This article describes the development, field testing, and evaluation of an interactive computer program, "Life Challenge," developed by the New York State Department of Health as a tool for enhancing adolescents' sense of self-efficacy in HIV/AIDS prevention programs. The computer kiosks were field tested in 13 sites serving high-risk adolescents. The program uses a time travel adventure game format to provide information and nonthreatening skill practice. Users record and play back their responses as they "negotiate" with their chosen partners. A proof of concept evaluation with analysis of 211 audio responses found that users took negotiating tasks seriously; statistically significant learning gains were achieved on knowledge items and in self-efficacy scores (greatest improvement for those with low baseline self-efficacy levels). Challenges and problems encountered in implementing the project are described, and the potential of using computers for skill practice and educational interventions in health education is explored.
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References
1.
1. Facts About Adolescents and HIV/AIDS. Atlanta, GA, Centers for Disease Control and Prevention, 1993.
2.
2. Rotheram-Borus M, Mahler K, Rosario M: AIDS prevention with adolescents. AIDS Educ Prev7:321-324, 1995.
3.
3. Thomas R, Cahill J: Interactive Computer Programs for HIV/AIDS Prevention. Paper presented at the American Public Health Association Annual Meeting, Atlanta, GA, 1991.
4.
4. Kegeles S, Adler N, Irwin C: Sexually active adolescents and condoms: Changes over one year in knowledge, attitudes and use. Am J Public Health78:460-461, 1988.
5.
5. Stanton B, Black M, Keane V, Feigelman S: HIV risk behaviors in young people: Can we benefit from 30 years of research experience?AIDS Public Policy J5(l):17-23, 1990.
6.
6. Bandura A: Perceived self-efficacy in the exercise of control over AIDS infection. Evaluation and Program Planning13:9-17, 1990.
7.
7. Robinson T: Community health behavior change through computer network health promotion: Preliminary findings from Stanford Health-Net. Comput Methods Programs Biomed30:137-144, 1989.
8.
8. Levenson P, Morrow J: Learner characteristics associated with responses to film interactive video lessons on smokeless tobacco. Prev Med16:52-62, 1987.
9.
9. Paperny D, Aono J, Lehman R, Hammar S, Risser J: Computer-assisted detection and intervention in adolescent high-risk health behaviors. J Pediatr116:456-462, 1990.
10.
10. Paperny D, Start J: Adolescent pregnancy prevention by health education computer games: Computer-assisted instruction of knowledge and attitudes. Pediatrics83:742-752, 1989.
11.
11. Alemi F, Cherry F, Meffert G: Rehearsing decisions may help teenagers: An evaluation of a simulation game. Comput Biol Med19:283-290, 1989.
12.
12. Anderson D, Needle R, Mossow S: Evaluation of a microcomputer-enhanced intervention for elementary school children. Fam Comm Health11(1):36-46, 1988.
13.
13. Burnett K, et al: Computer-assisted behavioral health counseling for high school students. J Counseling Psychol36(1):63-67, 1989.
14.
14. Computer-Based Technology in Support of Health Lifestyles: The Body Awareness Resource Network (Final report to the W. K. Kellogg Foundation). Madison, Center for Health Systems Research and Analysis, University of Wisconsin-Madison, 1988.
15.
15. Horan P, Yarborough M, Besigel G, Carlson D: Computer-assisted self-control of diabetes by adolescents. The Diabetes Educator16:205-211, 1990.
16.
16. Thomas R, Hannum W, Steckler A, Schoene A: Final Evaluation Report: Increasing the Number of Second Nutrition Education Contacts Through Computer Assisted Instruction (North Carolina Division of Health Services). Chapel Hill, University of North Carolina, School of Public Health, 1988.
17.
17. Baffi C, Schroeder K, Redican K, McCluskey L: Factors influencing selected heterosexual male college students' condom use. J Am College Health38:137-141, 1989.
18.
18. Heterosexual behaviors and factors that influence condom use among patients attending a sexually transmitted disease clinic-San Francisco. MMWR, October 5, 1990.
19.
19. Bruce K, Shrum JC, Trefenthen BA, Slovik LF: Students' attitudes about AIDS, homosexuality, and condoms. AIDS Educ Prev2:220-234, 1990.
20.
20. Jemmott LS, Jemmott JB: Sexual knowledge, attitudes, and risky sexual behavior among inner-city Black male adolescents. J Adolesc Res5:346-369, 1990.
21.
21. Kegeles S: Adolescents and condoms: Associations of beliefs with intentions to use. Am J Public Health143:911-915, 1989.
