Program

Oct 07, 2014

OVERVIEW

Aimed at adolescent girls in low-income urban settings, this Healthy Improvement Project for Teens (HIP Teens) program gives participants information on risky sexual behaviors, motivation to avoid engaging in them, and the behavioral skills needed to apply what was learned in the program. It is designed to reduce the likelihood of risky sexual behavior and subsequently avoid its negative consequences, including unplanned pregnancy and sexually transmitted infection. In a randomized controlled trial of the program, participants had fewer sexual partners, fewer episodes of protected and unprotected vaginal intercourse, and fewer pregnancies than the control group after the intervention was complete. However, there was no difference in rates of sexually transmitted infection between the two groups.

DESCRIPTION OF PROGRAM

Target population: Adolescent girls in low-income urban areas

This Healthy Improvement Project for Teens (HIP Teens) program is a clinic-based approach that seeks to minimize the occurrence of these negative outcomes using an Information-Motivation-Behavioral (IMB) Skills model. Program participants received information about HIV, motivation to reduce or change risky behaviors, and instruction on how to interact and self-manage in ways that facilitate safer behavior and condom use, although contraception and pregnancy prevention were not specifically addressed. In four weekly, two-hour meetings, small groups of teenage girls meet with facilitators and participate in interactive learning activities that gradually become more challenging. Facilitators are trained, follow a program manual, and work in pairs. Three and six months after the month-long program, participants also attend 90-minute “booster” sessions where HIP Teens principles are reinforced.

 

EVALUATION OF PROGRAM

Morrison-Beedy, D., Jones, S., Xia, Y., Tu, X., Crean, H., & Carey, M. (2013). Reducing Sexual Risk Behavior in Adolescent Girls: Results From a Randomized Controlled Trial. Journal of Adolescent Health, 52, 314-321.

Evaluated population: The study sample consisted of 639 English-speaking girls, ages 15-19. Participants were recruited from youth development centers, adolescent health services, and school-based centers in upstate New York. To participate, girls had to be unmarried, sexually active in the past three months, not pregnant, and not having given birth in the past three months. Seventy-three percent of the girls were African American, 8 percent were white, 11 percent were multiracial, and the remaining 9 percent had other racial backgrounds. Sixteen percent of the participants had Hispanic background. A large majority (72 percent) of the girls received free school lunches, indicating poverty. On average, participants reported being 14 years old at the time of first vaginal intercourse, and 67 percent of the sample reported having unprotected vaginal intercourse in the three months before the study began.

Approach: Researchers used block randomization to assign each participant to a group of 6-9 girls receiving either the HIP Teens treatment or the control condition. The same facilitators led both the HIP Teens and control sessions, which met for equal durations and frequencies (once-weekly, two-hour meetings for a month) and followed IMB principles, but differed in content. Groups assigned to the SSR intervention discussed issues such as HIV, risky sexual behavior, and condom use, while the groups following the control protocol performed similar activities but on topics related to general health, such as nutrition. Both the intervention and control groups participated in 90-minute booster sessions three and six months after the study concluded.

At baseline and then three, six, and twelve months posttest, participants completed audio computer-assisted self-interviews to report the number of times they had protected and unprotected vaginal intercourse in the past three months, as well as if it was with a steady or nonsteady partner or partners. Participants also self-reported the number of sexual partners they had in the prior three months. Researchers reviewed medical records of participants to determine the rates of pregnancy and STI in the 12-month follow-up period. Because participants could not be pregnant or have recently given birth, only instances of STI were measured at the start of the study. Attendance at sessions was high, and attrition rates did not differ between the intervention and control groups during the course of the study or in the follow-up evaluations.

Results: Members of the HIP Teens intervention group demonstrated significantly lower instances of vaginal intercourse, both protected and unprotected, in the three- and twelve-month follow-up evaluations. At six months, the frequency of overall instances of vaginal intercourse was significantly reduced for the HIP Teens group, but there was no significant impact shown for the frequency of unprotected vaginal intercourse. In the six-month follow-up, recipients of the HIP Teens intervention were less likely to have one sexual partner (an odds ratio of 0.54) and two or more partners (OR of 0.39) than the control group; however, this impact was not found in the three- or twelve-month follow-up evaluations. In the twelve months after the intervention, participants in the HIP Teens group were less likely to document a pregnancy (OR of 0.44). There was no significant difference in rates of STI between the two groups twelve months after the intervention, when the medical evaluation was completed.

SOURCES FOR MORE INFORMATION

References

Morrison-Beedy, D., Jones, S., Xia, Y., Tu, X., Crean, H., & Carey, M. (2013). Reducing Sexual Risk Behavior in Adolescent Girls: Results From a Randomized Controlled Trial. Journal of Adolescent Health, 52, 314-321.

KEYWORDS: Adolescents (12-17), youth (16+), female only, African American, high-risk, urban, clinic/provider-based, skills training, teen pregnancy, STD/HIV/AIDS, sexual activity, condom use and contraception.

Program information last updated on 10/7/14.

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