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A Clinic-Based AIDS Education Program for Female Adolescents
Investigators: Vaughn Rickert, Anita Gottlieb, & Susan Jay
This is a single-session group intervention originally targeted toward sexually active girls between 13 and 21 years of age. The session includes a brief lecture on the transmission and prevention of HIV/AIDS (based on CDC guidelines), followed by a video explaining the purpose and use of condoms. As the session ends, participants receive an educational booklet reinforcing the program's lessons and coupons that may be redeemed anonymously for an unmarked box of condoms at a local pharmacy. The redemption rate of the coupons provides a measure of the program's impact. A field study of the intervention was conducted with 75 White and African-American females, all of whom were sexually active. Among prior purchasers of condoms, girls who took part in the intervention were significantly more likely to redeem the coupons than were control groups of their peers. Overall, 60% of program participants obtained condoms, a rate 2 1/2 times greater than that recorded in comparable programs without a confidential redemption procedure. Click here to view more detailed information on this program.
A Health Care Program for First-Time Adolescent Mothers and their Infants
Investigators: Ann L. O'Sullivan
Originally designed for low-income, unwed teens under 17 years of age, this clinic-based program aims to help first-time mothers prevent repeat pregnancies, return to school, improve immunization rates for their infants, and reduce their use of hospital emergency room services for routine infant care. Several services are offered in the context of a teen baby clinic, including: (1) well-baby care at 2 weeks, and at months 2, 4, 6, 9, 12, 15, and 18; (2) discussion of family planning and referral to a birth control clinic; (3) instruction on parenting skills with a social worker; and (4) informal parenting education through videotapes, slides, and discussions with a nurse practitioner or trained volunteer. A field study and 18-month follow-up assessment of the intervention were conducted with 243 African-American mothers at an urban teaching hospital. Compared to a control group of teens receiving routine well-baby care, program participants experienced significantly fewer repeat pregnancies (12% vs. 28%), reduced their use of the emergency room for routine care, and were more likely to obtain full immunization for their newborns. Click here to view more detailed information on this program.
A Peer Education Program for Taxicab/Tricycle Drivers and Other Bridge Populations
Investigators: Donald E. Morisky, ScD, ScM, MSPH, Chrystene Nguyen, MPH, Alfonso Ang, PhD, & Teodora V. Tiglao, EdD, MPH
The Peer Education Program aims to decrease sexual risk behaviors (such as unprotected sex) among members of a .bridge. population who are at risk of spreading STIs including HIV between high-risk groups (e.g., commercial sex workers) and the general population (e.g., other sexual partners). The Peer Education Program demonstrated increases in knowledge of HIV/AIDS transmission, positive attitudes toward condom use, and condom use frequency. The program includes a one-day needs assessment, a half-day peer educator information session and recruitment seminar, and a two-day peer educator training. For a year or more, peer educators share HIV prevention knowledge, distribute and promote condoms, and share educator-created prevention materials with coworkers and clients during normal work routines. Peer educators meet with program staff once a week throughout the program implementation to address questions or to problem solve ways to most effectively share safer sex messages with others. The Peer Education Program was originally implemented in the Philippines among drivers in the transportation industry but can readily be adapted to .bridge. populations in other settings and industries. The program.s peer education approach may also be useful in supporting HIV prevention behaviors among peers in many different types of communities and populations. Click here to view more detailed information on this program.
