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All4You2!

Overview of the Program

All4You2! is a program to prevent HIV, other STD and pregnancy among students ages 14–18 in alternative education settings.

The primary goal of All4You2! is to reduce the risk of HIV, other STD and pregnancy by reducing the number of students who have unprotected sexual intercourse (either by increasing condom use and use of other protection or reducing sexual intercourse). The program also aims to change key determinants related to sexual risk taking, such as attitudes, beliefs, and perceived norms.

All4You2! is delivered using a variety of interactive strategies such as stories, brainstorming, games, small-group work, advice columns, roleplays and videos.

Program Objectives

As a result of participating in All4You2! students will acquire:

  • Functional knowledge regarding STDs, including behaviors that increase risk and behaviors to prevent them
  • Understanding of the influence of multiple partners on STI transmission and the physical and emotional consequences of sexual activity
  • Negotiation and refusal skills
  • Skills for identifying and handling risky situations, establishing healthy relationships and ending relationships in healthy ways
  • Contraception and condom use skills
  • Strategies for overcoming barriers to preventing HIV, other STI and pregnancy
  • Knowledge of resources for HIV/STI and pregnancy testing and treatment

Sessions

The program consists of 15 50-minute lessons to be taught from 1 to 3 times a week.

Pre-Lesson: Setting the Stage

Lesson 1: Sexually Transmitted Diseases (STDs)

Lesson 2: HIV and Teens

Lesson 3: Reasons for Not Having Sex

Lesson 4: What’s the Risk?

Lesson 5: Examining the Risk

Lesson 6: Negotiation and Refusal Skills

Lesson 7: More Skills

Lesson 8: Handling Risky Situations

Lesson 9: Teens and Relationships

Lesson 10: Ending Relationships in Healthy Ways

Lesson 11: Reduce Your Risk

Lesson 12: It’s All About Condoms

Lesson 13: Talking about Condoms

Lesson 14: Testing and Resources

Lesson 15: Staying Safe

Unique Features of the Program

All4You2! is primarily for youth ages 14 to 18 in alternative school settings. The program could be used in a community setting if retention of youth can be maintained over the 15 sessions.

Peer leaders are also used to facilitate some of the activities.

Theoretical Framework

All4You2! is based on Social Cognitive Theory and the Theory of Planned Behavior.

Key content covered by the program consists of:

  • HIV, STIs, and pregnancy prevention risk factors
  • Influence of multiple partners on STIs
  • Emotional consequences of sexual activity
  • Negotiation and refusal skills
  • Contraception and condom use skills
  • Handling risky situations
  • Barriers to preventing HIV, other STI and pregnancy
  • Development of positive norms
  • Healthy relationships and ending relationships in healthy ways
  • HIV/STI and pregnancy testing and resources

Ordering and Training Information

To learn more about All4You2!, including ordering and training information visit: www.etr.org/ebi/programs/all4you2/

Evaluation Fact Sheet

Intervention

The initial All4You2! study was implemented during 2006-2009, with data collection follow-up extending 18 months after the last enrollment in the study. The evaluation featured a randomized trial involving 47 classrooms (765 young people) in alternative school settings (specifically continuation schools) located in urban areas with diverse populations in Northern California.

Research Design

Classrooms were randomly assigned to one of four conditions: (1) HIV/STI/pregnancy prevention curriculum only, (2) service learning only, (3) HIV/STI/pregnancy prevention curriculum plus service learning, or (4) an attention control curriculum. Participants included both males and females (53% male) who were an average age of 16.2 years. The majority of young people in the study reported being Hispanic/Latino (37.9%) or African American (22.3%).

To assess the effectiveness of the intervention, paper-pencil self-report surveys were collected from students three times during the study period: baseline, plus two follow up surveys at 6 and 18 months after baseline.

Findings

In general, youth receiving All4You2! HIV/STI and pregnancy prevention curriculum were less likely to have vaginal intercourse without a condom [odds ratio (OR) = 0.58, p=.04]; these effects diminished by final follow up. The program also significantly reduced students' exposure to risky situations and had other effects that were marginally significant (Coyle et al., 2013).

Six months after the baseline survey:

  • Students taking part in All4You2! were less likely to have intercourse without a condom in the previous 3 months than were students in the control group; these effects diminished by the 18-month follow up.
  • Students receiving All4You2! also reported having sexual intercourse fewer times than youth in the control condition, though the difference did not reach statistical significance (p = .09).
  • Students receiving All4You2! reported higher levels of refusal self efficacy than youth in the control group, but these differences were only marginally significant (p = .06).

Eighteen months after the baseline survey:

  • Students receiving All4You2! were less likely to place themselves in risky situations (p = .03) than were youth in the control condition.
  • Students receiving All4You2! reported having sexual intercourse fewer times than youth in the control condition, though the difference did not reach statistical significance (p = .07).

References

Coyle, K. K., Glassman, J. R., Franks, H. M., Campe, S. M., Denner, J., & Lepore, G. M. (2013). Interventions to Reduce Sexual Risk Behaviors Among Youth in Alternative Schools: A Randomized Controlled Trial. Journal of Adolescent Health, 53(1), 68-78.

Glassman, J. R., Franks, H. M., Baumler, E. R., & Coyle, K. K. (2014). Mediation analysis of an adolescent HIV/STI/pregnancy prevention intervention. Sex Education, 14(5), 497-509.