title: Improving the implementation of a condom availability program in urban high schools.
abstract: OBJECTIVE
  We conducted an intervention to improve the implementation of a high school condom availability program, and evaluated its effect on students' awareness of the program and acquisition of condoms.
  
  
  METHODS
  Twelve public high schools in the Los Angeles, CA area participated, half each in the intervention and control conditions. Project staff facilitated intervention schools' self-assessment of compliance with the school district's condom availability policy, creating an action plan by determining which mandatory program elements were lacking and identifying steps to improve compliance. Staff provided technical assistance and follow-up to assist schools in improving program implementation. From 2005 to 2009 (T1-T5), 29,823 students were randomly selected by classroom and they completed surveys. We tested for changes in students' awareness and acquisition of condoms over time between conditions using mixed model logistic regression analyses. Records of condom orders by schools also were reviewed.
  
  
  RESULTS
  Awareness increased significantly among intervention versus control participants from T1 to T3 (adjusted odds ratio [AOR]: 1.28; 95% confidence interval [CI]: 1.01, 1.62), T4 (AOR: 2.17; 95% CI: 1.70, 2.76), and T5 (AOR: 2.78; 95% CI: 2.18, 3.56). Acquisition of condoms increased significantly among intervention versus control participants from T1 to T4 (AOR: 1.69; 95% CI: 1.23, 2.32) and T5 (AOR: 1.81; 95% CI: 1.32, 2.49). Results were similar across gender and different levels of sexual experience. Orders of condoms increased markedly in intervention schools by T5.
  
  
  CONCLUSIONS
  Feasible minor enhancements to condom availability program implementation improved program delivery, resulting in increased student awareness of the program and acquisition of condoms.
authors.affiliation: Los Angeles County Department of Public Health, Sexually Transmitted Disease Program, Los Angeles, California 90007, USA. cderosa@ph.lacounty.gov
authors.forename: Christine J
authors.initials: CJ
authors.lastname: De Rosa
authors.forename: Robin A
authors.initials: RA
authors.lastname: Jeffries
authors.forename: Abdelmonem A
authors.initials: AA
authors.lastname: Afifi
authors.forename: William G
authors.initials: WG
authors.lastname: Cumberland
authors.forename: Emily Q
authors.initials: EQ
authors.lastname: Chung
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kerndt
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Ethier
authors.forename: Esteban
authors.initials: E
authors.lastname: Martinez
authors.forename: Richard V
authors.initials: RV
authors.lastname: Loya
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Dittus
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017280:Condoms / Q000706:statistics & numerical data / Q000600:supply & distribution*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D015141:Los Angeles; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D012572:School Health Services; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D011049:Social Control Policies; D014504:Urban Health