Do Information Technologies Improve Teenagers' Sexual Education? Evidence from a Randomized Evaluation in Colombia

Treatment consisted on an online sexual education course designed by the Colombian NGO Profamilia. Profamilia is Colombia's largest organization focused on sexual health and reproductive health. With more than 40 years of presence and over 1,800 employees nationwide, Profamilia is well known by the local population.

Motivated by the deterioration of some important adolescent sexual health indicators nationwide, such as teenage pregnancy rates (DHS 2005), as well as legal changes, which mandated the introduction of a sexual health curriculum in Colombian public schools, Profamilia embarked on the design of a comprehensive online sexual education course designed for adolescents.

The curriculum aims to shape adolescents' understanding and perceptions of sexuality, risks, reproductive health, sexual rights, and dating violence. The overarching theme is a human rights approach to pregnancy and teen sexuality. The course focuses on helping the students recognize themselves as endowed with rights, such as the right to say no to sex, to access basic health services, to access family planning services, and to live without sexual violence. Profamilia's course takes full advantage of internet connectivity to provide an interactive experience and responsive, anonymous counseling. The modules can be potentially accessed any time of day using a password protected account, and there is a remote tutor available to answer questions and support the learning process. These features aim to create a safe social environment for adolescents to discuss sensitive topics.

Treatment consisted of five modules. Students worked on the course for a total of 11 weeks. Each group of treated students was initially given three weeks to become acquainted with the platform and complete activities in the first module. After the first three weeks, each group was given two weeks per module to complete activities in the remaining four modules. Each school dedicated one session of 1.5 hours per week to allow the students to complete the course in the school’s computer labs.

In school, each group taking the course worked with the presence of a teacher, who was tasked with helping the students resolve questions about use of and access to the platform but not questions related to the content of the course. Students were assisted and monitored by an online tutor, who was a trained Profamilia counselor that dedicated part of his or her day to overseeing students during their completion of the course. The tutors had two main roles: answering students' questions about the course contents and monitoring the student's performance.

At the end of every module, the tutor provided the teacher responsible for the group with a grade for each student, based on the results of a test. Each school participating in the course included these grades as a component of the grade of one subject, typically computer education. Each student had to complete module evaluations individually, which were the basis for his or her individual performance report. Participation in the course was mandatory for students.

2009-08-01

2010-08-31

Condom voucher redemption, sexual health knowledge, sexual health attitudes.

We use aggregate standardized indices of sexual health knowledge, sexual health attitudes and condom voucher redemption rates.

To created aggregate standardized indices (over multiple related ouctomes) we follow Katz, Kling and Liebman (2007) and define a summary measure Y* as the unweighted average of all standardized outcomes in a family. For standardization of each variable we use the estimated mean and variance at baseline.

We study 138 classrooms spread over 69 schools. Our total sample size is 4,599 students, with an average of 33 students per classroom (group). 46 groups were assigned to control (across 23 schools), 46 groups (across 46 schools) were assigned to treatment, and 46 groups (across the same 46 schools) were assigned to the spillover condition. Randomization of treatment was performed before the baseline survey.

Randomization done in office by a computer using Stata random number generator.

A classroom (called group here).

Yes

138 groups

4,599 students

46 groups control
46 groups treatment
46 groups spillover

Sexual health problems cause negative externalities from contagious diseases and public expenditure burdens from teenage pregnancies. In a randomized evaluation, we find that an online sexual health education course in Colombia leads to significant impacts on knowledge and attitudes but no impact on self reported behavior, on average; although fewer STIs are reported for baseline sexually active females. To go beyond self-reported measures, we provide condom vouchers six months after the course to both treatment and control groups and estimate a 9 percentage point treatment effect (52% increase) on the likelihood of redemption. Using knowledge of friendship networks, we document a strong social reinforcement effect: the impacts of the course intensify when a larger fraction of a student’s friends is also treated. In particular, when full sets of friends are treated we find significant reductions in sexually active, frequency of sex, and number of partners. Throughout the analysis we fail to find evidence of cross-classroom spillovers.

Chong, Alberto and Gonzalez-Navarro, Marco and Karlan, Dean S. and Valdivia, Martin, Effectiveness and Spillovers of Online Sex Education: Evidence from a Randomized Evaluation in Colombian Public Schools (October 2013). Working Paper.

https://www.povertyactionlab.org/sites/default/files/publications/253_117%20Online%20Sex%20Ed%20Oct2013.pdf