California Survey of AIDS Knowledge, Attitudes & Behavior 1987

Investigators: State of California, Dept. of Health Services, Office of AIDS

The California Survey of AIDS Knowledge, Attitudes and Behavior: 1987 gathered data through a survey of California adults for the purpose of forecasting the course of the AIDS epidemic and planning risk reduction programs in the State of California. Augmented data collection was employed for three risk-groups: (1) gay-identifying men, (2) multiple/high-risk partner heterosexuals, and (3) recreational drug users. Interviews were conducted from October 4, 1987 through December 20, 1987. The 1988 follow-up study to the California Survey of AIDS Knowledge, Attitudes and Behavior: 1987 has been archived as Sociometrics AIDS/STI Data Archive Dataset 02. The 1987 data collection program had eight major objectives: To gather population-based data bearing on the size of the three primary AIDS risk groups in the State of California: homosexual/bisexual men, IV drug users, and multiple/high-risk partner heterosexuals; To determine the basic socioeconomic and other demographic characteristics of these risk groups in order to both enhance general understanding and allow for sufficient audience analysis to develop effective risk reduction interventions; To ascertain AIDS awareness and information levels among risk groups, as well as determining the impact of the epidemic to date on sexual and other risk behaviors; To determine the incidence of specific risk behaviors among the risk groups, including unsafe sex practices, IV drug usage, and needle-sharing; and collect baseline information that would enable behavior change over time to be monitored; To measure the degree to which existing risk reduction programs have penetrated risk group audiences in the State of California, which will be useful in evaluating the effectiveness of such programs; To collect data bearing on the design of future risk reduction programs, including questions related to message definition and the selection of appropriate communication channels; To determine AIDS awareness and knowledge levels among the general (low-risk) population of the state of California; and To gather population based data on utilization of the health care delivery system in California. Interviews were conducted from October 4, 1987 through December 20, 1987. The completion rate for interviews was 71%. Interviews were conducted in two stages. An initial 15-minute interview determined whether a respondent was a member of one or more of three AIDS high-risk groups: gay-identifying men, multiple/high-risk partner heterosexuals, or recreational drug users (not limited to intravenous drug use). If a respondent qualified as high-risk, an additional battery of questions, lasting about 20 minutes, was administered.

California Survey of AIDS Knowledge, Attitudes & Behavior: 1988

Investigators: State of California, Dept. of Health Services, Office of AIDS

The California Survey of AIDS Knowledge, Attitudes and Behavior: 1988 gathered data on 311 variables through a telephone survey of California adults for the purpose of forecasting the course of the AIDS epidemic and planning risk reduction programs in the State of California. The study consisted of 4,661 telephone interviews with a household probability sample of California adults aged 18 and over. Data collection employed stratified random sampling with over-sampling in geographic areas with identified high risk-group populations. Augmented data collection was employed for three risk-groups: (1) gay-identifying men, (2) multiple/high-risk partner heterosexuals, and (3) recreational drug users. Interviews were conducted from September 30, 1988 through December 13, 1988. Data collected in this survey permit comparisons to the California Survey of AIDS Knowledge, Attitudes and Behavior, (KABB), conducted in 1987, which has been archived as Sociometrics AIDS/STI Data Archive Dataset 01. However, the population stratification design employed in 1987 differed from that utilized in 1988, and some differences in results between the surveys may be attributable to this variation in methodology. The 1988 data collection program had four major objectives: To increase the number of risk group cases on whom reliable survey data existed in order to facilitate more detailed analysis of attitudinal and behavioral trends; To assess change or continuity in the incidence and distribution of AIDS risk behaviors over the year between the 1987 KABB survey and the 1988 KABB survey; To assess change or continuity in knowledge levels and attitudes of high-risk individuals between the two surveys; To measure the effectiveness of recent educational initiatives in California, including the national household mailing conducted by the Surgeon General of the United States.

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.

Safer Sex Intervention (SSI)

Investigators: Lydia A. Shrier, MD, MPH, Rose Ancheta, MPH, Elizabeth Goodman, MD, Victoria Chiou, BA, Michelle R. Lyden, RN, PNP, & S. Jean Emans, MD

