The total study sample (Table 1) consisted of 265 female participants at baseline, and 229 female participants at follow-up. The majority of participants were attending school at the time of the program, 92.5% at baseline and 91.3% at follow-up. The community distribution changed significantly between pre- and post-test due to loss to follow-up of participants from specific locations (<0.01). The mean age was 11.62 years at baseline and 11.71 years at follow-up; the mean number of brothers per participant was 2.19 at baseline and 2.38 at follow-up; and the mean number of sisters per participant was 1.85 at baseline and 1.88 at follow-up, although none of these were statistically significant.

 The means of all three primary outcome variables changed significantly between baseline and follow-up (See Table 2). The communication scale increased from 1.95 at baseline to 2.39 at follow-up (<0.01). The gender equitable attitude score increased from 13.27 at baseline to 15.00 at follow-up (<0.01). The aspirations variable increased from 4.15 at baseline to 4.48 at follow-up (<0.01).

There was a significant positive correlation between age and all three outcome variables (p<0.01). Number of brothers was positively correlated with aspirations (p<0.05) and gender equitable attitudes (p<0.01). Those who attended school at the time of the pilot program were significantly different than those who did not only on the communication scale, and there was a significant difference between the communities for all three outcome variables (p<0.01). There was no correlation between number of sisters and any of the dependent variables (Table 3).

Pearson correlations were conducted to explore the associations between the outcome variables (See Table 2). The aspirations variable was positively correlated with communication and gender equity (p<0.01); communication was positively correlated with gender equity and aspirations (p<0.01); and gender equity was positively correlated with aspirations and communication (p<0.01).

Multivariable models were run to control for variables that were significantly different between baseline and follow-up (time period), and to further assess the changes in outcome variables.

The Girl Rising Pilot Program (GR) was developed to address the myriad of challenges young girls and adolescents face in Guatemala, particularly in rural indigenous communities. GR has developed and tested similar interventions in schools and community-organizations in India and found that a school-based intervention played an important role in changing gender attitudes during adolescence 11. The GR India program found that key outcomes changed positively post-intervention: gender equality scores increased; gender roles/privileges/restrictions scores increased; and gender attribute scores increased. The GR Guatemala program yielded positive outcomes for the girls who participated after just one iteration of the intervention. After the intervention, girls were more likely to report positive gender equitable attitudes which supports a previous 2015 study in Guatemala which found that that by participating in interactive workshops focused on gender norms and family planning in rural communities, both men s and women s gender attitude scores increased 12. This study provides further evidence that these changes can occur during adolescence as well.

Participants were also more likely to communicate with their parents or another adult about their education, future goals, and the obstacles that girls and women face in their community. After the intervention, girls spoke to adults more often about these important issues than they had prior to the GR program. While aspirations did not increase significantly between baseline and follow-up, they did increase as gender equitable attitudes increased and as communication increased. Girls were more likely to believe that they could be anything they wanted to be if they thought that boys and girls were more equal, or if they communicated more with adults about their education and goals. One possible reason for why aspirations did not increase significantly is that the mean score was already high at the onset e.g., participants agreed with the statement I think I can be anything I want or dream to be prior to the intervention (mean = 4.15) and moved slightly closer to strongly agree after the intervention (mean = 4.48).

In many parts of the world, including Guatemala, gender disparities exist from the moment a girl is born, and as she becomes an adolescent, it also the time when more pronounced gender discrimination begins to take hold. Unfortunately, this discrimination continues through the life course and into the next generation, and therefore, to break this inter-generational cycle of gender inequity, community organizations and schools have recognized the importance of reducing gender inequality by focusing more attention on adolescents, as this is the developmental time when are forming their own gender attitudes. However, few programs focusing on gender sensitization, equity, and empowerment have been adequately implemented, and even fewer have assessed quantifiable outcomes. Improving gender attitudes, aspirations and communication with adults is critical in increasing voice, agency, empowerment and gender equity in both the short and long term.