title: NATIVE-It's Your Game: Adapting a Technology-Based Sexual Health Curriculum for American Indian and Alaska Native youth.
abstract: Sexually transmitted infection (STI) and birth rates among American Indian/Alaska Native (AI/AN) youth indicate a need for effective middle school HIV/STI and pregnancy prevention curricula to delay, or mitigate, the consequences of early sexual activity. While effective curricula exist, there is a dearth of curricula with content salient to AI/AN youth. Further, there is a lack of sexual health curricula that take advantage of the motivational appeal, reach, and fidelity of communication technology for this population, who are sophisticated technology users. We describe the adaptation process used to develop Native It's Your Game, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing promising sexual health curriculum, It's Your Game-Tech (IYG-Tech). The adaptation included three phases: (1) pre-adaptation needs assessment and IYG-Tech usability testing; (2) adaptation, including design document development, prototype programming, and alpha testing; and (3) post-adaption usability testing. Laboratory- and school-based tests with AI/AN middle school youth demonstrated high ratings on usability parameters. Youth rated the Native IYG lessons favorably in meeting the needs of AI/AN youth (54-86 % agreement across lessons) and in comparison to other learning channels (57-100 %) and rated the lessons as helpful in making better health choices (73-100 %). Tribal stakeholders rated Native IYG favorably, and suggested it was culturally appropriate for AI/AN youth and suitable for implementation in tribal settings. Further efficacy testing is indicated for Native IYG, as a potential strategy to deliver HIV/STI and pregnancy prevention to traditionally underserved AI/AN middle school youth.
authors: Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA. Ross.Shegog@uth.tmc.edu.
authors: Ross
authors: R
authors: Shegog
authors: Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR, 97201, USA.
authors: Stephanie
authors: S
authors: Craig Rushing
authors: Inter Tribal Council of Arizona, Inc., 2214 North Central Avenue, Suite 100, Phoenix, AZ, 85004, USA.
authors: Gwenda
authors: G
authors: Gorman
authors: Division of Community Health Services, Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, AK, 99508, USA.
authors: Cornelia
authors: C
authors: Jessen
authors: Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA.
authors: Jennifer
authors: J
authors: Torres
authors: Inter Tribal Council of Arizona, Inc., 2214 North Central Avenue, Suite 100, Phoenix, AZ, 85004, USA.
authors: Travis L
authors: TL
authors: Lane
authors: Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR, 97201, USA.
authors: Amanda
authors: A
authors: Gaston
authors: Division of Community Health Services, Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, AK, 99508, USA.
authors: Taija Koogei
authors: TK
authors: Revels
authors: Division of Community Health Services, Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, AK, 99508, USA.
authors: Jennifer
authors: J
authors: Williamson
authors: Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA.
authors: Melissa F
authors: MF
authors: Peskin
authors: Center for Disease Control (CDC), Office of Public Health Scientific Services (OPHSS), Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Dekalb County, Atlanta, GA, USA.
authors: Jina
authors: J
authors: D'Cruz
authors: Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA.
authors: Susan
authors: S
authors: Tortolero
authors: Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center Houston, 7000 Fannin Street, Suite 2668, Houston, TX, 77030, USA.
authors: Christine M
authors: CM
authors: Markham
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology* / Q000523:psychology; D000413:Alaska / Q000453:epidemiology; D000072957:Alaska Natives / Q000193:education*; D055812:Community-Based Participatory Research / Q000379:methods / Q000458:organization & administration*; D003194:Computer-Assisted Instruction / Q000379:methods; D054521:Cultural Competency; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control; D006284:Health Plan Implementation / Q000379:methods / Q000458:organization & administration; D006801:Humans; D007198:Indians, North American / Q000193:education*; D020407:Internet; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology / Q000517:prevention & control*; D015397:Program Evaluation; D000074384:Sexual Health / Q000193:education*; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control*
keywords: Adolescents; Behavior; Communication technology; Computer-based health education; Computer-based learning; Cultural adaptation; Health communications; School-based health; Teen pregnancy prevention; Web-based health education