Francis Kimberly, Philliber Susan, Walsh-Buhi Eric R, Philliber Ashley, Seshadri Roopa, Daley Ellen
Kimberly Francis is with the Social and Economic Policy Division at Abt Associates, Cambridge, MA. Susan Philliber and Ashley Philliber are with Philliber Research and Evaluation, Accord, NY. Eric R. Walsh-Buhi is with the Graduate School of Public Health, San Diego State University, San Diego, CA. Roopa Seshadri is with Chapin Hall at the University of Chicago, Chicago, IL. Ellen Daley is with the University of South Florida College of Public Health, Tampa.
Am J Public Health. 2016 Sep;106(S1):S32-S38. doi: 10.2105/AJPH.2016.303307.
To determine if the Teen Outreach Program (TOP), a youth development and service learning program, can reduce sexual risk-taking behaviors compared with a business as usual or benign counterfactual.
We synthesized results of 5 independent studies conducted in 5 geographically and ethnically diverse locations between 2011 and 2015 with 17 194 middle and high school students. Each study cluster-randomized classes, teachers, or schools to treatment or control groups and included the students enrolled in those clusters at baseline in an intent-to-treat analysis. Multilevel models tested impacts on recent sexual activity, recent unprotected sexual activity, and sexual initiation among the sexually inexperienced at baseline at approximately 1 and 2 years after baseline.
Precision-weighted average effect sizes showed nonsignificant reductions of 1 percentage point or less in recent sexual activity (5 studies: -0.6; P = .32), recent unprotected sex (5 studies: -0.2; P = .76), and sexual initiation (4 studies: -1.1; P = .10) after 1 year.
There was little evidence of the effectiveness of TOP in reducing sexual risk-taking behaviors. Results underscored the importance of continually evaluating evidence-based programs that have previously been shown to be effective.
确定青少年拓展计划（TOP），一项青少年发展与服务学习计划，与常规或良性对照相比，是否能减少性冒险行为。
我们综合了2011年至2015年间在5个地理和种族多样的地点对17194名中学生和高中生进行的5项独立研究的结果。每项研究将班级、教师或学校整群随机分为治疗组或对照组，并在意向性分析中纳入基线时参与这些群组的学生。多层模型在基线后约1年和2年时测试对近期性活动、近期无保护性行为以及基线时性经验不足者的性初潮的影响。
精确加权平均效应大小显示，1年后近期性活动（5项研究：-0.6；P = 0.32）、近期无保护性行为（5项研究：-0.2；P = 0.76）和性初潮（4项研究：-1.1；P = 0.10）的减少幅度不显著，均在1个百分点或以下。
几乎没有证据表明青少年拓展计划在减少性冒险行为方面有效。结果强调了持续评估先前已证明有效的循证计划的重要性。
