Program

Aug 07, 2003

OVERVIEW

This skills-based intervention was designed to increase condom use among teens at high risk of getting STDs. The impacts of different combinations of the three potential program components-an informational comic book, informational videotape, and group skills training-were investigated. No significant impacts on high-risk teens’ sexual behavior were found for any of the variations.

DESCRIPTION OF PROGRAM

Target population: High-risk sexually active teens and youth

This skill-based intervention on condom use was designed to increase condom use among sexually-active teens who are at high risk of getting STDs. As detailed, below, information about STDs, STD testing, and condom use was provided by way of an informational comic book, a videotape, and/or group skills training. The goal of the intervention was to dispel participants’ misconceptions about STDs and negative beliefs about condom use, and to train participants in the communication skills needed to discuss condom use with partners.

The skill-based training in communicating about and negotiating condom use with partners was delivered one of three ways:

Component Provided by Duration Description
(1) Comic book (administered to both samples); Research team One time Delivered individually or in groups of two. 16-page comic book that contains: (a) basic information on sexually transmitted diseases (STDs), (b) vignettes intended to alter misconceptions about STDs and negative beliefs about condoms, (c) instructions on how to use a condom, (d) presentation of four skills to communicate with a partner about condom use, and (e) information on where to get condoms and STD checks, and a list of telephone numbers.
(2) Videotape & comic book (administered to both samples); Research team 27-minute video Video contained messages on STDs as well as enactments by teens on how to develop skills to use condoms. Intervention delivered individually or in groups of two.
(3) Group skills training, videotape, and comic book (administered only to sample in juvenile detention) Adult facilitator and two peer tutors Two 4-hour sessions scheduled 2 to 3 days apart Delivered in groups of 12 or fewer. Included the comic book and videotape as well as role-playing, visual aids, and structured small-group exercises led by trained peer educators and adult facilitators. Designed to teach participants four basic skill components, interaction skills with their partners, and consistent condom use.

EVALUATION(S) OF PROGRAM

STUDY 1: Gillmore, M.R., Morrison, D.M., Richey, C.A., Balassone, M.L., Gutierrez, L., & Farris, M. (1997). Effects of a skill-based intervention to encourage condom use among high-risk, heterosexually active adolescents. AIDS Prevention and Education, 9(Supplement A), 44-67.

Evaluated population: 396 heterosexually active teens aged 14-19 who were in an urban juvenile detention facility (228) or who had been to an urban public health or STD clinic (168). 46 percent of the juvenile detention sample and 58 percent of the clinical sample were females. Participants were African American and white, and were heterosexually active within the previous 3 months.

Of the juvenile detention group, 161 were located for the 3-month follow-up, and 174 were located for the 6-month follow-up. Of the clinical group, 145 were located for the 3-month follow-up, and 140 were located for the 6-month follow-up.

Objective:
To test three behavioral interventions intended to reduce the risk of contracting HIV/AIDS and other STDs.
Measurement instrument:
Pre-and post-tests and 3- and 6-month questionnaires. Questionnaires tapped self-efficacy, intentions, attitudes, perceived norms, outcome beliefs, condom use, number of sexual partners, and communications with partners.
Evaluation:
Type: Experimental and longitudinal
Statistical techniques: Individuals were not randomly assigned, but the order of intervention delivery was randomized. In other words, all individuals recruited in a given week received the same type of intervention. The order of intervention delivery was determined randomly and conditions were alternated at biweekly intervals. The groups were tested to be equivalent at baseline. The comic book group was intended to serve as a control group. Repeated measures at pre-test, post-test, and 3- and 6-month follow-ups. Analysis of covariance, chi-square analysis.
Significance level: Not significant = p of >.10; marginally significant = p = .10; significant = p = .05
Outcome:
Differences among interventions:
There were very few significant differences among interventions in either the clinical sample or the detention sample. In particular, there was no impact on behavioral outcomes such as number of sexual partners in the past 3 months, or refusing sex without a condom. Participants in the comic book plus videotape intervention were marginally, not significantly, more likely to use condoms with steady partners than were the other interventions.
Other information:
The group skills training intervention was administered only to the sample in juvenile detention.

SOURCES FOR MORE INFORMATION

References:

Gillmore, M.R., Morrison, D.M., Richey, C.A., Balassone, M.L., Gutierrez, L., & Farris, M. (1997). Effects of a skill-based intervention to encourage condom use among high-risk, heterosexually active adolescents. AIDS Prevention and Education, 9(Supplement A), 44-67.

Program also discussed in the following Child Trends publication(s):

Hair,
E., Ling, T., & Cochran, S. W. (2003). Youth development programs serving
educationally disadvantaged youth: A synthesis of experimental evaluations.

Washington, DC: Child Trends.

Manlove, J., Terry-Humen,
E., Romano Papillo, A., Franzetta, K., Williams, S., & Ryan, S. (2002). Preventing
teenage pregnancy, childbearing, and sexually transmitted diseases: What the
research shows
(Research brief). Washington , DC : Child Trends.

Manlove, J.,
Terry-Humen, E., Romano Papillo, A., Franzetta, K., Williams, S., & Ryan, S.
(2001). Background for community-level work on positive reproductive health
in adolescence: Reviewing the literature on contributing factors.

Washington, DC: Child Trends.

KEYWORDS: Adolescents, Black/African American, High-Risk, Clinic/Provider-Based, Sexual Activity, Condom Use and Contraception, STD/HIV/AIDS, Skills Training

Program information last updated 8/7/03.

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