Sexual Health

Adapting a Sexual Health Intervention for Adolescents Exposed to Adversity: Feasibility Study.

TL;DR

Recruiting, retaining, and engaging participants in an adapted Focus on Youth with Informed Parents and Children Together intervention for Black youth exposed to adversity is feasible, with high session attendance and assessment completion rates, though no changes in sexual health behaviors or partner communication were observed.

Key Findings

The adapted sexual health intervention demonstrated feasibility with high participant retention across all three assessment points.

  • 61 youth aged 13-16 years were recruited and randomized to intervention (n=33) or control (n=28) conditions
  • 87% (53/61) of participants completed all 3 assessments: baseline, posttest, and 3-month follow-up
  • Participants were recruited from 3 sites in Baltimore, Maryland
  • 121 youth were screened to yield 61 enrolled participants
  • Data were collected between January 2022 and April 2023

Participant engagement with the adapted intervention was high across session attendance and post-session feedback measures.

  • 80% (48/61) of participants attended at least 3 sessions
  • 75.2% (115/153) of after-session responses indicated participants would recommend a session to a friend
  • Recruitment was conducted via school and community presentations, digital flyers, and referrals

The intervention group showed a significant increase in sexual health knowledge compared to control.

  • Sexual health knowledge was measured as a secondary outcome
  • The intervention group showed a statistically significant increase in sexual health knowledge
  • No changes in sexual health behaviors or partner communication were observed in either group
  • Pregnancy intentions were also assessed as a secondary outcome but no significant changes were reported

Among participants who reported sexual activity, high rates of abstinence from substance use before sex were observed.

  • 18 of the 61 participants reported having any sex during the study period
  • All 18 (100%) of sexually active participants abstained from alcohol use before sex
  • 12 of 18 (67%) sexually active participants abstained from drug use before sex

The study targeted Black youth exposed to household challenges, adapting the Focus on Youth with Informed Parents and Children Together (FIYIPACT) intervention for this specific population.

  • The intervention was characterized as a selective intervention considering lived experiences and local context
  • Youth exposed to adversity are identified as among groups most vulnerable to sexual risk-taking in adolescence
  • The study was funded by the National Institutes of Health
  • ClinicalTrials.gov registration: NCT05033821
  • The findings will inform redesign of assessments to capture additional factors affecting sexual health behaviors

What This Means

This research suggests that a sexual health education program adapted specifically for Black teenagers who have experienced difficult home situations can successfully recruit and keep participants engaged. The study enrolled 61 young people aged 13-16 in Baltimore and found that 87% completed all study check-ins over several months, and 80% attended most program sessions. Three-quarters of post-session surveys indicated participants liked the sessions enough to recommend them to friends, suggesting the program content felt relevant and acceptable to this group. This research suggests the program improved participants' knowledge about sexual health, though it did not appear to change actual sexual behaviors or how young people communicated with partners about sex. Among the smaller group of teens who reported being sexually active, all of them said they had not used alcohol before sex, and most said they had not used drugs before sex — though the study was not designed to definitively determine whether the program caused these outcomes. This matters because young people who have faced adversity at home are known to be at higher risk for sexual health challenges during adolescence, yet few programs are specifically designed with their experiences in mind. This feasibility study shows that reaching and keeping this group engaged in a tailored program is achievable, which is an important first step before testing whether the program can actually reduce sexual risks. The researchers note that future studies will need better measurement tools to capture the full range of factors influencing sexual health in this population.

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Citation

Powell T, Smith B, Moser N, Kachingwe O, Lewis Wallace Q, Offiong A, et al.. (2026). Adapting a Sexual Health Intervention for Adolescents Exposed to Adversity: Feasibility Study.. JMIR formative research. https://doi.org/10.2196/72782