The research proposed here will replicate two established interventions-Reducing the Risk (RTR), a social learning-based, skills-focused school HIV and pregnancy prevention school curriculum which is among a small number supported by the Centers for Disease Control, and a media campaign based on principles from a highly-successful program developed by one of the investigators and associates which were adopted as part of the model for the multi-year national media campaign currently being conducted by the Office of National Drug Control Policy. The interventions, which have been shown in published studies to be effective in urban areas with a general population of adolescents, will be applied to adolescents in rural areas and small towns in an economically-depressed Appalachian region, an area of generally lower incomes, higher unemployment, and poorer health. Particularly targeted will be high sensation-seekers and impulsive decision-makers, groups that the investigators have established in previous research are considerably more likely to engage in HIV-related sexual behaviors. Versions of the interventions, based on our previous work, will be specifically adapted to be successful with these high-risk groups. The project will involve formative research during the first year of the study to adapt and pretest the interventions followed by experimental interventions in which cohorts of ninth graders receive either no skills-based curriculum (the comparison group), the standard RTR curriculum, or an enhanced version of the RTR curriculum featuring more novel presentations and interactive projects. One of the enhanced versions also will include an HIV+ speaker and another will include peer leader participation. Students in half of the communities will receive a media campaign during Years 2 and 3 (first cohort) and half will receive the media campaign during Years 4 and 5 (second cohort). Each cohort will receive a 10-15 class intervention the first year and a 4-5 session booster intervention the second year. All interventions will have as their goals prolonging sexual abstinence, increasing condom use, reducing the number of partners, and reducing substance use with sex. An estimated 6552 ninth grade students in the two cohorts will be measured at baseline and at two follow-up intervals to assess the impact of the interventions on skills, behavioral intentions, and sexual risk-taking behaviors. The proposal involves a randomized design which includes individual, school, and community levels, to be assessed through hierarchical linear modeling, structural equation modeling, and repeated measures MANCOVA.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (ZHD1-DRG-A (15))
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Borek, Nicolette
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University of Kentucky
Schools of Medicine
United States
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Anderman, Eric M; Cupp, Pamela K; Lane, Derek R et al. (2011) Classroom Goal Structures and HIV/Pregnancy Prevention Education in Rural High School Health Classrooms. J Res Adolesc 21:904-922
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Cupp, Pamela K; Zimmerman, Rick S; Massey, Christi Sporl et al. (2006) Using community ties to facilitate school-based prevention research. Health Promot Pract 7:459-66
Zink, M C; Coleman, G D; Mankowski, J L et al. (2001) Increased macrophage chemoattractant protein-1 in cerebrospinal fluid precedes and predicts simian immunodeficiency virus encephalitis. J Infect Dis 184:1015-21