5 –8 50-minute lessons. Lessons include short videos or case studies, discussion, group activities (e.g., role playing), and demonstrations. Can be used in school or community settings. |
| A.C. Green’s Game Plan Abstinence Program. Libby Gray and Scott Phelps/Project Reality |
The developers describe this curriculum as a “sports-themed, positive approach to abstinence education.” Topics related to RME include making future plans, boundaries within relationships, the consequences of premarital sex, choosing friends, and looking at marriage as a goal. | Grades 7–9. Game Plan is designed primarily as a public school health curriculum with each of 8 lessons intended for one class period. | |
| National Organization Initiatives | Project Alpha. March of Dimes Birth Defects Foundation and the Alpha Phi Alpha Fraternity, Inc. |
Program designed to provide education, motivation and skill-building on the issues of responsibility, relationships, teen pregnancy and sexually transmitted diseases to black males. | Black males ages 12–15. Designed to be delivered in half-day workshops, weekend long retreats, or shorter informational sessions. |
Character Education (CE) Curricula
CE is the most nebulous type of curriculum identified by informants. While it is sometimes defined as “teaching and learning for personal development” and may include “moral reasoning/cognitive development,” “social and emotional learning,” and “moral education/virtue” (Otten, 2000), informants noted that they themselves were not clear about the definition of character education and expressed discomfort with the concept (or term) for two reasons. First, there is the well-known question: “Whose ‘values’ are to be taught?” (Otten, 2000). A second closely related concern raised by an educator we spoke with is that there is a lack of clear standards against which youth are expected to be held. As one state education representative we spoke with noted,
Character education is soft and done in pieces. . . . [I]t doesn’t really hold kids accountable from one district to the next. It says “ This is how we are nice to each other” rather than setting a standard of behavior that affects your relationship and this is the way you need to act.
By extension, a lack of standards or clear expectations of outcomes makes it difficult for curriculum developers to design an intervention that can effectively change attitudinal or behavioral relationship outcomes.
One of the earliest developed relationship-focused curricula, The Art of Loving Well, is described as a literature-based CE curriculum, although one of its key developers, Nancy McLaren, emphasizes that originators of the curriculum define character education as essentially synonymous with the development of social-emotional intelligence (Nancy McLaren, personal communication, August 7, 2006). The Art of Loving Well is an anthology of short stories intended to help adolescents learn about responsible sexual and social values through literature. The goals of the curriculum include convincing adolescents that good relationships require hard work but contribute to quality of life; reducing sexual activity, adolescent pregnancy, and AIDS; and countering family and school violence by providing models of conflict resolution. The curriculum is also designed to promote conversations between adolescents and parents, and many of the stories provide positive models of healthy relationships and marriages. Stories and activities from Loving Well are sometimes integrated into lessons in other multicomponent curricula (e.g., Love U2).
Abstinence Education (AE) Curricula
Increasingly, policymakers have criticized AE and comprehensive sex education for too often ignoring relationships and romance, suggesting that abstinence and sex education should be taught within the context of relationship education (Whitehead and Pearson, 2006). This is reflected in a recent ACF program announcement that emphasized a preference for AE applicants to address healthy relationships during adolescence and healthy marriages in adulthood (Department of Health and Human Services, 2006). On a practical level, incorporating RME curricula into abstinence education curricula may be an effective strategy for moving RME curricula into schools. At least one distributor of AE and RME curricula we spoke with noted that he was having difficulty selling the latter to schools, even those schools with whom they have an established relationship selling AE curricula. This distributor believed that incorporating RME into AE curricula would be the most effective way of getting RME curricula into the schools he works with and would have the added benefit of strengthening the RME curricula at the same time.
National Organization Initiatives
The fifth category of programs includes efforts or initiatives by national organizations that seek to improve relationship outcomes as a primary or secondary objective of programs targeting at-risk youth. The one example of such an initiative that we reviewed for this project is Project Alpha, collaboratively developed and implemented by Alpha Phi Alpha Fraternity, Inc., and the March of Dimes Birth Defects Foundation. Project Alpha is designed to provide “education, motivation, and skill-building on issues including responsibility, relationships, teen pregnancy, and sexually transmitted diseases” for young black male students ages 12–15. The program is cosponsored by local college and alumni fraternity chapters and local March of Dimes units and is delivered in anything ranging from half-day workshops to weekend retreats.
