Stockton Collaboration: University of the Pacific (Stockton) and San Joaquin County Public Health Services (Stockton)
This study evaluated the effectiveness of an AIDS prevention intervention for alternative high school students, based on the cognitive-behavioral approach of Rotheram-Borus et al. (1991), and modified to include peer educators. Approximately 330 high risk adolescents attending eight alternative high schools (students under court order or expelled from regular schools) in San Joaquin County were randomly selected to be experimental and control group participants. AIDS knowledge, self-efficacy (belief in one’s ability to reduce transmission behaviors), intentions and actual risk behavior were measured at pre-test, post-test, and at 5-month intervals.
- Approximately 162 students at 4 alternative high schools received a portion of the 20 session (over 10 weeks) HIV educational, peer led program.
- 66 students accessed free HIV testing during the evaluation period.
- SJCPHS provided one training for HIV positive speakers, two trainings for peer educators and two trainings for peer educators and teachers.
- Condoms were made available to students in the experimental schools. A minimum of 40 latex condoms were provided to each experimental school every week.
- Effective peer educators were trained for this intervention, and were excellent in building trust with the students and being open to hear students’ concerns and questions.
- A total of 330 youth were enrolled in the study. 212 completed the pre and the post test, and 123 completed the pre-test, post-test, and five month follow up.
- More males than females participated and the mean number of intervention sessions attended by experimental group participants was 14.9 out of 20.
- For the research team, the project increased their awareness of community health provider roles, opened up new learning and career roles for students at the university, and provided an excellent applied research opportunity.
Summary of Research Findings:
- Data were analyzed from three sources: a descriptive analysis from pre-test data, pre- and post-test results by experimental and control groups measuring the effectiveness of the intervention, and pre-, post- and five month follow-up by experimental and control groups measuring intervention effectiveness and changes in AIDS knowledge and intentions.
- Effectiveness of the intervention was assessed using 212 participants who had both pre-test and post-test data. Experimental participants did not differ from controls on any measure of sexual behavior at pre-test.
- The pre-test/post-test comparison show positive effects of the intervention on future intentions regarding high risk behaviors, but not on current behavior with either regular or occasional partners.
- Scores for AIDS knowledge for pre-post test participants increased significantly for experimental versus control participants. Females scored significantly higher on tests of AIDS knowledge, although the general level of AIDS knowledge was high.
- Of this group, 62% of males and 60% of females were sexually active, with males having significantly more partners.
- Males also reported more consistent condom use than females for both regular and occasional partners.
- At post-test, a significantly higher percentage of experimental than control group participants intended to ask their partner about AIDS risk.
- Open-ended responses were asked about previous sex education and safer sex classes. A wide variety of responses were indicated in all levels of school grades. Few students indicated education from parents; none mentioned church as a source. Requests for free condoms and free HIV testing were frequent.
- Collaboration with teachers was the key to a successful intervention. The study team found it important to have teacher’s support, commitment and enthusiasm for the success of the intervention. Although this collaborative relationship is challenging (getting the teachers involved), teachers and peers taking responsibility and ownership is crucial.
- Having the project coordinator observe the intervention sessions greatly helped increase rapport with teachers, peers and students, and helped better describe the context of the study in conjunction with the data collected.
- HIV+ speakers’ presentations were as helpful for the speakers as they were for the students. These presentations gave them the means to be able to help others in their community.
Last modified: February 24, 2011