CULTURALLY APPROPRIATE STD/AIDS EDUCATION

IN A CLINIC SETTING

OVERVIEW

Two culturally appropriate STD/AIDS education interventions were developed for use with African American male adolescents in clinic settings – one was a short videotape; the other was a brief presentation by a health educator.  In a random assignment study, African American male adolescents were randomly assigned to receive either the videotape intervention, the health educator delivered intervention, or standard clinic services. 

Adolescents who received the video intervention scored higher than did adolescents who received standard clinic services on a post-test measure of sexual knowledge.  Adolescents who received the health educator delivered intervention scored even higher than did adolescents who received the video intervention.  All adolescents had greater confidence in their ability to use condoms, but adolescents who received the health educator-delivered intervention reported greater confidence in their ability to use condoms at post-test than did adolescents who received standard clinic services.  During a six-month follow-up period, however, neither the adolescents who received the video intervention nor the adolescents who received the health educator delivered intervention practiced more consistent condom use than did adolescents who received standard clinic services.

DESCRIPTION OF PROGRAM

Target population: African American males, aged 15-19

A videotape was developed to promote condom use among African American male adolescents in clinic settings.  The 14-minute videotape was designed by adolescents in the target population to be culturally appropriate – it included actors, dress, music, and language suitable for an African American adolescent audience.  The video focused on a message of “We got to keep the brothers alive” and discussed the risks of STDs and the benefits associated with condom use.  The video also included a demonstration of the correct way to put on and take off a condom.

A health educator was trained to deliver messages comparable to those in the video.  The health educator followed a 14-minute script that touched on all the topics covered in the videotape.  Having a health educator deliver the intervention content allowed for each patient to ask questions about intervention content and to receive feedback as he practiced placing and removing a condom from a penis model.

EVALUATION(S) OF PROGRAM

Evaluated population: 562 African American males seeking care at a city health department STD clinic served as the study sample for this investigation.  Males were between the ages of 15 and 19.  Over one-quarter of the subjects had already fathered at least one child.

Approach: Subjects were randomly assigned to the videotape condition, the health educator condition, or a control group.  Subjects assigned to the videotape condition viewed the 14-minute videotape as part of their clinic session.  Subjects assigned to the health educator condition engaged in a 14-minute session with an African American female health educator as part of their clinic session.  Subjects assigned to the control group received the clinic’s standard care and education program.

All subjects completed baseline questionnaires before receiving care.  Follow-up questionnaires were administered immediately after subjects received care, one month after baseline, and six months after baseline.

Results: All subjects showed gains in sexual knowledge at immediate post-test.  Subjects who viewed the videotape showed greater gains than did control subjects.  Subjects who met with the health educator showed even greater gains than did subjects who viewed the videotape. 

Also, all subjects reported greater confidence in their condom use abilities at immediate post-test.  Subjects who met with the health educator reported greater confidence than did control subjects.  And, among subjects with a steady sexual partner, subjects who met with the health educator also reported greater intention to use condoms than did control subjects. 

There were no significant differences between any groups on frequency of condom use, however.  Further, at neither the one-month or the six-month follow-up did any significant differences emerge between groups on frequency of sex or number of sexual partners.

SOURCES FOR MORE INFORMATION

References:

DeLamater, J., Wagstaff, D.A., & Havens, K.K.  (2000).  The Impact of a Culturally Appropriate STD/AIDS Education Intervention on Black Male Adolescents’ Sexual and Condom Use Behavior.  Health Education & Behavior, 27(4), 454-470.

Program categorized in this guide according to the following:

Evaluated participant ages: 15-19

Program age ranges in the guide: Youth

Program components: Clinic-Based

Measured outcomes: Reproductive Health

Program information last updated on 2/8/07.