Re:MIX Shows Promising Short-term Impacts on Pregnancy Prevention for Latinx Youth
Despite declines in recent decades, the United States still has one of the highest teen birth rates among industrialized nations.[1] The United States also has important disparities in teen birth rates by race/ethnicity: For example, Latinx teens have higher birth rates than the national average.[2] To address these disparities, schools and communities with a large percentage of Latinx youth require teen pregnancy prevention programs that are tailored for, and effective with, this population. One promising approach is to incorporate peer educators (educators of similar age and background as the program’s target youth) into teen pregnancy prevention programming; this may be effective with a variety of adolescent populations.[3],[4],[5],[6] Reproductive health messages from peers may be more meaningful to youth, and adolescents may be more likely to approach their peers than adults with sensitive questions.[7],[8]
From 2015 to 2020, Child Trends conducted a randomized controlled trial to evaluate the impact of Re:MIX on early sex, unprotected sex, and key mediators. Re:MIX, developed by EngenderHealth, is a comprehensive, in-school teen pregnancy prevention program targeting youth ages 13 to 17. The program is co-facilitated by a professional health educator and a young parent educator, and was piloted in schools with a high percentage of Latinx students. Findings from this random assignment evaluation, recently published in the Journal of School Health (JOSH), expand research on peer education approaches and highlight the feasibility and promise of this method with Latinx students. This research brief summarizes the results from the JOSH article.
Key Findings
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- Re:MIX was implemented with high fidelity and quality. Facilitators covered, on average, 90 percent of planned activities and most students completed at least 8 of 10 sessions. On average, observers rated session quality a 4 out of 5.
- The Re:MIX curriculum was well-received. Most students reported liking their young parent and adult health educators (90% and 89%, respectively).
- Re:MIX improved students’ knowledge and self-efficacy. Immediately after program completion, the evaluation found positive impacts of Re:MIX on students’ sexual and reproductive health knowledge, their knowledge of where to go in their community to access contraception, and their ability to ask for and give consent. These impacts were sustained at the long-term follow-up, approximately 12 months later.
- Re:MIX improved students’ intentions to use contraception. Immediately after the program, Re:MIX had a positive impact on students’ intentions to use hormonal or long-acting contraception if they had sex; however, this finding was no longer significant at the long-term follow-up.
- Re:MIX did not have an impact on students’ sexual behaviors. Despite promising findings on mediating outcomes associated with sexual activity and contraceptive use, the evaluation found no impact of Re:MIX on measured behavioral outcomes—sexual experience and unprotected sex—at long-term follow-up.
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References
[1] Sedgh, G., Finer, L.B., Bankole, A., Eilers, M.A., & Singh, S. (2015). Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. Journal of Adolescent Health, 56(2):223-230.
[2] Martin, J., Hamilton, B., Osterman, M., Driscoll, A., & Drake, P. (2018). Births: Final data for 2017. National Vital Statistics Reports. Hyattsville, MD: National Center for Health Statistics.
[3] Lugo-Gil, J., Lee, A., Vohra, D., Harding, J., Ochoa, L., & Goesling, B. (2018). Updated Findings from the HHS Teen Pregnancy Prevention Evidence Review: August 2015 through October 2016. Washington, DC: U.S. Department of Health and Human Services.
[4] DiClemente, R., Wingood, G., Harrington, K., et al. (2004). Efficacy of an HIV prevention intervention for African American adolescent girls: A randomized controlled trial. Journal of the American Medical Association, 292(2): 171-179.
[5] Coyle, K., Basen-Engquist, K., Kirby, D, et al. (2001). Safer Choices: Reducing teen pregnancy, HIV, and STDs. Public Health Reports, 116: 82-93.
[6] Kirby, D., Baumler, E., Coyle, K., et al. (2004). The “Safer Choices” intervention: Its impact on the sexual behaviors of different subgroups of high school students. Journal of Adolescent Health, 35(3): 442-452.
[7] Mellanby, A.R., Newcombe, R.G., Rees, J., & Tripp, J.H. (2001). A comparative study of peer-led and adult-led school sex education. Health Education Research, 16(4): 481-492.
[8] Layzer, C., Rosapep, L., & Barr, S. (2014). A peer education program: delivering highly reliable sexual health promotion messages in schools. Journal of Adolescent Health, 54(3): S70-S77.
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