Intervention Description
Intervention Package Information
Evaluation Study and Results
References and Contact Information
Intervention Description
Target Population
Adolescents of high risk for HIV who live in urban, low-income housing developments
Goals of Intervention
- Increase sex abstinence
- Increase condom use
Brief Description
Teen Health Project is a community-level intervention (CLI) that helps adolescents develop skills to enact change, and provides continued modeling, peer norm and social reinforcement for maintaining the prevention of HIV risk behavior. Adolescents first attend two 3-hour workshops that focus on HIV/STD education and skills training on avoiding unwanted sex, sexual negotiation, and condom use, with themes of personal pride and self-respect. Workshops are conducted separately for males and females, who are divided by younger and older enrollees. Adolescents then attend 2 follow-up sessions and various community activities and events with peers from their social networks in the housing development. Opinion leaders are selected based on nominations and represent 15% of the total number of adolescents in each housing development. A Teen Health Project Leadership Council (THPLC) is established in each housing development to encourage attendance, reinforce abstinence and condom use, plan HIV prevention activities to maintain risk reduction, set norms supporting abstinence and condom use, and gain support from adults to promote activities. Through pledges and videotaped testimonials, adolescents are encouraged to make commitments to HIV reduction. HIV prevention messages were emphasized throughout the activities and on small media, project newsletters, and t-shirts. Prevention messages were also featured at community-wide social events, talent shows, musical performances, and festivals in order to establish and maintain HIV risk-reduction norms among peers, family members, and the larger community. In addition, parents of adolescent enrollees are offered a workshop that focuses on HIV/AIDS information and approaches to discussing issues related to abstinence and condom use with their children. |
Theoretic Basis
- Diffusion of Innovation
- Social Cognitive Theory
Intervention Duration
Two 3-hour workshops conducted 1 week apart; the community-level intervention phase (2 follow-up sessions, 4 program activities and 2 community-wide events, each of unspecified length) delivered over 10 months; and a 90-minute parent workshop.
Intervention Settings
Low-income housing developments Deliverer
Two trained facilitators; THPLC peer opinion leaders
Delivery Methods
- Performances
- Risk reduction supplies (condoms)
- Skills building exercises
- Small media (e.g. brochures, project newsletters, t-shirts)
- Social events
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Intervention Package Information
An intervention package is currently available from
Sociometrics.
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Evaluation Study and Results
The original evaluation was conducted in Milwaukee and Racine, Wisconsin; Roanoke, Virginia; and Seattle and Tacoma, Washington between 1998 and 2000.
Key Intervention Effects
- Continued abstinence
- Increased condom use
Study Sample
The baseline study sample of 1172 adolescents in 15 housing developments is characterized by the following:
- 51% African American, 20% Asian, 10% East African, 5% White, 3% Hispanic, 3% Ukrainian, 2% Russian, 1% Native American, 5% Other
- 50% Female, 50% Male
- Mean age of 14.5 years, ranging from 11-18 years
- Mean education of 7th grade; 99% currently attending school, 73% not yet in high school
Recruitment Settings
Housing developments
Eligibility Criteria
- The eligible communities were low-income housing developments located in urban areas with high rates of STD and drug use.
- Adolescent residents were eligible for assessment if they were between 12 and 17 years by the onset of the intervention.
Assignment Method
Five sets of 3 housing developments (1 set in each city) were matched by tenant characteristics (e.g., adolescents’ age and gender). Within the 5 sets, each housing development was randomly assigned to 1 of 3 groups: Community-level Intervention (5 developments, 392 adolescents), Workshop Intervention (5 developments, 428 adolescents), or AIDS Education Comparison (5 developments, 352 adolescents).
Comparison Group
- The Workshop Intervention, a group-level intervention (GLI), was the same as the workshop phase of the Community-level Intervention.
- The AIDS Education Comparison consisted of a standard community AIDS education session delivered to groups of youth in the housing development with a videotape and discussion, and adolescents were invited to participate in the workshop intervention at study completion. Educational brochures and condoms were available for participants in all study groups.
Relevant Outcomes Measured and Follow-up Time
- Sex behaviors (including never
engaging in sexual intercourse
[abstinence] and condom use at last sex)
were measured at 2 months after the
completion of the community intervention
phase (18 months post baseline)
Participant Retention
- Community-level
Intervention (CLI):
61% retained at 18 months post
baseline (2 months after completion
of the CLI events)
- Workshop Intervention:
64% retained at 18 months post
baseline (12 months after the
workshop intervention)
- AIDS Education Comparison:
72% retained at 18 months post
baseline
Significant Findings
- Sexually inexperienced adolescents
in the Community-level Intervention (CLI)
communities were significantly more
likely to have remained abstinent than
adolescents in the AIDS Education
comparison communities (p = .04) at 18
months post baseline (2 months after
completion of the CLI).
- Sexually active adolescents in the
CLI communities were significantly more
likely to report condom use at last sex
than adolescents in the AIDS Education
comparison communities (p =.05) at 18
months post baseline (2 months after
completion of the CLI).
Considerations
- This intervention fails to meet the best-evidence criteria due to < 70%
retention in the CLI arm at 2 months after the completion of the CLI events.
- Because the CLI had more activities and, thus, was longer in duration,
the length of time from the end of the intervention to the final follow-up
assessment differed from that of the AIDS Education Comparison.
- The effects of the community-level intervention on continued abstinence
and condom use differed only from the AIDS Education Comparison. There was
no significant intervention effect when compared with the GLI Workshop
intervention.
- Sexually active adolescents in the GLI Workshop Intervention communities
were significantly more likely to report condom use at last sex than
adolescents in the AIDS Education comparison communities (p =.01) at 12
months after the completion of the workshop.
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References and Contact Information
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