Evaluation of a Youth-Led Intervention to Improve Adolescent Sexual and Reproductive Health Knowledge, Efficacy, and Autonomy [ID: 1377919]

INTRODUCTION: Youth bear a disproportionate burden of sexually transmitted infections (STIs) and unintended pregnancy. Knowledge about sexual and reproductive health (SRH) is low among this population, and youth face numerous barriers to care. We sought to develop and assess a youth-led intervention to increase youth SRH knowledge, self-efficacy, and autonomy, which are key indicators in developing positive sexual health behaviors and skills to feel confident in accessing health services. METHODS: Nine interactive, youth-led, 2-hour sessions were held virtually or in-person over 9 months. Session topics included human immunodeficiency virus and STIs, contraception, reproductive anatomy, menstrual health, healthy relationships, sexual decision-making, sexual violence, substance use, goal setting, gender identity and sexuality, and navigating health care services as an adolescent. Monetary compensation and transportation were provided. Sexual and reproductive health knowledge, self-efficacy, and autonomy were assessed using validated scales via an electronic questionnaire before and after implementing the intervention (IRB approved). Paired t tests were used to assess intervention effect. RESULTS: Thirty-seven participants with a mean age of 15.8 years (SD 1.13) were enrolled. All lived in the greater Baltimore area, and the majority self-identified as female. 52% were Black/African American, 28% Asian/Asian American, 12% White, and 8% Hispanic/Latino. Average attendance across sessions was 88%. Participants showed improvement in SRH knowledge (P=.02), advocacy and self-efficacy (P<.001), and personal safety and autonomy (P<.01). They reported increased comfort using trusted sites to procure SRH information (P<.01). CONCLUSION: A youth-led SRH intervention effectively increased SRH knowledge, self-efficacy, and autonomy. Further work should be done to explore the effects and expansion of peer-to-peer SRH education.