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Compendium of Evidence-Based HIV Behavioral Interventions

Focus on Youth (FOY) plus ImPACT

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Intervention Description

Target Population
High-risk African American youth living in low-income urban community sites

Goal of Intervention
Reduce adolescent truancy, substance abuse, and sexual risk behaviors

Brief Description

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.

Theoretic Basis
Protection Motivation Theory

Intervention Duration
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.

Intervention Setting
Thirty-five sites located throughout the community (urban housing developments, community centers, recreation centers) for FOY and ImPACT; in participants’ homes for ImPACT.

Deliverer
An interventionist and assistant group leader deliver FOY ImPACT is delivered by an interventionist.

Delivery Methods

  • Exercises/Games
  • Group discussion
  • Lectures
  • Role plays
  • Risk-reduction supplies (condoms)
  • Videos

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Intervention Package Information

The intervention package and training are available through CDC’s Diffusion of Effective Behavioral Interventions (DEBI) project.

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Evaluation Study and Results

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

Study Sample

  • 100% African American
  • 58% Female, 42% Male
  • Median age of 14 years (range: 13–16 years)

Recruitment Settings
Housing developments, community centers, and recreation centers

Eligibility Criteria
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.

Assignment Method
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).

Comparison Group
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

      Participant Retention

      • 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

      Significant Findings
      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.

      Considerations

      • 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.

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      References and Contact Information

      • 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
      e-mail: bstanton@dmc.org

      Dr. Jennifer Galbraith
      Centers for Disease Control and Prevention
      1600 Clifton Road, Mailstop E-37
      Atlanta, GA 30333
      e-mail: jgalbraith@cdc.gov

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