Abstract
We assessed the effectiveness of a culturally grounded, multimedia, sexual risk reduction intervention called Circle of Life (mCOL), designed to increase knowledge and self-efficacy among preteen American Indians and Alaska Natives. Partnering with Native Boys and Girls Clubs in 15 communities across six Northern Plains reservations, we conducted a cluster randomized controlled trial among 10- to 12-year-olds (n = 167; mean age = 11.2). Club units were randomly assigned to mCOL (n = 8) or the attention-control program, After-School Science Plus (AS+; n = 7). Compared with the AS+ group, mCOL youth scored significantly higher on HIV/sexually transmitted infection (STI) knowledge questions at both follow-ups; self-efficacy to avoid peer pressure and self-efficacy to avoid sex were significantly higher at posttest; self-perceived volition was significantly higher at 9-month follow-up; and no differences were found for behavioral precursors to sex. mCOL had modest effects on precursors to sexual behavior, which may lead to less risky sexual behavior in later years.
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Author Biographies
Carol E. Kaufman, PhD, is an associate professor at the Centers for American Indian and Alaska Native Health at the University of Colorado, Anschutz Medical Campus. She has over 15 years of research experience working with American Indian and Alaska Native communities on sexual health issues, with a special emphasis on the development and evaluation of culturally-appropriate and theoretically based interventions. She has worked steadily to develop community partnerships that have served to support and facilitate scientifically rigorous projects in tribal community settings.
Traci M. Schwinn, PhD, is an associate research scientist at the Columbia University School of Social Work. Her area of interest is substance use prevention among adolescents. For over a decade, she has been developing and testing computer-based interventions to prevent substance abuse and other risky behaviors among adolescents. In particular, her work focuses on tailoring interventions for girls and minority or underserved youth.
Kirsten Black, PhD, MPH, RD, is an instructor at the Centers for American Indian and Alaska Native Health at the University of Colorado, Anschutz Medical Campus. She is project director for evaluations of risk behavior preventive interventions. Her areas of research interest include health behavior change, health promotion, and maternal and child nutrition. She has also taught in a family medicine residency program, worked as a state WIC consultant, and been the evaluator for the Nurse Family Partnership program.
Ellen M. Keane, MSPH, MA, LPC, is a research associate the Centers for American Indian and Alaska Native Health at the University of Colorado, Anschutz Medical Campus. She has over 20 years of research experience working with Native people coupled with experience in direct mental health service provision. She has worked on a variety of data collection and intervention evaluation efforts collaborating with many different tribes, including projects related to sexual health and HIV/STD prevention. Her direct mental health experience has provided both conceptual and direct project expertise.
Cecelia K. Big Crow, BS, is an Oglala Sioux Tribal mother and grandmother. She has been working toward helping her people live healthier lives all of her life. She is a senior professional research assistant at the Centers for American Indian and Alaska Native Health at the University of Colorado, Anschutz Medical Campus, with 17 years of research experience working with American Indian tribes. She is proud to say that all of the research projects she has been involved with have helped improve health and health education for members of her tribe.
Carly Shangreau, BSHS, is an enrolled member of the Oglala Sioux Tribe and a Veteran of the United States Armed Forces. She is a senior professional research assistant of the Centers for American Indian and Alaska Native Health at the University of Colorado, Anschutz Medical Campus. For the past 7 years, she has been working in the areas of health promotion and disease prevention among American Indian populations, with a special emphasis in sexual health. She has been responsible for the hands-on implementation of preventive interventions within Native American communities across the Northern Plains.
Nicole R. Tuitt, MPH, is a senior professional research assistant at the Centers for American Indian and Alaska Native Health, University of Colorado, Anschutz Medical Campus. She has over 10 years of experience in public health at both local and state levels; including experience in building the capacity of community based organizations, program planning and implementation, and program evaluation. Her career interests are identifying and implementing innovative solutions to addressing health inequities through community mobilization and health policy.
Ruth Arthur-Asmah, BS, is a professional research assistant at the Centers for American Indian and Alaska Native Health at the University of Colorado, Anschutz Medical Campus. She has worked with Native American communities for over 6 years, focusing on pregnancy and adolescent HIV/AIDS prevention in youth of Northern Plains tribal communities. Her work is focused on data management and analysis, with specific application to remote rural and remote settings.
Bradley Morse, MA, has worked in American Indian communities for over 13 years. He is a senior professional research assistant at the Centers for American Indian and Alaska Native Health at the University of Colorado, Anschutz Medical Campus, with an expertise in technology and visual media intervention adaptation in health promotion and education. His research interests include leveraging technology as a channel for tailored interventions that aim to extend the reach and relevancy of face-to-face classroom-based interventions for health management.

