Evaluating a Future-Oriented Positive Youth Development Intervention to Reduce Sexual Risk Among Highly Mobile Youth: Results and Challenges

Pamela J Drake; Susan C Potter; Leslie F Clark; Mona Desai; Frances LaSalle-Castro; Tatiana Masters; Sankari Ayyaluru

doi:10.1016/j.jadohealth.2024.03.003

Evaluating a Future-Oriented Positive Youth Development Intervention to Reduce Sexual Risk Among Highly Mobile Youth: Results and Challenges

J Adolesc Health. 2024 May 13:S1054-139X(24)00157-5. doi: 10.1016/j.jadohealth.2024.03.003. Online ahead of print.

Authors

Pamela J Drake¹, Susan C Potter², Leslie F Clark³, Mona Desai⁴, Frances LaSalle-Castro⁴, Tatiana Masters², Sankari Ayyaluru²

Affiliations

¹ ETR, Scotts Valley, California. Electronic address: Pam.Drake@etr.org.
² ETR, Scotts Valley, California.
³ Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California.
⁴ Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California.

PMID: 38739052
DOI: 10.1016/j.jadohealth.2024.03.003

Abstract

Purpose: Youth experiencing or at risk of experiencing homelessness need tailored prevention programming to prevent unplanned pregnancy and sexually transmitted infections. This study evaluated the efficacy of a small-group, future-oriented positive youth development (PYD) intervention to reduce sexual risk behaviors.

Method: Youth aged 14-19 (n = 483) experiencing or at risk of experiencing homelessness were recruited at youth-serving agencies and in alternative schools. Each cohort enrolled was randomized either to a 10-session, 5-week group future-oriented intervention to support them in adopting health-promoting behaviors such as using contraception, including condom use (n = 244) or to a no-treatment condition where they received usual services/schooling (n = 239). We assessed at baseline and 3-month and 9-month follow-up (1) vaginal intercourse without consistent contraception use, (2) vaginal and anal intercourse without consistent condom use, and (3) sexual risk behaviors, including current (last 3 months) effective contraception use by females who did not report current use at baseline.

Results: There was no significant difference between treatment and control conditions for most outcomes. However, among females not currently using contraception at baseline, 34% in the treatment condition compared to 12.9% in the control condition reported using contraception in the 3 months before the 9-month survey, a statistically significant difference.

Discussion: This sexual risk reduction intervention, grounded in PYD theory and tailored to address the needs of marginalized groups of youth, demonstrated efficacy at increasing contraceptive uptake among females. The need for PYD interventions that can be delivered in a variety of nontraditional school and service settings are discussed.

Keywords: Evaluation study; Positive youth development; Pregnancy and sexual risk reduction in adolescence; Vulnerable youth.