文章基本信息

标题：Draw the Line/Respect the Line: A Randomized Trial of a Middle School Intervention to Reduce Sexual Risk Behaviors
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作者：Karin K. Coyle ; Douglas B. Kirby ; Barbara V. Marín 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2004
卷号：94
期号：5
页码：843-851
语种：English
出版社：American Public Health Association
摘要：Objectives. This study evaluated the long-term effectiveness of Draw the Line/Respect the Line, a theoretically based curriculum designed to reduce sexual risk behaviors among middle school adolescents. Methods. The randomized controlled trial involved 19 schools in northern California. A cohort of 2829 sixth graders was tracked for 36 months. Results. The intervention delayed sexual initiation among boys, but not girls. Boys in the intervention condition also exhibited significantly greater knowledge than control students, perceived fewer peer norms supporting sexual intercourse, had more positive attitudes toward not having sex, had stronger sexual limits, and were less likely to be in situations that could lead to sexual behaviors. Psychosocial effects for girls were limited. Conclusions. The program was effective for boys, but not for girls. Sexually transmitted diseases (STDs) (including HIV) and pregnancy remain serious problems for youths in the United States. According to the Office of National AIDS Policy, 1 young people in the United States between the ages of 13 and 24 years are estimated to be contracting HIV at a rate of 2 per hour, and half of all new HIV infections occur among persons younger than 25 years. Further, roughly 1 in 4 sexually experienced adolescents aged 13 to 19 years acquires an STD each year. 1, 2 Finally, even with recent declines, the United States still has the highest teen pregnancy and birth rates among comparable industrialized nations. 3, 4 Unfortunately, many consequences of unprotected sexual intercourse are more common among some subgroups of youths (e.g., African American and Latino) than others. For example, African American and Latino youths are disproportionately affected by HIV and AIDS, 1 and Latino adolescents aged 15 to 19 years currently have the highest birth rate of all racial/ethnic groups. 5 Several prevention programs have been shown to reduce adolescent sexual risk behaviors. 6 Many of these studies have been conducted in high school settings 6– 11 or with high school youths in nonschool settings. 12, 13 It is important to target younger youths with prevention messages before they begin having risky sexual intercourse so that programs can help individuals delay sexual intercourse or avoid unprotected sexual intercourse. 14 Fortunately, most young people attend school, 15 which provides an efficient mechanism to reach them with effective prevention programs. To date, however, there are no published randomized trials of school-based HIV, other STD, and pregnancy prevention programs in middle schools with significant positive effects on behavior. 16– 19 Studies with quasi-experimental designs have found some positive effects. 20, 21 Additionally, randomized trials of non–school-based programs have found effects. 22, 23 Given the significant consequences of unprotected sexual intercourse for adolescents, and the need for more program options at the middle school level, we developed Draw the Line/Respect the Line, an innovative theory-based program for middle school youths. Draw the Line/Respect the Line is a 3-year, school-based HIV, other STD, and pregnancy prevention program for youths in sixth, seventh, and eighth grades. The primary aim of Draw the Line/Respect the Line is to reduce the number of students who initiate or have sexual intercourse and to increase condom use among those students who do have sexual intercourse. In addition, the program was designed to affect mediating variables (e.g., attitudes, perceived norms) drawn from our theoretical models. This article presents the results of a randomized controlled trial undertaken to assess the impact of Draw the Line/Respect the Line . It also examines the relation between psychosocial variables and selected behavioral outcomes. The reported data are from a cohort of predominantly Latino sixth-grade students who were followed for 36 months.