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| ID | Type | Description | Link |
|---|---|---|---|
| R01MH062049 | U.S. NIH Grant/Contract | View source | |
| DAHBR 9A-ASPA | Other Identifier | National Institute of Mental Health |
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| Name | Class |
|---|---|
| National Institute of Mental Health (NIMH) | NIH |
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This study will develop and evaluate the effectiveness of culturally appropriate HIV/sexually transmitted disease risk-reduction interventions in reducing sexual risk behavior among young African-American adolescents.
Adolescents risk the negative consequences of early sexual involvement, including not only HIV, but other sexually transmitted diseases (STDs) and unintended pregnancies. Compared with older adults, young people, especially African-American young people, are at higher risk of acquiring an STD. Specifically, people 15 to 24 years of age acquire nearly 50% of all new STDs in the United States, but this age group represents only 25% of the sexually active population. Adolescents are especially vulnerable to STD infections because of a lack of education about proper condom use and consequences of sexual risk behaviors. Previous research has suggested that behavioral interventions can reduce adolescents' sexual behaviors tied to risk of acquiring STDs. Nevertheless, there is continuous debate over the appropriateness and effectiveness of different types of adolescent sexual-risk-reduction interventions, including abstinence education or comprehensive sexual education. Few studies have tested the long-term effectiveness of abstinence education, which emphasizes delaying sexual initiation for sexually inexperienced adolescents. This study will compare the effectiveness of an abstinence-only HIV/STD risk-reduction intervention with other types of interventions in reducing sexual risk behavior among young African-American adolescents.
Participation in this study will last 24 months. Participants at participating schools will be randomly assigned to one of five treatment groups:
Sessions for all groups will be led by trained adult facilitators and will include group discussions, videos, games, brainstorming, experiential exercises, and skill-building activities designed to be educational, interactive, and entertaining. All participants will complete self-reports concerning sexual behaviors, condom use, and knowledge about STDs at baseline and Months 3, 6, 12, 18, and 24 of follow-up.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Abstinence-only | Experimental | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. |
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| Safer-sex only | Experimental | Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. |
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| Comprehensive-long | Experimental | Participants will receive the 12-h long comprehensive HIV/STD risk-reduction intervention. |
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| Comprehensive-short | Experimental | Participants will receive the 8-h short comprehensive HIV/STD risk-reduction intervention. |
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| Health-promotion control | Active Comparator | Participants will receive the health promotion control intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Abstinence-only HIV/STD risk-reduction intervention | Behavioral | Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. |
| Measure | Description | Time Frame |
|---|---|---|
| Self-report of Ever Having Sexual Intercourse | Self-reported sexual initiation during the follow-up period among participants who reported never having sexual intercourse at baseline. | 24 months post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported Sexual Intercourse in the Past 3 Months | Self-report of having sexual intercourse in the past 3 months | Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention |
| Self-report of Having Multiple Sexual Partners in the Past 3 Months |
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Inclusion Criteria:
Exclusion Criteria:
- Those not meeting inclusion criteria were excluded.
