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.

Armitage, C. J., Conner, M. (2001). Efficacy of the theory of planned behaviour: A meta-analytic review. British Journal of Social Psychology, 40, 471-499. doi:10.1348/014466601164939
Google Scholar | Crossref | Medline | ISI
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
Google Scholar
Bandura, A. (1990). Perceived self-efficacy in the exercise of control over AIDS infection. Evaluation and Program Planning, 13, 9-17. doi:10.1016/0149-7189(90)90004-G
Google Scholar | Crossref | ISI
Buhi, E. R., Goodson, P. (2007). Predictors of adolescent sexual behavior and intention: A theory-guided systematic review. Journal of Adolescent Health, 40, 4-21. doi:10.1016/j.jadohealth.2006.09.027
Google Scholar | Crossref | Medline | ISI
Campbell, M., Elbourne, D., Altman, D. (2004). CONSORT statement: Extension to cluster randomised trials. British Medical Journal, 328, 702-708. doi:10.1136/bmj.328.7441.702
Google Scholar | Crossref | Medline
Carey, M., Morrison-Beedy, D., Johnson, B. (1997). The HIV-Knowledge Questionnaire: Development and evaluation of a reliable, valid, and practical self-administered questionnaire. AIDS and Behavior, 1, 61-74. doi:10.1023/A:1026218005943
Google Scholar | Crossref
Cecil, H., Pinkerton, S. D. (2000). Magnitude: An important dimension of self-efficacy. Journal of Applied Social Psychology, 30, 1243-1267.
Google Scholar | Crossref
Centers for Disease Control and Prevention . (2011). Youth Risk Behavior Surveillance System (YRBSS). Retrieved from http://www.cdc.gov/HealthyYouth/yrbs/index.htm
Google Scholar
Centers for Disease Control and Prevention . (2013). HIV surveillance report, 2011 (Vol. 23). Retrieved from http://www.cdc.gov/hiv/topics/surveillance/resources/reports/
Google Scholar
Craig Rushing, S., Gaston, A., Kaufman, C. E., Markham, C., Jessen, C., Gorman, G., Koogei Revels, T. (2015). Using technology to promote health and wellbeing among American Indian and Alaska Native teens and young adults. In Dyson, L. E., Grant, S., Hendriks, M. (Eds.), Indigenous people and mobile technologies (pp. 163-178). New York, NY: Routledge.
Google Scholar
Craig Rushing, S., Stephens, D. (2011). Use of media technologies by Native American teens and young adults in the Pacific Northwest: Exploring their utility for designing culturally appropriate technology-based health interventions. The Journal of Primary Prevention, 32, 135-145. doi:10.1007/s10935-011-0242-z
Google Scholar | Crossref | Medline
Crick, N. R., Dodge, K. A. (1996). Social information-processing mechanisms in reactive and proactive aggression. Child Development, 67, 993-1002. doi:10.1111/j.1467-8624.1996.tb01778.x
Google Scholar | Crossref | Medline | ISI
DeRavello, L., Everett Jones, S., Tulloch, S., Taylor, M., Doshi, S. (2014). Substance use and sexual risk behaviors among American Indian and Alaska Native high school students. Journal of School Health, 84, 25-32. doi:10.1111/josh.12114
Google Scholar | Crossref | Medline
DiClemente, R. J., Brown, L. K., Beausoleil, N. I., Lodico, M. (1993). Comparison of AIDS knowledge and HIV-related sexual risk behaviors among adolescents in low and high AIDS prevalence communities. Journal of Adolescent Health, 14, 231-236. doi:10.1016/1054-139X(93)90011-D
Google Scholar | Crossref | Medline | ISI
Fhi360, Education Equity Center . (1999). After school science PLUS. Retrieved from http://www.edequity.org/programs/science-and-math-programs#23
Google Scholar
Fishbein, M., Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.
Google Scholar
Glassman, J. R., Franks, H. M., Baumler, E. R., Coyle, K. K. (2014). Mediation analysis of an adolescent HIV/STI/pregnancy prevention intervention. Sex Education, 14, 497-509. doi:10.1080/14681811.2014.914025
Google Scholar | Crossref
Griner, D., Smith, T. B. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43, 531-548. doi:10.1037/0033-3204.43.4.531
