Researchers designed an internet-delivered program to prevent sexually transmitted infections (STIs) and unintended pregnancies among older Black teens in Louisiana. The program, which includes eight modules, successfully engaged its audience and showed modest success at six months.1
This is how the program worked:
• Module 1: BUtiful Beginnings. The program is titled Be yoU, Talented, Informed, Fearless, Uncompromised, and Loved (BUtiful). It is an adaptation of a different program, called Sisters, Informing, Healing, Living, and Empowering (SiHLE), that was found to reduce STI and unintended pregnancy rates.
BUtiful includes four prototypic characters, representing a single mother, an athlete, a student, and an artsy/dreamy girl. Another character is an older woman and a moderator.
“They walk through different exercises and talk to them about communication,” says Patricia Kissinger, PhD, BSN, MPH, professor of epidemiology in the department of epidemiology at Tulane University School of Public Health and Tropical Medicine in New Orleans.
The first module also introduces participants to women in music and media.
• Module 2: Be YoU! This part is about understanding values, setting goals, and helping teens identify how they can meet their goals.
“If they set these goals, and if they got pregnant, that might derail their goals,” Kissinger explains. “We wanted to make sure they were making that connection.”
The module’s videos explained the program’s rules, including not using personal names. It explained how to blog their thoughts after each module. It also asked them about their role models.
“One wrote about her mom and gave her mom’s name, number, and address, and we had to get that information out of there,” Kissinger says.
Also, researchers would eliminate any blogs that were becoming toxic.
“There were some fun games they could do to test their knowledge,” Kissinger adds.
• Module 3: BUtiful Body. The focus of this module was on female reproductive anatomy and the menstrual cycle.
“This module had all of the educational information they should have learned in basic sex ed, but didn’t know if they had that education,” Kissinger says. “A lot of them said they had sex ed, but its quality was not good. We went back to make sure they had the basics on anatomy.”
• Module 4: BUtiful Choices. The choices were about contraceptives, including hormonal methods, non-hormonal barrier methods, and natural birth control options and availability. The videos and education involved explaining the use of contraceptives, including condoms, and discussed side effects and efficacy.
“It talks about choices and where to get contraceptives if they needed them. It gave them all the information they could possibly need, including about condoms and explaining why a dual method is so important to protect from sexually transmitted infections,” Kissinger explains. “With birth control, women can relax, but they can still get STIs. We talked about using both hormonal contraception and condoms.”
This module also covered condom negotiation, the female/internal condom, and how to make a dental dam, if needed.
• Module 5: BUtiful and Informed. This section talks about STIs and HIV prevention. It tells the teens how they could contract an STI and HIV. It also explains methods of prevention, including the human papillomavirus vaccine.
“There’s more information about condoms, talking about what would happen if you got an STD, and where you would go for STI testing,” Kissinger explains. “We gave them website links.”
• Module 6: BUtifully Communicate. Participants learn more about condom negotiation in this module.
“It talks about how to recognize when you’re in a bad relationship and how to recognize when you’re in a good relationship,” Kissinger says.
The videos and information also teach youths how to handle problems effectively. For example, there is a scene where a girl visits a nail salon. The technician makes a mistake, and the first time this happens, the girl becomes aggressive and yells at the technician. Then, it asks what would happen if the girl didn’t yell and become angry.“It shows what would happen if she said, ‘Oh, wow — that’s not the color,’ and the lady said, ‘Oh, sorry, let’s swap it out,’” Kissinger says.
This lesson on how to handle negotiation and disagreement also applies to condom use, she adds.
• Module 7: BUtiful Relationships. “We had the dating game, where you could see different guys, and she could pick a better intentional mate,” Kissinger explains. “We also talked about substance use and abuse and how you can’t give consent when under the influence.”
• Module 8: We Are BUtiful. For the wrap-up session, the teens were asked to take one of the concepts they had learned and teach one of their friends about it.
“Then they could come back and blog and tell us how it went,” Kissinger says. “We were trying to get them to learn better by having them teach.”
REFERENCE
- Kissinger PJ, Green J, Latimer J, et al. Internet delivered sexually transmitted infection and teen pregnancy prevention program: A randomized trial. Sex Transm Dis 2023;Feb 20. doi: 10.1097/OLQ.0000000000001784. [Online ahead of print].
Researchers designed an internet-delivered program to prevent STIs and unintended pregnancies among older Black teens in Louisiana. The program, which includes eight modules, successfully engaged its audience and showed modest success at six months.
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