Evaluation of a sexuality education program for young adolescents in Jamaica
Despite their increasing numbers, few of the sexuality education and pregnancy prevention programs in developing countries have been evaluated. This study, conducted in 19951997, assesses the impact of a schoolbased sexuality education program, the Grade 7 Project, on 945 Jamaican seventh graders (aged 1114) and their initiation of sexual activity and use of contraception at first intercourse, as well as the knowledge and attitudes that influence their behaviors. Using a quasiexperimental design, the study measured the effects of the Grade 7 Project when the ninemonth intervention was completed (short term) and one year after that (long term). Multivariate logistic regression analysis indicated that the project had no effect on initiation of sexual activity, but it had a positive shortterm impact on use of contraception at first intercourse (P = 0.08); adolescents in the intervention group were more than twice as likely to use contraception. The project also had a positive shortterm influence on several aspects of the adolescents' knowledge of and attitudes about sexuality and pregnancy. The modest impact of the Grade 7 Project is encouraging, as schoolbased sexuality education programs of limited duration rarely have a longterm impact. Moreover, competing socioeconomic and cultural forces in Jamaica encourage early sexuality and parenthood among adolescents. The use of more participatory teaching methods and smaller class sizes might strengthen the Grade 7 Project and enhance its impact.