Replicating Reducing the Risk: 12-Month Impacts of a Cluster Randomized Controlled Trial.
OBJECTIVE
To test the effectiveness of Reducing the Risk, an evidence-based sexual health curriculum designed to help prevent adolescent pregnancy and sexually transmitted infections, on youth sexual behavior and intermediate outcomes thought to lead to these behaviors.


METHODS
Classes within schools in St. Louis, Missouri; Austin, Texas; and San Diego, California; were randomly assigned to receive Reducing the Risk or "business as usual." Youths completed Web-based surveys at baseline (preintervention, August 2012-January 2014) and 12 months later (August 2013-January 2015). Intent-to-treat analyses were conducted across sites; we tested for differences in impacts between sites and other subgroups.


RESULTS
The program had no overall impact on sexual behaviors. However, at 1 site, program participants were significantly less likely to have engaged in recent sexual intercourse than were control group members. There were positive overall impacts on intermediate outcomes (e.g., knowledge, attitudes).


CONCLUSIONS
After 12 months, Reducing the Risk was unsuccessful at changing sexual behaviors. Other results were mixed, but promising evidence (e.g., behavioral impacts at 1 site, impacts on intermediate outcomes) suggests potential for more widespread behavioral impacts over a longer term.
Meredith Kelsey, Michelle Blocklin, Cristofer Price, Randall Juras, and Lesley Freiman are with Abt Associates, Inc., Cambridge, MA. Jean Layzer is with Belmont Research Associates, Belmont, MA.
Meredith
M
Kelsey
Meredith Kelsey, Michelle Blocklin, Cristofer Price, Randall Juras, and Lesley Freiman are with Abt Associates, Inc., Cambridge, MA. Jean Layzer is with Belmont Research Associates, Belmont, MA.
Michelle
M
Blocklin
Meredith Kelsey, Michelle Blocklin, Cristofer Price, Randall Juras, and Lesley Freiman are with Abt Associates, Inc., Cambridge, MA. Jean Layzer is with Belmont Research Associates, Belmont, MA.
Jean
J
Layzer
Meredith Kelsey, Michelle Blocklin, Cristofer Price, Randall Juras, and Lesley Freiman are with Abt Associates, Inc., Cambridge, MA. Jean Layzer is with Belmont Research Associates, Belmont, MA.
Cristofer
C
Price
Meredith Kelsey, Michelle Blocklin, Cristofer Price, Randall Juras, and Lesley Freiman are with Abt Associates, Inc., Cambridge, MA. Jean Layzer is with Belmont Research Associates, Belmont, MA.
Randall
R
Juras
Meredith Kelsey, Michelle Blocklin, Cristofer Price, Randall Juras, and Lesley Freiman are with Abt Associates, Inc., Cambridge, MA. Jean Layzer is with Belmont Research Associates, Belmont, MA.
Lesley
L
Freiman
Fam Plann Perspect. 1991 Nov-Dec;23(6):253-63
1786806
J Adolesc Health. 2014 May;54(5):499-507
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