WHAT COULD YOU DO?
Interactive Video Intervention to Reduce Adolescent Females’ STD Risk

Julie Downs, PhD, Wändi Bruine de Bruin, PhD, Claire Palmgren, Baruch Fischhoff, PhD, Pamela Murray, MD, MPH, Joyce Penrose, DPH, RN-C


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SUMMARY

WHAT COULD YOU DO? was developed to provide a cost-effective method of delivering an STD risk-reduction intervention for adolescent girls. The interactive video intervention aims to increase knowledge of STDs, decrease sexual risk behaviors, and decrease STD acquisition.

Participants were recruited from four healthcare sites in the urban Pittsburgh area: a children’s hospital’s adolescent medicine clinic, two community health centers, and a women’s teaching hospital. The young women participating in the study were all between 14 and 18 years old, and had engaged in heterosexual vaginal sex in the six months prior to the study. Written informed consent was obtained from all participants, or from their parents/guardians for participants under 18.

Following the completion of baseline measures and a self-administered vaginal swab, participants were randomly assigned to one of three conditions: 1) interactive video (experimental condition), 2) content-matched control condition (a 127-page book containing all of the content of the interactive video), or 3) topic-matched control condition (23 commercially available brochures, with content closely matching that of the video and book). Booster sessions followed at one, three and six months after the initial intervention.

At all follow-up points, the participants in all three conditions increased their STD knowledge, both general and specific.

Participants in the video condition were more likely than their control condition counterparts to have been completely abstinent in the time from baseline to the three-month follow-up (OR = 2.5, p = 0.027. This pattern diminished between the three-month and six-month visits (OR = 1.45, p = 0.344). Although there were no significant differences in condom use among the conditions, there was a trend toward more condom use and fewer condom failures among the participants of the video condition.

At the six-month follow-up, participants in the control conditions were nearly twice as likely as video condition participants to have been diagnosed with an STD (OR = 2.79, p = .05). This pattern held for all nine reported diseases.

SUITABLE FOR USE IN

WHAT COULD YOU DO? is suitable for use in physician and clinic offices. It may be suitable for use in schools provided there is privacy for the viewer (some of the material is graphic in nature).

ORIGINAL INTERVENTION SAMPLE

Age, Gender
The original intervention sample consisted of 300 females, aged 14-18.

Race/Ethnicity
Most participants (75%) self identified as African American, with 15% white and 10% “Other” or mixed
race.

PROGRAM LENGTH

Given the interactive nature of the video, the amount of time a viewer spends with it will depend largely on the selections she makes at any of the several decision points. The “structured” version of the DVD permits the viewer to follow a single story line, whereas the “flexible” version allows the viewer to skip or review sections at will. In the original evaluation study of WCYD?, girls spent an average of 45 minutes viewing the interactive video.

STAFFING REQUIREMENTS/TRAINING

No staffing or training is required for the interactive video. Only a television and DVD player, or personal sized DVD player are needed. (Note: Although the DVD can be viewed on a computer, it functions more smoothly when viewed with a DVD player.)

   Primary Pregnancy Prevention
   Secondary Pregnancy Prevention
   STD/HIV/AIDS Prevention

ORIGINAL SITE
   School-Based
   Community-Based
   Clinic-Based

APPROACH
   Abstinence
   Behavioral Skills Development
   Community Outreach
   Contraceptive Access
   Contraceptive Education
   Life Option Enhancement
   Self-Efficacy/Self-Esteem
   Sexuality/STD/HIV/AIDS Education

COMPONENTS
   Adult Involvement
   Case Management
   Group Discussion
   Lectures
   Peer Counseling/Instruction
   Public Service Announcements
   Role Play
   Video

   Other: Cognitive rehearsal

   

PASHA PROGRAM PACKAGE

The PASHA Program Package for this program includes:

  • PASHA User's Guide
  • Two versions of the WHAT COULD YOU DO? DVD: Flexible and Structured. In the former, the viewer can select topics/scenarios to view or review. In the latter, the selection she makes at the first decision point will determine the content available for viewing.
  • Prevention Minimum Evaluation Data Set (PMEDS)
  • Local Evaluator Consultant Network Directory

  • Telephone technical support on implementation and evaluation for 1 year
Note: There are some secondary materials you will need to obtain to offer this intervention. A television and DVD player or personal DVD player will be needed to view the video. While not required, headphones will help ensure privacy for the viewer.

NOTES ABOUT EVALUATION
This program box contains a copy of the exit interview for girls used to collect baseline and follow-up data during the original evaluation of this program. (Please refer to the yellow .Original Evaluation Materials. booklet.) Additional resources for evaluation are also included: (1) Prevention Minimum Evaluation Data Set (PMEDS), a generic questionnaire that can be adapted to suit most prevention programs, and (2) Local Evaluator Consultant Network Directory