title: Adapting an HIV Risk Reduction Curriculum: Processes and Outcomes.
abstract: Becoming a Responsible Teen (BART) is a community-based, HIV risk reduction curriculum shown to increase safer sex behaviors among African American adolescents. However, BART does not address common barriers to sexual health care access, which may limit program efficacy. We used a community-engaged adaptation process to maximize program relevance and health outcomes by incorporating a broad ecological perspective. Adolescent and staff advisory boards at a community-based organization recommended modifications (e.g., delete references to Kwanzaa, update language, localize incentives) and supported inclusion of critical on-site health services, such as sexually transmitted infection testing and condom provision. We conducted a trial of adapted BART (one session/week for 8 weeks) with 36 adolescents at two community organizations (mean age = 15.5 years, 52% female; 61% reported previous sexual intercourse). Most received on-site sexually transmitted infection testing (61%) and condoms (70%). Adolescents demonstrated significant improvements in self-efficacy for safer sexual practices (p < .02), AIDS risk knowledge (p < .001), condom knowledge (p < .001), and condom attitudes (p < .04). Adolescents and staff were satisfied with the revised curriculum and found on-site services acceptable. Based on improvements in constructs influencing behavior and the successful delivery of services essential for optimal health, future studies to assess efficacy and sustainability of the adapted curriculum appear warranted.
authors.affiliation: 1 Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Miller
authors.affiliation: 2 University of Kansas Medical Center, Kansas City, KS, USA.
authors.forename: Joi
authors.initials: J
authors.lastname: Wickliffe
authors.affiliation: 1 Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.
authors.forename: Sharon G
authors.initials: SG
authors.lastname: Humiston
authors.affiliation: 1 Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.
authors.forename: M Denise
authors.initials: MD
authors.lastname: Dowd
authors.affiliation: 3 University of Missouri-Kansas City, Kansas City, MO, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Kelly
authors.affiliation: 1 Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: DeLurgio
authors.affiliation: 1 Children's Mercy Hospitals and Clinics, Kansas City, MO, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Goggin
mesh_terms: D000293:Adolescent; D001741:Black or African American; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D016730:Program Development; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D021841:Safe Sex; D020377:Self Efficacy
keywords: HIV/AIDS; access to health care; child/adolescent health; health disparities; minority health; program planning and evaluation