Program

Jun 16, 2014

OVERVIEW

All4You2! is a school-based HIV/STI/pregnancy prevention program, designed for students in alternative schools. The program is a follow-up to the previous All4You! program and is aimed to tackle unanswered questions about whether service learning or skills-based components of the curricula are what contribute to observed changes in behavior. In an experimental study, classrooms were randomly assigned to one of four conditions: HIV/STI/pregnancy prevention curriculum only, service learning only, the combined HIV/STI/pregnancy prevention and service learning curriculum, or the attention control curriculum. The HIV/STI/pregnancy prevention program was found to have positive, statistically significant short-term impacts on reported engagement in unprotected sexual intercourse and exposure to risky situations compared with the control group. Behavioral impacts were found to diminish over time. No statistically significant behavioral impacts were found for the service learning condition or for the service learning and HIV/STI/pregnancy prevention combination relative to the no-treatment control group. Positive impacts on psycho-social factors were limited.

DESCRIPTION OF PROGRAM

Target population: Students attending alternative high schools.

All4You2! is a school-based HIV/STI/pregnancy prevention program for students in alternative schools. The program is designed to decrease engagement in risky sexual behavior. Treatment consists of in-school curricula, involving 32 hours of instruction taught two to three times per week. The content includes highly structured, interactive lessons taught by trained health educators with experience in alternative schools. Content areas include examining attitudes toward sex and building skills for correct condom use, as well as service learning through class visits during school hours to volunteer sites, and participating in preparation and reflection.

EVALUATION OF PROGRAM

Coyle, K.K., Glassman, J.R., Franks, H. M., Campe, S.M., Denner, J., & Lepore, G.M. (2013). Interventions to reduce sexual risk behaviors among youth in alternative schools: A randomized controlled trial. Journal of Adolescent Health, 53, 68-78.

 Evaluated population: The sample consisted of 47 classrooms containing 765 students from 11 northern California alternative high schools. All students enrolled at baseline were eligible unless they were on extended leave, had been suspended or incarcerated, or were categorized as having dropped out of school due to low attendance. The mean age of the study population was 16.2 years; 37.9 percent were Hispanic/Latino, 22.3 percent were African American, and 53 percent were male

Approach: The sample was randomized at the level of the classrooms, which were assigned to one of four intervention conditions: HIV/STI/pregnancy prevention curriculum only (N = 212); service learning only (N = 184); the combined HIV/STI/pregnancy prevention and service learning condition (N = 149), or the attention control curriculum (N = 217).

The service learning and HIV/STI/pregnancy prevention groups received instruction from the attention control curriculum to make the length of each intervention condition equal. The HIV/STI/pregnancy prevention group lessons involved examining attitudes toward sex and building skills for correct condom use. The service learning curriculum included class visits during school hours to volunteer sites, as well as participating in preparation and reflection. The combined group received parts of both of these sets of instruction. The attention control curriculum involved lessons about physical education and nutrition.

Data were collected at baseline, as well as at 6 and 18 months following baseline. Data were collected on sexual risk behaviors, engagement in volunteering, and psycho-social factors that included knowledge about sex, perceived self-efficacy, negotiating skills, and attitudes and beliefs about sex and condoms.

No statistically significant differences between treatment groups were found at baseline in terms of sexual behaviors. Attrition reached 30 percent by the second follow-up survey, although no statistically significant differences in attrition rates were found between treatment groups.

Results: Compared with the control group, HIV/STI/pregnancy prevention group students were significantly less likely to have intercourse without a condom in the three months prior to the 6-month follow-up, but by the 18-month follow-up these effects had diminished. The HIV/STI/pregnancy group also reported having sexual intercourse fewer times compared with the control group at both follow-ups, however the impact was not statistically significant. There were no statistically significant impacts on behavioral outcomes for the service learning or combined conditions at either follow-up.

Compared with the control group, students in the HIV/STI/pregnancy prevention group reported higher levels of refusal self-efficacy, but these impacts were not statistically significant. Members of the HIV/STI/pregnancy group were significantly less likely to place themselves in risky situations at the second follow-up. Students in the service learning group reported a significantly lower sense of efficacy to make change in their communities and less favorable perceptions of peer condom use at both follow-ups. The combination group reported a lower sense of efficacy to make change in their communities at both follow-ups, though this difference was not statistically significant. The combination group also reported lower levels of optimism at both follow-ups. This impact was significant at the 6-month follow-up, but not at the 18-month follow-up.

Several statistically significant impacts emerged between participants in the combination and individual component conditions. Most notably, compared with the HIV/STI/pregnancy prevention group, participants in the combination group reported lower levels of optimism at the 6-month follow-up and lower sense of efficacy to make change in their communities at the 18-month follow-up. Students in the combination group also reported significantly lower levels of efficacy to make change in their communities than the service learning students at both follow-ups.

SOURCES FOR MORE INFORMATION

References

Coyle, K.K., Glassman, J.R., Franks, H. M., Campe, S.M., Denner, J., & Lepore, G.M. (2013). Interventions to reduce sexual risk behaviors among youth in alternative schools: A randomized controlled trial. Journal of Adolescent Health, 53, 68-78.

Contact Information

Karin K. Coyle, Ph.D.

Research Department, ETR Associates

4 Carbonero Way,

Scotts Valley,

CA 95066

karinc@etr.org

831-438-4060

KEYWORDS: Adolescents, High School, Males and Females (Co-ed), High-Risk, Black/African American, Hispanic/Latino, School-based, Skills Training, Service Learning, Health Status/Condition, Community Service, Teen Pregnancy, STD/HIV/AIDS, Sexual Activity, Condom Use and Contraception

Program information last updated on 6/16/14