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- Relative to the standard school curriculum, did the adapted version of Reducing the Risk in Kentucky change students’ behaviors, knowledge, attitudes, and intentions after two years?
- Did the impacts of the program vary for certain subgroups of students?
- How much did the adapted version of Reducing the Risk cost to implement?
This report presents evidence on the longer-term impacts of an adapted version of the Reducing the Risk teen pregnancy prevention curriculum in rural Kentucky. Although rural counties have the highest teen birth rates in the United States, teen pregnancy prevention practitioners and researchers have developed and tested relatively few programs for youth in rural areas. To add to the research on effective pregnancy prevention approaches for youth in rural areas, the Administration for Children and Families within the U.S. Department of Health and Human Services funded a rigorous evaluation of an adapted, eight-hour version of Reducing the Risk in 13 high schools in a primarily rural area of central and southwestern Kentucky. The program was delivered by trained staff from two local health departments in Kentucky with federal grant funding from the Personal Responsibility Education Program (PREP).
This report is the last in a series on the implementation and impacts of the adapted version of Reducing the Risk in Kentucky. It presents evidence on the program’s longer-term impacts after two years. It also provides information on program costs and documents the study methods.
An earlier report presented evidence on the program’s shorter-term impacts after one year. That earlier report showed that students in the Reducing the Risk schools had better knowledge of contraception and sexually transmitted infections and expressed greater support when asked about the importance of condom use among sexually active youth. Relative to the standard school curriculum, Reducing the Risk did not change students’ sexual risk behaviors, intentions to have sex, attitudes toward abstinence, or perceived ability to avoid sexual risk behaviors after one year.
Key Findings and Highlights
- The longer-term impact findings show that the adapted version of Reducing the Risk led to a sustained increase in students’ knowledge of contraception and sexually transmitted infections after two years, and that a longer-term impact on sexual risk behavior had emerged for one subgroup of students.
- Relative to the standard school curriculum, the adapted version of Reducing the Risk did not change the likelihood of having sex or having sex without a condom in the three months before the two-year follow-up survey for the overall sample.
- The program did, however, reduce the likelihood of having sex without a condom in the three months before the two-year follow-up survey for the smaller sample of students who were already sexually active prior to study enrollment.
- For the overall sample, the program increased students’ knowledge of contraception and sexually transmitted infections relative to the standard school curriculum.
- After two years, the program did not change students’ attitudes, refusal skills, communication with parents, or intentions to have sex.
- The program’s impacts are commensurate with the dosage of programming offered (eight hours) and a modest operational cost of $113 per student.
Schools were randomly assigned during the 2013–2014 and 2014–2015 school years to either a treatment group that offered the adapted version of Reducing the Risk or to a control group that offered the school’s standard health curriculum. In schools assigned to the treatment group, trained professional health educators from two local health departments delivered the curriculum as part of a mandatory health class for primarily 9th‑ and 10th-grade students. Students’ outcomes were assessed through surveys administered one and two years after study enrollment. The two-year outcomes are the focus of this report.
Two earlier reports presented evidence on the implementation of the program and early impacts after one year:
Goesling, Brian, Joanne Lee, Robert G. Wood, and Susan Zief (2018). Adapting an Evidence-based Curriculum in a Rural Setting: The Longer-Term Impacts of Reducing the Risk in Kentucky, OPRE Report # 2018-27, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
- Personal Responsibility Education Program