Youth Development Behavioral Interventions Coordinated with Community Service to Reduce Sexual Risk Behaviors in Adolescents

Youth development behavioral interventions employ a holistic approach to adolescent health and wellness, and may or may not include components that are focused directly on pregnancy and STI prevention. These interventions emphasize:

• Social, emotional, or cognitive competence training that promotes pro-social norms
• Improved decision making
• Self-determination
• Improved communication skills
• Positive bonding experiences between youth and their peers or non-parental role models

Community service may involve scheduled activities in one or more community settings such as nursing homes, hospitals, and homeless shelters. This experience provides extended opportunities for adolescents to interact with adults in the community and have a sense of membership in a group with explicit rules and responsibilities.

Summary of Task Force Recommendations & Findings

The Community Preventive Services Task Force recommends youth development focused behavioral interventions coordinated with community service on the basis of sufficient evidence that these combined approaches are effective in reducing sexual risk behaviors in participating adolescents.

All of the interventions evaluated in this review included sexual behavior or risk reduction content as part of the behavioral intervention, although the emphasis on this component varied. The Task Force acknowledges that this review, focused on the subset of intervention studies that evaluated change in sexual risk behavior outcomes, does not provide a complete, systematic assessment of all of the evidence regarding overall effectiveness of these combined approaches.

Results of the Systematic Reviews

Nine studies qualified for the review.

• The included studies targeted recruited adolescents (ages 10–19 years).
• Rate of pregnancy: median relative decrease of 39% (interquartile interval: -59% to -9%) over a median of 9 months of observation (6 studies)
• Self-reported sexual activity among study participants: reductions in favor of the intervention (3 studies)
• Use of birth control or condom use: inconsistent results (3 studies)
• Initiation of sexual intercourse: inconsistent results (3 studies)
• All interventions included in this review had some sexual risk reduction content.
• To be included in the review, studies had to include sexual risk behavior outcomes.
• These interventions were effective in rural, suburban, and urban U.S. communities for disadvantaged participants (students of low economic status, from racial or ethnic minorities, or from schools with low graduation rates or test scores).
• Further research is required to assess the effectiveness of these interventions on use of birth control, use of condoms and on initiation of sexual intercourse.
• Among included studies, the content and delivery differed, but most studies used interactive group sessions held in school or community settings.

These results were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to adolescent sexual behavior and youth development.

Supporting Materials

• Summary evidence tables [PDF - 107KB]
• Included studies
• Search strategy

Publications

The findings and results of this systematic review have not been published. Read other Community Guide publications about the Prevention of HIV/AIDS, other STIs and Pregnancy in our library. You may also subscribe to be notified as new materials on this topic become available.

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Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Guide to Community Preventive Services. Sexual Behavior: youth development behavioral interventions coordinated with community service to reduce sexual risk behaviors in adolescents. www.thecommunityguide.org/hiv/youthdev-community.html. Last updated: MM/DD/YYYY.

Review completed: October 2007