Universal family-focused intervention with young adolescents: effects on health-risking sexual behaviors and STDs among young adults

Abstract

Considering the prevalence and consequences of health-risking sexual behaviors (HRSBs) and STDs among young adults, their prevention is a public health priority. Emerging etiological and prevention outcome literatures suggested study of the long-term effects of universal family-focused interventions on young adult HRSBs and STDs. Although earlier studies have demonstrated intervention impact on adolescent substance misuse, no study has examined universal family-focused intervention effects on young adult HRSBs and STDs via reductions in adolescent misuse. Sixth grade students and their families enrolled in 33 rural Midwestern schools were randomly assigned to experimental conditions. Self-report questionnaires provided data at pretest (Ns = 238, 221, and 208 for the Iowa Strengthening Families Program [ISFP], Preparing for the Drug Free Years [PDFY], and control groups, respectively), with seven data points through young adulthood (age 21). In latent growth modeling, three young adult HRSB measures (number of sexual partners, condom use, substance use with sex) and lifetime STDs were specified as distal outcomes mediated by adolescent substance initiation growth factors (average level and rate of change). Results showed that the models fit the data and, except for condom use, there were significant indirect effects, with a higher frequency of significant findings for ISFP. The model additions of direct intervention effects on young adult outcomes generally were not supported, consistent with a model positing that long-term intervention effects on young adult HRSBs and STDs outcomes are indirect. As an indication of the practical significance of long-term effects, analyses revealed relative reduction rates ranging from 6% to 46% for significant outcomes.

Fig. 1

Model of universal intervention effects via adolescent growth in substance initiation. Note. Controlling for gender, T1AAII, T1 Parents’ Marital Status, T1 Family Income and T1 Parent Education; Intercept was specified at the midpoint of the adolescent time frame