Program

Nov 13, 2007

OVERVIEW

The Youth AIDS
Prevention Project (YAPP) for junior high school students is a school-based
prevention program designed to prevent HIV/AIDS and STDs among 7th
and 8th graders and was implemented in the early 1990s. YAPP
includes a curriculum that integrates AIDS education, emphasizes abstinence,
provides parent-child communication activities, and focuses on refusal,
negotiation, and decision-making skills. Fifteen urban school districts were
randomly assigned to assess the impacts of YAPP. Results showed that there was
no statistical difference between the control and treatment groups on number of
partners or use of condoms, but students in the treatment group were more
likely to have used condoms with foam by eighth grade. Among students who
became sexually active between the pretest and posttest, use of condoms and
spermicidal foam was higher.

DESCRIPTION OF PROGRAM

Target population: African-American junior
high school students

The Youth AIDS Prevention Project (YAPP) for junior high
school students was designed using social cognitive theory and the social
influences model of behavior change. YAPP is a school-based prevention program
which promotes abstinence as its main goal and is also designed to prevent
STDs, HIV/AIDS, and substance abuse among young teens. The classroom
intervention consists of 10 sessions over a 2-week period (one per day) in the
7th grade and 5 additional sessions over a 1-week period in the 8th
grade. The program takes place during regularly scheduled health classes and
consists of lectures, discussions, videos, group exercises, role plays,
educational competitions, and discussion of questions from students. All
of the sessions were carried out by Master’s level
health educators who were extensively trained. The study focused on the
impact of YAPP on student participation in sexual intercourse, use of condoms
and foam, and student intentions in the next 12 months to have sexual
intercourse while using condoms and spermicidal foam.

EVALUATION(S) OF PROGRAM

Levy, S.R., Perhats, C., Weeks,
K., Handler, A.S., Zhu, C. & Flay, B.R. (1995). Impact of
a School-Based AIDS Prevention Program on Risk and Protective Behavior for
Newly Sexually Active Students. Journal of School Health, 65,
(4,) 145-151.

Evaluated population: 15 school districts were
recruited from 45 districts in the Chicago
metropolitan area. These school districts were at the greatest risk for HIV
infection and were high in other risk factors such as poverty, proportion of
minorities, STD rates, teen pregnancies, drop out rates, and reading scores on
state exams.

Approach:The school districts were randomly assigned
to one of the three conditions: parent interactive treatment (n=5), parent noninteractive treatment (n=5) and delayed
treatment/control (n=5). All three groups were given pretest and
posttest surveys. The students in the control group received basic AIDS
education as taught by their schools, such as short workshops or a simple
health museum field trip. The two experimental groups both underwent the same
classroom intervention, while one treatment group added a parental involvement
component. For analysis the two treatment groups were linked together due
to lack of parent involvement in the parent interactive treatment group.
The students were 7th and 8th graders, the majority of
whom were African-American. The total study population was 1,669, with 668
children in the control group and 1,001 children in the combined treatment
group. This total population was a decrease from the original 2,393 seventh
grade students, reflecting 32 percent attrition for the treatment group and 30
percent for controls. Many cases were not included in the analysis due to
dropouts, absenteeism, and family mobility.

Results:About one-third of the entire evaluated
population had had sexual intercourse by the 7th grade and about
half of the total evaluated population had had sexual intercourse by 8th
grade posttest. No differences were found in risk behaviors comparing the
treatment and control groups, however. About 19% of the students who became
sexually active between 7th and 8th grade were labeled as
“changers” for non-experimental analyses.

The researchers analyzed the impacts of the treatment on the
changers, and the following results are in regards to only the changers. There
were no differences between the control and treatment groups in number of
sexual partners and condom usage. There was a statistically significant
difference between the control and treatment groups in condom usage with
spermicidal foam. Researchers also found that there was no difference between
the two groups on the students’ intentions to have sex or use condoms in the
next 12 months, but students again differed significantly in their intentions
to use condoms with spermicidal foam. The researchers concluded that the
treatment program (YAPP) influenced changers to take on protective sexual
behaviors. For those planning to have sex, 84.6 percent of the treatment group
intended to use condoms with foam whereas 62.9 percent of the control group had
similar intentions. An effect size of 1.81 (p<.1) was found for the YAPP
group on whether they have used condoms in the previous 12 months and effect
size 3.36 (p<.001) for using condoms in the next 12 months.

