Please take our brief survey

Blueprints Programs = Positive Youth Development

Return to Search Results

Promising Program Seal

Promoting Health Among Teens! (Comprehensive)

Blueprints Program Rating: Promising

A 12-hour pregnancy prevention program to reduce risky sexual behavior for African American teens through various types of sex education, including HIV/sexually transmitted infections (STI) and pregnancy prevention, safer sex, and abstinence education.

  • John B. Jemmott III
  • Professor
  • University of Pennsylvania, School of Medicine
  • Department of Psychiatry
  • Center for Health Behavior and Communication Research
  • 3535 Market Street
  • Philadelphia, PA 19104-3309
  • 215-573-9366
  • jjemmott@asc.upenn.edu
  • Sexual Risk Behaviors

    Program Type

    • Cognitive-Behavioral Training
    • Skills Training

    Program Setting

    • Community (e.g., religious, recreation)
    • School

    Continuum of Intervention

    • Universal Prevention (Entire Population)

    A 12-hour pregnancy prevention program to reduce risky sexual behavior for African American teens through various types of sex education, including HIV/sexually transmitted infections (STI) and pregnancy prevention, safer sex, and abstinence education.

      Population Demographics

      The program targets African American 6th and 7th grade students living in urban settings.

      Age

      • Early Adolescence (12-14) - Middle School

      Gender

      • Male and Female

      Race/Ethnicity

      • African American

      Race/Ethnicity Specific Findings

      • African American

      Race/Ethnicity/Gender Details

      Jemmott et al. (2010) included only African American students and did not disaggregate results by gender.

      Goal-oriented behavior, problem-solving and negotiation skills, and resistance to peer pressure reduce risky sexual behaviors.

      • Individual
      Protective Factors
      • Individual: Problem solving skills, Refusal skills

      See also: Promoting Health Among Teens! (Comprehensive) Logic Model (PDF)

      The program is a 12-hour HIV/sexually transmitted infections (STI) and pregnancy-prevention intervention for African American teens that offers optional booster sessions and one-on-one meetings for up to two years following program completion. It aims to increase knowledge of HIV and STIs, strengthen behavioral beliefs supporting abstinence, strengthen behavioral beliefs supporting condom use, increase skills to negotiate abstinence, and increase skills to use condoms and negotiate condom use among 6th and 7th grade students.

      The program is a 12-hour HIV/sexually transmitted infections (STI) and pregnancy-prevention intervention for African American teens that is delivered over 12 one-hour modules. In addition, there are optional booster sessions and one-on-one meetings for up to two years following program completion. It aims to increase knowledge of HIV and STIs, strengthen behavioral beliefs supporting abstinence, strengthen behavioral beliefs supporting condom use, increase skills to negotiate abstinence, and increase skills to use condoms and negotiate condom use among 6th and 7th grade students. Four hours of the curriculum are focused on the safer-sex content, four hours are focused on the abstinence content, and another four hours are devoted to general content applicable to both single-component interventions. Modules are delivered by trained facilitators and include brief group discussions, videos, games, brainstorming, experiential exercises, and skill-building activities.

      The program draws upon: 1) social cognitive theory, 2) the theory of reasoned action, and 3) the theory of planned behavior. All three theories emphasize the importance of beliefs and considering whether a given behavior will have negative or positive consequences.

      • Cognitive Behavioral

      The study (Jemmott et al., 2010) randomly assigned 662 African American 6th and 7th grade students recruited from 4 public middle schools in a northeastern US city. Participants randomly assigned to the 12-hour version of a comprehensive intervention including abstinence and safer sex (treatment group) were compared to participants randomly assigned to 8-hour abstinence only, 8-hour safer sex only (focusing on condom use), 8-hour version of the comprehensive intervention, and an 8-hour health promotion control group focusing on health behaviors unrelated to sexual contact. In addition, students in each intervention were randomly assigned to a maintenance program. The primary measure was a self-report of sexual contact, and secondary measures addressed other sexual behaviors such as multiple partners, unprotected intercourse, and consistent condom use. Participants completed pretest, posttest, and 3-, 6-, 12-, 18-, and 24-month follow-up questionnaires.

      Across the study period (Jemmott et al. 2010), participants in the 12-hour comprehensive treatment group were significantly less likely to report multiple recent sexual partners as compared to participants in the control group.

      Across the study period (Jemmott et al., 2010), compared to the control group, participants in the 12-hour comprehensive treatment group were significantly less likely to:

      • report having multiple sexual partners in the last three months

      Jemmott et al. (2010) did not conduct a formal mediator analysis.

      Jemmott et al. (2010) reported a small effect size (risk ratio of .95).

      The study (Jemmott et al., 2010) was conducted at 4 public middle schools in one city with mostly African-American students.