Are Relationship Education Curricula Effective?
How can policymakers evaluate whether any relationship education curriculum is effective? As we have already noted, one obstacle faced by efforts to assess the effectiveness of these programs is the fact that program objectives are often vague. To the extent that it is not clear whether programs are designed to promote healthy marriages in adulthood or healthy relationships in adolescence, the criteria for measuring the effectiveness of these programs are not obvious. A second obstacle is that conducting rigorous evaluation research is difficult and costly. The “gold standard” for evaluating interventions requires random assignment, or, failing that, quasi-experimental designs involving careful matching of treatment and comparison groups. If students who participate in a relationship education program have better relationship outcomes during adolescence (however those are defined) or better marital outcomes as adults, then the program is deemed effective. Because relationship education curricula for adolescents are relatively new (Gardner, 2001), no experimental evaluations have yet been completed.
Three of the curricula described in Table 5.2— The Art of Loving Well, Connections, and Love U2—have been evaluated with quasi-experimental studies (Gardner, 2001, 2005; Kreitzer, 1998; Jennifer Kerpelman, personal communication, April 21, 2006). Combined, the results of these evaluations are at most suggestive that relationship education curricula may improve relationship outcomes during adolescence. Each of these evaluations measured some combination of short-term (i.e., adolescent) attitude and/or behavioral outcomes (which may or may not be related to later adult marital outcomes).
Based on the promising findings from the quasi-experimental evaluation of Relationship Smarts, Jennifer Kerpelman and colleagues were recently funded by ACF to conduct a more rigorous evaluation of the intervention, with Alabama teachers working in schools having a high percentage of minority and low-income students. One problem with the earlier evaluation of Relationship Smarts and Connections is that they were delivered in FACS classes. A strength of the new evaluation is that it will test whether the intervention is effective in health courses (which are required of all high school students prior to graduation) as well as FACS, to assess the portability of the intervention to different courses and to evaluate whether the program is effective for a more representative group of students (such as males, who are underrepresented in FACS classes).
The study investigators are working closely with Relationship Smarts curriculum developer Marline Pearson to produce a streamlined version of Love U2 (Relationship Smarts module) for use in this larger evaluation and to replace the current version being distributed. We review this streamlined version later in this chapter. The evaluation will examine short- and long-term knowledge (up to three years post-intervention), attitudes, identity styles, behaviors, and skills, both pre- and post-intervention, for control and intervention students. Because the investigators of this study carefully examined extant curricula at the time that they were formulating the study design and chose the one that they thought most appropriate developmentally, the results of this study will contribute substantially to assessing if and how the current generation of relationship curricula is effective, and should highlight areas of the curriculum that can be improved.
The fact that quasi-experimental evaluations have yielded suggestive results does not necessarily portend that the results from the experimental evaluation will be positive. In particular, when quasi-experimental evaluations have relatively weak comparison groups, such as in the case of the three completed evaluations described above, the results from experimental designs can often differ substantially, and just as likely in a negative direction as a positive one (see Lipsey and Corday, 2000, for discussion of this literature).
Nevertheless, even if the results of the ongoing study are disappointing, the field stands to gain from this rigorous evaluation. First, based on the opinion of several informants we spoke with, Love U2 is the curriculum that many believe is the strongest. If the results of this evaluation are disappointing, it is likely that other curricula would not have fared better if they had been examined. Yet, as seen in the next section, Love U2 covers many of the same concepts as other curricula. Thus, lessons learned from the implementation analysis of this evaluation are likely to apply to other curricula.
Second, disappointing results can also provide the impetus necessary to generate a second or third generation of programs that are more effective than earlier generations, as happened in the drug prevention field. About two decades ago, vast quantities of money were being funneled into subsequently disproved program strategies or into programs like D.A.R.E. (Drug Abuse Resistance Education) that had not been carefully evaluated. Later evaluations showed that D.A.R.E. had very little or no effect and that the costs were not justified. As a result, the federal government has pushed for adopting better-designed programs, like Project ALERT, that have rigorous evaluations and yield credible and positive results. Such evaluations have shown that drug prevention can work and, perhaps even more important, have helped to confirm the value of these programs to policymakers who fund them. Moreover, such evaluations have shown which drug intervention programs work and which do not, critical information for schools selecting a program to implement. In the event that the ongoing evaluation by Kerpelman and colleagues is disappointing, the relationship education field could still benefit greatly if it used these results as an impetus to push the curricula to be more effective in producing better relationships (however such outcomes are eventually defined).
