Protective knowledge, skills, perceptions, and intentions of youth from 1 developing country can be significantly improved by youth intervention delivered through the schools. Longer follow-up is needed to determine if risk behaviors will be reduced and how long protective results will be sustained.

Data from 752 Bahamian youth and their parents were analyzed to examine the relationship of youth depression with youth risk involvement, parental monitoring, and parent-youth communication. Depressed youth were older, more likely to engage in risk behaviors, and they perceived significantly lower levels of parental monitoring and higher levels of

The inclusion of parents in adolescent-targeted interventions is intended to benefit the adolescent. Limited research has explored whether parents participating in these programs also directly benefit. We examined the impact of Caribbean Informed Parents and Children Together (CImPACT), the parenting portion of an adolescent-targeted HIV prevention intervention, on parent reported measures. Bahamian parent-youth dyads (N=1833) participating in the randomized control trial were assigned to receive one of four conditions. Parents were assessed longitudinally at baseline and 6 and 12 months later. Through 12 months follow-up, parents exposed to CImPACT showed higher knowledge of condom-use skills, perceptions of improved condom-use competence on the part of their youth, and perceived improved parent-child communication about sex-related information. Although youth were the targeted beneficiary, parents also directly benefited from the sexual risk reduction parenting program. Parents demonstrated improved perceptions and knowledge which would enable them to more effectively guide their child and also protect themselves from sexual risk.

The present study randomly assigned 15 Bahamian elementary schools to one of three intervention conditions. To assess the adequacy of cluster randomization, we examined two concerns identified by the local research team: inequality of gender distribution and environmental risk among groups. Baseline significant differences in risk and protective behaviors were minimal. There were significantly more males in the intervention group. Males had higher rates of risk behavior at all assessments. Poor school performance was also higher among the intervention condition and was significantly associated with increased rates of many but not all risk behaviors. Prior to adjusting for gender and school performance, several risk behaviors appeared to be higher after intervention among intervention youth. Adjusting for gender and school performance eradicated the group differences in risk behavior rates. Results demonstrate the importance of adequate randomization where outcomes of interest are rare events at baseline or differ by gender and there is an unequal gender distribution and the importance of the local research team's knowledge of potential inequalities in environmental risk (i.e., school performance). Not considering such individual differences could impact the integrity of trial outcomes.