Focus on Teen Men: Evaluating the Effectiveness of the Wise Guys Program

Researcher-Practitioner Partnerships to Implement and Evaluate Sexual and Relationship Violence Prevention Programs for Boys and Men

Although male-focused sexual and relationship violence (SRV) prevention programs are widely promulgated, limited guidance concerning how programs should be implemented for rigorous evaluation exists. To help develop evidence for such guidance, this paper reports on 20 interviews with leaders at youth-serving community-based organizations (CBOs) and educational institutions, which are sites for male-focused SRV prevention programs. This study examined: (1) how programs can be designed to engage male participants; and (2) how youth-serving CBOs and educational institutions can partner with researchers for evaluations. Findings underscore the importance of attending to the unique needs of program participants, their parents/guardians, and host organizations.

From "Homegrown" to Research-Ready: Converting an Existing Practitioner-Developed Violence Prevention Intervention Into an Evaluable Intervention

There is an increased call for research on promising prevention programs already embedded in communities ("homegrown interventions"). Unfortunately, there is limited guidance to help researchers prepare these types of interventions for rigorous evaluation. To address this need, this article presents our team's process for revising a promising community-based sexual violence prevention intervention for rigorous research. Our extensive and iterative process of reviewing and revising the intervention was guided by evaluability assessment (EA) approaches, implementation science, and a close collaboration with our community partners. Our EA process allowed us to specify the intervention's core components and develop a "research ready" standardized curriculum with implementation fidelity assessments. We offer four lessons learned from our process: (1) even with existing materials and an extensive history of community-based delivery, community-developed programs are not necessarily research-ready; (2) close collaboration and a trusting relationship between researchers and community partners throughout the revision process ensures the integrity of core program components are maintained and implementation in diverse community settings is feasible; (3) observations of program implementation are a crucial part of the revision process; and (4) it is important to budget adequate time and resources for such revisions.

Can Teenage Men Be Targeted to Prevent Teenage Pregnancy? A Feasibility Cluster Randomised Controlled Intervention Trial in Schools

The World Health Organisation advocates a direct focus on adolescent men in reducing adolescent pregnancy; however, no trials have been conducted. This trial (ISRCTN11632300; NCT02092480) determines whether a novel Relationship and Sexuality Educational intervention, If I Were Jack, is acceptable and feasible to implement in mixed sex UK classrooms. The intervention is a teacher-delivered intervention that emphasises male alongside female  responsibility in preventing unintended pregnancies and is designed to prevent unprotected sex. The trial was a parallel-group cluster randomised controlled feasibility trial with embedded process and cost evaluation in eight secondary schools (unit of randomisation) among 831 pupils (mean age 14) in Northern Ireland, alongside a qualitative evaluation of transferability in ten schools in Scotland, Wales and England. The sampling strategy was a maximum variation quota sample designed to capture a range of school management types. Four schools were randomised to each arm and the control arm continued with usual practice. Study duration was 12 months (from November 2014), with follow-up 9 months post-baseline. Results demonstrated that the intervention was acceptable to schools, pupils and teachers, and could be feasibly implemented, cost-effectively, with minor enhancements. The between-group difference in incidence of unprotected sex (primary outcome at pupil level) of 1.3% (95% CI 0.5–2.2) by 9 months demonstrated a potential effect size consistent with those reported to have had meaningful impact on teenage pregnancy. The study responds to global health policy for a paradigm shift towards inclusion of men in the achievement of sexual and reproductive health goals in a practical way by demonstrating that a gender-sensitive as well as a gender transformative intervention targeting males to prevent teenage pregnancy is acceptable to adolescent men and women and implementable in formal education structures. If I Were Jack now merits further effectiveness testing.

Interventions to reduce risk for sexually transmitted infections in adolescents: A meta-analysis of trials, 2008-2016

BACKGROUND

Numerous studies have evaluated the efficacy of interventions to reduce risk for sexually transmitted infections in adolescents in recent years, but their global effects remain unknown since 2008, the last date of a comprehensive review of prior studies.

AIMS

This study aims at evaluating the efficacy of interventions to promote sexual health, reduce STIs and unplanned pregnancies targeted to adolescents available after 2008; and analyzing the moderators of their global efficacy.

METHODS

We searched electronic databases and manual searches of some journals focused on STIs in May 2016. The studies evaluated the efficacy of interventions to reduce sexual risk in adolescents (age range: 11-19) anywhere in the world. Effect size of the relevant outcomes for sexual risk was calculated for every study. Analyses incorporated random-effect assumptions for each outcome. The homogeneity in the results was examined with the I2 statistic and its associated 95% confident interval.

RESULTS

Data from 63 studies (59,795 participants) were analyzed for behavioral and non-behavioral outcomes. In the short term, interventions had a positive impact in sexual health-related knowledge (Hedges'g = 1.01), attitudes (g = 0.29), self-efficacy toward condom use (g = 0.22), intention to refuse sex (g = 0.56), condom use intention (g = 0.46), and condom use (g = 0.38). In the medium term, positive effects observed at the short-term were maintained, although effect size significantly decreased in all variables. In the long term, interventions improved condom use (g = 0.47). Moderators of the efficacy are discussed.

CONCLUSIONS

Sexual health promotion interventions are effective to promote sexual health through increasing condom use. Effects on non-behavioral variables tend to decrease over time, while condom use increased in the long-term. Interventions should focus on the long-term efficacy, especially in behavioral and biological measures.

Assessing the effectiveness of Wise Guys: A mixed-methods approach

Previous research with teens raised questions on the validity of survey studies with this population. As one response, our team implemented a mixed-methods study to evaluate an evidence-based, interactive curriculum, Wise Guys, that is designed to promote healthy relationships and sexual behavior in young men 14-17 years of age. The current study included a Youth Advisory Group, focus groups, and a video-journaling project to delineate teens' thoughts on the most salient aspects of Wise Guys and we used these to develop a stakeholder-informed survey instrument. The survey was administered via REDCap, a computer-based medium via phones and mobile devices. Quantitative survey analyses revealed significant positive changes in study constructs. Qualitative interpretations provided rich data that validated the survey findings. Community engagement in the research process and mixed methods may provide the infrastructure for future research and evaluation efforts related to teens.