Serowoky, Mary, Nancy George, and Hossein Yarandi
Background and Significance: Only 25% of teens are sexually active, yet these teens account for 50% of sexually transmitted infections (STIs). Hispanic teens’ pregnancy rates are nearly twice the national average; 52% become pregnant at least once before age 20. The issues of STIs and unintended pregnancy need an evidence-based approach in clinical settings with trusted providers. Nurse practitioners (NPs) provide primary care in school-based health centers (SBHC), a comfortable environment for teens, with NP providers they trust.
Purpose: The purpose of this project is to evaluate ¡Cuídate!, a CDC Diffusion of Effective Behaviors Interventions project, using the Program Logic Model. ¡Cuídate! uses the theory of planned behavior/theory of reasoned action. The aim of ¡Cuídate! is to facilitate increases in the following areas: sexual health knowledge scores; positive attitudes towards condom use; self-efficacy with regards to condom use; intentions to use condoms.
Methods: The project uses an evaluation repeated measures research approach; the subjects serve as their own controls. Twenty-six English-speaking Hispanic adolescents were recruited and completed a baseline tool. Following the last module of ¡Cuídate! and 8-12 weeks post-program, they completed the same tool. The six module program was delivered in the high school during the adolescents’ lunch hours. The data analysis plan included the use of multivariate ANOVA within subjects, between groups, and the within subjects-between groups interaction; behavior changes were measured using chi-square.
Implications/Impact/Findings: The project was accomplished within the projected timeframe, with high participant retention (95.8%) and was well below budget. The participants demonstrated increases in knowledge, positive attitudes towards condom use, increased self-efficacy, and intentions to use condoms if they were to have sex. No participants experienced a pregnancy or an STI by program completion. There were no instances of a sexual debut during or following ¡Cuídate! This Clinical Inquiry Project demonstrated that an evidence-based intervention previously tested within the structure of a randomized controlled trial, can be successfully implemented in a SBHC with similar results of efficacy. Future programming can focus on enhancing parental involvement, with a more cost-effective staffing model (use of an RN or community health worker). This CIP provides information to support change in the types and variety of prevention programming done in the school setting and to involve advanced practice nurses in sexual health planning and evaluation.