Description) The Center for Disease Control and Prevention (CDC) has identified five """"""""Programs that Work"""""""". One of these programs, """"""""Focus on Kids"""""""" (FOK) was developed and evaluated by an interdisciplinary team located at the University of Maryland. The UMAB investigators, in collaboration with researchers at the statewide West Virginia Rural Health Education Partnerships housed at West Virginia University, are proposing a three-celled trial comparing two approaches to intervention replication of FOK and a control intervention in a new study population. The new target population differs by both race (white compared to African-American) and by geography (rural West Virginia compared to urban Baltimore). In one replication approach, the investigators will seek to replicate the intervention development process with a prolonged ethnographic phase enabling them to translate the guiding theoretic model into the local culture. FOK will be the template for this approach, but it is likely that this cultural adaptation of FOK will produce a substantially different program, CAP, which will differ in content (e.g., different risk and protective behaviors and different perceptions of these behaviors) and may differ in presentation from FOK. In the second replication approach (CM-FOK), the investigators shall attempt to modify primarily the """"""""cosmetic"""""""" features of FOK, e.g., names, local resources. Finally, they propose a Control condition since it is possible that neither of these programs will be effective in this new study population. 900 youth 12-16 years of age living in 36 """"""""communities"""""""" from six counties in rural West Virginia with the highest rates of teen pregnancy will be recruited in three intervention waves occurring over 18 months. At each wave, youth will be recruited from 12 communities. After all youth in a given wave have completed baseline risk/protective assessment measures, which will be administered via """"""""talking"""""""" Macintosh computers, the 12 communities will be randomly assigned to receive one of the three interventions: CAP, CA-FOK, or Control. After all three waves are completed, a total of 12 communities (300 youth) will be assigned to each intervention condition. Intervention impact on HIV/STD risk and protective behaviors and perceptions will be assessed at 3, 6, and 9 months post-intervention.