A third reason to push for more rigorous evaluations of relationship education is that, given the nature of the research in this field, and the impracticality and the ethical issues involved in random assignment in terms of romantic and marital behaviors, studying the effect of interventions on immediate and long-term consequences of adolescent romantic relationships may be one of very few feasible ways to evaluate models of romantic relationships rigorously. For the most part, researchers can only measure correlations among relationship precursors, including attitudes and behaviors, and make educated guesses about underlying processes. If they include random assignment and a valid control group, careful evaluations of interventions that modify specific precursors can help to demonstrate whether changes in those precursors affect other precursors or subsequent relationships and marital outcomes.
Are Major Relationship Education Curricula Aligned with the Research Base?
When results from rigorous evaluations are lacking, an alternative way of evaluating the likely effectiveness of curricula is to assess how well the content of the curricula aligns with what the basic research literature suggests is likely to be important. There is solid research demonstrating that interventions targeting general and at-risk youth positively affect many of the precursors of healthy adolescent relationships identified in Chapters Three and Four of this report (and summarized in Figure 3.1), including relationships with parents, stress, and prevalence of substance abuse (Johnson et al., 1990; Johnson et al., 1996; Weiss and Nicholson, 1998); timing of entry into sexual relationships; sexual behavior; and incidence of sexually transmitted diseases and pregnancy (Philliber et al., 2002); and longer-term outcomes, such as educational attainment (Myers and Schirm, 1999). Some effective interventions are multicomponent interventions; others seek to impart knowledge or teach skills to affect attitudinal and behavioral changes. Unfortunately, as with almost all evaluations, it is not possible to isolate what intervention component or knowledge or skills produced the desired outcome. We can only conclude that research demonstrates that specific precursors can be positively affected by an intervention.
For each curriculum reviewed for this chapter, we indicate in Table 5.3 whether the content seeks to modify (not just discuss or address) each adolescent health relationship precursor listed in the first column. In the case of Art of Loving Well, which is a compendium of short stories, we only coded efforts to affect precursors based on the stated objectives of the developers on their Web site because otherwise it was difficult to ascertain from the text exactly what behavioral or attitudinal changes are sought. Unlike the other curricula, the intended impact on attitudes or behaviors is not typically obvious with each story.1
In the remainder of this section, we illustrate the variety of ways that each precursor is addressed in these curricula. In some cases, a curriculum seeks to impart some knowledge as a way to effect behavior. In other cases, the curriculum clearly tries to help students build skills necessary to modify the precursor. There are few consistent approaches to addressing the precursors across the curricula.
Immediate Context
Four of the five precursors that our integrative framework identifies as relevant elements of the immediate context of the adolescent are addressed by at least one of the curricula reviewed here. The one (possible) exception is family structure, where we allocate partial credit to three curricula for addressing future (rather than current) family structure. For example, the two textbooks emphasize the difficulties resulting from parental divorce. None of the curricula tries to modify the structure of the current family of the youth. The only curriculum that seeks to affect school environment is The Art of Loving Well—the stated objectives of this curriculum (as of many character education efforts), as described on its Web site, is to “counter school violence by providing positive models of conflict resolution” as well as to “enhance mutual respect among adolescents, parents, and teachers.” The most commonly addressed of the immediate context precursors are peer groups, followed by stress. Peer groups are discussed in two ways: (1) emphasizing the importance of selecting friends who share the same attitudes (e.g., Game Plan); and (2) describing peer pressure and providing resistance strategies (e.g., Families Today,
Connections: Dating and Emotions, Art of Loving Well).
