The goal of this 4 year Special Interest Project (SIP) is to adapt and evaluate the effectiveness of an Internet-based HIV/STI, and pregnancy prevention curriculum for American Indian/Alaska Native (AI/AN) middle school-aged youth (12-14 years). This curriculum will be adapted from a successful, Internet-accessible, prevention program, It’s Your Game…Keep it Real, (IYG). To capture the heterogeneous experience of AI/AN youth the AI/AN-IYG Internet-based program will be adapted and evaluated in 3 large, geographically dispersed AI/AN communities in Alaska, the Pacific Northwest (Oregon, Washington State, Idaho), and Arizona Plains.
There are 5 study aims:
- Among AI/AN youth, assess the availability of educational technology infrastructure, review existing evidence-based sexual health programs targeting AI/AN youth, test the usability of existing IYG activities, and develop adaptation design documents (Months 1 – 12).
- Program and test the usability and feasibility of the adapted Internet-based IYG computer intervention for the AI/AN youth (Months 12 – 24).
- Evaluate the effectiveness of the AI/AN-IYGInternet-based intervention relative to a comparison condition, on sexual behavior outcomes (proportion of youth initiating sexual intercourse, proportion that are sexually active, number of times youth engage in unprotected sex, number of youth’ sexual partners) among 1200 middle school youth (Months 25 – 48). Youth will be recruited from middle school and Boys and Girls Clubs (n=400 youth from each region) and randomly assigned (by site) to each study arm. The primary hypothesis is that youth who receive ‘AI/AN-IYG’ will delay sexual activity relative to those who receive the comparison condition at 16 month follow-up.
- Evaluate the effect of ‘AI/AN-IYG’ relative to a comparison condition on psychosocial variables (e.g., intentions, knowledge, self-efficacy, skills, attitudes, perceived norms related to sexual risk-taking behavior)(Months 25 – 48). Secondary hypotheses will also examine the effect of the intervention on the proportion of youth who are sexually active, number of times youth engage in unprotected sexual intercourse, and number of sexual partners.
- 5. Disseminate findings to the AI/AN communities, partners and scientific community, and, if found effective, provide ongoing access to the program to AI/AN communities across the United States (Months 42 – 48 ongoing).
The collaboration between the University of Texas PRC, Indian Health Service, Alaskan Native Tribal Health Consortium, Northwest Portland Area Indian Health Board, Intertribal Council of Arizona, Oregon State Health University(OHSU) PRC, Bureau of Indian Education, and Tribal Boys and Girls Clubs collectively provides extensive experience in developing and testing sexual health programs for middle-school aged youth and in conducting youth-based research in AI/AN communities.
This study is significant because it addresses the need for HIV/STI and pregnancy prevention intervention for AI/AN youth who represent an at-risk and underserved population. There are relatively few early adolescent interventions with evidence of effectiveness for middle-school age in this population, supporting the need for further research with this age group. It is innovative in HIV/STI, and pregnancy prevention for AI/AN youth because it will 1) further understanding of AI/AN youth sexual behaviors and factors affecting this, 2) further understanding of AI/AN youth technology usage, 3) provide an intervention addressing the unique needs of AI/AN youth while catering to the diversity of this population, 4) provide an Internet-based sexual health curriculum that represents a cost-effective, high-fidelity, readily accessible curriculum for widely dispersed AI/AN youth.
For more information on this project, contact the Principal Investigators: