Guide to Effective Programs
for Children and Youth

Youth AIDS Prevention Project

OVERVIEW

The Youth AIDS Prevention Project (YAPP) for junior high school students is a school-based prevention program designed to prevent HIV/AIDS and STDs among 7^th and 8^th graders and was implemented in the early 1990s. YAPP includes a curriculum that integrates AIDS education, emphasizes abstinence, provides parent-child communication activities, and focuses on refusal, negotiation, and decision-making skills. Fifteen urban school districts were randomly assigned to assess the impacts of YAPP. Results showed that there was no statistical difference between the control and treatment groups on number of partners or use of condoms, but students in the treatment group were more likely to have used condoms with foam by eighth grade. Among students who became sexually active between the pretest and posttest, use of condoms and spermicidal foam was higher.

DESCRIPTION OF PROGRAM

Target population: African-American junior high school students

The Youth AIDS Prevention Project (YAPP) for junior high school students was designed using social cognitive theory and the social influences model of behavior change. YAPP is a school-based prevention program which promotes abstinence as its main goal and is also designed to prevent STDs, HIV/AIDS, and substance abuse among young teens. The classroom intervention consists of 10 sessions over a 2-week period (one per day) in the 7^th grade and 5 additional sessions over a 1-week period in the 8^th grade. The program takes place during regularly scheduled health classes and consists of lectures, discussions, videos, group exercises, role plays, educational competitions, and discussion of questions from students. All of the sessions were carried out by Master’s level health educators who were extensively trained. The study focused on the impact of YAPP on student participation in sexual intercourse, use of condoms and foam, and student intentions in the next 12 months to have sexual intercourse while using condoms and spermicidal foam.

EVALUATION(S) OF PROGRAM

Levy, S.R., Perhats, C., Weeks, K., Handler, A.S., Zhu, C. & Flay, B.R. (1995). Impact of a School-Based AIDS Prevention Program on Risk and Protective Behavior for Newly Sexually Active Students. Journal of School Health, 65, (4,) 145-151.

Evaluated population: 15 school districts were recruited from 45 districts in the Chicago metropolitan area. These school districts were at the greatest risk for HIV infection and were high in other risk factors such as poverty, proportion of minorities, STD rates, teen pregnancies, drop out rates, and reading scores on state exams.

Approach: The school districts were randomly assigned to one of the three conditions: parent interactive treatment (n=5), parent noninteractive treatment (n=5) and delayed treatment/control (n=5). All three groups were given pretest and posttest surveys. The students in the control group received basic AIDS education as taught by their schools, such as short workshops or a simple health museum field trip. The two experimental groups both underwent the same classroom intervention, while one treatment group added a parental involvement component. For analysis the two treatment groups were linked together due to lack of parent involvement in the parent interactive treatment group. The students were 7^th and 8^th graders, the majority of whom were African-American. The total study population was 1,669, with 668 children in the control group and 1,001 children in the combined treatment group. This total population was a decrease from the original 2,393 seventh grade students, reflecting 32 percent attrition for the treatment group and 30 percent for controls. Many cases were not included in the analysis due to dropouts, absenteeism, and family mobility.

Results: About one-third of the entire evaluated population had had sexual intercourse by the 7^th grade and about half of the total evaluated population had had sexual intercourse by 8^th grade posttest. No differences were found in risk behaviors comparing the treatment and control groups, however. About 19% of the students who became sexually active between 7^th and 8^th grade were labeled as “changers” for non-experimental analyses.

The researchers analyzed the impacts of the treatment on the changers, and the following results are in regards to only the changers. There were no differences between the control and treatment groups in number of sexual partners and condom usage. There was a statistically significant difference between the control and treatment groups in condom usage with spermicidal foam. Researchers also found that there was no difference between the two groups on the students’ intentions to have sex or use condoms in the next 12 months, but students again differed significantly in their intentions to use condoms with spermicidal foam. The researchers concluded that the treatment program (YAPP) influenced changers to take on protective sexual behaviors. For those planning to have sex, 84.6 percent of the treatment group intended to use condoms with foam whereas 62.9 percent of the control group had similar intentions. An effect size of 1.81 (p<.1) was found for the YAPP group on whether they have used condoms in the previous 12 months and effect size 3.36 (p<.001) for using condoms in the next 12 months.

The authors note that a major limitation of this study is that a substantial number of cases were lost for the posttest which meant many of the changers were in fact not high risk, since many of the lost cases were more likely to be sexually active and have elicit drug use. Additionally, since the school districts were recruited and not chosen randomly, the results may only be generalized to the specific population for which the study was conducted.

Note: Analyses were not designed to adjust for the effect of clustering within schools.

Weeks, K., Levy, S. R., Gordon, A. K., Handler, A., Perhats, C., & Flay, B. R. (1997). Does parental involvement make a difference? The impact of parent interactive activities on students in a school-based AIDS prevention program. AIDS Education and Prevention, 9, 90-106.

Evaluated Population: 7^th grade students were recruited from 15 school districts with higher risk for HIV and AIDS. All participants (N=2,392) were surveyed at seventh and eighth grades. Researchers attempted to contact students at the ninth grade follow-up; a 55.8% response rate yielded a sample of 1,229 students who completed surveys.

Approach: School districts were randomly assigned to one of three conditions. The parent-interactive (N=5 schools) condition received fifteen 40-50 minute lessons of the YAPP treatment program. In addition, students in this condition were given homework assignments to be worked on with a parent. The parent non-interactive (N=6 schools) condition also received fifteen 40-50 minute YAPP program lessons but were not assigned homework to be completed with a parent. The control (N=6 schools) condition consisted of a delayed treatment where received basic, minimal AIDS education. Data were collected on AIDS-related knowledge and opinions as well as self-reported participation in AIDS-related risk behaviors at seventh grade pre-test, eighth grade post-test, and at ninth grade 1 year follow-up.

Results: At pre-test, students in the control group were found to have higher levels of AIDS-related knowledge compared with the intervention groups. At the post-test data collection point, students in the treatment conditions had higher levels of AIDS-related knowledge compared with the control group. At post-test, students in the intervention groups were more comfortable in talking with parents about sexuality and drug issues compared with students in the control group. At 1 year follow-up, the treatment did not have any impact on student behaviors compared to the control group in the areas of sexual activity, recently bought condoms, use of condoms, or the intention to use condoms. The only treatment effects were found in the area of intention to use condoms with foam such that students in treatment groups (M=3.31-nonparent, 3.27-parent) were more likely to report the intention to use condoms with foam than the control group (M=2.97). Difference between non-parent and parent conditions were found in reports of using condoms with foam last time participant had sex, recently bought condoms with foam, and overall use of condoms with foam such that participants in the parent condition were less likely to report using or buying condoms with foam compared with the non-parent condition.

It is important to note that students who dropped out of the study were more likely to be involved with high-risk activities at baseline compared to those who remained in the study.

Note: Analyses were not designed to adjust for the effect of clustering within schools.

SOURCES FOR MORE INFORMATION

Link to program curriculum: http://www.socio.com/srch/summary/pasha/passt06.htm

References

Program categorized in this guide according to the following:

Evaluated participant ages: 7^th and 8^th graders, adolescence (12-14).

Program components: school-based, parent or family based.

Measured outcomes: education and cognitive development; teen pregnancy and reproductive heath

Program information last updated 11/13/07