Web-Based Middle School HIV Prevention Curricula: Aspiring for Reach and Impact

描述（由申请人提供）：基于网络的中学艾滋病预防课程：渴望达到和影响青少年早期性行为在美国是一个重要的公共卫生问题。然而，很少有项目被证明能有效地延缓中学生的性行为，而且许多项目的大规模推广潜力有限。这个调查小组开发并评估了一个新的艾滋病毒、性传播感染和怀孕预防教室和电脑程序，名为“It's Your Game……”保持真实（IYG）。经过长期随访，我们发现IYG在延迟青少年性行为开始方面是有效的。这个评估是基于学生在课堂和电脑上的参与。为了增加其传播潜力，确定以计算机为基础的部分作为独立课程的相对长期效力已成为该领域的重要下一步，因为它审查了预防的其他途径。我们最近把所有的国际青年运动的电脑活动转换成一个基于互联网的平台。以电脑为基础的国际青年小组的互联网版本结合了技术进步和互联网对青年的吸引力，这可能有可能加强效果，提高课程的保真度，并以具有成本效益的方式促进传播。在这个网络项目的一个小型试点研究中，接触到这个项目的学生更有可能报告说，在与高风险性行为相关的心理社会因素方面，它产生了积极的影响。这些发现需要在更大规模的试验中得到证实；因此，这项为期3年的研究建议评估这种基于互联网的艾滋病毒、性传播感染（STI）和怀孕预防课程，作为一个独立的干预措施，在一个大城市学区的中学生。将对1600名中学生进行随机双臂嵌套设计，其中接受互联网课程的学校（n=7所学校）将与接受常规护理的对照学校（n=7）进行比较。这项研究建立在这一领域广泛的先前研究的基础上，将有助于我们理解使用互联网向中学生提供艾滋病毒、性传播感染和怀孕预防计划。

DESCRIPTION (provided by applicant): Web-Based Middle School HIV Prevention Curricula: Aspiring for Reach & Impact Early adolescent sexual behavior is a significant public health problem in the U.S. Few programs, however, have proven effective in delaying sexual behavior among middle school students, and many have limited potential for wide-scale dissemination. This investigative team has developed and evaluated a new HIV, STI and pregnancy prevention classroom and computer-based program, entitled It's Your Game...Keep it Real (IYG). We found IYG to be effective in delaying sexual initiation among youth after long term follow-up. This evaluation was based on student's participation in both the classroom and computer-based components. To increase its dissemination potential, determining the relative long-term effectiveness of the computer-based component as a standalone curriculum has become an important next step in the field, as this examines additional avenues for prevention. We recently converted all of the IYG computer activities to an Internet-based platform. An Internet version of the IYG computer-based component incorporates technological advances and the appeal of the Internet for youth, which may have the potential to bolster effects, improve lesson fidelity, and facilitate dissemination in a cost-effective manner. In a small pilot study of this Internet program, students exposed to the program were more likely to report positive effects on psychosocial factors related to risky sexual behavior. These findings need to be replicated in a larger trial; thus, this 3-year study proposes to evaluate this Internet-based HIV, sexually transmitted infection (STI), and pregnancy prevention curriculum as a standalone intervention for middle school students in a large urban school district. A randomized two-arm nested design will be conducted with 1,600 middle school students where schools receiving the Internet-based curriculum (n=7 schools) will be compared with comparison schools receiving usual care (n=7). This study builds on extensive prior research in this domain and will contribute to our understanding of using the Internet to deliver an HIV, STI, and pregnancy prevention program to middle school students. PUBLIC HEALTH RELEVANCE: Narrative Description The use of computers, games, and the Internet to address adolescent sex education is a burgeoning research area. An Internet-based HIV, STI, and pregnancy prevention program for middle school students has the potential for low-cost, high fidelity dissemination, if it is proven to be effective at delaying sexual initiation.