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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 and 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.

Economic Evidence

Two studies qualified for the economic review that applied youth development and community service as part of multicomponent strategies. Monetary values are reported in 2007 U.S. dollars.

  • Both studies assessed the economic impact of pregnancies prevented due to the interventions.
  • Based on the evidence from these two studies, the interventions appear to be cost beneficial with net benefits ranging from $204 to $1127 per person per year.
    • Program costs ranged from $699 to $764 per person per year.
    • Benefits from pregnancies prevented ranged from $903 to $1891 per person per year.

Supporting Materials

Publication Status

Full peer-reviewed articles of this systematic review will be posted on the Community Guide website when published. Subscribe External Web Site Icon to be notified when we post these publications or other materials. See our library for previous Community Guide publications on this and other topics.


The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.

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. Last updated: MM/DD/YYYY.

Review completed: October 2007