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Research on the effects of intervention dose on outcomes within adolescent sexual health education programming is lacking. Existing research on dose typically utilizes number of sessions as a variable. In a school setting, there are scheduling limitations, student absences, and other logistical barriers that have the potential to affect the dose of an intervention and, in turn, impact the efficacy of programming. This article evaluates the effectiveness of a peer led, comprehensive sexual health education program provided in several high schools in a southwest urban area.
A primary goal of the study was to analyze the extent to which the dose of intervention may impact youth outcomes. It was hypothesized that between baseline and post-training assessments intervention (i.e., dose) and participant variables (i.e., age, gender) would be significantly associated with changes in sexual knowledge and attitudes.
Methods
The study employed a pre-post design assessing sexual health knowledge, attitudes, and behaviors for public high school students who participated in the intervention groups. Youth were recruited for participation with the assistance of school counselors and teachers. A total of 144 high school students from four public high schools answered baseline survey assessments, while a total of 66 responded to post-test surveys.
Sexual health knowledge, attitudes, and behaviors were all measured using Likert type scales.
A repeated measures MANOVA was used to evaluate the effects of individual difference variables (i.e., age and sex) and intervention variables (i.e., overall dose of the intervention calculated as total number of minutes of intervention) on changes in participants’ knowledge and attitudes across two time points (i.e., baseline and post-intervention).
Results
There was a significant between-subjects effect between knowledge scores over time and total dose of the intervention, F(1, 67) = 4.75, p= .033 with more total minutes of education being associated with larger increases in knowledge following the intervention. Age was also significantly associated with changes in knowledge over time, F(1, 67) = 6.79, p= .011 with older youth demonstrating larger changes in knowledge. There was no significant main effect of attitudes (p = .15) or interactions of individual difference variables (i.e., age p = .09) and intervention variables (i.e., overall dose of the intervention p = .48) on changes in participants’ attitudes across the two time points (i.e., baseline and post-intervention).
Conclusions and Implications
Dose measured in minutes was found to be more rigorous than evaluating the number of sessions or duration of program (i.e., semester-long, year-long). Finding a significant effect on knowledge related to the number of minutes of the intervention, rather than duration of program, could open up possibilities for wider implementation of adolescent sexual health education programs at schools and other settings where there is concern about feasibility of implementing lengthy programs. The fact that the total number of minutes was more robust than the number of sessions also suggests that other researchers may want to assess this variable in future studies. Widespread inclusion of measuring dose in minutes may also allow for more comparison across programs.