Evaluation of the Heritage Abstinence Education Program: Charleston, SC 2007-2008

Jerry Raymond, Regional Director, Heritage Community Services, North Charleston, SC.
Jane Stafford, PhD, Professor, Local Evaluator, University of South Carolina Aiken, Aiken, SC. Stan Weed, PhD, Director, National Evaluator,  Institute for Research and Evaluation, Salt Lake City, UT.

Introduction

The project targets public school adolescents in two distinctly different environments, rural and urban. This is a primary intervention method that targets 12-18 year old (7-12^th grad), low-income, African American populations. The program’s goal is to increase the proportion of adolescents abstaining from sexual activity until marriage by targeting predictors (mediating variables) of adolescent sexual activity proven to have causal impact on sexual initiation.

Heritage does this by promoting abstinence as the most effective way to prevent unintended pregnancies and sexually transmitted infections, as well as encouraging the avoidance of other risky behaviors. This is a community-based approach that also involves parents, families, and community leaders. The program measures pre-post changes in these predictors and reports on outcomes derived from post surveys. During this time, Heritage Community Services obtained initial and revised approval from the National Abstinence Education Association IRB #1.

This theory based program draws from the Behavior Change Model, Social Learning Theory, Emotional Intelligence, Miller’s Typologies, and Dr. Stan Weed’s Predictors of Adolescent Risk Behavior. It emphasizes A-H compliance and medical accuracy, is delivered in public schools as a supplement to other health education classes, and requires 450 minutes of class time.

Our hypothesis is Do the mediating variable show significant change from pre- to post- test time periods?

Method

To test this hypothesis, Heritage enrolled 462 students from program schools and 286 students (12-14 year old, 7-8^th grade) from comparison schools. Program students were given a pre-survey, an intervention, and then a post-survey. Comparison students were given pre- and post-surveys without an intervention. Comparison students were not surveyed for the Independence from Peer Sexual Influence and Future Impacts of Sex Variables. Surveys for the program and comparison schools were administered on similar data collection schedules. Due to survey administration barriers at program schools, a cohort of 37 program students was selected for analysis.

Result

Six mediating variables were used to assess the program student (program effect/significance level: comparison effect/significance level):

1. Abstinence Values: Importance of abstinence until marriage and its inclusion in the student’s moral value system (0.82/<0.001: 0.08/0.152).
2. Abstinence Efficacy:  Confidence in their ability to engage in refusal skills and avoid situations that could lead to sex (0.45/<0.01: 0.09/0.112).
3. Future Impact of Sex:  The perception that sex could interfere with goals regarding education, careers, marriage, and family life (1.28/<0.001: missing from comparison group).
4. Independence from Peer Sexual Influence:  The ability to follow their own values system and personal goals, to communicate standards and values, and to reject negative peer pressure to initiate sexual activity (0.58/<0.01: missing from comparison group).
5. Justification for Sex:  Agreement with the rationalizing and justifying that student’s often engage in to legitimize their initiation into sexual activity (0.83/<0.001: -0.09/0.131).
6. Behavioral Intentions for Sex:  The level of intent and commitment to abstain from sexual activity (0.65/<0.001: -0.07/0.131).

Discussion

The student’s scores on the mediating variables showed improvement from pretest to posttest in the program group but not in the comparison group. The program group showed high significance and moderate to very large effects across all six scales, all of which were statistically significant. Significance levels for all mediators were .01 or less. The comparison group demonstrated no overall change. None of the comparison changes were statistically significant.

The results of this study suggest that a carefully developed abstinence-centered education program may affect pre-post improvement on key mediating variables related to sexual activity. The results support the premise that primary prevention efforts to influence teens towards sexual abstinence are a viable strategy.

One-year follow-up is scheduled which will allow measuring sexual behavior and sexual initiation rates to be collected over a one year period for both program and comparison schools.