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| Name | Affiliation | Role |
|---|---|---|
| John B. Jemmott III, PhD | University of Pennsylvania | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pennsylvania | Philadelphia | Pennsylvania | 19104 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20124144 | Result | Jemmott JB 3rd, Jemmott LS, Fong GT. Efficacy of a theory-based abstinence-only intervention over 24 months: a randomized controlled trial with young adolescents. Arch Pediatr Adolesc Med. 2010 Feb;164(2):152-9. doi: 10.1001/archpediatrics.2009.267. | |
| 26214076 | Result | Zhang J, Jemmott JB 3rd, Jemmott LS. Mediation and moderation of an efficacious theory-based abstinence-only intervention for African American adolescents. Health Psychol. 2015 Dec;34(12):1175-84. doi: 10.1037/hea0000244. Epub 2015 Jul 27. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Comprehensive-long | Participants will receive the long comprehensive HIV/STD risk-reduction intervention. Long comprehensive HIV/STD risk-reduction intervention: Participants will attend three sessions consisting of twelve 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. The intervention consists of the safer-sex-specific content (4 hours), the abstinence-specific content (4 hours), and the general content that is common to both of the single-component interventions (4 hours). |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Safer-sex-only HIV/STD risk-reduction intervention | Behavioral | Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. |
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| Long comprehensive HIV/STD risk-reduction intervention | Behavioral | Participants will attend three sessions consisting of twelve 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. The intervention consists of the safer-sex-specific content (4 hours), the abstinence-specific content (4 hours), and the general content that is common to both of the single-component interventions (4 hours). |
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| Short comprehensive HIV/STD risk-reduction intervention | Behavioral | Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. |
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| Health promotion control intervention | Behavioral | Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. |
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Self-report of having sexual intercourse with more than one partner in the pat 3 months. |
| Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention |
| Self-reported Consistent Condom Use in the Past 3 Months | Self-report of using a condom during every sexual intercourse act in the past 3 months | Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention |
| Self-report of Having Sexual Intercourse Without Using a Condom During the Past 3 Months | Measured at baseline and3, 6, 12, 18, and 24 months post-intervention |
| FG001 | Comprehensive-short | Participants will receive the short comprehensive HIV/STD risk-reduction intervention. Short comprehensive HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. |
| FG002 | Safer-sex Only | Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. Safer-sex-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. |
| FG003 | Abstinence-only | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. Abstinence-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. |
| FG004 | Health-promotion Control | Participants will receive the health promotion control intervention. Health promotion control intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. |
| Followed-up at 3 mo |
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| Followed-up at 6 mo |
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| Followed-up at 12 mo |
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| Followed-up at 18 mo |
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| Followed-up at 24 mo |
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| COMPLETED |
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| NOT COMPLETED |
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Sociodemographic Characteristics and Self-Reported Sexual Behaviors at Baseline of Participating African American Students in Grades 6 and 7 by Intervention Arm
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| ID | Title | Description |
|---|---|---|
| BG000 | Comprehensive-long | Participants will receive the long comprehensive HIV/STD risk-reduction intervention. Long comprehensive HIV/STD risk-reduction intervention: Participants will attend three sessions consisting of twelve 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. The intervention consists of the safer-sex-specific content (4 hours), the abstinence-specific content (4 hours), and the general content that is common to both of the single-component interventions (4 hours). |
| BG001 | Comprehensive-short | Participants will receive the short comprehensive HIV/STD risk-reduction intervention. Short comprehensive HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. |
| BG002 | Safer-sex Only | Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. Safer-sex-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. |
| BG003 | Abstinence-only | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. Abstinence-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. |
| BG004 | Health-promotion Control | Participants will receive the health promotion control intervention. Health promotion control intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. |
| BG005 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Grade in School | Number | participants |
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| Live with both parents | Number | participants |
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| Ever had sexual intercourse | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Self-report of Ever Having Sexual Intercourse | Self-reported sexual initiation during the follow-up period among participants who reported never having sexual intercourse at baseline. | Participants reporting never having sexual intercourse at baseline (i.e., virgins) with follow-up data on self-reported sexual intercourse during the post-intervention assessments. | Posted | Count of Participants | Participants | 24 months post-intervention |
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| Secondary | Self-reported Sexual Intercourse in the Past 3 Months | Self-report of having sexual intercourse in the past 3 months | Participants with data at baseline and at least one post-intervention assessment. | Posted | Count of Participants | Participants | Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention |
