Although 15-24 year olds are only 25% of the U.S. sexually active population, they account for nearly 50% of the 19 million new cases of sexually transmitted infections (STI) each year. Although historically low, the U.S. teen pregnancy rate continues to be one of the highest in the developed world. Evidence-based prevention efforts can help avoid the costs and health consequences associated with STIs and unwanted teen pregnancy among youth. Making Proud Choices (MPC) is an evidence-based STI and pregnancy risk-reduction program with multiple trials demonstrating its effectiveness among teens. To promote faithful implementation, ETR, the non-profit organization that distributes MPC, encourages facilitators to complete their in-person training program. In-person training can yield high implementation fidelity, but is often inaccessible due to high cost, high turnover, and inconvenience. To address these limitations, programs have begun to develop online trainings. However, delivery methods of traditional online training (e.g., video, music, animation), even those that involve trainee practice, limit trainees? ability to develop facilitator skills in sensitive subjects like sexual health and condom use, lack true give-and-take interactions. Building upon existing partnerships, dfusion in collaboration with ETR, the RAND Corporation, Allen Interactions, and Dr. Loretta Jemmott (developer of MPC), propose to develop and test an online virtual training program to provide effective and accessible facilitator training for MPC. Based on promising research from RAND?s Project ALERT substance abuse prevention program that uses guided conversations to build skills and self-confidence in trainees, the proposed virtual training prototype will provide MPC facilitator trainees the opportunity to make decisions, build facilitator skills, practice core concepts and enhance self-efficacy with a virtual audience programmed to display a range of behaviors and emotions, simulating a true-to-life experience with immediate feedback. Seventy-two adults who have experience working with adolescents but not with MPC, STI, or pregnancy prevention education will receive MPC training. Participants will be randomly assigned to either: 1) virtual training in the MPC module on condom use n=36), or 2) dfusion/ETR?s traditional in-person training in the same module (n=36). Using mixed methods (survey, focus groups, observations), the project will evaluate the virtual training?s impact on STI/pregnancy prevention knowledge, teaching efficacy, and teaching skills and its usability, feasibility, and acceptability. This study also paves the way to develop and disseminate effective virtual trainings for a wide range of school- and community-based programs.
Sexually active teens are at high risk for contracting sexually transmitted infections (STIs) and unintended pregnancy. Although 15-24 year olds are only 25 percent of the U.S. sexually active population, they account for nearly 50% of the 19 million new cases of STIs each year. This is not surprising considering only 57% of sexually active 15-19 year olds report using condoms the last time they had sexual intercourse and 15% report having had sex with four or more partners in their lifetime. Effective programs for reducing teen sexual health risk exist. Making Proud Choices (MPC) is a leading evidence-based HIV/STI/teen pregnancy risk-reduction program with multiple trials demonstrating its effectiveness among youth, but challenges exist to ensure MPC is implemented well and that facilitator training is easily accessible to youth-serving organizations. Training is expensive and to- date few sites using the curriculum are choosing to access the expensive trainings available which impacts fidelity and effectiveness. Online, avatar-based training simulations, for very little cost, can help schools and community organizations conduct evidence-based programs with fidelity by overcoming limitations of in-person training. This will improve implementation of the program, improve fidelity, and ideally improve outcomes. This in turn, as MPC is one of the most widely used programs, will contribute to an overall improvement in teen sexual health risk reduction. If successful the findings could inform other nascent efforts to develop avatar facilitator trainings that could make a range of evidence-based programs more accessible to community-based organizations, further improving sexual health education and outcomes for adolescents.
