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Assisting in Rehabilitating Kids (ARK)
Overview of the Curriculum
Assisting in Rehabilitating Kids (ARK) is a small group, 12-session intervention consisting of educational, behavioral skills training, and motivational risk-sensitization components designed to increase abstinence, increase safer sex behaviors, and eliminate or reduce sex risk behaviors among substance-dependent adolescents.
This intervention is based on the Becoming a Responsible Teen (BART) intervention, which is identified as a best-evidence intervention. BART was originally tested with African American adolescents in family public health clinics. This intervention was designed for substance-dependent adolescents and includes additional sessions focusing on problem-solving skills, anger management skills, and motivating youth to change behavior.
Twelve 90-minute sessions are delivered to small groups of mixed-gender youth over 28 days.
Sessions 1-2: Information. Standard HIV/STD prevention and transmission information is presented in these two sessions.
Sessions 3-11: Behavioral Skills. Five behavioral skills sessions based on Becoming a Responsible Teen provide training and practice for correct condom use, negotiation and refusal skills, and communicating information and skills to peers. Problem-solving and anger management skills relevant to drug-dependent adolescents are taught in four sessions.
Session 12: Motivation. This session introduces an emotion-based risk-sensitization manipulation. It entails taking a digital photograph of each participant and digitally transforming it to depict how one might appear at end-stage AIDS. A discussion follows, focusing on adolescents' emotional responses and the effect of the images on their willingness to engage in risky or safer sexual behaviors.
Unique Features of the Curriculum
All participants in this study received the standard three-week detoxification program provided by the drug treatment facilities and remained in the facility for 30 days after initial detoxification. Drug treatment programs were based on the 12-step Alcoholics Anonymous program and involved group sessions around substance abuse, educational classes, and recreational activities.
The ARK curriculum includes taking a digital photograph of each adolescent at baseline, downloading it into a computer, and electronically transforming it to visually depict how the adolescent might appear at end-stage AIDS. This risk-sensitization manipulation is designed to increase awareness of personal vulnerability and, along with their improved self-efficacy, to motivate youth to adopt and be able to maintain risk reduction behaviors.
Information Motivation Behavior (IMB) Model: The IMB model provides a multi-dimensional approach. The "information" component of the model targets the cognitive domain to provide knowledge to support the behavior change. The "motivation" aspect addresses the affective domain and allows opportunity for developing a favorable attitude towards positive health behaviors and capitalizing on existing social support systems to enhance motivation. The third component, the "behavior" aspect of the model, aligns with the psychomotor domain.
Extended parallel process model (EPPM): EPPM is a model of how attitudes are formed and changed when fear is used as a factor of persuasion. The model states that fear appeals are most effective when an individual cares about the issue or situation, and that individual possesses and perceives that they possess the ability to deal with that issue or situation.
Ordering and Training Information
Ordering: An intervention package is not available at this time. For details on intervention materials, please contact:
Dr. Janet S. St. Lawrence
Mississippi State University Meridian
1000 Highway 19 North
Meridian, MS 39307.
Evaluation Fact Sheet
Assisting in Rehabilitating Kids (ARK) is an intervention designed to increase abstinence, increase safer sex, and reduce risky sex behaviors in substance-dependent youth. The intervention is delivered in small groups after the participants’ initial detoxification in the drug treatment facilities. Delivery methods include games, group discussion, lectures, practice, and training.
A significantly greater percent of ARK intervention participants reported abstinence at the 6-month (p < .05) and 12-month (p < .05) follow-ups when compared to the health education participants and at the 12-month follow-up (p < .05) when compared to the behavioral skills training participants.
ARK intervention participants reported a significantly lower frequency of unprotected vaginal sex and greater frequency of condom-protected sex than the health education participants at the 6-month and 12-month follow-ups (all p's < .05).
ARK intervention participants also reported a significantly lower frequency of unprotected vaginal sex (p < .05) and greater frequency of condom-protected sex (p < .05) than participants in the behavioral skills training intervention at the 12-month follow-up.
ARK intervention participants reported significantly greater percentages of condom-protected sex at the 6-month (p < .05) and 12-month (p < .05) follow-ups when compared to the health education participants and at the 12-month follow-up (p < .05) when compared to the behavioral skills training participants.
The enrolled study sample of 161 adolescents was 75% White, 22% African American, 2% Native American, 1% Hispanic. In addition, 68% were male and 32% female with the mean age of 16 years and the mean education of 10 years. Participants were recruited from two residential drug treatment programs serving adolescents in Mississippi.
Adolescents were eligible for the study if they were admitted to one of two youth residential drug treatment programs, completed the three-week detoxification program, and had informed consent provided by the parent or guardian.
Participants (N = 161) were grouped in 24 cohorts based on entry into drug treatment, where each cohort was randomly assigned to 1 of 3 groups: ARK Behavior Skills + Risk Sensitization intervention (n = 54), Behavior Skills only intervention (n = 54), or Health Education comparison (n = 53).
The Health Education comparison consisted of 12 sessions, including 2 sessions of basic information on the epidemiology of HIV/STD and 10 sessions of standard health education curriculum. The curriculum included information on birth control, drinking, peer pressure, drug education, smoking, gangs, weapons, and handling stress. The curriculum was delivered in a developmentally appropriate format and included educational games and group discussions, changing the focus every 10 to 15 minutes.
St. Lawrence, J. S., Crosby, R. A., Brasfield, T. L., & O'Bannon III, R. E. (2002). Reducing STD and HIV risk behavior of substance-dependent adolescents: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70, 1010 – 1021.