Fact Sheet: Number 6 (1996)
Every year in the United States, one-quarter of new HIV infections occur among people between the ages of 13 and 21. This means that an average of two young people are infected with HIV every hour of every day. Also, about 3 million teens contract an STD each year. (1)
Adolescents can learn to protect themselves through proper education. Hence, it is important that the highest quality educational programs, including effective content and presentations of specific messages, be developed.
Authors of HIV/STD education material for adolescents often face difficult and unique challenges in producing appropriate messages. To assist authors in creating the most effective educational messages, eleven principles which address several common issues facing authors are suggested.
Use Behavior Change Models. Several behavior change models or theories are useful to program designers. Because these models provide insights about how or why people choose their health behaviors, they can suggest specific areas for educational intervention. Authors may want to use several models in developing the material. (2, 3)
Use Performance Standards. HIV/STD education has lacked univerally accepted and adopted standards for message content and presentation, resulting in varied and inadequate instructional material. Performance standards, against which new material can be developed and current material can be evaluated, can contribute toward assuring a greater quality of instructional messages. Yarber (4) developed performance standards for three areas of school HIV/STD education curricula for adolescents: specific student material content, student material presentation, and teacher material content. Seventy-three specific criteria/performance standards representing the three components were developed and presented as a checklist. Other valuable performance standards or guides are available. (5-8)
Use Creditable Information Sources. A dilemma often facing authors is deciding what is the accepted scientific belief about a specific HIV/STD issue. In general, authors should acquire HIV/STD information for basing the message content from creditable sources that have the most recent and accurate information. Federal and state government publications (or government sponsored material) and reputable scientific journals are good sources.
Promote Desired Outcome. An important national public health objective is the reduction of HIV/STD incidence in adolescents. Sometimes relevant information necessary to achieve this objective is omitted in instructional material. Model adolescent programs increase HIV/STD prevention knowledge, personalize information to motivate change, improve attitudes, and develop behavioral skills for sexual abstinence and delaying sexual activity. Proper HIV/STD education is reality-based and acknowledges the value of both abstinence and risk-reduction messages in preventing HIV/STD infection. (1) Further, the instructional messages should largely focus on the types and influences of health behaviors related to HIV/STD transmission, prevention, disease recognition, accessing health care, partner referral and treatment compliance. (9)
Incorporate Components of Successful Programs. Research has shown that some HIV/STD education programs have been effective in averting or reducing certain risk-related behaviors. Authors may want to incorporate as many of these elements as possible when constructing educational messages. Holtgrave (10) reviewed the characteristics of successful, behaviorally-based HIV prevention programs and identified several common elements. For example, the programs were based on specific needs, were cultural competent, had clearly defined audiences, objectives, and interventions, and were based on behavior change theory.
Assess Target Audience. HIV/STD educational material should be culturally relevant and age-appropriate to accommodate the context of the lives of young people and their families. Author knowledge of selected traits of the target audience, such as its knowledge, attitudes, behaviors, interests, concerns, and worries, will enhance the likelihood that the messages will meet the audience's educational needs.
Use Health Promoting/Objective Material. The instructional material should emphasize self-directed, health-conducive behavior, including responsibility for the health of others. The material should be absent of moral judgements, overly emphatic adjectives or adverbs, obtrusive style, or offensive content, and should be anxiety-alleviating. (4)
Assure Verbal/Visual Quality. The material reading level should be sixth/seventh grade, with minimal use of words with more than three syllables. Long, complex sentences and paragraphs should be avoided. The syntax should be sound, with precise and simple presentation of concepts. The pages should have ample "white-space," with a logical layout. The print should be an adequate size and a variety of print-types and/or colors should be used. Photos, graphs, and illustrations could be used to enhance student interest and understanding, with none producing negative, confusing, or prejudicial effects. (4)
Account for Varied Ideological Views. Some people and groups favor a more narrow approach to HIV/STD education, particularly related to the completeness of prevention and risk-reduction messages. HIV/STD education material for adolescents that does not account for the restrictive approach may not be usable in a wide range of communities. Authors who want their material to be palatable to many constituencies must be creative in addressing varied ideologies, yet not abandon the principles of comprehensive HIV/STD education. They could construct messages that reflect a compromise.
Solicit Views of Parents and Professionals. Addressing parental interests can make the messages more acceptable to parent groups. More must be done to educate parents about the risks their children face and the value of comprehensive HIV/STD education in preventing infection. (1) Further, the input of respected professionals can be valuable for creating appropriate messages.
Test Message Effectiveness. Evaluation of newly created HIV/STD education material is important in determining if the material meets student needs. Pilot, process and outcome evaluation can be conducted to identify the content weaknesses so refinements can be made.
The content and presentation of specific HIV/STD education messages in formal education have an impact of program effectiveness. The messages will more likely influence the achievement of the desired program outcomes if certain principles of message construction are followed. Authors are encouraged to followed the suggested principles when developing educational messages for adolescents.
Sources of information
This FACT SHEET was largely based on the publication: Yarber, W. L. (1995). SSSS Presidential address: Principles for creating AIDS/sexuality education messages for youth. Journal of Sex Research, 32, 269-274.
- Office of National AIDS Policy. (1996). Youth & HIV/AIDS: An American Agenda. Washington, DC: The White House.
- Rural Center for the Study and Promotion of HIV/STD Prevention. (1995). Behavior change models for reducing HIV/STD risk. (Fact Sheet #3). Bloomington, IN: RCSPHP.
- Grimley, D. M., DiClemente, R. J., Prochaska, J. O., & Prochaska, G. E. (1995). Preventing adolescent pregnancy, STD and HIV: A promising new approach. Family Life Educator, 13(3), 7-15.
- Yarber, W. L. (1989). Performance standards for the evaluation and development of school HIV/AIDS education curricula for adolescents. SIECUS Reports, 13(6), 18-26.
- National Guidelines Task Force. (1991). Guidelines for comprehensive sexuality education: Kindergarten-12th grade. New York: Sex Information and Education Council of the United States.
- Popham, J. W., & Hall, E. A. (n. d.) Appraising an HIV curriculum (Booklet 3). In Handbook for Evaluating HIV Education. Atlanta: Centers for Disease Control.
- World Health Organization. (1992). School health education to prevent AIDS and sexually transmitted diseases. Geneva: WHO.
- Centers for Disease Control. (1988). Guidelines for effective school health education to prevent the spread of AIDS. Morbidity and Mortality Weekly report, 37(S-2). 1-14.
- Centers for Disease Control. (1985). Guidelines for STD education. Atlanta: CDC.
- Holtgrave, D. R., Qualls, N. L., Curran, J. W., Valdiserr, R. O., Guinan, M. E., & Parra, W. C. (1995). An overview of the effectiveness and efficiency of HIV prevention programs. Public Health Reports, 111, 134-146.