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Focus on Youth: An HIV Prevention Program for African-American Youth

Focus on Youth was adapted from the evidenced-based Focus on Kids program.)

Overview of the Curriculum

Focus on Youth is a community-based 8-session HIV, STD and pregnancy prevention intervention for African American youth. It provides youth with the skills and knowledge to make healthy decisions that will prevent unplanned pregnancy, HIV and other sexually transmitted diseases. The curriculum uses fun, interactive activities such as games, role plays and discussions, and community projects to convey prevention knowledge and skills. The intervention was updated from Focus on Kids, a community-university linked research and intervention program.

Focus on Youth includes information and skills about: decision making, values, how to access information, communication, negotiation, goals for the future, teen pregnancy, abstinence, contraception, STD, HIV, alcohol and other drug use, and facts about a healthy sexual lifestyle.

The most current edition of Focus on Youth (2009) provides updated information and more tools to facilitate implementation and increase the relevance of the program for African-American youth between ages 12 and 15 who are at risk for HIV infection. Eight agencies were selected to participate in a pilot of the Focus on Youth revision. Over a 6-month period, each of the agencies piloted the new program with 8-10 youth. Their feedback has been incorporated in the final version.

Curriculum Objectives

At the completion of the program, youth will be able to:

  • State correct information about HIV and other STDs including modes of transmission and prevention.
  • State correct information about abstinence and various methods of contraception including the correct way to use condoms.
  • Identify their own personal values and understand how their values relate to decisions about relationships, sexuality and sexual risk behaviors.
  • Be skilled in communicating and negotiating with other youth regarding sexual topics and in decision making that supports sexual health.

Curriculum Sessions

Focus on Youth includes the following 8 sessions:

Session 1: Trust Building and Group Cohesion

Session 2: Risks and Values

Session 3: Educate Yourself: Obtaining Information

Session 4: Educate Yourself: Examining Consequences

Session 5: Building Skills: Communication

Session 6: Information About Sexual Health

Session 7: Attitudes and Skills for Sexual Health

Session 8: Review and Community Project

Unique Features of the Curriculum

Focus on Youth includes the following features that distinguish it from other HIV and STD prevention curricula:

  • It serves African American youth, ages 12-15, in community-based settings.
  • It is designed for small groups of no more than 6-10 youth.
  • It uses two skilled facilitators, with at least one matching the ethnicity of the majority of the participants.
  • It makes use of naturally occurring friendship groups to strengthen peer support of alternatives to risky activities.
  • It uses culturally and linguistically appropriate interactive activities, such as games, role plays, discussions and community projects.
  • It includes a “family tree” to contextualize and personalize abstract concepts e.g., decision-making and risk assessment.

Theoretical Framework

Focus on Youth is based on the Protection Motivation Theory, a social cognitive theory which emphasizes the balance between pressures to engage in the risk behavior, the risks involved, and the consideration of alternatives. Focus on Youth addresses each of these critical elements of the theory by:

  • Providing opportunities to consider the personal and social rewards (pressures) of engaging in sexual risk-taking behavior. Through all its varied learning activities, youth learn to create positive feelings about themselves without engaging in risky behaviors. In addition, in Session Two, youth dispel the myth that all peers approve of risky behavior.
  • Examining the health risks involved in unprotected sexual behavior. Sessions Two, Three, Four and Seven increase youth's awareness of their vulnerability to HIV, STD, and unplanned pregnancy if they engage in sexual risk-taking behaviors and their knowledge about the difficulties of living with HIV.
  • Identifying the alternatives to sexual risk-taking behavior. Through the SODA Decision Making model, the Family Tree Activities, and role play activities, youth learn to consider the alternatives to risk-taking behavior and practice decision making, communication and condom use skills necessary to act on healthy decisions. Rogers, R.W. (1983). Cognitive and physiological processes in fear appraisals and attitude change: A revised theory of protection motivation. In Cacioppi, T. & Petty, R.E. (Eds.), Social Psychology. (pp. 153-176). New York, NY: Guilford Press.

Ordering and Training Information

To learn more about Focus on Youth, including ordering and training information visit: http://pub.etr.org/ProductDetails.aspx?id=100000083&itemno=Z006

Evaluation Fact Sheet

Focus on Youth was adapted from the research-proven Focus on Kids program. The adaptation served to provide updated information and tailor activities to increase the relevance of the program for African-American youth between ages 12-15 who are perceived to be at high risk for HIV infection. Specific features have been adapted and improved, while fidelity to the original program was carefully maintained. Highlights of the original Focus on Kids evaluation are described below:

Intervention

In the spring of 1993, African American youth were recruited from nine recreation centers associated with three public housing developments to attend eight weekly sessions of an AIDS risk reduction intervention. Grounded in a social-cognitive theory (Protection Motivation Theory) and developed to be culturally appropriate for the target audience, the intervention provided facts about HIV and AIDS and emphasized skills development with regard to communication, decision making, and condom use. The youth formed intervention groups consisting of two to 10 same-gender friends who were within three years of age of each other. In addition to condom use and abstinence, avoidance of substance use and drug trafficking were emphasized in the curriculum.

Research Design

The 76 naturally formed peer groups consisting of 383 African American youth were randomly assigned to receive the Focus on Kids intervention (n=206) or a control condition (n=177). The control condition consisted of eight sessions which provided facts about HIV and AIDS prevention but did not emphasize skills development with regard to negotiation, communication or condom use and was not delivered to the naturally occurring groups of friends.

Participants completed questionnaires via a "talking" Macintosh computer at baseline and six months after the intervention. Measures assessed actual risk behaviors, perceptions of risk behaviors, and intentions.

Behavioral Findings

At baseline, condom use rates did not differ significantly between the intervention and control groups. However, at the six-month follow-up, rates were significantly higher among the intervention group than the control group (85% versus 61%, P<.05). The intervention was especially strong among boys (85% versus 57%, P<.05) and among teens aged 13 to 15 years (95% versus 60%, P<.01).

Other Significant Findings

Youth did not differ in their intentions to use condoms at baseline, but in the post-intervention period, intervention youth were significantly more likely than control youth to intend to use a condom. Likewise, in the post-intervention period, intervention youth perceived greater peer use of condoms and increased personal vulnerability to HIV.

References

Stanton BS, Li X, Ricardo I, Galbraith J, Feigelman S, Kaljee L. A randomized, controlled effectiveness trial of an AIDS prevention program for low-income African-American youths. Archives of Pediatrics and Adolescent Medicine 150:363-372.