Effectiveness of a community-based intervention to improve adolescent reproductive health knowledge and social risk outcomes in rural Honduras: a mixed-methods pre–post evaluation

Background Honduras has the highest rates of teen pregnancy and HIV in Central America, which are disproportionately concentrated in rural, low-income communities with high school dropout rates and limited access to sexual health education. This study evaluated the ‘Taking Care of You’ (TCY) program, a community-based educational intervention designed to improve reproductive health knowledge and social risk awareness among adolescents aged 11–18 years in rural northwest Honduras. Methods We conducted a single-group, pre–post quasi-experimental study in El Rosario, Locomapa, Honduras. Eighty-seven adolescents were recruited through community leaders and school networks and participated in eight 3-h sessions from April to July 2024, covering sexual and reproductive health and social risk behaviours. A structured questionnaire with quantitative and qualitative components was administered pre- and post-intervention. McNemar tests, Wilcoxon signed-rank tests, and logistic regression models were used for quantitative analysis; descriptive-interpretive thematic analysis was applied to qualitative data. Results Before TCY, only 35.6% of participants knew about sexually transmitted infections (STIs), and fewer than half recognised risks of unprotected sex or substance use. Following TCY, there was increased knowledge on STIs, recognition of unprotected sex risks, self-assessed reproductive health knowledge, attitudes toward contraception, and comfort discussing sexual health and behaviours. Equitable gains were made across sex and age groups. Qualitative findings revealed shifts from stigma and avoidance toward openness and protective intentions. Conclusions Knowledge and attitudinal gains were observed across sex and age groups; however, sustained behavioural change will require longer follow-up and continued structural support. Controlled trials with extended follow-up are needed to assess long-term behavioural impact