Google Scholar | Crossref | ISI
Guse, K., Levine, D., Martins, S., Lira, A., Gaarde, J., Westmorland, W., Gilliam, M. (2012). Interventions using new digital media to improve adolescent sexual health: A systematic review. Journal of Adolescent Health, 51, 535-543. doi:10.1016/j.jadohealth.2012.03.014
Google Scholar | Crossref | Medline | ISI
Hamilton, B. E., Martin, J., Ventura, S. (2013). Births: Preliminary data for 2012. National Vital Statistics Reports, 62(3), 1-20.
Google Scholar
Hardnett, F. P., Pals, S. L., Borkowf, C. B., Parsons, J., Gomez, C., O’Leary, A. (2009). Assessing mediation in HIV intervention studies. Public Health Reports, 124, 288-294. doi:10.1177/003335490912400217
Google Scholar | SAGE Journals | ISI
Hawkins, E. H., Cummins, L. H., Marlatt, G. A. (2004). Preventing substance abuse in American Indian and Alaska Native youth: Promising strategies for healthier communities. Psychological Bulletin, 130, 304-323. doi:10.1037/0033-2909.130.2.304
Google Scholar | Crossref | Medline | ISI
Igras, S. M., Macieira, M., Murphy, E., Lundgren, R. (2014). Investing in very young adolescents’ sexual and reproductive health. Global Public Health, 9, 555-569. doi:10.1080/17441692.2014.908230
Google Scholar | Crossref | Medline
Kaufman, C. E., Black, K., Keane, E. M., Big Crow, C. K., Shangreau, C., Arthur-Asmah, R., . . .Tuitt, N. R. (2014). Planning for a group-randomized trial with American Indian youth. Journal of Adolescent Health, 54(Suppl. 3), S59-S63. doi:10.1016/j.jadohealth.2013.12.028
Google Scholar | Crossref | Medline
Kaufman, C. E., Litchfield, A., Schupman, E., Mitchell, C. M. (2012). Circle of Life HIV/AIDS-prevention intervention for American Indian and Alaska Native youth. American Indian and Alaska Native Mental Health Research, 19, 140-153. doi:10.5820/aian.1901.2012.140
Google Scholar | Crossref | Medline
Kaufman, C. E., Whitesell, N. R., Keane, E. M., Desserich, J. A., Giago, C., Sam, A., Mitchell, C. M. (2014). Effectiveness of Circle of Life, an HIV-preventive intervention for American Indian middle school youths: A group randomized trial in a Northern Plains tribe. American Journal of Public Health, 104(6), e106-e112. doi:10.2105/AJPH.2013.301822
Google Scholar | Crossref | Medline
Kazdin, A. E. (2011). Single-case research designs: Methods for clinical and applied settings (2nd ed.). New York, NY: Oxford University Press.
Google Scholar
LaFrance, J., Nichols, R. (2009). Indigenous evaluation framework: Telling our own story in our place and time. Retrieved from https://portalcentral.aihec.org/Indigeval/Book%20Chapters/0-Intro_Contents.pdf
Google Scholar
LaFromboise, T. D., Hoyt, D. R., Oliver, L., Whitbeck, L. B. (2006). Family, community, and school influences on resilience among American Indian adolescents in the upper Midwest. Journal of Community Psychology, 34, 193-209.
Google Scholar | Crossref | ISI
Markham, C. M., Craig Rushing, S., Jessen, C., Lane, T. L., Gorman, G., Gaston, A., . . .Shegog, R. (2015). Factors associated with early sexual experience among American Indian and Alaska Native youth. Journal of Adolescent Health, 57, 334-341. doi:10.1016/j.jadohealth.2015.06.003
Google Scholar | Crossref | Medline
Markham, C. M., Tortolero, S. R., Peskin, M. F., Shegog, R., Thiel, M., Baumler, E. R., . . .Robin, L. (2012). Sexual risk avoidance and sexual risk reduction interventions for middle school youth: A randomized controlled trial. Journal of Adolescent Health, 50, 279-288. doi:10.1016/j.jadohealth.2011.07.010
Google Scholar | Crossref | Medline
Mitchell, C. M., Beals, J., Kaufman, C. E. (2007). Alcohol use, outcome expectancies, and HIV risk status among American Indian youth: A latent growth curve model with parallel processes. Journal of Youth and Adolescence, 17, 729-740.
Google Scholar
Mitchell, C. M., Kaufman, C. E., Beals, J. (2005). Resistive efficacy and multiple sexual partners among American Indian young adults: A parallel-process latent growth curve model. Applied Developmental Science, 9, 160-171. doi:10.1207/s1532480xads0903_3