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| Precursors of Relationship Outcomes | Connections | Relationship Smarts | Art of Loving Well | Families Today | Contemporary Living | Choosing the Best | The Game Plan | Project Alpha | |
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| * The precursor is partially addressed in the curricula. The precursor is addressed in the curricula. |
Individual Differences
All eight curricula address self-esteem or a related concept in relation to interpersonal relationships. The two RME curricula (Connections: Relationships and Dating and Love U2) devote a lesson to self-awareness and developing a vision of how students would like to be in the future. Both textbooks define self-esteem and provide exercises for strengthening it, and one textbook (Contemporary Living) links self-esteem to marital quality. The CE and FACS texts are each intended to address substance abuse—CE through literature and the FACS texts by describing the adverse consequences of substance abuse. Although most of the curricula address personality and ways that it can interact with romantic and marital relationships, none seems to seek to modify personality.
Attitudes and Beliefs
All the curricula we reviewed touch on each of the attitude and belief precursors. Each curriculum introduces one or more models of relationships and intimacy—in most cases, these include positive models, although one, Choosing the Best Soul Mate, emphasizes negative examples of relationships and intimacy to highlight problems that can plague relationships. The curricula seek to shape attitudes and beliefs about dating and marriage, emphasizing the value of postponing dating and suggesting that the purpose of dating is to get to know someone and assess compatibility. All the curricula emphasize the importance of abstinence.
Relationship Behavior
Relationship behavior is the second most comprehensively covered domain in the curricula we reviewed. All the curricula address commitment, sexual behavior, partner choice, and STDs and pregnancy as factors that influence the quality of romantic and/or marital relationships. Six of the eight curricula encourage youth to postpone entry into serious relationships. Four of the curricula address duration and/or number of relationships and five address violence. With respect to violence, the emphasis is on helping youth define or identify abusive or violent relationships and providing recommendations for how to end such relationships.
Practical Concerns in Delivering Relationship Education Curricula to Low-Income Youth
One of the goals of the ACF Healthy Marriage Initiative is to increase the percentage of youth and young adults with the skills and knowledge necessary to form healthy relationships and marriages (Department of Health and Human Services, 2006). To explore this issue, we spoke with several ACF staff who are overseeing efforts to extend HMI efforts to include programs targeting adolescents, as well as with ACF grantees that have some experience providing relationship education programming to adolescents in community settings (or sometimes AE with a relationship education emphasis) or that are preparing to do so. Among the organizations we spoke with that have some experience encouraging healthy relationships among adolescents, there is uniform agreement that this programming is vital and that the additional funds will help them better address the needs of the adolescents they work with. Moreover, there is also consensus that youth who participate in these efforts are highly receptive to them. For these two reasons, these organizations said that they would, if possible, continue to refine and provide this programming. The remainder of this section discusses the practical and resource issues that emerged in our discussion with ACF decision makers and grantees.
Most organizations we spoke with said that the major curricula they selected from were those featured at Smart Marriages conferences. It is important to note that the organizations we spoke with were not necessarily using the specific curricula reviewed in this chapter. We asked informants from these organizations to describe for us, in generic terms, the types of issues and concerns they perceived in implementing relationship education curricula, but we did not attempt to map whether these issues and concerns apply to one or more of the curricula reviewed here.
The Need for More Culturally Appropriate Curricula
Perhaps the most commonly cited difficulty that organizations expressed is a shortage of relationship education curricula that appear suitable for their specific target population. is ranged from a concern that the curricula are too explicit for the youth that are served (and their parents) to a concern that the curricula do not accurately reflect youth culture (e.g., hip-hop). Grantees in the latter group acknowledged that curricula (particularly abstinence-only curricula) are increasingly incorporating media (especially commercials and hip-hop) and that these efforts are well received by youth. AE programs were most frequently mentioned as doing a good job at incorporating culture (sometimes defined as hip-hop music or explicit commercials)—but we did not hear this comment applied to RME curricula. Given the limitations of this review, we were not able to ascertain whether organizations perceived that lack of culturally appropriate curricula reflects a failure to adequately incorporate media into the curriculum. Because we did not speak with youth directly, we were unable to assess whether these perceptions are those of the informants we spoke with, those of the youth they work with, or of the parents of the youth. We also could not assess the validity of these perceptions. The RME field, in particular, may benefit from exploring the potential reasons for these perceptions and whether the extent of their cultural adaptation is insufficient, on average, or whether they need to address perceptual barriers.
