Introduction
The avoidance of sexual activity among youth ensures the prevention of unplanned teen pregnancies and sexually transmitted infections (STIs). It can also promote healthy outcomes and contribute positively to the development of youth. Sexual risk avoidance education (SRAE) is a primary prevention approach that educates youth about the benefits of avoiding non-marital sexual activity and other risky behaviors. SRAE also emphasizes the importance of building life skills that promote healthy decision making, personal responsibility, self-regulation, healthy relationships, and goal setting.
This brief describes a program model for implementing sexual risk avoidance programming for youth that is research-based (Inanc et al. 2020) and also informed by the legislation authorizing SRAE grants. Mathematica developed the SRAE program model as part of a portfolio of youth-focused projects on sexual risk avoidance funded by the Administration for Children and Families within the U.S. Department of Health and Human Services and supported by ACF’s Family and Youth Services Bureau and Office of Planning, Research, and Evaluation. Purpose
The SRAE program model described in this brief identifies key content, strategies, and resources needed to design and implement SRAE programs, and the expected key outputs of implementation related to staff facilitation, curriculum delivery, and youth engagement. It also presents expected short- and longer-term outcomes for youth, along with contextual factors that might influence program implementation. The program model clarifies key elements of SRAE for grant recipients, to ensure their programs align with legislative and program requirements. The model can be used by a variety of audiences to refine curricular products, guide ongoing program improvements and research, and inform future grant opportunities.
Key Findings and Highlights
The SRAE program model identifies the range of components a program needs to meet the SRAE legislative requirements. A detailed graphical figure depicts the program model’s key components, including the inputs and outputs intended to influence outcomes related to sexual risk avoidance and other, non-sexual outcomes that reflect overall health and well-being. The overarching objectives for the program model are to educate youth to recognize the benefits and value of avoiding sex until it is part of a healthy, married relationship, and also to empower youth by building skills that promote personal responsibility, self-regulation, healthy relationships, and goal setting. Consistent with the SRAE legislation, the model suggests content in five main areas (as well as subtopics for each content area):
- Life skill building to support future goals and well-being
- Advantages of refraining from non-marital sexual activity to improve future outcomes, enhance overall health, and avoid poverty
- The importance of healthy relationships and their influence on the formation of friendships, romantic relationships, healthy marriages, and safe and stable families
- Avoidance of negative risk behaviors, such as drug and alcohol use
- Prevention of and support related to sexual coercion and dating violence
SRAE is designed to be appropriate for all youth, regardless of socioeconomic status, background, or previous sexual experience. SRAE programming is most commonly delivered in middle or high school settings via group lessons taught by professional health educators or trained facilitators. Key program features include the use of a curriculum that aligns with the program model’s content and objectives; dynamic staff with strong interpersonal skills who are committed to the SRAE approach and able to engage youth; and in-depth training and assistance that promotes high-quality facilitation. In particular, the program model highlights how SRAE program content, features, and delivery are designed to influence the factors (or short-term outcomes) that research shows offer protection against risky sexual decision making and behavior. Through well-implemented programming and by targeting these factors that are linked to the avoidance of sexual activity among youth, SRAE programming may in turn promote positive long-term outcomes that reflect overall health and well-being.
Methods
The SRAE program model is the product of an effort to synthesize and apply research findings to improve the design and implementation of SRAE programs and promote their potential effectiveness. Mathematica relied on information from three types of data sources to develop the program model. First, the team used a previously developed conceptual model that identified research-based protective and risk factors that influence sexual risk avoidance (Inanc et al. 2020). Many of these factors can potentially be modified by program interventions. The SRAE program model specifies the content and other components designed to target and influence these modifiable factors, which are included as short-term outcomes in the program model. By influencing these factors, programs may in turn influence the avoidance of sexual activity among youth and also promote other outcomes that reflect youth’s overall health and well-being.
Second, the Mathematica team held virtual interviews with over 30 individuals from the SRAE field—program practitioners, curriculum developers, technical assistance providers, and federal leaders and staff within the U.S. Department of Health and Human Services—to gather input on key program features, strategies, and content most relevant for educating and supporting youth in a manner consistent with the SRAE legislation.
Finally, the team incorporated information from a review of over 20 background documents and resources applicable to SRAE, youth-focused programming more generally, and program implementation science. These documents helped to inform the program model’s content, features and delivery system, and other program inputs and considerations.
Recommendations
The SRAE program model offers a blueprint for delivering SRAE programs in a manner consistent with the SRAE legislation and informed by research. It can serve as a helpful resource for a variety of audiences to guide program activities related to planning, monitoring, and evaluation. Moreover, it offers the field common language and an evidence-informed approach to program design and implementation. Widespread use of the program model has the potential to provide a more standard SRAE program experience across providers and for youth. It can ensure that key program components are in place, regardless of context, with the aim of providing a positive program experience and improving outcomes for all participating youth.
Citation
Blesson, Elizabeth, Alicia Meckstroth, and Heather Zaveri. (2022). “Promoting Healthy Futures for Youth: A Program Model for Sexual Risk Avoidance Education.” OPRE Report Number 2022-170. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.