Strategies to maximize retention of a sample of young adolescents in a longitudinal evaluation of Healthy & Alive!

The authors implemented strategies to maximize cohort retention to avert loss of statistical power and minimize bias in a longitudinal evaluation of a middle school HIV/STD prevention intervention. A retention rate of 80% of the baseline sample (n = 2,975) at six months and 73% at 18 months was achieved despite high reported rates of student mobility and a major system reorganization in one urban district. The strategies increased retention but did not eliminate differences in demographic characteristics and behaviors between the groups of retained and lost students. Results confirm the need to implement retention strategies early and to maintain them throughout data collection. Information from a tracking data base can be used to prioritize students for follow-up to reduce bias from sample loss.

Condom availability in New York City public high schools: relationships to condom use and sexual behavior.

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago. METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey. RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in the past 6 months), condom use was greater in New York (OR = 1.85) than in Chicago. CONCLUSIONS: Condom availability has a modest but significant effect on condom use and does not increase rates of sexual activity. These findings suggest that school-based condom availability can lower the risk of HIV and other sexually transmitted diseases for urban teenagers in the United States.

Attitudes about AIDS education and condom availability among parents of high school students in New York City: a focus group approach.

This paper describes parents' views of the New York City Public High School's AIDS Education and Condom Availability Program. It presents findings from 12 focus groups with 81 parents of students at six representative high schools. Focus groups were conducted as part of an independent, comprehensive 3-year evaluation of the program, consisting of both qualitative and quantitative components. Participants were mostly supportive of the program, citing intense concern about AIDS among adolescents, fear that teenagers do not adequately perceive themselves as being vulnerable, and personal experiences with infected relatives and friends. Implications of these findings for program development are discussed and recommendations for social policy changes are presented.

PIP: During 1992-94, focus groups of parents of students from six randomly selected New York City public high schools were conducted to determine the parents' attitudes about changes affecting implementation of the AIDS Education and Condom Availability Program. The changes included failure to reappoint the chancellor who initiated the program, voluntary departure of many of his staff who were architects of the program, and the court-order parent opt-out. Most parents supported school-based AIDS education and condom availability. They considered AIDS to be a deadly threat to teens. They thought that sexually active adolescents do not adequately perceive AIDS as a threat. Some parents saw a general sense of invincibility and futility among teens as a major barrier to their understanding of the seriousness of AIDS. The death of a family member made AIDS salient to teens. Parents were most interested in the protection afforded by regular condom use. They believed that schools can reinforce what parents teach at home. A minority of parents objected strongly to the program, especially the availability of condoms. They wanted the program to focus on abstinence, moral values, and self-respect. Opponents of the program were most likely to object to the lack of outreach of the program to involve parents in the development of the program. Informational workshops have helped parents communicate with their children about AIDS and helped them alleviate their fear that condom availability promotes sexual activity. These workshops were not in place at all schools, however. Many parents said that the threatening nature of the AIDS epidemic supersedes issues of parental authority. A minority of parents chose the opt-out provision because sex and condoms were the parents' responsibility, not the school's. Their reactions again suggested frustration with not being included in the decision-making process. Most parents talked to their children about AIDS, sex, and condoms. The media more than the school promoted such discussions, however. Parents who had poor communication patterns especially appreciated the program.

Gender differences in attitudes and use of condom availability programs among sexually active students in New York City public high schools.

In 1991, the New York City Board of Education expanded HIV/AIDS education to include condom availability in public high schools. A three-year study was initiated to assess the program's impact on student risk behavior, the schools' social environments, and patterns of communication about HIV/AIDS and condoms among students, their parents and teachers in 12 randomly selected New York City high schools. Findings on gender differences in both attitudes and use of the program among sexually active students are reported here. Sexually active girls' attitudes toward using condoms and the condom availability program were more positive than those of sexually active boys, yet boys were more likely to have used the program. Girls reported embarrassment and confidentiality concerns as the main deterrents to using the program. Data suggest that schools need to examine the address gender-specific attitudes that contribute to reluctance to use the program among sexually active girls.

Parents' attitudes and beliefs about HIV/AIDS prevention with condom availability in New York City public high schools.

In 1991, the New York City Board of Education expanded HIV/AIDS education to include condom availability in every public high school. The evaluation was designed to examine the impact of the program on students and monitor changes in parent's knowledge, attitudes, and beliefs. Findings are reported from the first wave of data from the parent survey, 716 parents from 12 randomly chosen NYC high schools and 81 parents from 12 focus groups held at six of the schools. Sixty-nine percent of parents believed students should be able to receive condoms at school, although nearly half felt they should have the right to keep their children from doing so. Most believed making condoms available would result in safer sex practices among students who were sexually active. Data suggest parents support the school's role in reducing HIV/AIDS transmission among adolescents and believe making condoms available represents an acceptable component of an HIV/AIDS prevention program.

Contraceptives and minors: The Emperor Has No Clothes.

PIP: The rate of teenage pregnancy in the US is significantly higher than in any other industrialized nation. Studies have shown the teenagers in other countries are not more sexually active. The biggest difference between US and the rest of the industrialized world is the US failure to make contraceptives easily available to teenagers. There are only 2 ways to prevent teenage pregnancy: 1) get them to shop having sex, or 2) get them to use contraceptives. When forming policy it is important to know which method will be more successful. Policymakers, educators, and health professionals are all guilty of rationalizing why option 1 will work better than option 2, even though their is little or no research or anecdotal evidence to support their claim. The facts are clear: in other industrialized countries the more freely available contraceptives are to teenagers, the lower the pregnancy rate. In New York City, 840 condoms were distributed in just 4 months upon request to participants in a male responsibility discussion group. Nationwide 2000 teenage boys were sent a coupon for free condoms by mail and 6% returned their coupons (the normal rate of return would be 3%). A 1988 study revealed that condom usage between 1979-88 among 17-19 year old males in metropolitan areas doubled. A 1987 Harris poll found that 60% of all adults favored condom advertising on television. A 1989 follow-up study revealed that 89% of parents of adolescents favored condom advertising on television. The most common reason given for not increasing access to contraceptives is that teenagers will receive the wrong message. Another fear is that parents will complain, yet in the 2000 condom coupon example, less than 1/3 of 1% of the parents complained. Is the rest of the industrialized world giving their teenagers the wrong message by making contraceptives easily available? Clearly, US policy against contraceptive access for teenagers is giving the worst message and the high teenage pregnancy rate is the best evidence.^ieng

The effect of appealing distractors on the performance of hyperactive children.

The study investigated whether hyperactive children were more susceptible to appealing distractors than were normal children. Twenty hyperactive and 20 normal children performed arithmetic tasks under three levels of distraction: no distraction, low-appeal distraction, and high-appeal distraction. Hyperactive children were significantly more affected by both low- and high-appeal distractors than were the normal children.