 |
|
Early Effects of a School-Based Human Immunodeficiency Virus Infection and Sexual Risk Prevention Intervention
David M. Siegel, MD MPH;
Marilyn J. Aten, PhD RN;
Klaus J. Roghmann, PhD;
Maisha Enaharo, MPH
Arch Pediatr Adolesc Med. 1998;152:961-970.
Objective To determine the short-term effect of a middle and high school–based human immunodeficiency virus and sexuality intervention (Rochester AIDS Prevention Project for Youth [RAPP]) on knowledge, self-efficacy, and behavior intention.
Design Nonrandomized intervention study with 2 intervention groups and 1 control group.
Setting Middle and high school health classes in an urban, predominantly minority school district.
Participants Middle and high school students (N=3635) enrolled in health classes in 9 schools; 50% African American, 16% Hispanic, 20% white, and 14% other. Less than 10% of students refused participation.
Intervention There were 3 study conditions: (1) Control, usual health education curriculum taught by classroom teacher; (2) RAPP adult health educator, intervention curriculum implemented by ethnically diverse male-female pairs of highly trained health educators; and (3) RAPP peer educator, intervention implemented by male-female pairs of extensively trained high school students. Health classes within schools were assigned to 1 of the 3 conditions each semester, and simultaneous implementation of the control program with health educators or peer educators in the same school and during the same semester was not permitted.
Main Outcome Measure A confidential questionnaire administered to all study subjects before and immediately after the intervention, containing scales to measure knowledge, sexual self-efficacy, and safe behavior intention.
Results Preintervention data indicated that the study population was involved in sexual activity and other risk behaviors at rates comparable to those of other urban adolescent populations. Examination of 3 outcome constructs as dependent variables (knowledge, sexual self-efficacy, and safe behavior intention) revealed that the health educators and peer educators increased students' knowledge significantly more than did the control condition for both middle (females, P<.01; males, P<.01) and high (females, P<.001; males, P<.001) school. Comparisons of self-efficacy changes across intervention groups did not reach statistical significance, and safe behavior intention changes differed significantly by intervention group for high school but not for middle school students. For all analyses, the preintervention scores for each outcome variable were the most powerful predictors of postintervention scores, and analysis of variance models predicted substantial overall variance.
Conclusions At short-term follow-up, the RAPP intervention had a powerful effect on knowledge for all students and a moderate effect on sexual self-efficacy and safe behavior intention, particularly for high school students. The peer educators were found to be equally and, for some variables, more effective than the highly trained adult educators. The substantial effect of the baseline scores and the high prevalence of risk behavior already evident by seventh grade indicate the importance of early implementation of school-based sexuality programs.
From the Department of Pediatrics (Drs Siegel and Roghmann and Ms Enaharo) and the School of Nursing (Dr Aten), University of Rochester, Rochester General Hospital, Rochester, NY.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
HIV prevention in Mexican schools: prospective randomised evaluation of intervention
Walker et al.
BMJ 2006;332:1189-1194.
ABSTRACT
| FULL TEXT
Building Teen Power for Sexual Health
Talashek et al.
J Transcult Nurs 2003;14:207-216.
ABSTRACT
Effects of Peer Education on the Peer Educators in a School-Based HIV Prevention Program: Where Should Peer Education Research Go from Here?
Ebreo et al.
Health Educ Behav 2002;29:411-423.
ABSTRACT
Long-term Effects of a Middle School- and High School-Based Human Immunodeficiency Virus Sexual Risk Prevention Intervention
Siegel et al.
Arch Pediatr Adolesc Med 2001;155:1117-1126.
ABSTRACT
| FULL TEXT
|
