Cooperative Agreement TP2AH000084

RIGOROUS EVALUATION OF THE TEEN TALK HIGH SCHOOL REFRESHER - ETR, ALONG WITH OUR IMPLEMENTATION PARTNER HEALTH CONNECTED, PROPOSE THE RIGOROUS EVALUATION OF THE TEEN TALK HIGH SCHOOL REFRESHER (TTHSR) BOOSTER PROGRAM, DESIGNED TO EQUIP STUDENTS IN 11TH AND 12TH GRADE WITH THE KNOWLEDGE AND SKILLS NECESSARY TO MAKE INFORMED SEXUAL HEALTH DECISIONS AS THEY TRANSITION FROM HIGH SCHOOL INTO ADULTHOOD. THE OVERALL GOAL OF THIS PROJECT IS TO TEST THE EFFECTIVENESS OF TTHSR IN PREVENTING BEHAVIORAL RISK FACTORS UNDERLYING UNINTENDED TEEN PREGNANCY AND SEXUALLY TRANSMITTED INFECTIONS AMONG YOUTH LIVING IN RURAL COMMUNITIES IN CALIFORNIA. USING A RIGHTS-BASED, SOCIAL JUSTICE-INFORMED APPROACH, TTHSR FOCUSES ON HEALTHY RELATIONSHIPS AND SELF-ADVOCACY IN A CONSOLIDATED 5-HOUR INTERVENTION. THE TTHSR EVALUATION WILL USE A GROUP RANDOMIZED CONTROLLED TRIAL DESIGN TO EVALUATE THE IMPACT OF THE TTHSR CURRICULUM ON PREGNANCY PREVENTION AND SEXUAL HEALTH BEHAVIORS AMONG YOUTH IN GRADES 11 AND 12 (ROUGHLY AGES 16-18). THE STUDY TEAM (ETR AND HEALTH CONNECTED) AND THEIR PARTNERS WILL RECRUIT 20 SCHOOLS FROM WITHIN RURAL COUNTIES IN CALIFORNIA AND INVOLVE APPROXIMATELY 1,500 STUDENTS. YOUTH IN SCHOOLS RANDOMIZED TO THE TREATMENT CONDITION WILL RECEIVE THE 5-HOUR TTHSR CURRICULUM OVER 5 CONSECUTIVE DAYS, IMPLEMENTED BY TRAINED EDUCATORS. WE WILL SURVEY ALL ELIGIBLE YOUTH WHO PROVIDE CONSENT TO PARTICIPATE IN THE STUDY AT BASELINE (BEFORE IMPLEMENTATION) AS WELL AS 6- AND 12-MONTHS POST-BASELINE. WE HAVE IDENTIFIED ONE PRIMARY AND THREE SECONDARY CONFIRMATORY RESEARCH QUESTIONS TO GUIDE OUR STUDY: (PRIMARY) WHAT IS THE IMPACT AT 6-MONTHS POST-BASELINE OF TTHSR RELATIVE TO A "BUSINESS AS USUAL" COMPARISON CONDITION ON THE PROPORTION OF YOUTH WHO SELF-REPORT THEY EITHER DID NOT HAVE VAGINAL OR ANAL SEX OR USED CONDOMS OR EFFECTIVE BIRTH CONTROL WHEN THEY HAD VAGINAL OR ANAL SEX IN THE PAST 90 DAYS? EFFECTIVE BIRTH CONTROL IS DEFINED AS ALL HORMONAL AND LONG-ACTING METHODS IN ADDITION TO TUBAL LIGATION AND VASECTOMY. (SECONDARY) WHAT IS THE IMPACT AT 6-MONTHS POST-BASELINE OF TTHSR RELATIVE TO A "BUSINESS AS USUAL" COMPARISON CONDITION ON THE PROPORTION OF YOUTH WHO SELF-REPORT IMPROVED SELF-EFFICACY FOR SELF-ADVOCATING WITH HEALTHCARE PROVIDERS, PEERS, AND PARTNERS ABOUT THEIR SEXUAL HEALTH AND SEXUALITY? (SECONDARY) WHAT IS THE IMPACT AT 6-MONTHS POST-BASELINE OF TTHSR RELATIVE TO A "BUSINESS AS USUAL" COMPARISON CONDITION ON THE PROPORTION OF YOUTH WHO SELF-REPORT IMPROVED SELF-EFFICACY TO FIND AND ACCESS SEXUAL HEALTH SERVICES? AND (SECONDARY) WHAT IS THE IMPACT AT 12-MONTHS POST-BASELINE OF TTHSR RELATIVE TO A "BUSINESS AS USUAL" COMPARISON CONDITION ON THE PROPORTION OF YOUTH WHO SELF-REPORT THEY EITHER DID NOT HAVE VAGINAL OR ANAL SEX OR USED CONDOMS OR EFFECTIVE BIRTH CONTROL WHEN THEY HAD VAGINAL OR ANAL SEX IN THE PAST 90 DAYS? THE PROPOSED EVALUATION OF TTHSR IS INNOVATIVE IN THAT IT WILL ADDRESS MULTIPLE GAPS IN EXISTING EVIDENCE-BASED PROGRAMS INCLUDING: FOCUSING ON AN UNDERSERVED POPULATION OF RURAL YOUTH; PROVIDING SEXUAL HEALTH EDUCATION DESIGNED FOR OLDER ADOLESCENTS WHO ARE CLOSER TO ADULTHOOD AND MORE LIKELY TO BEGIN ENGAGING IN SEXUAL ACTIVITY; TESTING A BOOSTER PROGRAM IN A CONSOLIDATED FORMAT TO BUILD ON SEXUAL HEALTH EDUCATION YOUNG PEOPLE HAVE ALREADY RECEIVED; AND ADDRESSING TOPICS RELEVANT TO YOUNG PEOPLE'S DEVELOPMENT BY USING A RIGHTS-BASED, SOCIAL JUSTICE LENS.