HIV is a significant health concern among African American (AA) youth. Practicing safer sex behaviors can decrease the risk of HIV infection. Effective strategies for preventing HIV include interventions that are appealing, interactive, and involve youth in both the planning and implementation. It is increasingly common for adolescents to have a cellular phone. Text messaging, a major feature of cellular phones, is a popular means of communication within adolescent social networks. Studies have documented the effectiveness of cellular phone text messaging as a health promotion delivery medium for smoking and alcohol cessation and diabetes management;however, no studies have examined the feasibility of cellular phone text messaging as a format for delivery of HIV prevention interventions. The broad objective of this research is to adapt a recognized HIV prevention curriculum, Becoming a Responsible Teen (BART) using cellular phone text messaging with 13-18 year old adolescents and to evaluate the feasibility of using text messages as boosters to the BART curriculum.
The specific aims are to: 1) adapt/modify the BART curriculum for delivery to adolescents using a cellular phone text messaging component to supplement and reinforce messages and behavioral changes;2) assess the feasibility of delivering the modified curriculum using cellular phone text messaging and make final modifications based on feedback from the feasibility sample;and 3) pilot test the feasibility of the proposed recruitment and retention plan, measures, role play assessments and scoring, and obtain preliminary data on the effectiveness of the BART+TM in modifying sexual risk behaviors of AA adolescents. It is hypothesized that adolescents who receive the BART+TM will show greater knowledge of HIV risk, greater sexual assertiveness skills, greater perception of individual HIV risk, fewer perceived barriers to condom use, and fewer HIV risk behaviors, at post intervention, and 3 month follow-up as compared to baseline. This research will be conducted in 3 phases. In Phase 1, Adaptation, we will use the ADAPT-ITT framework to systematically guide the adaptation process to enhance its appropriateness for text messaging delivery. In Phase 2, Integration, we propose to draft a protocol of the modified curriculum to be pilot tested with a group of 10 adolescents to assess the acceptability of the curriculum with text messaging and to identify any needed modifications. In Phase 3, Testing, a pilot study will be carried out with 32 adolescents to assess the feasibility of delivering the BART+TM curriculum and to do preliminary analyses to see if the sample's data supports the efficacy of the intervention. Adolescents will complete ACASI assessments on three occasions. Exit focus groups will be conducted with parents and adolescents regarding the feasibility and effectiveness of BART+TM. 7.
The relevance of HIV text messaging to public health is that behavior change can occur at the population level. If effective, cellular phone text messaging will offer potential as a new public health initiative in reducing HIV risks for African Americans adolescents.
