April 29, 2009
School-based drug education programs for adolescents can have a long-term positive impact on sexual behavior in addition to curbing substance abuse, according to a new RAND Corporation study.
Researchers found that young adults who had been exposed to a popular drug abuse prevention program as adolescents were less likely to engage in risky sexual behavior five to seven years later, according to the findings published online by the Journal of Adolescent Health. The study provides the strongest evidence to date that drug abuse prevention programs can also curb risky sexual practices in young adulthood.
"The lessons these young people learned about how to avoid drug and alcohol abuse appears to have had a positive impact on their sexual behavior as well," said Phyllis Ellickson, the lead author of the study and a researcher at RAND, a nonprofit research organization.
The study found that youth exposed to a drug abuse education program were significantly less likely as young adults to either engage in sex with multiple partners or to have unprotected sex because of drug and alcohol use than their peers who had not received the training.
However, researchers found that those who received drug prevention training were no more likely to use condoms consistently than their peers who did not receive the training.
The RAND Health study tracked the experiences of 1,901 unmarried 21-year-olds who took part in a randomized controlled trial of Project ALERT, a drug use prevention program for middle school students developed by RAND. Study participants were exposed to Project ALERT while they attended middle school in South Dakota.
Among the participants, 631 attended schools that received 14 Project ALERT lessons during middle school, 499 attended schools that received 10 additional lessons during high school and 771 attended schools that did not offer the Project ALERT program.
While risky sexual behavior was common among the study participants, such behavior was less prevalent among those exposed to Project ALERT.
Young adults exposed to Project ALERT were both less likely to have sex with multiple partners (44 percent versus 50 percent) and to have unprotected sex because of drug use (27 percent versus 32 percent) than their peers who had not been exposed to the program.
About 71 percent of study participants reported inconsistent use of condoms, regardless of whether they had been exposed to Project ALERT.
Researchers say that part of the differences between the two groups may be due to the lower use of drugs and alcohol among those exposed to Project ALERT since the behavior is linked to risky sexual practices. But the differences in sexual behavior between the two groups were not entirely explained by the lower substance use levels.
"Although the effects we found are somewhat modest, these findings show that the benefits of drug abuse prevention programs are not confined to drug use alone and can continue for many years after young people receive the instruction," Ellickson said.
The study found no significant difference in risky sexual behavior between study participants who received the basic Project ALERT lessons in middle school and those who also received extended Project ALERT lessons during ninth and 10th grades.
Ellickson said the study findings are particularly relevant for school officials across the nation who are facing significant budget cuts in the months ahead.
"The findings support the case for the cost-effectiveness of the basic Project ALERT program by showing it provides benefits for two different types of risky behaviors and by showing that those benefits are long lasting," Ellickson said.
Support for the study was provided by the National Institute on Drug Abuse. The Conrad N. Hilton Foundation supported the original development of Project ALERT. Other authors of the study are Daniel F. McCaffrey and David J. Klein.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics. RAND Health is the creator of COMPARE (Comprehensive Assessment of Reform Efforts), a one-of-a-kind online resource that provides objective analysis about national health care reform proposals. Visit www.randcompare.org to learn more.