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Evaluation of a randomized intervention to delay sexual initiation among fifth-graders followed through the sixth grade.

ABSTRACT: US adolescents initiate sex at increasingly younger ages, yet few pregnancy prevention interventions for children as young as 10-12 years old have been evaluated. Sixteen Washington, DC schools were randomly assigned to intervention versus control conditions. Beginning in 2001/02 with fifth-grade students and continuing during the sixth grade, students completed pre-intervention and post-intervention surveys each school year. Each year, the intervention included 10-13 classroom sessions related to delaying sexual initiation. Linear hierarchical models compared outcome changes between intervention and control groups by gender over time. Results show the intervention significantly decreased a rise over time in the anticipation of having sex in the next 12 months among intervention boys versus control boys, but it had no other outcome effects. Among girls, the intervention had no significant outcome effects. One exception is that for both genders, compared with control students, intervention students increased their pubertal knowledge. In conclusion, a school-based curriculum to delay sexual involvement among fifth-grade and sixth-grade high-risk youths had limited impact. Additional research is necessary to outline effective interventions, and more intensive, comprehensive interventions may be required to counteract adverse circumstances in students' lives and pervasive influences toward early sex.ClinicalTrials. gov identifier: NCT00341471.

SUBMITTER: Koo HP

PROVIDER: S-EPMC3158595 | biostudies-literature | 2011 Feb

REPOSITORIES: biostudies-literature

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Evaluation of a randomized intervention to delay sexual initiation among fifth-graders followed through the sixth grade.

Koo Helen P HP Rose Allison A El-Khorazaty M Nabil MN Yao Qing Q Jenkins Renee R RR Anderson Karen M KM Davis Maurice M Walker Leslie R LR

Sex education 20110201 1

US adolescents initiate sex at increasingly younger ages, yet few pregnancy prevention interventions for children as young as 10-12 years old have been evaluated. Sixteen Washington, DC schools were randomly assigned to intervention versus control conditions. Beginning in 2001/02 with fifth-grade students and continuing during the sixth grade, students completed pre-intervention and post-intervention surveys each school year. Each year, the intervention included 10-13 classroom sessions related ...[more]

PMID: 21857793

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Project description:BACKGROUND:The majority of children and adolescents are insufficiently physically active. Self-efficacy is considered one of the most important determinants of physical activity (PA). The purpose of this study was to validate the German version of the physical activity self-efficacy scale by means of a multi-level approach. Factorial validity, internal consistency and criterion validity were examined for the individual and the class level. METHODS:The final sample comprised 454 female sixth-graders of 33 classes. To examine the factorial validity of the translated 8-item scale, a multi-level confirmatory factor analysis was conducted with the lavaan package in R. Internal consistency was estimated with the alpha function of the psych package. Criterion validity was examined by correlating self-efficacy with moderate-to-vigorous physical activity (MVPA) assessed with accelerometers. RESULTS:In contrast to previous validation studies, a unidimensional structure of the scale was not supported. Instead, two highly correlated (rindividual?=?.87; rclass?=?.69) but distinct latent factors, representing PA self-efficacy and social support from family and friends, were differentiated on both the individual and class level. The best overall fit exhibited a multi-level 1?×?1-model, including only the six items measuring PA self-efficacy (?2?=?32.10, CFI?=?.986, TLI?=?.976, RMSEA?=?.059, SRMR?=?.035). Internal consistencies for the complete 8-item scale and the 6-item scale were good on the individual level and excellent on the class level. For the two items measuring social support, Cronbach's alpha was low on the individual and excellent on the class level. Weak relations between self-efficacy and MVPA were found for the individual level, strong associations were found for the class level. CONCLUSIONS:The validation speaks for the use of the abridged 6-item scale, which allows for a unidimensional assessment of PA self-efficacy. Generally, the results support the relevance of a multi-level approach, which not only differentiates between self-efficacy on the individual level and on the class level but also between the respective implications regarding reliability and criterion validity on both levels. Thereby, this study offers a rigorously validated scale and further illustrates possible consequences of the usual neglect of group-level variance in scale validation.

Project description:IntroductionAdolescents' physical activity (PA) behavior can be driven by several psychosocial determinants at the same time. Most analyses use a variable-based approach that examines relations between PA-related determinants and PA behavior on the between-person level. Using this approach, possible coexistences of different psychosocial determinants within one person cannot be examined. Therefore, by applying a person-oriented approach, this study examined (a) which profiles regarding PA-related psychosocial variables typically occur in female sixth-graders, (b) if these profiles deliver a self-consistent picture according to theoretical assumptions, and (c) if the profiles contribute to the explanation of PA.Materials and methodsThe sample comprised 475 female sixth-graders. Seventeen PA-related variables were assessed: support for autonomy, competence and relatedness in PE as well as their satisfaction in PE and leisure-time; behavioral regulation of exercise (five subscales); self-efficacy and social support from friends and family (two subscales). Moderate-to-vigorous PA was measured using accelerometers. Data were analyzed using the self-organizing maps (SOM) analysis, a cluster analysis including an unsupervised algorithm for non-linear models.ResultsAccording to the respective level of psychosocial resources, a positive, a medium and a negative cluster were identified. This superordinate cluster solution represented a self-consistent picture that was in line with theoretical assumptions. The three-cluster solution contributed to the explanation of PA behavior, with the positive cluster accumulating an average of 6 min more moderate-to-vigorous PA per day than the medium cluster and 10 min more than the negative cluster. Additionally, SOM detected a subgroup within the positive cluster that benefited from a specific combination of intrinsic and external regulations with regard to PA.DiscussionThe results underline the relevance of the assessed psychosocial determinants of PA behavior in female sixth-graders. The results further indicate that the different psychosocial resources within a given person do not develop independently of one another, which supports the use of a person-oriented approach. In addition, the SOM analysis identified subgroups with specific characteristics, which would have remained undetected using variable-based approaches. Thus, this approach offers the possibility to reduce data complexity without overlooking subgroups with special demands that go beyond the superordinate cluster solution.

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Evaluation of a randomized intervention to delay sexual initiation among fifth-graders followed through the sixth grade.

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Evaluation of a randomized intervention to delay sexual initiation among fifth-graders followed through the sixth grade.

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