title: A Rights-Based Sexuality Education Curriculum for Adolescents: 1-Year Outcomes From a Cluster-Randomized Trial.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the impact of a rights-based sexuality education curriculum on adolescents' sexual health behaviors and psychosocial outcomes 1 year after participation.
  
  
  METHODS
  Within 10 urban high schools, ninth-grade classrooms were randomized to receive a rights-based curriculum or a basic sex education (control) curriculum. The intervention was delivered across two school years (2011-2012, 2012-2013). Surveys were completed by 1,447 students at pretest and 1-year follow-up. Multilevel analyses examined curriculum effects on behavioral and psychosocial outcomes, including four primary outcomes: pregnancy risk, sexually transmitted infection risk, multiple sexual partners, and use of sexual health services.
  
  
  RESULTS
  Students receiving the rights-based curriculum had higher scores than control curriculum students on six of nine psychosocial outcomes, including sexual health knowledge, attitudes about relationship rights, partner communication, protection self-efficacy, access to health information, and awareness of sexual health services. These students also were more likely to report use of sexual health services (odds ratio, 1.37; 95% confidence interval, 1.05-1.78) and more likely to be carrying a condom (odds ratio, 1.97; 95% confidence interval, 1.39-2.80) relative to those receiving the control curriculum. No effects were found for other sexual health behaviors, possibly because of low prevalence of sexual activity in the sample.
  
  
  CONCLUSIONS
  The curriculum had significant, positive effects on psychosocial and some behavioral outcomes 1 year later, but it might not be sufficient to change future sexual behaviors among younger adolescents, most of whom are not yet sexually active. Booster education sessions might be required throughout adolescence as youth initiate sexual relationships.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Rohrbach
authors.affiliation: Center for Research on Adolescent Health and Development, Public Health Institute, Oakland, California.
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Berglas
authors.affiliation: Center for Research on Adolescent Health and Development, Public Health Institute, Oakland, California.
authors.forename: Petra
authors.initials: P
authors.lastname: Jerman
authors.affiliation: Center for Research on Adolescent Health and Development, Public Health Institute, Oakland, California.
authors.forename: Francisca
authors.initials: F
authors.lastname: Angulo-Olaiz
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chou
authors.affiliation: Center for Research on Adolescent Health and Development, Public Health Institute, Oakland, California; Division of Community Health and Human Development, School of Public Health, University of California, Berkeley, California. Electronic address: nconstantine@berkeley.edu.
authors.forename: Norman A
authors.initials: NA
authors.lastname: Constantine
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016001:Confidence Intervals; D003479:Curriculum; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012572:School Health Services / Q000458:organization & administration; D020377:Self Efficacy; D012736:Sex Education / Q000379:methods*; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000517:prevention & control
keywords: Cluster-randomized trial; Evaluation; Relationship rights; School-based intervention; Sexual behavior; Sexual rights; Sexuality education