Original article
Efficacy of It's Your Game-Tech: A Computer-Based Sexual Health Education Program for Middle School Youth

https://doi.org/10.1016/j.jadohealth.2015.01.001Get rights and content

Abstract

Purpose

Few computer-based HIV, sexually transmitted infection (STI), and pregnancy prevention programs are available, and even fewer target early adolescents. In this study, we tested the efficacy of It's Your Game (IYG)-Tech, a completely computer-based, middle school sexual health education program. The primary hypothesis was that students who received IYG-Tech would significantly delay sexual initiation by ninth grade.

Methods

We evaluated IYG-Tech using a randomized, two-arm nested design among 19 schools in a large, urban school district in southeast Texas (20 schools were originally randomized). The target population was English-speaking eighth-grade students who were followed into the ninth grade. The final analytic sample included 1,374 students. Multilevel logistic regression models were used to test for differences in sexual initiation between intervention and control students, while adjusting for age, gender, ethnicity, time between measures, and family structure.

Results

There was no significant difference in the delay of sexual activity or in any other sexual behavior between intervention and control students. However, there were significant positive between-group differences for psychosocial variables related to STI and condom knowledge, attitudes about abstinence, condom use self-efficacy, and perceived norms about sex. Post hoc analyses conducted among intervention students revealed some significant associations: “full exposure” (completion of all 13 lessons) and “mid-exposure” (5–8 lessons) students were less likely than “low exposure” (1–4 lessons) students to initiate sex.

Conclusions

Collectively, our findings indicate that IYG-Tech impacts some determinants of sexual behavior, and that additional efficacy evaluation with full intervention exposure may be warranted.

Section snippets

Study design and participants

We evaluated IYG-Tech using a randomized, two-arm nested design in a large, urban school district in southeast Texas. We randomized 10 schools to the intervention condition (IYG-Tech) and 10 schools to the control condition (state-approved health education usually from a textbook, without any exposure to a structured health education program). After randomization, one intervention school was dropped because of changes in its administration, which prevented us from conducting timely recruitment.

Sample characteristics

The baseline sample had a mean age of 14.3 years (standard deviation = .59), and was 59% female, 74% Hispanic, 17% African-American, and 9% other race/ethnicity. Close to 20% of students reported ever engaging in any type of sex (vaginal, oral, or anal) at baseline. No significant differences in these characteristics were observed across conditions (Table 1).

Intervention exposure

We created five categories of intervention exposure: completion of no lessons (“no exposure”), 1–4 lessons (“low exposure”), 5–8 lessons

Discussion

In the present study, we evaluated the behavioral and psychosocial effects of IYG-Tech, a completely computer-based HIV, STI, and pregnancy prevention curriculum for middle school students. We found that IYG-Tech did not significantly impact sexual initiation or any other sexual behavior. However, we did find that IYG-Tech significantly impacted several important psychosocial factors (e.g., knowledge about STIs and condoms, beliefs about waiting until marriage to have sex, perceived friends'

Acknowledgments

The authors thank Lionel Santibáñez for his editorial assistance. These findings were presented at the American Public Health Association 142nd Annual Meeting and Exposition.

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    Conflicts of Interest: All authors have no potential conflicts of interest, either real or perceived, to disclose.

    This trial is registered at clinicaltrials.gov (NCT01280136).

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