The Strong African American Families (SAAF) HIV prevention program is the first intervention developed specifically for rural African American youth and tested in a randomized prevention trial. Analyses of data gathered from rural African American families with middle-school-aged youth supported SAAF's efficacy in deterring youths'vulnerability to HIV-related risk behavior 2 years post-intervention. Some participants, however, experienced extensive barriers to attending the group-based prevention sessions, such as a lack of transportation, inflexible work schedules, exhausting jobs, and responsibility for the care of children other than the target youth. Recent advances in computer-based interactive technology offer a potentially cost-effective means to implement SAAF that could overcome rural African American families'logistical and practical barriers to attending prevention program sessions. Rural African Americans'increasing access to and familiarity with computer technology make a computer-based version of SAAF a feasible option that would ultimately facilitate the program's large-scale diffusion. In this proposal, we request 5 years of additional funding to conduct a three-arm prevention trial in which families will be randomly assigned to one of three conditions: (1) a computer-based version of SAAF, SAAF- CD;(2) the original group-based program, SAAF;or (3) a minimal intervention control group. Alongside this prevention trial, we propose to conduct an economic evaluation of the interventions. This design provides information about the potential of a computer-based versus a group-based intervention to increase the accessibility and diffusion potential of HIV risk reduction programming for rural African Americans. We will test the hypothesis that SAAF-CD will be efficacious, but expect it to be less so than the group-based version, Economic analysis will be performed to ascertain if this decrement may be acceptable and even preferable if SAAF-CD is more cost-effective. The sample will include 600 rural African American families with a 7th-grade student. Pre-intervention, post-intervention, and long-term follow-up assessments of youths'sexual behavior will be gathered from the entire sample.
