Sexual Health Risk Reduction and Pregnancy Prevention Among Older Adolescents

Purpose :  Crossroads is a school-based intervention program that provides educational and social support to 17-19 year old adolescents who have recently dropped out of high school with the aim of helping them graduate, while simultaneously building knowledge about the prevention of pregnancy.  The program was developed based on research that suggests that high school dropout can be directly linked to an increased likelihood of teen pregnancy.  Previous research has established that teenagers who dropped out of high school engage in sex at an earlier age than students remaining in school, and that higher academic achievement and greater school engagement and attachment have been linked to later, less frequent sex and fewer pregnancies and births.  This presentation will focus on the results of two of the five objectives of the program:  1) Increased knowledge of risk reduction strategies to prevent pregnancy and sexually transmitted infections (STIs); and 2) Increased knowledge of sexual health related community resources. 

Method:  Crossroads is evaluated using a randomized two-group repeated measures design to assess changes in knowledge, attitudes, intended behaviors, and self-reported behaviors.  Control and Intervention group participants completed a proctored online assessment tool at baseline and at 3-month follow-up. The study sample was composed of 252 participants, of which 134 were males (53.2%).  The sample’s mean age was 18.8 years. More than half of the participants were Hispanic (53.4%), and 32.1% were Black/African-American, 22.6% were Caucasian, 6.8% were American Indian, 3.2% were Asian, and 39.7% identified themselves as an “Other” race. 

Results:  Results indicated that Intervention participants demonstrated a significant increase in their knowledge of risk reduction strategies specifically related to condom usage (z= -2.27 p = .023), and these gains persisted when comparing responses from the Intervention and Control group participants (z= -2.16 p = .03).  The Intervention group had an 18.4% increase in knowledge of where to go to get tested for an STI, compared to a 9.7% increase in the Control group.  Further, when asked to list sexual health related community resources, the Intervention group listed significantly more resources at follow-up than at baseline (z = -4.14, p<.0001), and Intervention participants were significantly more likely to list more community resources at follow-up than the Control group (z = -1.95, p=.05). 

Conclusion/Implications:  These results indicate that the Crossroads program is having a positive impact on participants’ knowledge of sexual health risk reduction strategies, and is successfully enhancing participants’ awareness of community resources available to assist them with their sexual health needs.  The initial success of this program can provide support to the notion that school-based sexual health and pregnancy prevention interventions like Crossroads can be successful in promoting healthy sexual behaviors among adolescents. As the first program of its kind to intervene with high school dropouts with the specific intention of preventing teen pregnancy while simultaneously encouraging high school or GED completion and college planning, Crossroads has the potential to provide valuable insight for social work practitioners, policy makers, and researchers about pregnancy prevention and risk reduction among high-risk adolescents.