: Development and Evaluation of a Sexual Risk Reduction Program for Adolescent Females: Results from a Randomized Controlled Trial

Background: Adolescent females face unique challenges in the age of social media, with body dissatisfaction, bullying, problems associated with sexual behaviors, and heighted rates of depression The unique considerations between adolescent males and females lead to the need for gender specific sexual risk reduction programming--especially at the early adolescent years. The curriculum, GO GRRRLS was specifically evaluated. The program focuses on the gender specific pychological, biological, and social changes that occur during early adolescence.

Methods: A total of 284 adolescents (approximately ages 11-15) youth who identified as girls or non-binary were recruited primarily from middle schools and 268 (94%) were subsequently randomized to receive either the Go Grrrls curriculum (n=135) or an active placebo control condition, the Digital Citizenship curriculum (n=133). The curriculum was offered primarily in a school-based setting, usually as an alternative lesson during the school day. All adolescents who were randomized completed intake surveys (N=268). Data from 203 adolescents comprised the analytic sample at immediate post-test. 3- and 6-month analytic samples ranged from n=199 to n=200 and n=157 to n=159, respectively, depending on the outcome. The impact study used self-administered surveys that were confidentially administered to participants. Participants were assessed at intake (pre-test), immediate post-test following completion of the curriculum, 3-month post-test, and 6-month post-test follow-up periods.

Results: Between-group analyses revealed significant differences at 3-months for all dimensions of healthy adolescent development, positive identity (p=.006, g=.35), positive coping skills (p=<.001, g=.44), focus on the future (p=.011, g=.32), peer relationship connectedness (p=.003, g=.40), independent decision making skills, (p<.001, g=.46), and sexuality (p<.001, g=.47). Between-group analyses also revealed significant differences at 6-months for nearly all dimensions of healthy adolescent development, positive identity (p=.043, g=.30), positive coping skills (p=.041, g=.29), peer relationship connectedness (p=.020, g=.36), independent decision-making skills, (p=.009, g=.40), and sexuality (p=.002, g=.47).

A significant association was also observed between the study group and one perceived sexual norm outcome at 3-months, χ2 (1) = 5.31, p=.021, with a larger percentage of adolescents randomized to the Go Grrrls program reporting they know where to find birth control if needed (85% vs. 72%). Marginally significant associations were also observed at 6-months for understanding of how to give consent to another person (Go Grrrls = 95% vs. Digital Citizenship = 87%), χ2 (1) = 3.41, p=.065 and knowing where to find birth control if needed (Go Grrrls = 82% vs. Digital Citizenship = 70%), χ2 (1) = 3.12, p=.077.

Conclusions/Implications: These efforts demonstrate program development, rigorous evaluation, and dissemination of a sexual risk reduction program. The results of earlier studies and the current study suggest effectiveness for this prevention study. Strong implementation data, implementation in a variety of settings, and the significance of multiple outcomes show promise for greater dissemination of the program.