Is a 1995 EB Curriculum Still Relevant in 2013-2014? Teen Sexual Risk Behaviors, African American Youth and the B.a.R.T. Curriculum

Background/Purpose:  Risky sexual behaviors (RSB) among adolescents are associated with negative health outcomes such as the transmission of sexually transmitted infections (STIs) including HIV, and teen pregnancy.  The implementation of evidence-based (EB) curricula targeting RSB among adolescents has been found effective in addressing such outcomes.  Since 2010, the use of EB programs is a requirement of all Teen Pregnancy Prevention (TPP) programs funded by the U.S. Office of Adolescent Health (OAH). B.A.R.T. is one such EB program model included in the OAH’s TPP Evidence Review.  Since B.A.R.T.’s initial development in 1995, almost two decades later, it continues to be indicated as an effective intervention by organizations such as the CDC and OAH.  Curiously however, published empirical research on B.A.R.T. is sparse in that via systematic review techniques, only 7 empirical research articles about B.A.R.T. were identified by our research team during Fall 2014. Therefore, the purpose of this study is to contribute to the knowledge base an updated empirical study of B.A.R.T. by testing its effectiveness on knowledge and risky sexual behaviors of African-American (AA) youth, a group identified by CDC and OAH as an at-risk group in this context.

Methods:  Using a quasi-experimental, pre-/post-test design (111-intervention and 44-comparison group), data were collected from a community-based sample of 155 AA youth (50.3% male, mean age 16.5) who completed the B.A.R.T. Student Knowledge Survey (BSKS) and other self-reported measures of RSB.  At baseline, both groups exhibited RSB. Collectively, 70.3% had engaged in sexual intercourse. Among those sexually active, the mean age of sexual debut was 14.2 years; and 27.5% did not use a condom during most recent sexual intercourse.  A series of t-test and  x² analyses yielded intervention (IG) /comparison group (CG) equivalence on key demographic variables. After the IG received the 8-session BART curriculum, their post-test measures were compared to those of the CG's time 2 scores via paired sample t-tests and x² tests. Additionally, logistic regression analyses were conducted to model the prediction of condom use.

Results:  Analyses revealed an increase in the intervention group's HIV/STI-related knowledge as measured by BSKS scores [t(110)=4.972, p<0.00]; and condom use (x_(df=1)²= 10.6, p=0.004) between pre-test and post-test. The logistic regression model revealed that a one year delay in sexual debut increased the likelihood of condom use by 20.4% (Wald _(df=1)=1.027, p=0.311>0.05) for the IG; and the likelihood of IG participants’ condom use was 2.23 times greater than their CG counterparts  (Wald=3.821,df=1, p=0.05).

Conclusions/Implications:  Our results demonstrate the continued effectiveness of the B.A.R.T. curriculum on improving AA participants’ knowledge of HIV/STI and reducing risky sexual behaviors (defined by condom use), which supports the OAH’s and CDC’s identification of B.A.R.T. as an effective EB curriculum with AA youth. Future studies are needed to improve the rigor of research methodology (e.g. larger sample sizes and randomization to demonstrate generalizability) and examine BART’s effectiveness on other risky sexual behaviors beyond condom use. Effective curricula such as B.A.R.T. offer community-based and public health social work practitioners culturally relevant options for use with adolescents regrading RSB.