All4You! is a program to prevent HIV, other STD and pregnancy among students in grades 9-12 in alternative education settings.
Overview
The primary goal of All4You! is to reduce the number of students who have unprotected sexual intercourse, which is associated with increased risk of HIV, other STDs, and unplanned pregnancy. The program also aims to change key determinants related to sexual risk-taking, such as attitudes, beliefs and perceived norms.
Curriculum
All4You! is delivered through mini-lectures, brainstorming, games, small-group work, role-plays, guest speakers, videos, reflection activities, and service-learning visits.
The program is about 26 hours total and consists of 14 sessions and a pre-session to prepare for implementation.
- 9 classroom sessions range from 70 to 90 minutes each and focus on skill development (13.5 hours total).
- 5 sessions involve service learning in the community and require about 140 minutes. This includes travel time to and from the service-learning site (12.5 hours total).
Sessions should be scheduled 2 to 3 times per week.
This combination of strategies is used because both have been shown to reduce sexual risk-taking behaviors and related determinants. The combination addresses a broader range of potential determinants—both sexual (e.g., attitudes and beliefs regarding condom use) and non-sexual (e.g., optimism and hope for the future)—than either approach alone.
Content
All4You! is based on Social Cognitive Theory, the Theory of Planned Behavior, and Social Development Theory, all of which have been used in other evidence-based prevention programs.
Key content covered by the program consists of:
- HIV, STIs, and pregnancy prevention risk factors
- Negotiation and refusal skills
- Contraception and condom use skills
- Handling risky situations
- Attitudes and beliefs regarding perceived risk of STIs/pregnancy and barriers to condom use
- Development of positive norms
- Community engagement through service-learning visits
Results
Students who received All4You! training showed frequency of unprotected sex, reduced frequency of sex, and increased use of condoms.
Evidence Summary
Research Design
The initial All4You! study was implemented during 2000-2001, with data collection follow-up extending through 2003 for the last cohort of youth enrolled in the study. The evaluation featured a randomized trial involving 24 alternative schools (specifically community day schools) located in 4 large urban areas with diverse populations in Northern California. Schools ranged in size from approximately 12 to 62 students, with an average enrollment of 28 students. Thirteen of the schools were randomly assigned to receive the All4You! intervention. The remaining 11 schools served as control sites.
Data Gathering
To assess the effectiveness of the intervention, paper-pencil self-report surveys were collected from students four times during the study period: baseline, and 6, 12, and 18 months after baseline.
Findings
In general, youth receiving All4You! reduced the frequency of unprotected sex, reduced the frequency of sex and increased their use of condoms (Coyle et al., 2006) at the initial follow-up.
Six months after the baseline survey:
- Students taking part in All4You! were less likely to have intercourse without a condom in the previous 3 months than were students in the control group, and they were more likely to use condoms during last intercourse.
- Students taking part in All4You! reported having sex less frequently than did students in the control group.
- Youth receiving All4You! had greater HIV and condom knowledge than did students in the control group, and this effect was still significant up to 18 months after the baseline survey.
References
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