Poder Latino: A Community AIDS Prevention Program for Inner-City Latino Youth

Investigators: Hispanic Office of Planning & Evaluation and New England Research Institutes

This multifaceted community-based intervention targets Latino youth, ages 14 to 20, at elevated risk for HIV/AIDS. One goal of the program is to increase awareness of the disease by saturating target neighborhoods with public service announcements broadcasting risk reduction messages. In addition, the program aims to reduce infection by encouraging sexually active teens to use condoms. Project messages are reinforced through ongoing activities conducted by specially-trained peer leaders, including workshops in schools, community organizations, and health centers, group discussions in teens' homes, presentations at large community centers, and door-to-door canvassing. At all activities, condoms are available, along with pamphlets explaining their correct use. In a field study of the intervention in Boston, MA, researchers compared the sexual behavior of teens in the target community and a similar, control community. At the 18-month follow-up assessment, the intervention appeared to reduce the incidence of multiple sexual partners among females and delay the onset of sexual activity among males. 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.

Information-Motivation-Behavioral Skills HIV Prevention Program (IMB)

Investigators: Jeffrey Fisher, William A. Fisher, Stephen J. Misovich, & Angela D. Bryan

The goal of the Information-Motivation-Behavioral Skills HIV Prevention Program (IMB Program) is to reduce high school students' risk of HIV infection. Program objectives include positively influencing students' HIV prevention knowledge, attitudes and norms, increasing students' levels of HIV prevention behavioral skills, and increasing students' levels of HIV preventive behavior. The intervention involves a four-session classroom component to be conducted by trained high school teachers. The IMB Program is based on the Information, Motivation and Behavioral Skills (IMB) model of health behavior change, which assumes that information, motivation and behavioral skills are the fundamental determinants of HIV preventive behavior. An evaluation of the curriculum offered in three intervention formats (classroom-based only, peer-based only, and combination classroom and peer-based delivery) was conducted by the Center for Health/HIV Intervention and Prevention in 1999. Participants were 1,577 students in four inner-city high schools in Connecticut (61% African-American, 28% Hispanic-American, 11% Caucasian, mixed or "other.") The classroom-based HIV prevention education component effectively promoted risk reduction behavior change in these urban high school settings at one year post-intervention. 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 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.

Family Growth Center: A Community-Based Social Support Program for Teen Mothers and Their Families

Investigators: Richard Solomon & Linda Solomon

The Family Growth Center (FGC) is a comprehensive, community-based family support program designed to reduce repeat pregnancy and school drop-out rates among adolescent mothers. The program aims to provide teen mothers in high-risk neighborhoods with a comprehensive set of educational and support services, offered within family and neighborhood contexts. Young women are recruited for the program by perinatal counselors/coaches when they arrive at participating hospital clinics for prenatal visits. Thereafter, they are offered a range of intervention components, coordinated by FGC Case Managers. Program components include home visits, crisis intervention, bimonthly parenting classes, supervised daycare, transportation services, recreational opportunities, and advocacy and referral services. The evaluated FGC Pilot Program took place in several of Pittsburgh's high-risk urban neighborhoods. Of the 88 first-time mothers recruited for the study, 49 were assigned to the intervention group and 39 to the control group. An attrition group was formed to follow the 25 women (15 intervention, 10 control) who dropped out of the program. Protocol assessment measures were diverse and included interview and questionnaire data and psychosocial and behavioral outcomes of mothers and their children. Researchers found that the proportion of the intervention group mothers who dropped out of school (3/34) was significantly less than the proportion of the control group (12/29), a pattern which held at both Time 1 (two years after recruitment) and Time 2 (three years after recruitment) analysis points. Significant differences were also found in the frequency of repeat pregnancies between the two groups. At Time 1, three repeat pregnancies occurred in the intervention group (less than 10%) versus 11 repeat pregnancies (38%) in the control group (p=0.006). The Time 2 pattern was the same, with a total of 7 repeat pregnancies among the intervention group and 21 within the control group (p=0.020). 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.

Human Sexuality - Values & Choices: A Values-Based Curriculum for 7th and 8th Grades

Investigators: Search Institute

Developed for use in 7th and 8th grade classrooms, this program aims to reduce teenage pregnancy by promoting seven core values that support sexual abstinence and healthy social relationships: equality, self-control, promise-keeping, responsibility, respect, honesty, and social justice. The curriculum including 15 student lessons and 3 adult-only sessions is distinguished by: 1) an emphasis on parent-child communication; and 2) the use of a standardized, video-assisted format. Participants gain mastery through role plays, group discussions, and behavioral skills exercises. Following a field test in nine schools, program participants showed a greater understanding of the risks associated with early sexual involvement, and they expressed increased support for postponing sexual activity, as compared to a control group of their peers. Click here to view more detailed information on this program.

Keepin' It R.E.A.L.! A Mother-Adolescent HIV Prevention Program

Investigators: Colleen DiIorio, Frances McCarty, Dongqing Terry Wang, Pamela Denzmore, Ken Resnicow, Anindya K. De, William N. Dudley, PhD

The KEEPIN. IT R.E.A.L.! (Responsible, Empowered, Aware, Living) evaluation tested the effectiveness of two HIV prevention interventions designed for mothers and their adolescents, as compared to a control group. Sites were randomly assigned to one of three conditions: the Social-Cognitive program (SCT--four sites, the focus of this replication kit); another program not included in this kit; or the control condition (four sites). The SCT program was designed to delay initiation of sexual intercourse for those adolescents who were not yet sexually active, and to increase condom use among sexually active participants. SCT involved seven 2-hour meetings conducted over 14 weeks. Participating adolescents (N = 582) were between the ages of 11 and 14 years, mostly male (60%), and African American (97.7%). The number of participating mothers was 470; 110 mothers had more than one adolescent in the study. Assessments were conducted at baseline, and at 4, 12 and 24 months after baseline. At the 24-month assessment, a higher percent of sexually active participants in the SCT groups reported condom use at last sex compared to their control group peers (96% and 85%, respectively), condom use intentions (100% and 94%, respectively), and cessation of sexual activity until they were older (43% and 24%, respectively). For the mothers, their levels of self-efficacy and comfort for talking with their adolescents about sex increased over time. Both mothers and adolescents demonstrated an increase in HIV knowledge. Click here to view more detailed information on this program.