It's Your Game – Tech: A Web-Based HIV, STI, and Pregnancy Prevention Middle School Curriculum

Background: Adolescent birth and sexually transmitted infection (STI) rates indicate a need for effective HIV/STI, and pregnancy prevention middle school curricula that can be widely disseminated. It's Your Game … Keep it Real (IYG) is an effective classroom and computer-based sex education curriculum that provides a life skills paradigm for middle school youth. Individual and organizational dissemination challenges for IYG include lesson fidelity and ongoing training and support. Purpose: A web-based adaptation of IYG is described to address these challenges and results of preliminary usability testing reported. Methods: IYG computer-based lessons were converted to a FLASH-based web application. A single group pre-test post-test study with 7th and 8th grade students (n=33; 13.9 ± 1.14 years) was conducted to assess usability, attitudes, and impact on psychosocial mediators of sex. Content analysis, guided by Intervention Mapping (IM), was used to identify and create new lessons and to adapt existing classroom lessons for the web. Results: IYG web-based activities ranked highly on usability factors and impacted normative perceptions, self-efficacy, and intentions related to risky sexual behavior (p<0.05). A new 13-lesson web-based curriculum (IYG-Tech) was developed containing over 250 activities comprising original and modified IYG computer activities (66%), adapted classroom activities (10%), and new activities (24%). Critical added elements included refusal skills training, avoidance of unhealthy relationships, values clarification, and negotiating risk reduction strategies. Conclusions: The IYG-Tech curriculum represents a unique approach to sexual health education that has the potential to positively impact sexual risk behavior while mitigating dissemination challenges of fidelity and access.