Assessment of a Culturally-Tailored Sexual Health Education Program for African American Youth

Using the intervention mapping for adaption framework to adapt an evidence-based sexual health intervention for youth affected by trauma

BACKGROUND

Children exposed to household challenges (i.e., parental substance use, incarceration, and mental illness) are among the groups most vulnerable to sexual risk-taking in adolescence. These behaviors have been associated with a range of negative outcomes later in life, including substance abuse, low educational attainment, and incarceration. Adapting an evidence-based intervention (EBI) to be suitable for this population is one strategy to address the needs of this group.

METHODS

In this study, we describe the use of the Intervention Mapping for Adaption (IM-Adapt) framework to adapt an evidence-based, sexual health intervention (Focus on Youth with Informed Children and Parents). We describe the actions taken at each step of the IM-Adapt process which are to assess needs, search for EBIs, assess fit and plan adaptions, make adaptions, plan for implementation and plan for evaluation.

RESULTS

Key changes of the adapted intervention include the incorporation of trauma-informed principles and gender inclusive language, standardization of the session length, and modernization of the content to be more appropriate for our priority population.

CONCLUSIONS

The adapted intervention shows promise toward meeting the behavioral health needs of Black youth exposed to household challenges. Our process and approach can serve as a model for researchers and practitioners aiming to extend the reach of EBIs.

A Systematic Review on Sexual Health and Drug Use Prevention Interventions for Black Girls

BACKGROUND

The relationship between drug use and poor sexual health outcomes in Black adolescent females such as diagnoses of sexually transmitted infections, HIV, and early/unwanted pregnancy has been established in the literature. Yet, very few interventions have been successful in reducing the risk of poor sexual health outcomes and drug use for adolescent girls. Even more rare are interventions that are catered to specifically to Black girls in the United States, which is a group that has the highest rates of poorer sexual health outcomes and negative consequences associated with drug use. Therefore, this systematic review sought to identify and organize interventions that are focused on preventing HIV, STIs, early pregnancy and drug use for and include large samples of Black girls. Fifteen interventions were identified that met the review's search criteria.

RESULTS

A total of 15 interventions that were published between 2005 and 2020 were included in the review. While all but one intervention focused on sexual health outcomes, two interventions infused drug use education for girls.

CONCLUSION

This review provides recommendations for sexual health and drug use prevention researchers to engage in an intersectional framework and concludes with a summary of next steps to guide future research and policy work to address disparities that impact Black girls.

Revisiting the Association between Race, Ethnicity, and Beliefs about Pregnancy

Objective

Black and Latinx individuals are often the focus of health educational efforts to 'correct' perceived flawed beliefs about pregnancy, in order to increase contraceptive use and reduce unintended pregnancies. We sought to revisit the association between race, ethnicity, and beliefs about pregnancy.

Methods

We administered a web-based survey to 2,099 heterosexual men and women aged 21-44 years, using non-probability quota sampling. We analyzed a subset who were not currently pregnant (n=1,884) and conducted chi-square tests to examine the association between race/ethnicity and beliefs about avoiding pregnancy (can be avoided, determined by fate/God, 'just happens,' and is a natural process). We then performed a two-stage multinomial logistic regression, modeling the belief that pregnancy can be avoided. The first model included sociodemographic characteristics and the second model added feelings about pregnancy.

Results

Bivariate analyses revealed that, compared with Whites, those who identified as Black/African American or Latinx were significantly more likely to believe that pregnancy was determined by fate/God (15%,13% vs 9%, respectively) or a natural process (13%,13% vs 9%, respectively) and less likely to report that it can be avoided (57%,56% vs 67%, respectively; P=.001). In the first regression model, these differences persisted. However, in the second model, being Black/African American or Latinx was not significantly associated with beliefs about avoiding pregnancy.

Conclusions

Our findings suggest that once more nuanced beliefs about pregnancy prevention are considered, Black and Latinx individuals do not hold strongly different beliefs than Whites. Efforts that exclusively focus on people of color to change beliefs about pregnancy appear unwarranted.

A Community-Based Participatory Approach to the Development and Implementation of an HIV Health Behavior Intervention: Lessons Learned in Navigating Research and Practice Systems from Project HAPPY

African American young adults continue to be disproportionately affected by HIV/AIDS. The Southern United States has been particularly affected by HIV/AIDS, accounting for 52% of the new HIV diagnoses. Efforts to reduce the burden of HIV among young African Americans are still needed. Project HAPPY (HIV/AIDS Prevention Project for Youth) was developed and implemented using a community-based participatory research (CBPR) model. There were several challenges that arose during implementation of Project HAPPY that included recruitment, partner engagement, and retention. The realities of implementing an HIV prevention project with urban adolescents is discussed in detail and strategies to overcome these challenges, using a CBPR approach are described. The lessons learned from CBPR implementation of Project HAPPY include: (1) Create a feedback loop to receive community input and guidance throughout the life of the project; (2) Periodic community inventory to determine who is providing similar services to avoid saturation; (3) Prepare for Alternative Partner Engagement; (4) Consult (formally and informally) with the Institutional Review Board prior to submitting proposed changes to avoid unnecessary delays in implementation; (5) Select meaningful incentives for your priority population; and (6) Maintain multiple points of contact with community partners to mitigate the effects of staff turnover.

Puberty Education in a Global Context: Knowledge Gaps, Opportunities, and Implications for Policy

Youth programs and policies provide opportunities for institutions and societies to support healthy adolescent development. Puberty education programs are universally important, as they provide crucial knowledge and skills to help youth and their caregivers navigate the physical, emotional, and interpersonal changes of puberty with positive outcomes. However, few puberty programs have been rigorously evaluated, resulting in a lack of evidence-based knowledge and practice in this area. This review examines the status of research on puberty education and related programs and draws on the broader intervention literature and recent research findings on adolescence to identify program features that might improve program effectiveness. Implications for policy are also discussed. The need for rigorous program evaluation is emphasized throughout.