The authors note that a major limitation of this study is
that a substantial number of cases were lost for the posttest which meant many
of the changers were in fact not high risk, since many of the lost cases were
more likely to be sexually active and have elicit drug use. Additionally, since
the school districts were recruited and not chosen randomly, the results may
only be generalized to the specific population for which the study was
conducted.

Note: Analyses were not designed to adjust for the effect of
clustering within schools.

Weeks, K., Levy, S. R., Gordon, A. K., Handler, A., Perhats, C., & Flay, B. R. (1997). Does parental
involvement make a difference? The impact of parent
interactive activities on students in a school-based AIDS prevention program.
AIDS Education and Prevention, 9,90-106.

Evaluated Population:7th grade students
were recruited from 15 school districts with higher risk for HIV and
AIDS. All participants (N=2,392) were surveyed at seventh and eighth
grades. Researchers attempted to contact students at the ninth grade
follow-up; a 55.8% response rate yielded a sample of 1,229 students who completed
surveys.

Approach:School districts were randomly assigned to
one of three conditions. The parent-interactive (N=5 schools) condition
received fifteen 40-50 minute lessons of the YAPP treatment program. In
addition, students in this condition were given homework assignments to be
worked on with a parent. The parent non-interactive (N=6 schools)
condition also received fifteen 40-50 minute YAPP program lessons but were not
assigned homework to be completed with a parent. The control (N=6 schools)
condition consisted of a delayed treatment where received basic, minimal AIDS
education. Data were collected on AIDS-related knowledge and opinions as
well as self-reported participation in AIDS-related risk behaviors at seventh
grade pre-test, eighth grade post-test, and at ninth grade 1 year follow-up.

Results:At pre-test, students in the control group
were found to have higher levels of AIDS-related knowledge compared with the
intervention groups. At the post-test data collection point, students in
the treatment conditions had higher levels of AIDS-related knowledge compared
with the control group. At post-test, students in the intervention groups
were more comfortable in talking with parents about sexuality and drug issues
compared with students in the control group. At 1 year follow-up, the
treatment did not have any impact on student behaviors compared to the control
group in the areas of sexual activity, recently bought condoms, use of condoms,
or the intention to use condoms. The only treatment effects were found in
the area of intention to use condoms with foam such that students in treatment
groups (M=3.31-nonparent, 3.27-parent) were more likely to report the intention
to use condoms with foam than the control group (M=2.97). Difference between
non-parent and parent conditions were found in reports of using condoms with
foam last time participant had sex, recently bought condoms with foam, and
overall use of condoms with foam such that participants in the parent condition
were less likely to report using or buying condoms with foam compared with the
non-parent condition.

It is important to note that students who dropped out of the
study were more likely to be involved with high-risk activities at baseline
compared to those who remained in the study.

Note: Analyses were not designed to adjust for the effect of
clustering within schools.

SOURCES FOR MORE INFORMATION

Link to program curriculum:<a
href=”http://www.socio.com/srch/summary/pasha/passt06.htm”>http://www.socio.com/srch/summary/pasha/passt06.htm

References

Levy, S.R., Perhats, C., Weeks,
K., Handler, A.S., Zhu, C. & Flay, B.R. (1995). Impact of
a School-Based AIDS Prevention Program on Risk and Protective Behavior for
Newly Sexually Active Students. Journal of School Health, 65,
(4), 145-151.

Weeks, K., Levy, S. R., Gordon, A. K., Handler, A., Perhats, C., & Flay, B. R. (1997). Does parental
involvement make a difference? The impact of parent
interactive activities on students in a school-based AIDS prevention program.
AIDS Education and Prevention, 9,90-106.

Program categorized in this guide according to the
following:

Evaluated
participant ages: 7th and 8th graders, adolescence
(12-14).

Program components:
school-based, parent or family based.

Measured outcomes: education and cognitive development; teen
pregnancy and reproductive heath

KEYWORDS:Adolescence (12-17), School-Based, Education, Reproductive Health,
Teen Pregnancy, STDS/HIV/AIDS, Risky Sex,Education, Cognitive
Development. Urban, Black
or African American, White or Caucasian, Hispanic or Latino.

Program information last updated 11/13/07