Purpose Teenage girls in low-income urban settings are at elevated risk for HIV, sexually transmitted infections (STIs), and unintended pregnancies. The purpose of this study was to evaluate the efficacy of a sexual risk-reduction intervention, supplemented with post-intervention booster sessions, targeting low-income, urban, sexually active teenage girls. Method Randomized controlled trial in which sexually-active urban adolescent girls (n=738) recruited in a mid-size, northeastern U. S. city were randomized to a theory-based, sexual risk reduction intervention or to a structurally-equivalent health promotion control group. Assessments and behavioral data were collected using ACASI at baseline, then at 3, 6 and 12-months post-intervention. Both interventions included four small group sessions and two booster sessions. Results Relative to girls in the control group, girls reciving the sexual risk-reduction intervention were more likely to be sexually abstinent; if sexually active, they showed decreases in (a) total episodes of vaginal sex at all followups, (b) number of unprotected vaginal sex acts at 3 and 12-months, and (c) total number of sex partners at 6 months. Medical record audits for girls recruited from a clinical setting (n=322) documented a 50% reduction in positive pregnancy tests at 12-months. Conclusions Theory-based, behavioral interventions tailored to adolescent girls can help to reduce sexual risk and may also reduce unintended pregnancies. Although sexually active at enrollment, many of the girls receiving the intervention were more likely to practice secondary abstinence. Continued refinement of sexual risk-reduction interventions for girls are needed to ensure they are feasible, appealing, and effective.
Adolescent girls remain vulnerable to HIV and other sexually transmitted infections. Understanding their sexual and substance use behaviors is essential to designing effective interventions to reduce their risk. In this study, baseline data were analyzed from 738 adolescent girls ages 15 to 19 years in Rochester, New York. Data on sexual behavior and substance use (lifetime, past 3 months, and most recent sexual experience) were collected. Nearly one half of recent vaginal (42%) and anal (45%) sex acts were not condom protected; 39% had a prior sexually transmitted infection (STI) and 12% were currently infected with an STI. Approximately one third (31%) of girls had more than one sex partner in the past 3 months. Girls with multiple partners reported that their recent sexual experiences were more likely to involve drug and alcohol use by themselves and partners. Adolescent girls, particularly those with multiple sexual partners, continue to report high-risk sexual behaviors and need focused risk-reduction interventions.
This chapter describes the use of semistructured play in the Children of Divorce Intervention Program (CODIP), a developmentally based, preventive intervention for children of divorce. The goals, objectives, and key components of the intervention and implementation process are described, as are a number of outcome studies that provide a solid evidence base for the program's effectiveness. Implications for replication and transportability in various settings are also discussed. RATIONALE FOR PLAY-BASED PREVENTIVE INTERVENTIONSAdvocates of prevention efforts have provided a compelling rationale for allocating resources toward the promotion of wellness rather than trying to contain difficulties once they become chronic and entrenched (Albee,
This study investigated attendance at an HIV prevention randomized controlled trial for urban adolescent females. The intervention included four 2-hour sessions that were held at convenient community-based locations. Participants were recruited from reproductive and general health care clinics, as well as youth development programs. Of the 744 girls who consented to participate in the research study, 86% (n = 640) attended one or more of the risk reduction sessions but 14% (n = 104) did not attend any sessions. Data analyses indicated that girls who attended were more likely to be younger, African American, and non-Hispanic. They also reported earlier sexual debut and more recent sexual partners. Results indicate that sexual risk reduction interventions are attractive to many at-risk female adolescents. Strategies to improve attendance are described for this vulnerable population sub-group.
A questionnaire was developed to assess the skillfulness of therapists from the perspective of the supervisor. This supervisor report yielded two scores: one for psychotherapeutic techniques and one for the educational alliance. These scores had high internal consistency and were relatively independent of one another. Ratings of proficiency in psychotherapeutic techniques accounted for 54% of the variance in supervisors' rating? of global skillfulness; educational alliance contributed an additional 12%. Compared with other supervisors, those who espoused self psychology based more of their appraisal of skill fulness on the trainee's use of the supervisory relationship.
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