A Technology-Based Training Tool for a Health Promotion and Sex Education Program for Justice-Involved Youth: Development and Usability Study

Abstract

Background Justice-involved youth are especially vulnerable to mental health distress, substance misuse, and risky sexual activity, amplifying the need for evidence-based programs (EBPs). Yet, uptake of EBPs in the justice system is challenging because staff training is costly in time and effort. Hence, justice-involved youth experience increasing health disparities despite the availability of EBPs. Objective To counter these challenges, this study develops and pilot-tests a prototype of a technology-based training tool that teaches juvenile justice staff to deliver a uniquely tailored EBP for justice-involved youth—PHAT (Preventing HIV/AIDS Among Teens) Life. PHAT Life is a comprehensive sex education, mental health, and substance use EBP collaboratively designed and tested with guidance from key stakeholders and community members. The training tool addresses implementation barriers that impede uptake and sustainment of EBPs, including staff training and support and implementation costs. Methods Staff (n=11) from two juvenile justice settings pilot-tested the technology-based training tool, which included five modules. Participants completed measures of HIV and sexually transmitted infection (STI) knowledge, sex education confidence, and implementation outcomes such as training satisfaction, adoption, implementation, acceptability, appropriateness, and sustainability. PHAT Life trainers assessed fidelity through two activity role plays participants submitted upon completing the training modules. Results Participants demonstrated increases in HIV and STI knowledge (t10=3.07; P=.01), and were very satisfied (mean 4.42, SD 0.36) with the training tool and the PHAT Life curriculum. They believed that the training tool and curriculum could be adopted, implemented, and sustained within their settings as an appropriate and acceptable intervention and training. Conclusions Overall, the results from this pilot test demonstrate feasibility and support continuing efforts toward completing the training tool and evaluating it within a fully powered randomized controlled trial. Ultimately, this study will provide a scalable option for disseminating an EBP and offers a more cost-effective and sustainable way to train staff in an EBP.

The Role of Family Factors in the Outcomes of Court-Involved Youth

“…Namely, youth delinquency and court-involvement cause stress and strain on the family system, and the family unit itself impacts youth behavior with notable potential for buffering and improvement in outcomes. Viewing delinquency in the context of both psychopathology and family factors is consistent with the Social-Personal Framework (SPF), which has been previously utilized in interventions targeting adolescent risk behaviors (Donnenberg et al, 2018;Brown et al, 2014;Snow-Hill et al, 2021;Kendall et al, 2017). The SPF highlights that adolescent risk-taking does not occur in isolation, but rather in the setting of personal attributes, family context, peer and partner relationships, and environmental circumstances (Donenberg & Pao, 2005).…”

The Impact of Technology on Adolescent Sexual and Reproductive Needs

“…In the United States, SRH telehealth interventions were found to increase self-efficacy with condom use [ 2 ] and were found feasible for screening for sexually transmitted infections [ 3 ]. With a focus on subgroups of adolescents, mHealth interventions targeted homeless adolescents [ 4 ], trans youth [ 5 , 6 , 7 ], and justice-involved youth [ 8 ]. This underscored the importance of mHealth interventions because numerous homeless and LGBTQ+ youth own a mobile phone, and many reported mental health issues, substance abuse, eating disorders, homelessness, risky sexual behaviors, and victimization during the pandemic.…”

“…Justice-involved youth were especially vulnerable to risky sexual behaviors and mental health issues during the pandemic. Snow-hill et al [ 8 ] tested and adapted the PHAT-Life intervention with juvenile justice staff and found that this intervention could be sustained within the justice system setting.…”