22.
22. Magura S, Shapiro J, Siddiqi Q, Lipton D: Variables influencing condom use among intravenous drug users. Am J Public Health80(1):82-84, 1990.
23.
23. Pleck JH: Correlates of Black adolescent males' condom use. J Adolesc Res4:247-253, 1989.
24.
24. Valdiserri R, Lyter D, Leviton L, Callahan C, Kinsley L, Rinaldo C: Variables influencing condom use in a cohort of gay and bisexual men. Am J Public Health78:801-805, 1988.
25.
25. Ross M, Caudle C, Taylor J: A preliminary study of social issues in aids prevention among adolescents. J School Health59(7):308-311, 1989.
26.
26. de la Vega E: Considerations for reaching the Latino population with sexuality and HIV/AIDS information and education. SIECUS Report18(3):1-8, 1990.
27.
27. Peterson J, Marin G: Issues in the prevention of AIDS among Black and Hispanic men. Am Psychol43(11):871-877, 1988.
28.
28. Mays V, Cochran S: Issues in the perception of AIDS risk and risk reduction activities by Black and Hispanic/Latina women. Am Psychol43(11):949-957, 1988.
29.
29. Stall R, Coates T, Hoff C: Behavioral risk reduction for HIV infection among gay and bisexual men: A review of results from the United States. Am Psychol43(11):878-885, 1988.
30.
30. Sonenstein F, Pleck J, Leighton C: Sexual activity, condom use and AIDS awareness among adolescent males. Fam Plann Perspect21(4):152-158, 1989.
31.
31. Valdiserri R, Vincent A, Proctor D, Bonati F: The relationship between women's attitudes about condoms and their use: Implications for condom promotion programs. Am J Public Health79:499-501,1989.
32.
32. Turner C, Miller H, Moses L (eds.): AIDS: Sexual behavior and intravenous drug use. Washington, DC, National Academy Press, 1989, pp. 288-290.
33.
33. Aspinwall LG, Kemeny ME, et al: Psychosocial predictors of gay men's AIDS risk-reduction behavior. Health Psychol10(6):432-444, 1991.
34.
34. Jemmott LS, Jemmott JB: Increasing condom-use intentions among sexually active Black adolescent women. Nursing Res41(5):273-279, 1992.
35.
35. Franzini L, Sideman L, Dexter K, Elder J: Promoting AIDS risk reduction via behavioral training. AIDS Educ Prev2:313-321, 1990.
36.
36. Schinke S, Botvin G, Orlandi M, et al: African-American and Hispanic-American adolescents, HIV infection, and preventive intervention. AIDS Educ Prev2:305-312, 1990.
37.
37. Lawrance L, Levy SR, Rubinson L: Self-efficacy and AIDS prevention for pregnant teens. J School Health69(1):19-24, 1990.
38.
38. Shafer MA, Boyer CB: Psychosocial and behavioral factors associated with risk of sexually transmitted diseases, including human immunodeficiency virus infection, among urban high school students. J Pediatr10(suppl.):826-833, 1991.
39.
39. Basen-Engquist K, Parcel G: Attitudes, norms, and self-efficacy: A model of adolescents' HIV-related sexual risk behavior. Health Educ Q19:263-277, 1992.
40.
40. Walter HJ, Vaughan RD, Gladis MM, et al: Factors associated with AIDS risk behaviors among high school students in an AIDS epicenter. Am J Public Health82(4):528-532, 1992.
41.
41. Kasen S, Vaughan RD, Walter HJ: Self-efficacy for AIDS preventive behaviors among tenth grade students. Health Educ Q19:187-202, 1992.
42.
42. Strecher VJ, Kreuter M, Den Boer DH, Kobrin S, Hospers HJ, Skinner CS: The effects of computer-tailored smoking cessation messages in family practice settings. J Fam Practice39:262-270, 1994.
43.
43. Skinner CS, Siegfried JC, Kegler MC, Strecher VJ: The potential of computers in patient education. Patient Educ Counseling22(1):27-34, 1993.
44.
44. Gold R: Microcomputer Applications in Health Education. Dubuque, IA, W. C. Brown, 1991.
45.
45. Milio N: Beyond informatics: An electronic community infrastructure for public health. J Public Health Management Practice1(4):84-94, 1995.
46.
46. Harris L (ed.): Health and the New Media: Technologies Transforming Personal and Public Health. Mahwah, NJ, Lawrence Erlbaum, 1995.
