The broad objective of this research is to identify theory-based interventions to reduce HIV risk-associated sexual behavior among African-American adolescents. Phase III trials that tested the efficacy of interventions with small, controlled experiments reveal that cognitive-behavioral interventions based on social cognitive theory and the theory of planned behavior can reduce HIV risk-associated sexual behavior and cause positive changes on theory-based mediators of such behavior. An important unanswered question is whether such interventions are effective when implemented by community-based organizations (CBOs), key end-users. Another important question is how variations in the intensity of training CBOs receive influence the effects of the intervention on adolescents' outcomes. In the proposed experiment, 96 CBOs serving African-American adolescents will be randomly assigned to implement an HIV Risk-Reduction Intervention or a control intervention on other health problems that are affected by behavior (e.g., heart disease, cancer, and hypertension). Orthogonal to this, the intensity of the training the CBOs receive will be varied randomly: a Manual-Only Condition that receives only the curriculum manual and related materials; a Standard Training Condition that receives the curriculum materials and 2 days of training; or an Enhanced Training Condition that receives the Standard Training, a practice session to implement the intervention with adolescents, and a 1-day booster training session. Each CBO will implement the intervention with eight groups of six to eight adolescents. All adolescents will complete pre- and post-intervention questionnaires. A representative sample will complete 3-, 6-, and 12-month follow-up questionnaires. The behavioral skills of a representative sample will also be assessed.
The Specific Aims i nclude whether the HIV intervention is effective when implemented by CBOs, how intensity of training influences the effects of the intervention on adolescents' behavior, how intensity of training affects implementation fidelity, and how effects are mediated and moderated by characteristics of CBOs, facilitators, and adolescents. Measures include facilitators' intentions, self-efficacy, and implementation fidelity and adolescents' intentions, beliefs, self-efficacy, behavioral skills, and self-reported HIV risk-associated sexual behavior. This research will provide data on whether HIV prevention intervention effects observed in small, controlled experiments are evident when CBOs implement the intervention.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (ZMH1-BRB-I (03))
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Pequegnat, Willo
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University of Pennsylvania
Other Domestic Higher Education
United States
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Jemmott 3rd, John B; Jemmott, Loretta S; Fong, Geoffrey T et al. (2010) Effectiveness of an HIV/STD risk-reduction intervention for adolescents when implemented by community-based organizations: a cluster-randomized controlled trial. Am J Public Health 100:720-6
Jemmott 3rd, J B; Jemmott, L S (2000) HIV risk reduction behavioral interventions with heterosexual adolescents. AIDS 14 Suppl 2:S40-52