Focus on Kids

FOCUS ON KIDS

OVERVIEW

Focus on Kids was developed as an AIDS prevention program for low-income African American children, aged 9-15. In an initial random assignment study, groups of friends were randomly assigned either to take part in the Focus on Kids intervention or to be members of a control groups. Groups of friends took part in Focus on Kids sessions together. Control group members were invited to attend informational sessions on AIDS; however, no effort was made to deliver informational sessions to naturally existing groups of friends. At the 6-month follow-up, children from friendship groups assigned to take part in the Focus on Kids intervention were significantly more likely than control children to report having used a condom during their last episode of intercourse. This intervention impact was no longer significant at the 12-month follow-up, but, after a booster session, was once again significant at the 18-month follow-up.

Another evaluation examined the program’s impact on white adolescents in rural communities and found that it had a positive impact on perceptions of abstinence on condom use, but no impacts on behavior.

A third evaluation randomly assigned black adolescents to receive the Focus on Kids intervention only, the Focus on Kids intervention plus a parental monitoring intervention called ImPACT, or both interventions plus boosters for the Focus on Kids intervention. This evaluation found that the combined intervention was superior to Focus on Kids alone in terms of impacts on sexual behavior, condom use, alcohol consumption, cigarette use, and perceptions of parental monitoring six months following the intervention; but by twelve months after the intervention the combined intervention was only superior in terms of drug use. Half of those in the combined intervention, selected randomly, received booster sessions after the six-month assessments and at ten months. Boosters had a positive impact on reducing crack/cocaine use, drug selling, and perceptions of problem communication with parents, but not on other risky behaviors or perceptions of parental monitoring or open communication with parents.

DESCRIPTION OF PROGRAM

Target population: groups of African American friends, aged 9-15

Focus on Kids is based on Protection Motivation Theory and was originally designed to be delivered to small groups of same-gender friends. Topics under discussion include decision-making, goal-setting, communication, negotiation, and consensual relationships. Communication and negotiation skills are emphasized, as are facts about AIDS, STDs, contraception, and human development. Multiple content delivery formats are employed, including small group discussions, lectures, videos, games, role-playing, acting, storytelling, and crafts projects. The program concludes with children developing community projects.

EVALUATION(S) OF PROGRAM

Stanton, B. F., Li, X., Galbraith, J., Feigelman, S., & Kaljee, L. (1996). Sexually Transmitted Diseases, Human Immunodeficiency Virus, and Pregnancy Prevention: Combined Contraceptive Practices Among Urban African-American Early Adolescents. Archives of Pediatric and Adolescent Medicine, 150, 17-24.

Stanton, B. F., Li, X., Ricardo, I., Galbraith, J., Feigelman, S., & Kaljee, L. (1996). A Randomized, Controlled Effectiveness Trial of an AIDS Prevention Program for Low-Income African-American Youths. Archives of Pediatric and Adolescent Medicine, 150, 363-372.

Evaluated population: 383 African-American children between the ages of 9 and 15 served as the study sample for this investigation. Children were recruited from nine recreation centers associated with three public housing developments in Baltimore, Maryland. 36% of children were sexually active prior to entry into the study.

Approach: Research staff conducted three introductory sessions at each recreation center in order to create interest in the study. Children were informed that they would have to enroll in the study as part of a “friendship group.” That is to say, children had to sign up with 3 to 10 same-gender friends in order to participate in the study.

383 children (organized into 76 friendship groups) received parental consent to participate in the study. Friendship groups were matched on the basis of gender, age, and sexual experience of group members. Friendship groups were then randomly assigned, within pairs, to receive either the treatment program or the control program.

Friendship groups assigned to receive the treatment program took part in the Focus on Kids intervention. Focus on Kids sessions were delivered to friendship groups by pairs of interventionists. Most interventionists were African Americans from the Baltimore community. At least one interventionist from each pair was gender-matched to the friendship group. Groups met at local community centers for 1.5 hours each week for seven weeks and then took part in a day-long session at a rural campsite.

Children from friendship groups assigned to receive the control program were invited to attend weekly AIDS information sessions offered at six sites in the community. No attempt was made to deliver these sessions to natural friendship groups; individuals could attend any session with or without their friends. Each session featured a video on AIDS and discussion of the video’s content.

Both the Focus on Kids program and the control program provided attendees with condoms.

All children completed questionnaires before the programs began. Follow-up questionnaires were distributed at 6, 12, and 18 months.

Results: At the 6-month follow-up, children from friendship groups assigned to take part in the Focus on Kids intervention were significantly more likely than control children to report having used a condom during their last episode of intercourse. They were also significantly more likely to report having an intention to use condoms, to perceive their peers as being condom-users, and to perceive themselves as being vulnerable to HIV.