Google Scholar | Crossref
Moran, J. R., Bussey, M. (2007). Results of an alcohol prevention program with urban American Indian youth. Child & Adolescent Social Work Journal, 24, 1-21. doi:10.1007/s10560-006-0049-6
Google Scholar | Crossref
Noar, S. M. (2008). Behavioral interventions to reduce HIV-related sexual risk behavior: Review and synthesis of meta-analytic evidence. AIDS and Behavior, 12, 335-353. doi:10.1007/s10461-007-9313-9
Google Scholar | Crossref | Medline | ISI
Noar, S. M., Black, H. G., Pierce, L. B. (2009). Efficacy of computer technology-based HIV prevention interventions: A meta-analysis. AIDS, 23, 107-115. doi:10.1097/QAD.0b013e32831c5500
Google Scholar | Crossref | Medline | ISI
Norton, I. M., Manson, S. M. (1996). Research in American Indian and Alaska Native communities: Navigating the cultural universe of values and process. Journal of Consulting and Clinical Psychology, 64, 856-860.
Google Scholar | Crossref | Medline | ISI
ORBIS Associates . (2002). Circle of life HIV/AIDS and STD prevention curriculum: Wellness education for American Indian and Alaska Native Middle school students. Washington, DC: ORBIS Associates.
Google Scholar
O’Sullivan, L. F., Meyer-Bahlburg, H. F. L., McKeague, I. W. (2006). The development of the sexual self-concept inventory for early adolescent girls. Psychology of Women Quarterly, 30, 139-149. doi:10.1111/j.1471-6402.2006.00277.x
Google Scholar | SAGE Journals | ISI
Pearson, J., Wilkinson, L. (2013). Adolescent sexual experiences. In Baumle, A. K. (Ed.), International handbook on the demography of sexuality (pp. 167-193). Dordrecht: Springer Netherlands.
Google Scholar | Crossref
Raudenbush, S. W., Spybrook, J., Congdon, R., Liu, X. (2011). Optimal design software for multi-level and longitudinal research (Version 3.01) [Software]. Retrieved from http://sitemaker.umich.edu/group-based/optimal_design_software
Google Scholar
Resnicow, K., Baranowski, T., Ahluwalia, J. S., Braithwaite, R. L. (1999). Cultural sensitivity in public health: Defined and demystified. Ethnicity & Disease, 9, 10-21.
Google Scholar | Medline
Statistical Package for the Social Sciences (SPSS) . (2013). IBM SPSS Statistics (Version 22.0). Somers, NY: IBM.
Google Scholar
Tingey, L., Mullany, B., Chambers, R., Hastings, R., Lee, A., Parker, A., . . .Rompalo, A. (2015). Respecting the circle of life: One year outcomes from a randomized controlled comparison of an HIV risk reduction intervention for American Indian adolescents. AIDS Care, 27(9), 1087-1097. doi:10.1080/09540121.2015.1028879
Google Scholar | Crossref | Medline
Torgerson, D. J., Sibbald, B. (1998). Understanding controlled trials. What is a patient preference trial? British Medical Journal, 316, Article 360. doi:10.1136/bmj.316.7128.360
Google Scholar | Crossref
Welsh, D. P., Haugen, P. T., Widman, L., Darling, N., Grello, C. M. (2005). Kissing is good: A developmental investigation of sexuality in adolescent romantic couples. Sexuality Research & Social Policy, 2(4), 32-41. doi:10.1525/srsp.2005.2.4.32
Google Scholar | Crossref
West, S. G., Duan, N., Pequegnat, W., Gaist, P., Des Jarlais, D. C., Holtgrave, D., . . .Mullen, P. D. (2008). Alternatives to the randomized controlled trial. American Journal of Public Health, 98, 1359-1366. doi:10.2105/AJPH.2007.124446
Google Scholar | Crossref | Medline | ISI

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.

View access options

My Account

Welcome
You do not have access to this content.



Chinese Institutions / 中国用户

Click the button below for the full-text content

请点击以下获取该全文

Institutional Access

does not have access to this content.

Purchase Content

24 hours online access to download content

Your Access Options


Purchase

JEA-article-ppv for $36.00

Article available in:

Related Articles

Citing articles: 0