Families’ Trust, a School-based Abstinence Education Prevention Program

Darcy Richardson BA, LeCroy & Milligan Associates
DeeAnn Arroyo, Pima Prevention Partnership

Introduction

Families’ Trust is a multifaceted, school-based abstinence education prevention program designed to delay the onset of adolescent sexual behavior among sixth grade students attending five middle schools, in Tucson, Arizona, through a combination of classroom education, parent and family support, and community norming that promotes abstinence and supports and strengthens the role of parents in adolescent decision-making. The six complementary components are: (1) a 10-session abstinence education curriculum; (2) 2-hour parent education classes; (3) 24-hour Family Strengthening classes; (4) family resource toolkits; (5) access to a Master’s level counselor; and (6) cultural events. The current literature, studying risk and protective factors related to adolescent sexual activity, indicates that when there is high family connectedness, along with parental supervision and clear expectations regarding maintaining abstinence, there is a significantly reduced likelihood of premarital sex. The program evaluation will assess whether students whose parents receive the parent education interventions demonstrate more positive outcomes as compared to students whose parents do not receive any parent education. Evaluation is based on the following four identified Youth Outcome Objectives: (1) increased mastery of perceived knowledge sets regarding the physical, social, and emotional consequences of sexual activity; (2) increased mastery of prevention skills related to avoiding sex (e.g. refusal skill, decision-making, and goal-setting skills); (3) stronger beliefs in abstinence; and (4) increased intention to remain sexually abstinent.

Methods

A rigorous group randomized trial design was selected for the evaluation of the Families’ Trust program and fully approved by local IRB. Five schools were chosen for the study based on the high population of at-risk students they serve and existing program relationships.  All 6^th grade students at these schools, whose parents consent to their participation, will receive 10 hours of abstinence education. The focus of this study is on the impact of parent and family education on the sexual decision-making of youth, thus the parent components are the basis of the school and individual level group randomized trial design. The five schools have been randomly assigned to either the treatment or control group.  The three treatment schools will receive additional parent interventions, and the other two schools will not.  Families in the treatment schools who complete the two-hour parent class will also be offered the opportunity to participate in the Family Strengthening study. Of the estimated 80 self-selected families interested in participating, half will be randomly assigned to receive an intensive 24-hour Family Strengthening class and half will receive no additional components.  Thus, there are three study conditions: 1) students who have received the 10-hour abstinence education classes only; 2) students whose parents also receive some brief interventions and resources (including a 2-hour workshop); and 3) students whose parents go on to receive the Family Strengthening program. 

Pre-program, post-program and 18- and 24-month follow-up surveys of students using the CORE instrument will be conducted in school and used to statistically compare outcomes in the three different study conditions. Progress toward the above stated Youth Outcome Objectives will be looked at over time using a longitudinal data structure.  Parent surveys will also be used to assess differences between the study groups and to assist in determining the effect of program components on knowledge of abstinence education strategies, household rules and consequences, and communication. Analyses will include methods to test for significant change from pretest to posttest and at subsequent data points. A taxonomy of nested models will be used to selectively introduce control and predictor variables.  Logistic and regression analysis will be used depending on the nature of the outcome variable in question.  Interactions across main effects will be tested. Specific tests have not yet been determined.

Results

The Families’ Trust program completed its first year of implementation in the spring of 2008. Thirty-eight 10-hour youth abstinence classes were conducted, with 710 students completing the course.  Of these students, 577 completed pre- surveys and 569 completed post surveys.  Thus, 81-82% of students participating in the class consented, assented, and provided a survey for entry at each time point.   Survey data is currently being analyzed, with initial quantitative findings toward program objectives available for presentation at the December AFL conference.  Teacher survey data identified the following as the primary information or skills youth gained from participation in the program: healthy decision-making, possible consequences of sexual behavior, self-knowledge and personal growth, and relationship skills.  Teachers noted minimal challenges, which primarily focused on the short implementation time frame at the end of the school year. Due to time constraints related to acquiring initial IRB and evaluation design approval, it was not feasible to implement all of the parent components in year one.  Two parent 2-hour workshops were completed, with 10 parents participating. Eighty percent of these parents expressed interest in participating in the Family Strengthening program. A parent advisory group is currently being formed at each school to assist with the design of a Parent Toolkit and cultural events, to continue to strengthen support for the program with schools and families, and to provide feedback to program/evaluation staff.  The Families’ Trust program began its second year of implementation in September 2008, with all youth programs scheduled to be completed by the end of the calendar year. The Family Strengthening program will be the focus of the spring 2009 semester. 

Discussion

Initial findings for year one suggest that the Families’ Trust program was successful in obtaining parental consent for youth participation and was able to implement the youth classes.  The school staff and teachers were very supportive, likely due to pre-existing positive working relationships with Pima Prevention Partnership.  Program teachers were able to conduct the youth and parent classes with limited challenges, most of which were based on the time constraints of beginning the program later in the spring semester.  Analysis of year one survey data will begin to inform program progress toward stated youth objectives.  Regarding the parental components, the ten parents who were able to participate in the 2-hour program were engaged and interested in participating in the Family Strengthening program.  This finding helps alleviate initial concerns in the evaluation design regarding recruitment of a sufficient number of participants into the intensive, 24-hour Family Strengthening program.  Parent recruitment efforts will concentrate on the two-hour classes. The Parent Advisory group at each school will play an important role in these and other aspects of the project.

Implications

Current literature in the field of adolescent pregnancy prevention suggests that parent education can help to increase parental knowledge of how to implement abstinence strategies, their skill at establishing and maintaining developmentally appropriate household rules and consequences, and their ability to communicate with their children about sexual decisions.  Parental involvement may be critical to the ability of the youth to delay sexual behavior. Findings from the evaluation of the Families’ Trust program will help to inform the field of adolescent health on some best practices in adolescent pregnancy prevention, more specifically on the importance of parent involvement and interventions.

Contact Person
DeeAnn Arroyo
Telephone: (520) 326-2528, ext.2107
Email Address: darroyo@thepartnership.us