Efficacy of It's Your Game-Tech: A Computer-Based Sexual Health Education Program for Middle School Youth.
OBJECTIVE
Few computer-based HIV, sexually transmitted infection (STI), and pregnancy prevention programs are available, and even fewer target early adolescents. In this study, we tested the efficacy of It's Your Game (IYG)-Tech, a completely computer-based, middle school sexual health education program. The primary hypothesis was that students who received IYG-Tech would significantly delay sexual initiation by ninth grade.


METHODS
We evaluated IYG-Tech using a randomized, two-arm nested design among 19 schools in a large, urban school district in southeast Texas (20 schools were originally randomized). The target population was English-speaking eighth-grade students who were followed into the ninth grade. The final analytic sample included 1,374 students. Multilevel logistic regression models were used to test for differences in sexual initiation between intervention and control students, while adjusting for age, gender, ethnicity, time between measures, and family structure.


RESULTS
There was no significant difference in the delay of sexual activity or in any other sexual behavior between intervention and control students. However, there were significant positive between-group differences for psychosocial variables related to STI and condom knowledge, attitudes about abstinence, condom use self-efficacy, and perceived norms about sex. Post hoc analyses conducted among intervention students revealed some significant associations: "full exposure" (completion of all 13 lessons) and "mid-exposure" (5-8 lessons) students were less likely than "low exposure" (1-4 lessons) students to initiate sex.


CONCLUSIONS
Collectively, our findings indicate that IYG-Tech impacts some determinants of sexual behavior, and that additional efficacy evaluation with full intervention exposure may be warranted.
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas. Electronic address: Melissa.F.Peskin@uth.tmc.edu.
Melissa F
MF
Peskin
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas.
Ross
R
Shegog
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas.
Christine M
CM
Markham
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas.
Melanie
M
Thiel
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas.
Elizabeth R
ER
Baumler
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas.
Robert C
RC
Addy
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas.
Efrat K
EK
Gabay
Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, Texas.
Susan Tortolero
ST
Emery
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control; D015397:Program Evaluation / Q000379:methods*; D012572:School Health Services / Q000458:organization & administration; D012736:Sex Education / Q000379:methods*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D012984:Software; D013334:Students / Q000523:psychology; D013781:Texas
Adolescents; HIV; Prevention; Sexual health; Sexually transmitted infections; Technology; Teen pregnancy