HIV, Other STIs, and Teen Pregnancy: Youth Development Behavioral Interventions to Reduce Sexual Risk Behaviors in Adolescents Coordinated with – Work or Vocational Training

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) finds insufficient evidence to support youth development behavioral interventions coordinated with employment or vocational training to reduce sexual risk behaviors among adolescents. Evidence is considered insufficient because effect estimates were small and inconsistent across the body of evidence.

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 CPSTF 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.

The CPSTF has related findings for youth development interventions coordinated with the following:

The full CPSTF Finding and Rationale Statement and supporting documents for HIV, Other STIs, and Teen Pregnancy: Youth Development Behavioral Interventions to Reduce Sexual Risk Behaviors in Adolescents Coordinated with — Work or Vocational Training are available in The Community Guide Collection on CDC Stacks.

Intervention

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

Work or vocational training experience includes opportunities in business; health; auto mechanics and repair; heavy equipment operation; or paid work at day camps, child care centers, and parks and recreation programs. This experience provides opportunities for adolescents to interact with adults in the work place and aims to assist them in forming a positive adult identity, as well as a sense of responsibility, dependability, and punctuality.

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 5 studies (search period 1980-2008). The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to preventing HIV, other STIs, and teen pregnancy.

Study Characteristics

Study characteristics of this intervention were not assessed because CPSTF did not have enough information to determine if the intervention works.

Summary of Results

Five studies qualified for the review.

  • The included studies targeted recruited adolescents (ages 10-19 years), had some sexual risk reduction content, and had to include sexual risk behavior outcomes.
  • Self-reported pregnancy: median decrease of 0.8% (interquartile interval:-42% to 4%) among program participants (5 studies)
  • Self-reported sexual risk behaviors: mixed results (4 studies)
  • Five additional studies examined the relationship between work intensity and problem behaviors. In general, problem behaviors were associated with working more than 20 hours per week, which suggests that students who maintain higher intensity work schedules (i.e. more than half-time) during school are more likely to experience problems with emotional distress, substance abuse, and sexual risk behaviors.

Summary of Economic Evidence

An economic review of this intervention was not conducted because CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

Evidence gaps for this intervention were not assessed because CPSTF did not have enough information to determine if the intervention works.

Implementation Considerations and Resources

CPSTF did not have enough evidence to determine whether the intervention is or is not effective. This does not mean that the intervention does not work, but rather that additional research is needed to determine whether or not the intervention is effective.