A Group Randomized Controlled Trial of Relationships Under Construction Sexual Risk Avoidance Education

J Sch Health. 2024 Feb 21. doi: 10.1111/josh.13441. Online ahead of print.

Abstract

Background: We analyzed data from a study to evaluate the effectiveness of the Relationships Under Construction (RUC) sexual risk avoidance education program promoting positive youth development and healthy relationships.

Methods: Twelve schools in the Midwestern region of the United States randomized to the intervention implemented RUC in health or science classes, while control schools collected study measures and implemented the standard curriculum.

Results: Post-randomization analyses revealed significant differences in grade, race/ethnicity, and prior relationship education at baseline between intervention and control students. Subsequent analyses controlled for these differences. We distributed parental notification letters to 641 students, and no parents requested that their adolescent opt out of data collection. We obtained assent and baseline computer-assisted survey interviews or paper-and-pencil instrument forms from 100% of these students. Findings suggest that RUC significantly reduced sexual activity (odds ratio = 0.56, p = .046) at 3-month follow-up, compared to those in the control group. RUC also reduced pornography viewing and improved attitudes about delayed gratification, beliefs, decision making, and negative outcome expectations.

Conclusions: Our findings suggest that RUC improves sexual attitudes, beliefs, and behaviors among this population of adolescents. Additional research is needed to assess RUC impacts among diverse populations.

Keywords: adolescent decision making; adolescent delayed gratification; adolescent pregnancy prevention; adolescent sexual activity; adolescent substance use; sexual risk avoidance education.