Targeted High-Risk Youth in Missouri PREP: Understanding Program Impacts on Youth Sexual Behavior Intentions

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.