By the 12-month follow-up, however, all intervention impacts were gone. Children from friendship group assigned to take part in the Focus on Kids intervention did not differ significantly from control children on any outcome measure.

At the 18-month follow-up, children from friendship groups assigned to take part in the Focus on Kids intervention were once again more likely to be using condoms than were control children.

At no time point did children from friendship groups assigned to take part in the Focus on Kids intervention differ significantly from control children on a measure of AIDS knowledge.

Stanton, B. Harris, C. Cottrell, L., Li, X., Gibson, C., Guo, J., Pack, R., Galbraith, J., Pendleton, S., Wu, Y., Burns, J., Cole, M., & Marshall, S. (2006). Trial of an urban adolescent sexual risk-reduction intervention for rural youth: A promising but imperfect fit. Journal of Adolescent Health, 38, 55.e25-55.e36.

Evaluated population: Participants were 1,131 white adolescents between the ages of twelve and sixteen years from twelve rural counties in West Virginia that had low rates of STDs. Of the total sample, 422 were recruited from community settings, and 709 were recruited from schools.

Approach: Groups (n=110) were randomly assigned to receive the Focus on Kids intervention or to the control condition. The control condition involved an environmental health intervention. Of those assigned to the Focus on Kids intervention, 84 percent completed it, and of those assigned to the control intervention, 88 percent completed it. For the community settings, the Focus on Kids intervention was delivered in one day-long session or two half-day sessions. For the school settings, the Focus on Kids intervention was delivered in the original eight-session format. Participants were assessed at baseline and three, six, and twelve months post-intervention on sexual initiation and participation, condom use behaviors, and perceptions of abstinence and condom use.

Results: Those who received the intervention had more positive perceptions of efficacy regarding abstinence at six months post-intervention and more positive perceptions of condom use at both three and six months post-intervention, compared with controls. There was no intervention impact on sexual initiation or participation or on condom use.

Wu, Y., Stanton, B.F., Galbraith, J.,Kalijee, L., Cottrell, L., Li, X., Harris, C.V., D'Alessandri, D., & Burns, J.M. (2003). Sustaining and broadening intervention impact: A longitudinal randomized trial of 3 adolescent risk reduction approaches. Pediatrics, 111, e32-e38.

Evaluated population: The sample was 817 Black adolescents between twelve and sixteen years old from 35 low-income communities. The sample was 42 percent male.

Approach: Participants were randomly assigned to receive the Focus on Kids intervention, the Focus on Kids intervention plus the ImPACT intervention (a parental monitoring intervention delivered in the home), or both interventions with boosters for the Focus on Kids intervention. Boosters occurred immediately after the six-month follow-up and ten months after the intervention for those randomly assigned to receive boosters; they involved reviewing activities completed in the initial sessions as well as new activities to review content from the initial sessions. Participants were assessed at baseline, and six and twelve months following the intervention on risk behaviors, risk-taking intentions, and perceptions of parental monitoring and communication.

Results: At six months post-intervention, participants who received the Focus on Kids plus ImPACT interventions had lower rates of sexual intercourse, sex without a condom, and alcohol and cigarette use, and they had marginally lower rates of risky sexual behavior, compared with those who only received the Focus on Kids intervention. Those who received both the Focus on Kids and ImPACT interventions also had greater perceptions of parental monitoring at six months post-intervention, compared with those who only received the Focus on Kids intervention. At twelve months post-intervention , those who received both the Focus on Kids and ImPACT interventions had lower rates of alcohol and marijuana use and marginally lower rates of cigarette use, compared with those who only received the Focus on Kids intervention. There was no impact on other risky behaviors or perceptions of parental communication. At twelve months post-intervention, those who received Focus on Kids and ImPACT with boosters had lower rates of crack/cocaine use and drug selling and lower perceptions of problem communication with parents, compared with those who received both intervention, but no boosters. There was no impact of the boosters on other risky behaviors or perceptions of parental monitoring or open communication.

SOURCES FOR MORE INFORMATION

Curriculum materials available for purchase at:

http://pub.etr.org/ProductDetails.aspx?prodid=R565

References:

Program categorized in this guide according to the following:

Evaluated participant ages: 9-15

Program age ranges in the guide: Middle Childhood, Adolescence, Youth

Program components: Clinic/Provider-Based, School-Based

Measured outcomes: Reproductive Health

KEYWORDS: Middle Childhood (6-11), Adolescence (12-17), Children (3-11), Black or African American, White/Caucasian, Community-based, School-based, Skills Training, Community or Media, Life Skills Training, Urban, Rural, Reproductive Health, STD/HIV/AIDS, Risky Sex, Teen Pregnancy

Program information last updated on 1/11/11.

		© Child Trends 2004