High School Intervention Increases Condom Usage

Talking with a friend today, it came to my attention that most people begin sexual exploration and experimentation in their high school years. Thus, it comes as no surprise that a new report released in August 2009 in Archives of Pediatrics & Adolescent Medicine shows success in a new inexpensive intervention aimed at promoting healthy relationships in high school. This new program combines information about developing strong relationships with the current curriculum for 9th grade students. It has demonstrated success in reducing episodes of violence in dating and increasing the use of contraceptives like condoms for years after. While the program was an overall success, it appeared to have a stronger effect amongst the male teenagers.

The report shows that approximately 10% to 20% of high school teenagers experience dating violence, including being slapped, beaten or hit by their partner. When a teenager experiences dating violence at this age, it often leads to violence in intimate relationships as adults. In addition, it can also lead to unsafe sexual practices, drug use, injuries or suicidal tendencies. David A. Wolfe from the University of Toronto along with colleagues studied the results of a three year trial (2004 to 2007) that involved a curriculum that instituted 21 lessons taught by teachers that had been given training on developing healthy relationships and the repercussions of violence in dating.

Close to 1000 students at 10 different high schools were introduced to the program called the “Fourth R: Skills for Youth Relationships.” According to the report, “Dating violence prevention was integrated with core lessons about healthy relationships, sexual health and substance use prevention using interactive exercises. Relationship skills to promote safer decision making with peers and dating partners were emphasized.” Over 750 high school students from 10 other high schools were in the control group. These students had an emphasis of similar topics but there were no materials handed out and no special training was given.

Over two years after the study (once these students were in 11th grade), these participants were given a survey. Those students in the control group had a higher rate of violence in dating (9.8% compared to 7.4% in those students who were participants in the actual program). The program seemed to positively affect the male high school students more. 7.1% of boys in the control group reported violence in dating compared to 2.7% of boys in the actual program. 12.1 % of the girls in the control group had reports of dating violence compared to 11.9% of the girls in the intervention program. Boys who participated in the intervention program who were also sexually active also reported higher condom usage (67.9%).

What makes this intervention program more appealing is the fact that it has such a low cost attached to it. In fact, it cost about $16 per student in Canada since there were no additional resources (time or human) needed. The report states, “The present evaluation of the Fourth R: Skills for Youth Relationships suggests that methods developed for single-focused interventions (e.g., skills-based, interactive delivery) can be combined effectively from a core relationship perspective. As in related trials, teachers with supplementary training can implement evidence-based prevention programs with sufficient fidelity and effectiveness to garner significant improvements over status quo classroom methods.”