Problem with Curricula Overlooking Young Parents
Grantees mentioned two key segments of the youth population that they believe existing curricula largely ignore: young mothers and fathers and pregnant women. At best, grantees said that they believed that certain sessions are simply awkward for these young adults to attend (and one grantee said that they recommend young mothers and pregnant women be pulled out of certain sessions) and in other cases they thought the entire curriculum was inappropriate for these population segments. Because teen fathers are not always recognized as such, there was a particular concern that teen fathers were most at risk of not benefiting from the programming. We are aware of some efforts to develop programming tailored for at-risk teens. For example, Marline Pearson (personal communication) reports that she may produce tailored editions of Love U2 for teen parents, foster teens, and possibly Hispanic teens. Pearson has also developed, in collaboration with Scott Stanley and Galena Kline, Within My Reach: Low Income PREP, a decision making and relationship skill-building and marriage promotion program designed specifically for low-income single mothers, who may be older adolescents or young adults. As another example, Connections is now available in Spanish. Another grantee we spoke with that provides technical assistance is likewise exploring ways to adapt other curricula so that they are appropriate for Hispanics and other groups. Finally, we note that other marriage education curricula not reviewed in this report are actively working to adapt curricula specific for different subgroups.
Insufficient Implementation Tools
Several organizations said that they could benefit from greater assistance in delivering curricula. In particular, they expressed the need for assistance or guidelines for adapting curricula. One organization we spoke with said that it picks and chooses components it thinks are best. Another grantee said that it does not have the necessary time to implement its selected curriculum with fidelity, so it removed some components. Grantees said they would appreciate some guidance for which curriculum components are believed to be essential to achieving a desired outcome versus which are likely to be duplicative and considered optional. Currently, grantees that must shorten the number or length of sessions combine two approaches to modifying the curricula: (1) pre-tests for youth to assess what components are core, and (2) asking staff to assess which curricula components are core. Several grantees said that they would prefer some guidance from the program developers on the issue of which components are core and which are optional. We also heard confusion expressed about whether organizations could modify curriculum without violating the terms of the agreement with the distributor.
Many argue that policymakers and funders should recognize the need to produce guidelines that communities can use to think about when and how science-based program components can be adapted to fit their setting. Among other definitions, adaptation has been defined as the deliberate or accidental modification of a program (Center for Substance Abuse Prevention, 2002). Adaptation can include deletions or additions of program components, changes in the manner or intensity of components, or cultural modifications (Center for Substance Abuse Prevention, 2002).
Although the impact of adaptation on participant outcomes is largely unknown, most believe that low fidelity is associated with worse outcomes (Blakely et al., 1987). If this is true, reports that organizations are commonly adapting curricula mean that target populations are not enjoying maximum benefits. It is also possible that, in the absence of easy-to-follow and effective adaptation guidelines, organizations may not bother with proven curricula to avoid the burden of adaptation, although we have not seen empirical evidence on this point. At this time there are no “proven” marriage education curricula, but assuming such curricula are developed, adolescent public health as a whole may benefit as much from making effective adaptation guidelines available to organizations as from commercially available curricula.
Although tools to guide adaptation are currently missing within the marriage education movement, this may be changing. One grantee we spoke with is developing a toolkit that organizations can use to design RME programs. This toolkit is intended to be a step-by-step guide in workbook form. It begins by walking the organization through such steps as developing the vision; building a foundation; creating a mission statement, goals, and activities (worksheets); determining participants; identifying barriers; and reviewing all aspects of marriage curricula (e.g., the pros and cons of different curricula, when and where to meet, how often, and how to perform an evaluation). Aspects of this tool overlap with similar efforts being undertaken in other fields, such as youth development and community health. Organizations can use all these tool to help them with needs assessment, setting of priorities, planning and delivering programs, monitoring, and evaluation (e.g., Chinman, Imm, and Wandersman, 2003). Such a toolkit would be useful to organizations that want to provide RME to youth, and it could be extended to incorporate adaptation guidelines.
Questions About the Age-Appropriateness of Some Curricula Components
Some informants we spoke with questioned the age-appropriateness of some of the RME curricula and their components. In particular, they expressed concern about whether PREP (or PREP-like components), a tool developed to improve communication of (primarily white, middle-class) adult married and premarital couples, is appropriate for adolescents and, if so, whether sufficient work has been done to tailor it to the developmental stage of youth. We heard that many in the marriage education field believe that PREP (or an adaptation of it) should be distributed for youth, and many of the curricula we reviewed incorporate PREP-like components. But we heard from some informants with a background in adolescence (rather than in marriage education) a concern that insufficient research has been conducted to confirm that the widespread use of such components is warranted at this time.