Data from the Centers for Disease Control and Prevention suggest that over 50% (and in some years, as high as two thirds) of the population who contract an STI are under the age of 25, and disproportionately, are adolescent girls. Adolescent girls with an STI infection are at risk for recurrence and more long-term reproductive health issues such as pelvic inflammatory disease (PID) and infertility. Safer Sex Intervention (SSI) is an individualized STI intervention program aimed at sexually active young women, ages 13-23, who have been diagnosed with an STI. The overall goals are to reduce high-risk sexual behaviors, increase condom use and prevent the recurrence of an STI among sexually active young women. The program is appropriate for use in clinics or community based organizations led by a female health educator. This individualized intervention was designed to be delivered at the time of STI diagnosis/treatment, when the participant was most likely to be contemplating her diagnosis relative to her sexual risk behaviors. The intervention is administered 1-on-1 and face-to-face using one of two discrete 30- to 50-minute sessions. Safer Sex Intervention (SSI) was evaluated with an opportunistic study design (at time of STI treatment) that included baseline, 1, 3, 6 and 12 month follow up. Subjects were female, under 24 years of age, with a diagnosis and treatment plan for either cervicitis or PID. At 1 month, the intervention condition subjects had increased sexual risk knowledge (P=.02), more positive attitudes towards condom use (P=.007). At 6 months, intervention subjects report fewer instances of sexual intercourse with non-main partners than the standard-of-care condition. In other words, they were more likely to report lower sexual risk (sex with a non-main partner) as compared to the standard-of-care (control) condition (P=.01). Consistent with findings at 1 month, the intervention condition had a continued increase in positive attitudes regarding condoms (P=.007). One year after SSI, the girls who received the program were more likely to have a main sexual partner and thus, decreased their risk (P=.07) and were also less likely to have recurrence of an STI than the control group (but this was not significant; P=.17). SSI is supported by the Office of Adolescent Health (OAH)'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.

ABAN AYA Youth Project: 5th Grade

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 5th Grade product contains all of the materials needed to implement the ABAN AYA 5th grade curriculum. 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.

Computer-Assisted Motivational Interviewing (CAMI): Preventing Repeat Births Among Adolescent Mothers

Investigators: Beth Barnet, Jiexin Liu, Margo DeVoe, Anne K. Duggan, Melanie A. Gold, & Edward Pecukonis

According to the Centers for Disease Control and Prevention, in 2010, more than 360,000 infants were born to women aged 15 to 19 years in the United States. Nearly one-quarter of adolescent mothers give birth to another child within two years, despite national efforts to increase timing between births. Adolescent mothers who give birth to more than one child may be at high risk for experiencing poorer medical, educational, economic, and developmental outcomes. The purpose of the Computer-Assisted Motivational Interviewing (CAMI) is to increase motivation among adolescent mothers to consistently use condoms and contraception with the long-term goal of reducing rapid repeat births. CAMI consists of at least two 60-minute sessions conducted in two-parts by trained counselors who meet one-on-one with pregnant and/or parenting adolescent mothers, ages 12 through 18 years old. During the first part of each session, participants use the computer-based CAMI Program to answer questions about current sexual relationships and contraceptive use intentions and behaviors. Based on the responses generated, CAMI counselors conduct a stage-matched motivational interviewing session to enhance participants' motivation to consistently use condoms and contraception in order to reduce the risk for a repeat pregnancy. An evaluation of CAMI has demonstrated that receiving two or more CAMI sessions, either alone or within a multi-component home-based intervention, reduced the risk of repeat births among adolescent mothers aged 18 years and younger. Click here to view more detailed information on this program.

ABAN AYA Youth Project: 6th Grade

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 6th Grade product contains all of the materials needed to implement the ABAN AYA 6th grade curriculum. 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.

ABAN AYA Youth Project: 7th Grade

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 7th Grade product contains all of the materials needed to implement the ABAN AYA 7th grade curriculum. 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.

ABAN AYA Youth Project: 8th Grade

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 8th Grade product contains all of the materials needed to implement the ABAN AYA 8th grade curriculum. 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.

FOCUS: Preventing Sexually Transmitted Infections and Unwanted Pregnancies among Young Women

Investigators: Cherrie Boyer, Mary-Ann Shafer, Lance Pollack, Kelli Betsinger, Y. Jason Yang, Julius Schachter, Richard Shaffer, Stephanie Brodine, Heidi Kraft

The FOCUS program, a four-session cognitive-behavioral group intervention addressing prevention of sexually transmitted infections (STIs) and unintended pregnancies, was originally delivered to young women US Marine Corps recruits. Following a baseline survey, 2,157 women were randomized into either the experimental group (n=1,062) or the control group (n=1,095). Both groups received interventions of four two-hour sessions. Follow-up surveys were conducted with both groups at approximately four months post-baseline and approximately 14 months post-baseline. The evaluation results revealed that a higher proportion of the control group had a post-intervention STI or unintended pregnancy than the intervention group (Odds Ratio = 1.41, 95% Confidence Interval = 1.01-1.98). Among study participants who had no pre-intervention history of STIs or pregnancy, but who engaged in risky sexual behaviors just before recruit training, the control group was significantly more likely to acquire a post-intervention STI than the intervention group (OR = 2.05, CI = 1.74-4.08). Among study participants who reported not being sexually experienced at baseline, control group participants were significantly more likely to have had multiple sexual partners post-intervention than intervention group participants (OR = 1.87, CI = 1.01-3.47). FOCUS is supported by the Office of Adolescent Health (OAH)'s Teen Pregnancy Prevention (TPP) program as an EBI that is medically accurate, age appropriate, and has been proven through rigorous evaluation to prevent teen pregnancy and/or associated sexual risk behaviors. Click here to view more detailed information on this program.