Abstract
Adolescent sexually transmitted infection (STI) and birth rates indicate a need for effective middle school HIV/STI, and pregnancy prevention curricula to delay, or mitigate consequences of, early sexual activity. Individual and organizational barriers to adoption, implementation, and maintenance, however, can hamper dissemination of evidence-based sexual health curricula, adversely impacting fidelity and reach. Internet-based approaches may help mitigate these barriers. This paper describes the development and feasibility testing of It’s Your Game (IYG)-Tech, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing effective sexual health curriculum—It’s Your Game… Keep it Real (IYG). IYG-Tech development adaptation steps were to: 1) Select a suitable effective program and gather the original program materials; 2) Develop “proof of concept” lessons and test usability and impact; 3) Develop the program design document describing the core content, scope, and methods and strategies; and 4) produce the new program. Lab- and school-based tests with middle school students demonstrated high ratings on usability parameters and immediate impact on selected psychosocial factors related to sexual behavior—perceptions of friends’ beliefs, reasons for not having sex, condom use self-efficacy, abstinence intentions, negotiating with others to protect personal rules, and improved knowledge about what constitutes healthy relationships (all p < .05). Youth rated IYG-Tech is favorably compared to other learning channels (>76.2% agreement) and rated the lessons as helpful in making healthy choices, selecting personal rules, detecting challenges to those rules, and protecting personal rules through negotiation and refusal skills (89.5% – 100%). Further efficacy testing is indicated for IYG-Tech as a potential strategy to deliver effective HIV/STI, and pregnancy prevention to middle school youth.
Highlights
Adolescent births and sexually transmitted infections (STIs) represent serious public health concerns in the United States
The prevalence rate for at least one STI is 24.1% among adolescent females (Forhan et al, 2009) and 37.7% among those who are sexually experienced. These statistics substantiate the need for effective HIV, STI, and pregnancy prevention interventions for adolescents, beginning at the middle school level
There are at least five sexual health programs developed for use in the middle school setting with demonstrated effectiveness at delaying sexual behavior among middle school students (USDHHS, 2013)
Summary
Adolescent births and sexually transmitted infections (STIs) represent serious public health concerns in the United States. Many students are not receiving timely sexual health education (Martinez et al, 2010; Darroch et al, 2000) and many middle and high schools are not implementing evidence-based programs (Kirby, 2002) or requiring pregnancy and HIV prevention as health topics (Kann et al, 2007). Irrespective of their effectiveness, dissemination of such programs may be hampered due to barriers at the level of the program, individual, or organization (Kirby, 2007; Rolleri, et al, 2008; Noar et al, 2009)
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