We note that this same criticism is applicable to all RME curricula and their components. A danger in not rigorously evaluating a curriculum or component that is primed to be widely distributed, such as PREP in adolescent programming, is that it may be enormously successful but subsequently found to not be as effective in accomplishing the desired outcome as an alternative. Yet, once programs accept and buy into a given curricula, it can be very difficult to disabuse them of the effectiveness of the intervention. For example, D.A.R.E., the drug abuse prevention program shown to be ineffective nearly 15 years ago, is still the most widely used drug prevention program in the United States and internationally, even though more effective alternatives are available.
Need for Training in the Logistics of Serving At-Risk Youth
Given the goal of the programming, some youth who could most benefit have logistical challenges. For example, one grantee said that there is need for training on how to incorporate child-care logistics to deal with the children of young parents. Given the nature of some of the discussion, there is also need for guidance on when male and female participants in these programs should be separated. For example, should separations be based on topic, age, or some combination of the two? And if so, how should the genders be separated? For the full course? For specific sessions? During breakout sessions? Some logistical issues are relevant for all curricula (e.g., child care), whereas other issues may be especially pertinent to a specific curriculum. Other logistical issues organizations recommend guidance on include if and when to offer incentives to potential participants (such as food or prizes) and where and when to deliver the curriculum. Many of these issues are relevant to all populations. However, because these grantees in many cases were considering expanding the scope of programming they provide to include RME—or expanding their target populations to include youth—grantees are revisiting logistical questions they faced before.
Marketing Relationship Education to Adult Decision makers
We heard concerns from grantees that while relationship education efforts were well-received by youth, parents and other adult decision makers were sometimes less enthusiastic. One grantee opined that part of this may be due to unfortunate terms—many parents interpret “relationship education” to mean a dating or “hook-up” service and protest that such service is not what their children need. If the issue is only one of terminology, then the recommendation for overcoming this limitation is to conduct a series of focus groups with parents to assess the appropriateness of other terms.
However, another grantee indicated that there may be a larger problem of the way adults and parents perceive the need for RME targeting youth. This organization delivers RME and AE services to service providers in the geographic area for a modest fee. It found that while most organizations were open to RME programming if the programming were cross- subsidized by other programming (such as abstinence education), these same organizations, when faced with restricted resources, would pay for AE programming but not for relationship education. They viewed relationship education as less important for youth than abstinence education. Ultimately, the board of directors decided that, financially, the grantee organization could no longer afford to cross-subsidize relationship education programming and would cease offering it.
This may reflect a larger need to assess whether parents and community decision makers believe that relationship education is important for their youth and are willing to back it. At the same time that ACF is reaching out to youth to understand how it can craft messages for youth, there may be a need to reach out to community leaders and parents who are not involved in the relationship and marriage education movement to assess where they stand on these matters. There may be a need to reach and educate adults about the need and potential benefits from RME efforts that coincides with or supersedes efforts to deliver this programming to youth.
Summary and Conclusions
The field of relationship education is relatively new and, consequently, the effects of the curricula on improving relationship outcomes in adolescence and subsequent adulthood have not been established. On the positive side, these curricula are evidence-based in that they draw on cutting-edge research on adolescent relationships. This cannot be said of first- and second-generation interventions in other fields (such as drug prevention). However, most of the evidence in the relationship education field is correlational, so it is unclear whether the precursors of healthy relationships identified in Chapters Three and Four are caused by third factors that have not been identified or if a change in these precursors really affects relationship outcomes. If the latter, then the existing curricula that all tend to touch on at least one precursor within each of the domains are likely to be at least somewhat effective. If the former, future research evaluating the effect of these interventions on relationship outcomes will be invaluable. If carefully done, it will provide a unique opportunity to rigorously test aspects of the model that are not otherwise available because of practical and ethical considerations. One such evaluation is currently under way, although the results will not be available for a few years. A key challenge facing the field will be to arrive at a consensus about what the clear and measurable short- and long-term goals of these programs ought to be.
