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Background: Missouri Personal Responsibility Education Program (PREP) provides sexual health education programs to youth with goals of reducing unintended teen pregnancies. Theories of change provide that youth improve their sexual health knowledge, intentions, attitudes, and behaviors as a result of program implementation. Program evaluations are needed to assess the degree to which PREP programs are meeting their goals of improving youth outcomes. Objective: The purpose of this study is to examine youth sexual intentions to use a condom, engage in sexual behavior, and abstain from sex as a result of Missouri PREP program implementation. We evaluate the effectiveness of the Missouri program in modifying youth intentions toward healthier planned behaviors. Method: All programs required youth to take pre- and post-program surveys. For this study, we evaluate a sample of 1335 youth's pre- and post-survey intentions related to condom use, sex, and abstention. We utilize t-tests as well as a lagged logistic regression approach to account for youth's respective pre-intentions. Results: Youth's scores on intentions, knowledge, and attitudes rise from pre- to post-survey. Knowledge gains are salient while attitudes remain relatively high and stable. Intentions to use condoms differ from those in intentions to have or abstain from sex. Program change in intentions to use a condom are highest among the three intention outcomes. Conclusions: Missouri PREP saw improvements in knowledge, attitudes, and intentions as a result of program implementation. Findings suggest that the Missouri PREP program is effective at positively influencing youth intentions to engage in risky or sexual behavior.

Objective: Our study assesses how women and men's health indicators are shaped by their spouse's retirement. Background: The retirement process can reshape the health of a retiree, but these effects can also extend onto the health of spouses. Although past research has largely focused on how men's retirement might negatively shape their wife's health outcomes, it is possible that wives' retirement has detrimental effects on their husband's health as well. Method: Using data from the Health and Retirement Study (HRS), we employ a fuzzy regression discontinuity design to identify the causal effects of spousal retirement on indicators of physical and mental health in married older adults. Results: Our results suggested that men, not women, experience the most negative spousal spillover effects of retirement on their health outcomes. We found the most support for spillover effects on spouses' physical health outcomes. Additionally, men who are not working when their spouse retires experienced the most negative health effects. Conclusion: Women and men's health is differentially affected by spousal retirement, where men might be the most negatively affected by their spouses' transition in the US context. These results contradict conventional wisdom that undergirds numerous untested assumptions underlying prior research on this significant life transition. [ABSTRACT FROM AUTHOR]

In recent decades, naturalization rates among U.S. immigrants have surged as many seek citizenship to regain lost rights and protections. However, the impact of naturalization on immigrants’ life outcomes, such as health, remains underexplored in academic research. Challenges arising from selection processes complicate the interpretation of any observed health disparities between naturalized citizens and noncitizens. To address this gap, we link restricted-use data from the 2000 U.S. census to individual Social Security records on citizenship change and death, enabling a 20-year observation of naturalization and mortality. Results from discrete-time hazard analysis of mortality risk reveals a significant protective health effect from naturalization, which increases in magnitude among long-term naturalized citizens. The effect is particularly strong across older ages and among groups with lower education, refugee entry status, Hispanic origin, and health limitations. These findings suggest that naturalization represents an important but stratifying source of institutional support for socially vulnerable immigrants. [ABSTRACT FROM AUTHOR]