      Jemmott et al. (2010)

      • Long-term effects were hard to determine because of the maintenence sessions provided to roughly half the sample

      Promoting Health Among Teens! – Abstinence-Only (PHAT – Abstinence), an 8-hour abstinence-based intervention that was also reported by Jemmott et al. (2010), is included as a separate write-up.

      • Blueprints: Promising

      Jemmott, J. B., Jemmott, L. S., & Fong, G. T. (2010). Efficacy of a theory-based abstinence-only intervention over 24 months: A randomized controlled trial with young adolescents. Archive of Pediatric and Adolescent Medicine, 164, 152-159.

      ETR
      100 Enterprise Way. Suite G300
      Scotts Valley, CA 95066
      Tel: (800) 620-8884
      Fax: (831) 438-4284
      Main Website: etr.org
      Program Website: pub.etr.org/ProductDetails.aspx

      Jemmott, J. B., Jemmott, L. S., & Fong, G. T. (2010). Efficacy of a theory-based abstinence-only intervention over 24 months: A randomized controlled trial with young adolescents. Archive of Pediatric and Adolescent Medicine, 164, 152-159.

      Jemmott, Jemmott, & Fong (2010).

      Evaluation Methodology

      Design:

      Recruitment: The study made announcements in assemblies, classrooms, and lunchrooms and sent letters to parents or guardians in 4 middle schools in a northeastern city in the U.S. African American students in the 6th and 7th grades who volunteered and had written parent or guardian consent were included in the study (which resulted in 86.9% of those eligible).

      Assignment: A total of 662 students were randomly assigned to one of the 5 conditions: 12-hour version of a comprehensive intervention including abstinence and safer sex (n = 131), 8-hour version of the comprehensive program (n = 134), 8-hour abstinence only (n = 134), 8-hour safer sex only (focusing on condom use; n = 129), and an 8-hour health promotion control group focusing on health behaviors unrelated to sexual contact (n = 134). In addition, 315 students (48% of the baseline sample) were randomly assigned to an intervention maintenance group for up to 21 months following program completion.

      Attrition: Participants completed pretest, posttest, and 3-, 6-, 12-, 18-, and 24-month follow-up questionnaires from 2001-2004. There were 559 students (84% of the baseline sample) that completed the 24-month follow-up . According to follow-up with the authors, there were no differences by condition in the attrition rates.

      Sample: About 53.5% of participants were female; ages ranged from 10-15 years with a mean of 12.2 years. Approximately 23.4% of the sample reported sexual initiation before the baseline measure.

      Measures: For the primary outcome of sexual initiation, the study included a self-report of ever having had sex. In addition, the study used self-reports of sex behaviors in the past 3 months, including sexual intercourse, multiple partners, unprotected intercourse, and consistent condom use. Trained data collectors were blind to participant assignment, and special efforts were made to obtain honest answers from students (including adding a social desirability scale that was found to have no association with the outcomes).

      Analysis: The study tested the report of ever having sexual intercourse using generalized linear regression with a log link. The study used either the Bernoulli or Poisson error distribution depending on whether predicted probabilities violated the 0,1 range of probability. The other measures were analyzed using Poisson generalized estimating equations with a log link. Analyses on ever having sexual intercourse excluded participants who reported having sexual intercourse at baseline. Analyses controlled for baseline outcome measures, time, condition, gender, and age where possible. The study conducted a 24-month follow-up, but did not report significance of results at each assessment point. Instead, the data were averaged over the entire period of the study, including the long-term follow-up.

      Intent-to-Treat: The study used an intent-to-treat approach in which participants’ data were analyzed regardless of the number of intervention or data collection sessions they attended. About 98% of those randomized were included in the analysis.

      Outcomes

      Implementation Fidelity: The study stated that the modules were highly structured and facilitators used an intervention manual, however no quantitative measures of fidelity were reported. Attendance was high for the 3 sessions comprising the 12-hour program (at least 95%).

      Baseline Equivalence: The study did not report significance tests of differences between conditions at baseline. However, this information was requested and obtained from the program developers, and their table showed only 1 of 9 significant differences between the conditions at baseline (condom use in the past 3 months).

      Differential Attrition: The study reported that there was no significant difference in attrition between conditions and that attending a follow-up session was “unrelated to gender, age, living with both parents, and sexual behavior outcomes.” Other tests of differential attrition were not reported.

      Posttest: Across the study period, the 12-hour comprehensive intervention had a significant effect on reducing multiple partners within the last three months but no effect on sexual initiation, recent sexual intercourse (i.e., sex within the last 3 months), consistent condom use, or unprotected intercourse.

      Maintenance/booster sessions were provided to roughly half the sample within the 21 months following completion of the 12-hour curriculum. Being assigned to the maintenance sessions did not moderate the efficacy of the intervention in reducing most outcomes, but the 12-hour comprehensive initiative did more to reduce multiple partners when the maintenance component was added.

      Long-Term: No long-term follow-up was reported.