Using Research and Community Collaboration to Develop a Family-Based HIV-Prevention Program
September 15, 2000
An article in a recent issue of AIDS Education and Prevention describes the development of the Chicago HIV Prevention and Adolescent Mental Health Project (CHAMP) Family Program. This family-based HIV-prevention program targeted African-Americans living in areas with high rates of HIV infection.
The program was designed to create an intervention that was based on research, suited to the needs of a specific community, and able to continue and expand after research funding ended.
The CHAMP Family Study
The program began in 1993 with the CHAMP Family Study which looked at 315 families with children in six target schools in the South and West sides of Chicago.
Families were interviewed once when the target child was a preadolescent (between the ages of 10 and 12) and again two years later when the child was an early adolescent (between the ages of 12 and 14).
Preliminary findings from the CHAMP Study were used to develop a preadolescent intervention. For example, researchers learned that when child participants were preadolescents only 3% reported experiencing sexual intercourse but when they were early adolescents that number rose to approximately 22%. From this they determined that a successful intervention must precede adolescence.
Preliminary data also showed that child participants who reported exposure to higher HIV risk were more likely to report pressure from friends and a greater tendency to yield to that pressure. Researchers concluded that the intervention must focus on helping children avoid peer pressure and negotiate peer relationships.
Researchers also used results from parent participants. For example, results suggested that parents with inaccurate knowledge and negative attitudes toward HIV/AIDS were less likely to report comfort discussing these sexual topics with their children. Researchers therefore concluded that the intervention must increase accurate knowledge and promote parent-child communication.
One of the goals of the project was to provide a setting in which the highest level of community partnership could be achieved. To do so, the project created a collaborative board made up of parents and staff members from each of the participating schools as well as staff members from the university sponsoring the program.
During the course of three pilot interventions, the community board worked to modify and improve the preadolescent curriculum. Board members offered suggestions on the structure of the intervention, helped to revise the timetable and schedule, identified literacy as an issue and suggested appropriate responses, and altered the content to be community-specific. For example, board members identified specific ways that public housing and gang territories posed risks for children and families in their community and suggested how the curriculum could address these issues.
The Preadolescent Curriculum
The finalized version of the preadolescent curriculum consists of 12 weekly, two-hour meetings for preadolescents and their parents. Sessions focus on developing talking and listening skills, strengthening support networks, monitoring children's activities, communicating accurate information about puberty and HIV, and creating reasonable expectations for children as they approach adolescence.
Sessions are facilitated by a two-person team made up of one community member and one undergraduate intern, both of whom are trained and compensated.
Families are also compensated for their participation in each session and a bonus is offered to families who attend at least 8 sessions. Families are reminded that they will be asked to return in two years for the adolescent intervention.
Evaluation of Preadolescent Curriculum
In the spring of 1996, 500 families agreed to take part in the finalized preadolescent intervention. Of these families, 324 were randomly assigned to receive the CHAMP's preadolescent curriculum and 176 were identified as control group participants.
Of the families assigned to CHAMP, 201 (62%) completed the program. The authors suggest that the high participation rate is, in large part, due to the culturally relevant curriculum and the collaborative work of community members.
Participants were given both pre- and post-intervention assessment measures, and preliminary data analyses show promising results. For example, parent participants report significant increases in both their knowledge about HIV/AIDS and their comfort talking about sensitive topics with their children. Preliminary data also suggest that after the intervention, parent participants were more actively involved with decision-making and reported higher social support.
Although the project is not complete, based on their experience developing the preadolescent curriculum and preliminary evaluation data, the authors feel that the CHAMP Family Program provides an example of how the combination of research and community collaboration can enhance both the development of context-sensitive prevention interventions and the recruitment and retention of urban families. They go on to say that the collaborative model can benefit not only the design, delivery, and outcome of the intervention but potentially the community as well.
For more information:
S. Madison, et al., "Basic Research and Community Collaboration: Necessary Ingredients for the Development of a Family-Based HIV Prevention Program," AIDS Education and Prevention, 12(4) pp. 281-98.
Additional information on CHAMP:
ResourcesThe Prevention Marketing Initiative: Constructing Teen HIV Risk Profiles is a new resource available from the U.S. Centers for Disease Control and Prevention (CDC). This resource is designed to help prevention service planners make effective use of epidemiologic and behavioral data as they plan and carry out interventions for adolescents in their community.
The manual is based on the Prevention Marketing Initiative (PMI) Demonstration Site Project, designed to reduce sexual transmission of HIV among young people under 25 and federally funded from 1994 to 1998. In order to best target media campaigns and other interventions, the PMI sites compiled special teen HIV Risk Profiles.
A teen HIV Risk Profile is a report that pulls together and interprets statistical information that is relevant to the risk of HIV infection in a specific population of adolescents. Such a profile can provide a starting point for understanding teen HIV risk in a community.
The manual is divided into four chapters. The first chapter answers basic questions about teen HIV risk profiles including who should develop a profile, how it can be used, and what resources are needed to construct one. Chapter Two provides a quick review of key epidemiologic and statistical terms such as probability and confidence intervals. Chapter Three provides information on HIV risk among young people including statistics on people living with AIDS, people who test positive for HIV, teen pregnancy, and sexually transmitted diseases. This chapter also includes statistics on teen drug use and information on high-risk youth. The final chapter provides a step-by-step process for constructing a teen HIV risk profile.
The manual complements previous technical assistance guidelines with information about newly available Web sites, special databases on teens, and examples of the ways in which the PMI sites used data for planning purposes. The authors of the manual note that improving access to information about disease and risk behavior patterns is the first step in putting program planning on a firm scientific basis. They add that this manual will help ground prevention programs in data and thus guard the health of teens in the United States.
For more information:
U.S. Centers for Disease and Control and Prevention (CDC)
This article was provided by Sexuality Information and Education Council of the United States. It is a part of the publication SHOP Talk: School Health Opportunities and Progress Bulletin.