The goal of this clinical trial is to test the effectiveness of a 6-week socialization and
sex education curriculum (STEPS2) among 856 adolescent and young adults (aged 16-27 years)
with mild to moderate intellectual or developmental disabilities (I/DD), including people
with Down syndrome.
The investigators are recruiting participants through collaboration with the New York State
Office of People with Developmental Disabilities (OPWDD), Service Providers, Care
Coordination Organizations and special programs, such as the Special Olympics. For
participants who meet eligibility criteria and have consented or assented (as appropriate), a
video call meeting is arranged to complete the baseline interview survey of socio-demographic
characteristics and sexual and reproductive health knowledge and behaviors. The interview
takes up to 45 minutes to complete. Once the baseline interview is completed the participant
is randomly assigned to either the STEPS2 or the STYH arm of the study. Half of the
participants will be randomized to STEPS2, and half to the STYH arm. Participants begin the
intervention within 2 weeks of having completed the baseline survey.
For the intervention, participants in both arms receive virtual video call one hour weekly
health education sessions for 6 weeks. The STEPS2 socialization and sexuality curriculum
(experimental arm) is provided during one-on-one sessions between a Study Health Educator and
the participant. The STYH curriculum (comparison arm) is provided during group sessions with
6-10 participants and a Study Health Educator. For both arms, participants choose whether
they wish for a guardian or helper to also attend for a given session.
Participants have follow-up interview surveys at month 2 (after completing the health
education intervention), month 6, and month 12, with the same sexual and reproductive health
measures as included in the baseline survey. The month 2 interviews also include measures of
participant satisfaction with the curriculum and with the Study Health Educator. Each survey
takes up to 45 minutes to complete. Survey interviewers are blinded to which curriculum
participants have received.
The investigators are comparing the proportion of participants who have had a conversation
with a doctor about sex, know their HPV vaccination status, have had the HPV vaccine, and
show an understanding of sex and pregnancy at the month 12 interview between the two arms,
after adjusting for baseline measures of these indicators, to test whether participation in
the STEPS2 arm had an effect on these measures. Analysis will include intention-to-treat
estimates, as well as instrumental variable estimates to adjust for incomplete attendance to
the 6-week curricula. Analyses will also be stratified by gender, age, and mild versus
moderate I/DD.
If the STEPS2 curriculum is found to improve reproductive and sexual health knowledge and
behaviors, the investigators will email the curriculum to all participants in the STYH arm at
study completion. Both curricula will be made publicly available at the end of the study.