Washington State Institute for Public Policy

School-based sexual education
Public Health & Prevention: School-based
Literature review updated April 2012.

School-based sex education curricula provide information about, and instruct students in, skills for sexual abstinence, Many programs also provide students information about birth control and ways to protect against sexually transmitted diseases (STD). We did not include programs that focused only on HIV or STD risk reduction because we focused on the prevention of teen pregnancy. We analyzed 14 studies of abstinence-only programs and comprehensive sexual health programs and found no significant differences (p=0.65) in effects on teens initiating sexual activity; only comprehensive programs measured pregnancy outcomes. Usually the programs lasted less than two months, however, a few were offered over two school years. Students were typically middle school- to early high school-age and most programs were led by teachers who received training in the curriculum. An exception was abstinence-only programs, which were usually offered by trained outside facilitators and trained student peer-leaders. Programs in our meta-analysis included Draw the Line/Respect the Line (Coyle 2004), Safer Choices (Coyle 2001), Reducing the Risk (Barth 1992), Sexual Health and Relationships (Henderson 2007), Promoting Health Among Teens comprehensive education (Jermmott 2010), Project Taking Charge (Jorgenson 1991), McMasters Teen Program (Mitchell-DiCenso 1997), Randomized Intervention Trial of Pupil Led Sex Education (Stephenson 2008), It’s Your Game: Keep It Real (Tortolero 2009), Managing Pressures Before Marriage (Blake 2001), For Keeps (Borawski 2005), Skills and Knowledge for AIDS and Pregnancy Prevention (Kirby 1997), and abstinence education (Treholm 2007).

META-ANALYSIS	CITATIONS

**Meta-analysis** is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The **outcomes** measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). **Treatment N** represents the total number of individuals or units in the treatment group across the included studies.

An **effect size** (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases.

**Adjusted effect sizes** are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the **first time ES is estimated** and the **second time ES is estimated**. We also report the **unadjusted effect size** to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.
Meta-Analysis of Program Effects
Outcomes measured	Primary or secondary participant	No. of effect sizes	Treatment N	Adjusted effect sizes (ES) and standard errors (SE) used in the benefit-cost analysis						Unadjusted effect size (random effects model)
				First time ES is estimated			Second time ES is estimated			Unadjusted effect size (random effects model)
				ES	SE	Age	ES	SE	Age	ES	p-value
Initiation of sexual activity	Primary	8	5474	-0.024	0.064	15	-0.024	0.064	25	-0.063	0.410
Teen pregnancy (under age 18)	Primary	4	6130	0.121	0.080	17	0.121	0.080	27	0.102	0.029

Citations Used in the Meta-Analysis

Barth, R.P., Leland, N., Kirby, D., & Fetro, J.V. (1992). Enhancing social and cognitive skills. In B. C. Miller, J. J. Card, R. L. Paikoff, & J. L. Peterson (Eds.), Preventing adolescent pregnancy: Model programs and evaluations (pp. 53-82). Thousand Oaks, CA: Sage.

Blake, S.M., Simkin, L., Ledsky, R., Perkins, C., & Calabrese, J.M. (2001). Effects of a parent-child communications intervention on young adolescents' risk for early onset of sexual intercourse. Family Planning Perspectives, 33(2), 52-61.

Borawski, E.A., Trapl, E.S., Lovegreen, L.D., Colabianchi, N., & Block, T. (2005). Effectiveness of abstinence-only intervention in middle school teens. American Journal of Health Behavior, 29(5), 423-434.

Coyle, K., Basen-Engquist, K., Kirby, D., Parcel, G., Banspach, S., Collins, J., . . . Harrist, R. (2001). Safer choices: Reducing teen pregnancy, HIV, and STDs. Public Health Reports, 116(Suppl. 1), 82-93.

Coyle, K.K., Kirby, D.B., Marin, B.V., Gomez, C.A., & Gregorich, S.E. (2004). Draw the line/respect the line: A randomized trial of a middle school intervention to reduce sexual risk behaviors. American Journal of Public Health, 94(5), 843-851.

Jemmott, J., Jemmott, L., & Fong, G. (2010). Efficacy of a theory-based abstinence-only intervention over 24 months: A randomized controlled trial with young adolescents. Archives of Pediatrics and Adolescent Medicine, 164(2), 152-159.

Jorgensen, S.R., Potts, V., & Camp, B. (1993). Project Taking Charge: Six-month follow-up of a pregnancy prevention program for early adolescents. Family Relations, 42(4), 401-406.

Kirby, D., Korpi, M., Adivi, C., & Weissman, J. (1997). An impact evaluation of project SNAPP: An AIDS and pregnancy prevention middle school program. AIDS Education and Prevention, 9(Suppl. 1), 44-61.

Mitchell-DiCenso, A., Thomas, B.H., Devlin, M.C., Goldsmith, C.H., Willan, A., Singer, J., . . . Hewson, S. (1997). Evaluation of an educational program to prevent adolescent pregnancy. Health Education & Behavior, 24(3), 300-312.

Stephenson, J., Strange, V., Allen, E., Copas, A., Johnson, A., Bonell, C., . . . the RIPPLE study team. (2008). The long-term effects of a peer- led sex education programme (RIPPLE): A cluster randomised trial in schools in England. PLoS Medicine, 5(11). doi: 10.1371/journal.pmed.0050224

Tortolero, S.R., Markham, C.M., Peskin, M.F., Shegog, R., Addy, R.C., Escobar-Chaves, S.L., & Baumler, E.R. (2009). It’s your game: Keep it real: Delaying sexual behavior with an effective middle school program. Journal of Adolescent Health, 46(2), 169-179.

Trenholm, C., Devaney, B., Fortson, K., Quay, K., Wheeler, J., & Clark, M. (2007). Impacts of four Title V, Section 510 abstinence education programs: Final report (Document No. PR07-07). Princeton, NJ: Mathematica Policy Research.