ABAN AYA Youth Project
Investigators: Brian Flay, DPhil, Sally Graumlich, EdD, CHES, & the ABAN AYA Team
ABAN AYA is an Afrocentric social development curriculum instructed over a four-year period, beginning in the fifth grade. The ABAN AYA name is drawn from two Ghanaian words: ABAN (fence) signifies double/social protection; AYA (the unfurling fern) signifies self-determination. The purpose of ABAN AYA is to promote abstinence from sex, and to teach students how to avoid drugs and alcohol, and how to resolve conflicts non-violently. ABAN AYA was developed to address multiple problem behaviors such as violence, substance abuse, delinquency and sexual activity, simultaneously in a long-term intervention specifically for African American youths in grades five through eight. The longitudinal evaluation of the program involved 12 schools in the metropolitan Chicago area between 1994 and 1998. At baseline, 1153 fifth graders participated in the pencil-and-paper assessment. All participants were African American. Follow-up assessments were conducted at the conclusion of grades five through eight. At study conclusion, there were no significant intervention effects for girls. For boys, however, ABAN AYA significantly reduced the rate of increase in violent behavior (by 35% compared with controls), provoking behavior (41%) school delinquency (31%) drug use (32%), and recent sexual intercourse (44%). ABAN AYA also improved the rate of increase in condom use (95%) as compared to the health education control condition. Aban Aya is supported by the Office of Adolescent Health's Teen Pregnancy Prevention (TPP) program as an EBI that is medically accurate, age appropriate, and has proven through rigorous evaluation to prevent teen pregnancy and/or associated sexual risk behaviors. Click here to view more detailed information on this program.
AIDS Prevention and Health Promotion among Women
Investigators: Stevan Hobfoll, Anita Jackson, Justin Lavin, & James Shepherd
AIDS Prevention and Health Promotion among Women is designed to assist participants between 16 and 29 years of age in developing and following a sound sexual health plan. Based on the concepts of empowerment, group social support and culturally sensitive skill building, this program comprises four 1 1/2- to 2-hour small (2-8 participant) group sessions conducted over the course of three months. Video segments promote group discussion, spark group role plays and engage participants in cognitive rehearsal and guided exercises designed to encourage healthy choices about one's body and sexuality. Specifically, this program encourages women to think about the physical and emotional consequences of unsafe sex. It helps them achieve a sense of mastery and positive expectations when discussing sexual history, HIV/AIDS testing, monogamy, spermicide and condom use, and other health-related concerns with their partners. In addition, the program teaches participants how to effectively negotiate safer sex with one's partner and maintain safer sex goals. This program was field tested with pregnant low-income African-American and white women who were using medical center obstetrics services in Akron, Ohio. Compared to control groups, participants showed significant and sustained increases in HIV/AIDS knowledge, safer sex goals, and safer-sex behaviors, including spermicide and condom purchases and use. Click here to view more detailed information on this program.
AIDS Prevention for Adolescents in School
Investigators: Heather J. Walter & Roger D. Vaughan
This six-session program for high school students is delivered by regular classroom teachers. Combining principles of the health belief model with social psychology, the curriculum aims to improve students' knowledge, beliefs, self-efficacy, and risk behaviors concerning HIV/AIDS. The first two classes provide general information about the transmission and prevention of HIV/AIDS and teach students how to appraise their own risk behaviors. During the next two sessions, myths about peers' sexual behaviors are corrected, values clarification is introduced, and students use role play and negotiation skills to practice delaying sexual intercourse. The final lessons involve discussions of purchasing and using condoms. A field study of the program was conducted with a predominantly African-American and Hispanic sample of students attending four New York City public high schools. Compared with a comparison group of peers, program participants scored significantly higher on measures of knowledge, beliefs about the benefits of risk reduction, and beliefs about one's own ability to effect positive change (e.g., self-efficacy). At the three-month follow-up assessment, the program was found to be particularly effective in reducing sexually active participants' number of total sex partners and number of sex acts with high-risk partners, and in increasing the use of condoms. Click here to view more detailed information on this program.
