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Each of the studies measured effects on teens throughout the community, not just on those teens directly served by programs. To date, there are only three studies of abstinence programs that meet reasonable scientific criteria. Some curricula also provided more detailed information about how to use condoms correctly. Effective programs provided modeling of, and practice with, communication, negotiation, and refusal skills.

Effective programs lasted a sufficient length of time to complete important activities. The second program with positive effects was similar to Project Action. Centers for Disease Control and Prevention. Nevertheless, because of the need to identify programs that reduce sexual risk-taking behavior, michael dameski nigel lythgoe dating these more demanding criteria are used in research studies and in this review.

On a one-to-one basis, the physician then reviewed the risk assessment with the patient and discussed concerns and methods of avoiding unprotected sex. Links Introduction Many adolescents engage in sexual intercourse with multiple partners and without condoms. Impact of Education Programs Before examining the impact of these programs, two considerations should be made. Furthermore, most of the interventions were not based upon theory, addressed few of the risk and protective factors associated with adolescent sexual risk-taking, and were very modest.

Effective programs provided basic information that students needed to assess risks and avoid unprotected sex. The evidence on these initiatives is mixed. Notably, condom use increased among all three groups over the six-month time period. First, the differences in results could be caused by differences in the research methods.

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Some of these programs have been effective at changing behavior, while others have not. Effective programs included activities that address social pressures that influence sexual behavior. Among both males and females, the risk category was often unidentified. And when they work in small groups, instructors may be able to involve the students more completely, to tailor the material to each group, and to cover more material and more concerns more quickly. At the very least, these studies suggest that clinic-based interventions should be further developed and rigorously evaluated.

They reflect the considerable creativity and differing perspectives of these agencies. Because these programs encourage discussion of sexuality between adolescents and their own parents, they avoid controversy that sometimes thwarts the implementation of other effective programs. Adolescent Sexual Risk-Taking Behavior In many countries throughout the world, sexually transmitted disease and unplanned pregnancy have always occurred among adolescents. Consequently, programs have been developed to increase this communication and thereby to decrease adolescent sexual risk-taking behavior. All of these activities improved student involvement in the program, promoted active awareness of the issues, and helped students integrate the information into the context of their own lives.

Activities in their programs then focused on those particular antecedents. Similarly, female teenagers have the highest age-specific rate of gonorrhea, whereas male teenagers have the third highest rate. The first effective intervention included a large, comprehensive social marketing campaign in Portland, Oregon called Project Action.

Among students in grades across the U. Additional, rigorous evaluations of abstinence-only programs are currently under way. Sometimes these networks do not connect with each other. Some of them also addressed peer norms about having sex or using condoms. In fact, in two studies, condom availability was associated with reduced sexual activity.

Instructors reached students by engaging them in the learning process, not through didactic instruction. These results suggest that to be effective for lengthy periods of time, community-wide initiatives need to be intensive and must be sustained. It should be noted that other studies have found that certain brief clinic interventions can increase contraceptive use.

Thus, short programs those lasting only a few hours or less did not appear to be effective, whereas longer programs that had many activities had a greater effect. Second, the differences in results could be caused by differences in the communities and in student needs.

Other groups believe that condoms and contraception should be covered in a medically accurate manner. Effective programs were based on theoretical approaches that have been demonstrated to be effective in influencing other health-related risky behaviors.

More specifically, these studies indicated that these prevention programs did not increase any measure of sexual activity. Studies of these programs have produced three general conclusions.

In combination, these studies consistently demonstrate that comprehensive community programs do not increase sexual behavior, even when they focus primarily on condom use. Less encouraging are the results from three studies of similar programs in Seattle and Boston. In general, it requires considerable time and multiple activities to change the most important antecedents of sexual risk-taking and to thereby have a real influence on behavior.

To the extent possible, they tried to use group activities to change group norms about what was the expected behavior. For example, history or civics classes are not evaluated by measuring their impact on voting, law breaking, or better citizenry. Thus far, three studies have measured the impact of these one-on-one education or counseling programs on condom use. Typically, this information was not detailed or comprehensive.

Thus, more theory-based and more intensive parent programs might be more effective. Abstinence Programs Abstinence programs focus upon the importance of abstinence from sexual intercourse, typically abstinence until marriage. This particular characteristic appeared to be one of the most important criteria that distinguished effective from ineffective curricula.

The second study evaluated a relatively modest intervention for female patients with chlamydia. First, these programs face a daunting challenge.

The fact that two of these studies found positive effects on behavior with such brief, modest interventions is encouraging. These effective programs have a number of identifiable characteristics in common that may serve as guideposts for future interventions. In some communities, proponents of abstinence-only approaches are willing to discuss condoms and other forms of contraception, but only if their failure rates are emphasized. Sometimes they target some of the highest risk groups, such as street youth.

Unfortunately, not many of these efforts have been studied nationwide. These high-risk groups are somewhat bounded by social networks, but this may change. If any or all of the effective programs are implemented more broadly, they can have a modest impact upon reducing adolescent sexual risk-taking behavior. These activities took a variety of forms.

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These networks are often defined by ethnicity, class, geographic location, and other socially defined norms. Effective programs incorporated behavioral goals, teaching methods, and materials that were appropriate to the age, sexual experience, and culture of the students. However, condom use varies with urban area, age, ethnicity, gender, and involvement in other risk-taking behaviors, and this national average obscures wide variations in different groups.

Nearly every activity was directed toward the behavioral goals. For example, several curricula discussed situations that might lead to sex. Finally, programs should address drug use and needle sharing.

In addition, particular groups of adolescents eg, males who have sex with males, injection drug users, and teens who have sex for drugs engage in even greater risk-taking behavior. The findings regarding impact on condom use were mixed.