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| Secondary | Self-report of Having Multiple Sexual Partners in the Past 3 Months | Self-report of having sexual intercourse with more than one partner in the pat 3 months. | Participants with data at baseline and at least one post-intervention assessment. | Posted | Count of Participants | Participants | Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention |
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| Secondary | Self-reported Consistent Condom Use in the Past 3 Months | Self-report of using a condom during every sexual intercourse act in the past 3 months | Participants with data at baseline and at least one post intervention assessment. | Posted | Count of Participants | Participants | Measured at baseline and 3, 6, 12, 18, and 24 months post-intervention |
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| Secondary | Self-report of Having Sexual Intercourse Without Using a Condom During the Past 3 Months | Participants with data at baseline and at least one post intervention assessment. | Posted | Count of Participants | Participants | Measured at baseline and3, 6, 12, 18, and 24 months post-intervention |
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24 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Comprehensive-long | Participants will receive the long comprehensive HIV/STD risk-reduction intervention. Long comprehensive HIV/STD risk-reduction intervention: Participants will attend three sessions consisting of twelve 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. The intervention consists of the safer-sex-specific content (4 hours), the abstinence-specific content (4 hours), and the general content that is common to both of the single-component interventions (4 hours). | 0 | 131 | 0 | 131 | ||
| EG001 | Comprehensive-short | Participants will receive the short comprehensive HIV/STD risk-reduction intervention. Short comprehensive HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence and for using condoms if participants decide to be sexually active. | 0 | 134 | 0 | 134 | ||
| EG002 | Safer-sex Only | Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. Safer-sex-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. | 0 | 129 | 0 | 129 | ||
| EG003 | Abstinence-only | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. Abstinence-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. | 0 | 134 | 0 | 134 | ||
| EG004 | Health-promotion Control | Participants will receive the health promotion control intervention. Health promotion control intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. | 0 | 134 | 0 | 134 |
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The data were based on self-reports, which can be inaccurate because of poor memory or socially desirability bias. The results may be limited to African American grade 6 and 7 students willing to take part in a health program on weekends.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. John B. Jemmott III | University of Pennsylvania | 215-573-9366 | jjemmott@asc.upenn.edu |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D012749 | Sexually Transmitted Diseases |
| D012725 | Sexual Behavior |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D012252 | Natural Family Planning Methods |
| ID | Term |
|---|---|
| D003267 | Contraception |
| D012099 | Reproductive Techniques |
| D013812 | Therapeutics |
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| Male |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| 8th |
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| No |
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| No |
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| Superiority or Other |
| OG002 |
| Safer-sex Only |
Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. Safer-sex-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. |
| OG003 | Abstinence-only | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. Abstinence-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. |
| OG004 | Health-promotion Control | Participants will receive the health promotion control intervention. Health promotion control intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. |
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| OG002 | Safer-sex Only | Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. Safer-sex-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. |
| OG003 | Abstinence-only | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. Abstinence-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. |
| OG004 | Health-promotion Control | Participants will receive the health promotion control intervention. Health promotion control intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. |
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| OG002 |
| Safer-sex Only |
Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. Safer-sex-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. |
| OG003 | Abstinence-only | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. Abstinence-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. |
| OG004 | Health-promotion Control | Participants will receive the health promotion control intervention. Health promotion control intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. |
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Participants will receive the safer-sex-only HIV/STD risk-reduction intervention. Safer-sex-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for using condoms during sexual intercourse. The intervention is not designed to influence abstinence. |
| OG003 | Abstinence-only | Participants will receive the abstinence-only HIV/STD risk-reduction intervention. Abstinence-only HIV/STD risk-reduction intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for practicing abstinence. The intervention is not an abstinence-until-marriage intervention; the target behavior is abstaining from sexual activity until later in life when the adolescent is more prepared to handle the consequences. The intervention does not contain inaccurate information, portray sex in a negative light, or employ a moralistic tone. It is not designed to affect condom use. |
| OG004 | Health-promotion Control | Participants will receive the health promotion control intervention. Health promotion control intervention: Participants will attend two sessions consisting of eight 1-hour modules that are designed to increase knowledge, motivation, and skill for avoiding cigarette smoking and for incorporating a healthful diet, aerobic exercise, and breast and testicular self-examinations. The control intervention will focus on reducing risk of heart disease, hypertension, diabetes, and certain cancers. The intervention provides a control for "Hawthorne effects" to reduce the likelihood that the HIV/STD interventions' effects can be attributed to group interaction and special attention. |
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