AIDS Risk Reduction Education and Skills Training Program (ARREST)
Investigators: Michele D. Kipke
Principles of the health belief model and social learning theory form the conceptual framework for this program, together with strategies previously found to be effective in changing such adolescent health-risk behaviors as cigarette smoking and early pregnancy. Originally designed for teens between 12 and 16 years of age, the intervention includes three 90-minute, small group sessions, in which participants receive five forms of assistance: (1) information about the transmission and prevention of HIV/AIDS; (2) instruction in purchasing and using condoms with spermicide; (3) guidance in self-assessment of risk behaviors; (4) training in decision-making, communication, and assertiveness skills; and (5) peer group support for HIV/AIDS prevention and risk reduction. In addition to lectures and modeling by instructors, teens complete role plays, skill-building exercises, and homework activities. A field study of the program was conducted with 87 African-American and Latino youths, who were recruited from three New York City community-based organizations providing alternative education and after-school programs for high-risk teens. Comparing four week follow-up measures of program participants with a control group of peers, participants showed significant gains in knowledge and attitudes about AIDS, as well as in sexual refusal and negotiation skills. However, no differences were found between the groups' risk-related sexual behaviors. Click here to view more detailed information on this program.
AIDS Risk Reduction for College Students
Investigators: Diane I. Kimble Willcutts, Jeffrey Fisher, William Fisher, & Stephen J. Misovich
Originally designed as a workshop for college students, this program consists of three two-hour sessions incorporating information, motivation, and behavioral strategies for AIDS risk reduction. The information component includes "AIDS 101," a slide show that explains the transmission and prevention of HIV, testing for the virus, and the importance of condoms for protection against HIV/AIDS among those who are sexually active. The motivation component is addressed through small-group discussions led by a peer health educator and a video narrated by persons who contracted HIV through unsafe heterosexual intercourse. Finally, behavioral skills development is encouraged through role plays of safe sex communication. In a field study of the program with 744 college students, participants showed significant gains in knowledge, motivation, and behavior; in particular, sexually active participants were more likely than similar control students to purchase and use condoms during a two- to four-month period following the intervention. Click here to view more detailed information on this program.
ASSESS for Adolescent Risk Reduction
Investigators: Bradley O. Boekeloo
The ASSESS program provides tools to enhance risk-reduction communication between health care providers and teens while in a physician's office or clinic setting. A randomized controlled behavioral intervention trial of the program was conducted in the metropolitan Washington, DC area between 1995 and 1997. The trial involved 19 physicians at five primary care pediatric practices, and 215 teens who were randomly assigned to intervention (n=205) or control group (n=114) conditions. Control group teens received their usual health care examination. Intervention group teens listened to an audiotape and answered 11 risk-related questions. The physician used answer sheets, pamphlets, an icebreaker activity and role-playing strategies to encourage risk behavior discussion and practice risk refusal strategies. Participants were interviewed post-checkup to determine how many sexual health topics they had discussed with their provider. Telephone follow-up interviews were conducted at three months and nine months. Study findings showed that more intervention teens reported discussing sexual topics with their physicians than did control group teens. At three-month follow-up, more sexually active intervention group teens reported condom use than control group teens. While more vaginal intercourse was also reported in the intervention group than the control group, this was not true of overall sexual intercourse. At nine months, there were no group differences in sexual behavior; however, more signs of STDs were reported by the control than the intervention group. Click here to view more detailed information on this program.
Adolescents Living Safely: AIDS Awareness, Attitudes and Actions
Investigators: Mary Jane Rotheram-Borus, Ph.D., Sutherland Miller, Ph.D., Cheryl Koopman, Ph.D., Clara Haignere, Ph.D. & Calvin Selfridge
To meet the comprehensive needs of runaway youths between 11 and 18 years of age, this program combines 20 small group discussion sessions with case management and private counseling. The group sessions provide general instruction about HIV/AIDS through video and art workshops in which youth create their own educational materials and review commercially available videos. Participants also receive behavioral and cognitive skills training for coping with high-risk situations. The case management and counseling components are designed to identify individual needs and provide youth with appropriate services (e.g., legal, medical, vocational). A field study of the program was conducted at two urban shelters serving predominantly African-American runaways. The sessions were held over a three week period, but youth joined the program at various points, and their levels of participation varied. For runaways who attended at least fifteen sessions, the high-risk pattern of sexual behavior dropped in frequency from 20% to zero over a six-month period. At the two-year follow-up assessment, program effects remained strongest for male and African-American participants. Click here to view more detailed information on this program.