In this chapter, we reviewed exemplar RME, CE, FACS, and AE curricula nominated by experts in the field. In terms of addressing the domains in the integrative framework developed in Chapter Three, the key strengths of these curricula are that they cover most of the attitudes and beliefs and most of the relationship behaviors that current research and theory suggest are relevant for the development of healthy relationships and marriages. The curricula are less consistent in how they address immediate context and individual difference precursors. An open question is whether RME programs should address these other factors at all, given that for some of these precursors, such as substance use prevention, there are already proven curricula.
We spoke with decision makers and community-based organizations that are offering or considering relationship education curricula about the issues they encounter. From these conversations, we derived a number of observations. First, there is a perceived need for more culturally appropriate curricula, which the field appears to be addressing. Second, some key subpopulations (e.g., teen fathers, pregnant teens) are not adequately addressed by existing curricula. At least one curriculum developer we spoke with said there were plans to address one or more of these subpopulations. More such efforts may be necessary.
Third, organizations almost unanimously indicated that they adapt existing curricula because of limited time or physical resources and that these adaptations are occurring with no guidance from the program developer. Some organizations are concerned that their adaptations are compromising the effectiveness of the curricula and would appreciate guidance. We recommend that there be more emphasis on adaptation guidelines and other implementation tools to use when delivering a new curriculum.
A fourth concern expressed by some organizations is that relationship education curricula are not always age-appropriate. These concerns ranged from questioning the appropriateness of the explicit sexual content of some of the materials (especially media examples) to whether the content of core materials (such as PREP) that were originally developed for adult couples is developmentally appropriate for teens.
Fifth, some organizations said that the relationship education programming often attracts some youth with special logistical needs (e.g., babysitting) that the organization is unequipped to handle. These organizations say they could benefit from technical assistance in how to deal with such logistics.
Finally, we saw evidence that adults, such as parents and leaders of community organizations, may not understand the purpose or need for relationship education programming. Since these adults are often in a position to influence whether relationship education programming is made available to youth, more attention to marketing to these influential adults may be required.
We conclude with an observation on the RME field. As in any field, the program developers, distributors, implementers, and some funders generally believe deeply in the importance and value of the curricula for improving the lives of adolescents. As a result, these individuals and organizations devote an enormous amount of energy and talent to developing and disseminating these programs. Among these parties, there appears to be a certain level of frustration with the failure to make sufficient inroads in schools and community settings. There is some disagreement as to which setting is ideal or realistic. On the one hand, schools are highly desirable because most adolescents attend them. On the other hand, schools are under enormous pressure to meet performance standards set by state and federal departments of education and are reluctant to add any curricula that would distract from time devoted to meeting these standards. Unfortunately, in the current environment, RME curricula are most likely to be incorporated in schools if they meet one of two criteria. One route would be to integrate this material into required courses (e.g., health education), as some distributors recommend. The concern with the health education route is that many of these classes are taught by coaches or others who may be less effective educators than standard teachers. The challenge here would be to modify the curricula so that anyone, particularly those who are likely to teach health classes, can effectively teach the curricula. A second route to gain entry into schools would be to convincingly demonstrate that RME curricula produce other outcomes by which schools are evaluated (e.g., attendance, standardized test scores). The results from the Auburn, Alabama, study described previously should provide evidence on whether such evidence is likely to be forthcoming (at least based on the current generation of RME curricula).
Alternatively, RME curricula may be pitched to other settings that desire curricula to address specific issues they care about. In this case, the field may be more successful with some mix of evidence and marketing. Increasingly, some nonschool practitioners are sophisticated about the evidence base. For example, after-school programs are very aware of the lack of evidence showing that participation in their programs leads to improved outcomes (such as higher standardized test scores or reduced behavioral problems). Nonetheless, these programs meet an important need (for childcare), so their viability, particularly in elementary schools, is assured. The issue they are facing is how to engage kids in their programs (particularly students in fifth grade and higher). Those in the RME field may find themselves welcomed by these programs if the RME field can rigorously demonstrate their that curricula have low resource demands (e.g., do not require staff to have much education or training); that students like the curriculum; and, most importantly, that it improves program attendance, behavioral problems, or staff-student relationships (Bodilly and Beckett, 2005). Similarly, other out-of-school-time settings may have unique needs that RME may be well qualified to help address.
1 As of May 6, 2007: http://www.bu.edu/education/lovingwell/LovingWell_Goals.html (back)
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