Using Intervention Mapping to Adapt an Effective HIV, Sexually Transmitted Disease, and Pregnancy Prevention Program for High-Risk Minority Youth

Tortolero, Susan R.; Markham, Christine; Parcel, Guy S.; Peters, Ronald J.; Escobar-Chaves, S. Liliana; Basen-Engquist, Karen; Lewis, Holly L.

doi:10.1177/1524839904266472

Cited by 70 publications

(69 citation statements)

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“…However, the sample is rather large and the use of both quantitative and qualitative methodologies provided evidence of consistent findings. Overall, the findings support the need for intervention to recognize cultural distinctions that characterize this poor migrant community (Elifson et al, 2006;Gaspar, 2005;Tortolero, Markham, Parcel, et al, 2005). …”

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confidence: 65%

Communication and Information About “Safer Sex”: Intervention Issues Within Communities of African Migrants Living in Poorer Neighborhoods in Portugal

Matos¹,

Gaspar²,

Simons-Morton³

et al. 2008

Journal of Poverty

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The aims of this study are to determine the influence of migrant status on sexual behavior and communication about "safer sex" and to identify ethnic-specific prevention issues. Data were obtained from a special administration of the Health Behavior in School-Aged Children Survey in a special sample of Portuguese schools located in low-income Lisbon neighborhoods with large proportions of African migrants.Survey participants included 919 6th, 8th and 10th graders (52.3% female), of whom 19.2% were migrant foreigners from African Portuguese-speaking countries, including Cape Verde (60.8%), Mozambique (1.6%), Angola (16.8%), S. Tomé (8%), and Guinea-Bissau (14.8%). Subsequently, four focus groups were held with adolescent who had participated in the survey (n = 45), three focus group with health and education professionals (n = 25), and one focus group with parents (n = 6).Compared with Portuguese adolescents, African migrant teens reported initial sexual intercourse at earlier ages, less frequent condom use, and less frequent and less comfortable communications with parents about sexual issues.Implications for selective prevention of STD are discussed and recommendations are made. KeywordsCommunication; Information; HIV prevention; Poverty; Ethnicity; Sexual risk Portugal has long been known as a society of immigrants. The arrival of large numbers of immigrants from Africa, and lately from Brazil and East European countries, has increased the multicultural population of Portuguese schools, providing new educational challenges. However, many of these differences were no longer significant when socio-economic status (SES) was considered. The associations between migrant status and poor health, lower wellbeing, school failure, family communication, and behavior problems, were fully mediated by poverty and were no longer present when comparing groups with the same SES. The only significant differences between migrant adolescents and other Portuguese adolescents with similar SES were related to sexual behavior (Gaspar, Matos & Gonçalves, 2005;Matos & Gaspar, 2003;Matos et al., 2003;Matos, Gaspar, & Gonçalves, 2004;Matos, Gonçalves, & Gaspar, 2005).Many migrants from Portuguese-speaking African countries (i.e., Cape-Verde, Mozambique, Angola, S.Tomé, Guinea-Bissau) live in poor neighborhoods, often illegally, under poor social and economic conditions. Young migrants are exposed to the different cultures and social patterns of their home country and of Portugal. Lifestyle and access to health and education are limited by poverty. Adolescents of low SES present more psychological symptoms and report less social support (Gaspar, 2005;Muuss & Porton, 1999), more health problems, poorer reading skills, and lower school attendance and performance. African migrants tend to marry young and have children early, a trend that is associated with school drop out and a lifetime of lower-paying work, frequent periods of unemployment, and socially-deviant behavior .Gender relationships among African migrants typically are not ...

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mentioning

confidence: 65%

Communication and Information About “Safer Sex”: Intervention Issues Within Communities of African Migrants Living in Poorer Neighborhoods in Portugal

Matos¹,

Gaspar²,

Simons-Morton³

et al. 2008

Journal of Poverty

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“…[17][18][19]33 Em relação aos profissionais envolvidos na execução dos programas, parte dos estudos tiveram a participação de profissionais de assistência social, 29,31 outros relataram o envolvimento de membros da comunidade 24,30 e parentes dos adolescentes. 32 Quanto à metodologia utilizada, em alguns houve preocupação de que os aspectos abordados estivessem culturalmente próximos à população alvo do programa, envolvendo as diferentes problemáticas da população em questão e os diversos atores sociais envolvidos nas decisões relacionadas à sexualidade destes adolescentes.…”

