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Predictors of Responsiveness Among American Indian Adolescents to a Community-Based HIV-Risk Reduction Intervention Over 12 Months

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Abstract

This analysis explored predictors of responsiveness to the Respecting the Circle of Life (RCL) intervention, a sexual and reproductive health program for American Indian (AI) youth. Data were collected over 12-month follow-up with 267 AI youth aged 13–19. We used mixed effects regression models to examine: (1) whether trajectory patterns of HIV/AIDS knowledge, condom beliefs, condom use self-efficacy, condom use intention and partner negotiation skills differed by baseline levels categorized into low, medium, and high scorers, and (2) the characteristics of youth who made no improvement over the post-intervention period. Results indicate the RCL intervention had greater longitudinal impact among subgroups with low and medium initial scores. High initial scores in knowledge, beliefs, efficacy, intention and skills predicted unresponsiveness to the RCL intervention. Youth differences in age, gender and school truancy (skipping/suspension) did not predict responsiveness to RCL. Results have important prevention science implications: (1) AI youth at greater risk (i.e., those with low initial levels of knowledge, beliefs, self-efficacy, intention and skills) are likely to respond to RCL and should be the target of replication and dissemination efforts. (2) Responsiveness analyses can guide adaptation of RCL and other sexual and reproductive health programs for AI youth to improve efficacy among unresponsive subgroups (i.e., high initial scorers). (3) RCL is equally likely to impact AI youth across different ages, genders and school status, thus validating population-wide implementation strategies.

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Acknowledgements

We gratefully acknowledge the youth and families who participated in this study and the Native American Research Centers for Health (#U26IHS300286/02) for their generous support of this research.

Funding

This study was funded by the Native American Research Centers for Health (#U26IHS300286/02).

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Authors and Affiliations

  1. Department of International Health, Center for American Indian Health, Johns Hopkins University, 415 N. Washington St., Baltimore, MD, 21231, USA

    Lauren Tingey, Rachel Chambers, Hima Patel & Summer Rosenstock

  2. Department of International Health, Center for American Indian Health, Johns Hopkins University, Whiteriver, AZ, USA

    Novalene Goklish, Francene Larzelere & Angelita Lee

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  1. Lauren Tingey
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  2. Rachel Chambers
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  3. Novalene Goklish
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  6. Angelita Lee
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  7. Summer Rosenstock
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Correspondence to Lauren Tingey.

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Tingey, L., Chambers, R., Goklish, N. et al. Predictors of Responsiveness Among American Indian Adolescents to a Community-Based HIV-Risk Reduction Intervention Over 12 Months. Arch Sex Behav 49, 1979–1994 (2020). https://doi.org/10.1007/s10508-018-1385-2

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