Evidence Summary

Findings

Journal of Adolescent Health article: The IN·clued Program: A Randomized Control Trial of an Effective Sex Education Program for Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning Youth

Youth Workshop:

The results of this Randomized Control Trial found that participants in the IN·clued Youth Workshop were significantly more likely to have the following positive outcomes than their peers who did not participate in the workshop 12 months after the baseline survey:

  • Lower likelihood of having recent vaginal sex without condoms (and fewer times doing so)
  • Greater knowledge of sexual health
  • Greater self-efficacy to advocate for their own sexual health needs
  • Greater likelihood of having been to a doctor or clinic for (and received) contraception or birth control

Outcomes varied by demographic characteristics and were positive among groups not often served by adolescent sexual health programs.

The IN·clued program had a significant and positive impact on sexual health care outcomes among those who identified as transgender, nonbinary, genderqueer, genderfluid, gender non-conforming or additional non-cisgender identities. In this subgroup, after one year, a significantly greater proportion of IN·clued participants than control participants reported having been to a doctor or clinic for contraception or birth control, receiving contraception or birth control, having had any sexual or STD health care, and having confidence talking to providers about sexual health issues.

The IN·clued program had significant and positive impacts for People of Color including significant and positive sexual behavioral changes. One year after the workshop, compared to control group youth, IN·clued participants had significantly smaller proportions reporting having had vaginal or anal sex without condoms in the past three months. Compared to the control group, IN·clued youth also reported higher self-efficacy scores and a greater proportion reported comfort asking their doctors to do something differently.

Health Center Workshop:

The results of this Randomized Control Trial found that participants in the IN·clued Health Center Workshop were significantly more likely to have the following positive outcomes than their peers who did not participate in the workshop.

  • The short-term clinic outcomes show statistically significant positive changes in overall knowledge scores, overall comfort scores, and overall desires for their work environments.
  • Provider comfort levels regarding serving LGBTQ youth, and asking patients about their gender, sexual orientation, and/or birth-assigned sex all increased significantly.
  • After the program, clinic staff were also significantly more likely to believe their clinics should use Q cards.

The long-term clinic outcomes one year later show statistically significant positive differences between the program and survey-only group for using inclusive or open-ended questions about sexual relationships.

Research Design

The IN·clued Program was rigorously evaluated by Philliber Research & Evaluation using a Randomized Control Trial (RCT) evaluation design. By conducting an RCT we are able to demonstrate that the outcomes for young people were directly caused by participation in the program, rather than by random chance. This evaluation was funded through the federal Office of Adolescent Health Teen Pregnancy Prevention Initiative.

Due to this evaluation process, each IN·clued workshop was subject to the following requirements:

  • The IN·clued curriculum was approved by the Office of Adolescent Health as being medically accurate, age and developmentally appropriate for the intended audience, inclusive, and trauma-informed.
  • Each IN·clued workshop was implemented with fidelity to the entire program curriculum. No site-specific adaptations to the program activities were made during the course of the evaluation.
  • Youth were randomly assigned to one of two groups. One group received the IN·clued Youth Workshop; the other group received a set of activities that were LGBTQ-centered but made no mention of sexual health information, skills, or content.
  • Clinics were randomly assigned to one of two groups. One clinic to the program group, which received the IN·clued youth-led workshop, and one to control, or survey-only group, which did not receive any specialized training.

The Youth Workshop evaluation was conducted from 2015 through 2020, and enrolled 1,401 LGBTQ young people between the ages of 14 and 19 from 16 states across the United States: Alaska, Washington State, Oregon, California, Montana, Utah, Texas, Nebraska, Iowa, Wisconsin, Minnesota, Michigan, Massachusetts, Rhode Island, Connecticut, and North Carolina.

The Health Center Workshop evaluation was conducted from 2015 through 2019, and enrolled a total of 22 clinics and 471 clinic staff from seven states across the United States: Alaska, Massachusetts, Minnesota, Montana, Oregon, Utah, and Washington.

Data Gathering

Youth Workshop:

Youth who attended the IN·clued Youth Workshops were asked to complete a baseline survey, a 3-month (after the workshop), and a 12-month follow-up survey, to gauge any short and long-term changes in knowledge, self-efficacy, healthcare acquisition, and sexual behavior. Those assigned to the IN·clued program group also took a satisfaction survey immediately after the workshop.

Health Center Workshop:

Clinic staff assigned to both groups were asked to complete a baseline survey and a survey one year after the program to gauge any long-term changes in knowledge, comfort, or desires for their work environments. Those assigned to the IN·clued program group also took a post-program survey immediately after the workshop to gauge any immediate changes.