Section: Resultsunclassified

“…16,17,34 Entre as experiências relatadas, a utilização de programas com conteúdo ampliado parece ser unânime, destacando a inclusão de temas voltados à prevenção das DST e uso métodos de prevenção da gravidez em suas abordagens. 16,17,34 No estudo de De Anda 18 foi realizada uma simulação através de bonecas para avaliar os cuidados maternos de adolescentes e as consequências de uma gravidez no curso de vida da adolescente mãe e de outros membros da família. Apesar de terem sido relatados muitos fatores relacionados à gravidez na adolescência, a mesma não foi avaliada e o autor apenas alega que o programa é efetivo para prevenir a gravidez.…”

Section: Discussionunclassified

“…11 Diversas políticas e intervenções têm sido propostas e executadas em vários países no sentido de reverter essa realidade de gravidez indesejada na adolescência. [12][13][14][15][16][17][18][19][20][21][22] No entanto, o aumento da taxa de fecundidade entre adolescentes e jovens, assim como o número de óbitos maternos nessa faixa etária, 2,23 evidenciam a necessidade de adequação de políticas de contracepção, planejamento familiar e atenção pré-natal.…”

Section: Introductionunclassified

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Efetividade das ações voltadas à diminuição da gravidez não-planejada na adolescência: revisão da literatura

Moccellin

Costa

Toledo

et al. 2010

Rev. Bras. Saude Mater. Infant.

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“…The adaptation process and program content of Safer Choices 2 is described elsewhere [18]. The adapted program consists of 15 lessons, a video, and journaling activities delivered in a classroom setting by a trained facilitator over an 8-week period.…”

Section: Methodsmentioning

confidence: 99%

Safer choices 2: Rationale, design issues, and baseline results in evaluating school-based health promotion for alternative school students

Tortolero

Markham

Addy

et al. 2008

Contemporary Clinical Trials

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Background-Students attending 'alternative' high schools form relatively small, highly mobile high-risk populations, presenting challenges for the design and implementation of HIV-, other STI-, and pregnancy-prevention interventions. This paper describes the rationale, study design, and baseline results for the Safer Choices 2 program.Study Design-Modified group-randomized intervention trial with crossover of schools but not of students. The study cohort was defined a priori as those who completed the baseline measures and were still enrolled at the time of first follow-up.Design Results-Of 940 students initially enrolled in the study, 711 (76%) formed the study cohort. There were significant demographic differences between those included and those excluded from the study cohort in sex, age, sexual experience, experience with pregnancy, drug use, and some psychosocial measures. There were no significant differences between the intervention and control groups within the study cohort. The only significant difference between those students excluded from the intervention group and those excluded from the control group was reported age at first intercourse.Baseline Data Results-Students (n = 940) enrolled were predominately African-American (29.7%) and Hispanic (61.3%); 57.3% were female; 66% had ever had sex; and reported drug use in the previous 30 days ran from 4.3% (cocaine) to 26.9% (marijuana). Of the 627 sexually experienced, 41.8% reported their age at first intercourse as 13 years or younger; 28.5% reported ever being or having gotten someone pregnant; 74% reported sex in the past 3 months. Of the 464 sexually active in the last 3 months, 55.4% reported unprotected intercourse and 31.3% reported using drugs beforehand. Conclusion-The cross-over design will provide a rigorous test of the intervention; however, loss to follow-up of this population can result in some selection bias. Students attending dropout prevention and recovery schools are at high risk for HIV, STIs, and pregnancy, and are in need of interventions.

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Using Intervention Mapping to Adapt an Effective HIV, Sexually Transmitted Disease, and Pregnancy Prevention Program for High-Risk Minority Youth

Cited by 70 publications

References 35 publications

Communication and Information About “Safer Sex”: Intervention Issues Within Communities of African Migrants Living in Poorer Neighborhoods in Portugal

Communication and Information About “Safer Sex”: Intervention Issues Within Communities of African Migrants Living in Poorer Neighborhoods in Portugal

Efetividade das ações voltadas à diminuição da gravidez não-planejada na adolescência: revisão da literatura

Safer choices 2: Rationale, design issues, and baseline results in evaluating school-based health promotion for alternative school students

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