"Staying Focused!"

There are 19 million cases of sexually transmitted diseases (STDs) annually in the United States (Centers for Disease Control & Prevention, 2005). This figure supports the fact that STDs, although preventable, remain a serious public health threat. Major findings of empirical studies on STDs indicate the need for innovative and sustainable STD prevention programs that can empower those in need while gaining control of their sexual behaviors and learning to adopt safer coital practices (Morbidity and Mortality Weekly Report, 2004; Hollander, 2003). Since learning does not occur in a vacuum, it is necessary to build STD prevention strategies around clients' particular needs, keeping in mind their cultural and ethnic diversity, risks, attitudes, personal as well as interpersonal differences, and social milieu. Understanding clients' cognitive, affective, cultural, and psychosocial aspects is part of planning (Bandura, 1997; CDC, 2007; Kalichman et al., 2001). Likewise, Healthy People 2010's objectives for sexual health reflect the importance of ensuring the availability of developmentally and culturally appropriate STD prevention programs that address the needs of a diverse population (U.S. Department of Health and Human Services, 2000). Utilizing the social cognitive theory (SCT) concepts of environment and situation, an anonymous survey (n=201) was conducted to determine the usefulness of the educational STD video routinely shown to clients in the STD urban clinic in promoting responsible coital practices. Findings of the survey indicated the following: 1)seventy-nine percent

(n = 160) reported that the video-based learning environment provided by the STD clinic was useful; 2) eighty-one percent(n=163)viewed the video-based educational intervention as helpful; 3)eighty-three percent (n=167) stated that they learned something new from the video. It is important to note that sixty-six percent (n=134) visited the clinic on more than one occasion. Findings from the survey were utilized by the graduate student to plan, implement, and evaluate a primary STD prevention initiative,"Staying Focused". This initiative targets at-risk women to empower them regarding their sexual health practices. One-on-one and group sessions revealed increased self efficacy in communicating their concerns with a health provider and sexual partner. Replication strategies are suggested.