Compendium of Evidence-Based HIV Behavioral Interventions
Focus on Youth (FOY) plus ImPACT
High-risk African American youth living in low-income urban community sites
Goal of Intervention
Reduce adolescent truancy, substance abuse, and sexual risk behaviors
FOY+ImPACT is a skill-building intervention to reduce substance and sex risk behaviors of high-risk youth. The first component, FOY , is an 8-session HIV risk reduction intervention delivered to small groups of 5–12 youth. The intervention emphasizes decision-making, goal setting, communication, negotiation, and consensual relationships. Through the use of games, discussions, homework, and videos, youth receive information on abstinence and safe sex, drugs, alcohol, drug selling, AIDS and STDs, contraception, and human development. ImPACT, the second component, is a single-session intervention delivered to each youth and his/her parent or guardian. ImPACT begins with a 20-minute video emphasizing parental monitoring and communication. After the video, the parent and youth role-play a vignette where the parent is confronted with evidence of a child’s involvement in a sexual relationship. Finally, the youth and parent are taught and practice correct condom use.
Protection Motivation Theory
The 9 intervention sessions (8 for FOY and 1 for ImPACT) last approximately 1.5 hours each, and are generally delivered one session per week. ImPACT is delivered to the parents at the beginning of the FOY delivery.
Thirty-five sites located throughout the community (urban housing developments, community centers, recreation centers) for FOY and ImPACT; in participants’ homes for ImPACT.
An interventionist and assistant group leader deliver FOY ImPACT is delivered by an interventionist.
- Group discussion
- Role plays
- Risk-reduction supplies (condoms)
The intervention package and training are available through CDC’s Diffusion of Effective Behavioral Interventions (DEBI) project.
The original evaluation study was conducted in Baltimore, Maryland between 1999 and 2002. The sample included 817 African American youth.
Key Intervention Effects
- Reduced sexual intercourse
- Reduced unprotected sex
- 100% African American
- 58% Female, 42% Male
- Median age of 14 years (range: 13–16 years)
Housing developments, community centers, and recreation centers
Youths were eligible if they were aged 12 to 16 years and living in or around 35 recruitment sites. Youth with a recognized psychiatric disorder or mental retardation were not eligible.
Recruitment sites were randomly assigned to one of three groups: FOY +ImPACT and multiple booster sessions (n = 238), FOY +ImPACT (n = 258), and FOY only comparison (n = 321).
Youth in the comparison group received the 8-session FOY intervention only, and parents and youth received information and participated in a discussion regarding employment readiness and education.
Relevant Outcomes Measured and Follow-up Time
- Sexual risk behaviors during the previous 6 months (including sexual intercourse and unprotected sex at last sexual encounter) were measured at 6-, 12-, and 24-month follow-ups
- FOY +ImPACT:
74% retained at 6 months
67% retained at 12 months
60% retained at 24 months
- FOY +ImPACT+Booster:
74% retained at 6 months
69% retained at 12 months
59% retained at 24 months
- FOY only comparison:
75% retained at 6 months
76% retained at 12 months
62% retained at 24 months
At the 6-month follow-up, youth receiving the FOY +ImPACT intervention who were sexually active at baseline reported significantly lower rates of sexual intercourse (p = .05) and unprotected sex (p = .005) than youth in the FOY only comparison.
- Compared to the FOY only comparison group, youth who received the FOY +ImPACT intervention were less likely to report other risk behaviors, including: cigarette smoking at 6 and 24 months, alcohol use at 6 and 12 months, marijuana use at the 12-month follow-up, and been pregnant or gotten a girl pregnant at 24 months.
- The FOY +ImPACT+Booster intervention, which included booster sessions at 7, 10, 13, and 16 months, did not meet the best evidence criteria. A significantly larger percent of youth participating in this intervention reported a pregnancy compared to youth participating in the FOY +ImPACT intervention at 24 months.
- Stanton, B., Cole, M., Galbraith, J., et al. (2004). Randomized trial of a parent intervention: Parents can make a difference in long-term adolescent risk behaviors, perceptions, and knowledge. Arch Pediatr Adolesc Med, 158, 947–955.
- Wu, Y., Stanton, B. F., Galbraith, J., et al. (2003). Sustaining and broadening intervention impact: A longitudinal randomized trial of 3 adolescent risk reduction approaches. Pediatrics, 111, e32–e38.
Researcher: Dr. Bonita F. Stanton
Department of Pediatrics
Children’s Hospital of Michigan, Suite 1k40
Wayne State University
3901 Beaubien St.
Detroit, MI 48201
Dr. Jennifer Galbraith
Centers for Disease Control and Prevention
1600 Clifton Road, Mailstop E-37
Atlanta, GA 30333
- FOY +ImPACT: