The Journal of Primary Prevention

, Volume 38, Issue 1–2, pp 27–48 | Cite as

NATIVE-It’s Your Game: Adapting a Technology-Based Sexual Health Curriculum for American Indian and Alaska Native youth

  • Ross Shegog
  • Stephanie Craig Rushing
  • Gwenda Gorman
  • Cornelia Jessen
  • Jennifer Torres
  • Travis L. Lane
  • Amanda Gaston
  • Taija Koogei Revels
  • Jennifer Williamson
  • Melissa F. Peskin
  • Jina D’Cruz
  • Susan Tortolero
  • Christine M. Markham
Original Paper


Sexually transmitted infection (STI) and birth rates among American Indian/Alaska Native (AI/AN) youth indicate a need for effective middle school HIV/STI and pregnancy prevention curricula to delay, or mitigate, the consequences of early sexual activity. While effective curricula exist, there is a dearth of curricula with content salient to AI/AN youth. Further, there is a lack of sexual health curricula that take advantage of the motivational appeal, reach, and fidelity of communication technology for this population, who are sophisticated technology users. We describe the adaptation process used to develop Native It’s Your Game, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing promising sexual health curriculum, It’s Your Game-Tech (IYG-Tech). The adaptation included three phases: (1) pre-adaptation needs assessment and IYG-Tech usability testing; (2) adaptation, including design document development, prototype programming, and alpha testing; and (3) post-adaption usability testing. Laboratory- and school-based tests with AI/AN middle school youth demonstrated high ratings on usability parameters. Youth rated the Native IYG lessons favorably in meeting the needs of AI/AN youth (54–86 % agreement across lessons) and in comparison to other learning channels (57–100 %) and rated the lessons as helpful in making better health choices (73–100 %). Tribal stakeholders rated Native IYG favorably, and suggested it was culturally appropriate for AI/AN youth and suitable for implementation in tribal settings. Further efficacy testing is indicated for Native IYG, as a potential strategy to deliver HIV/STI and pregnancy prevention to traditionally underserved AI/AN middle school youth.


Teen pregnancy prevention Cultural adaptation Communication technology Computer-based learning Behavior Adolescents Web-based health education Computer-based health education Health communications School-based health 



This work was made possible through funding from CDC cooperative agreement (Award# 5U48DP001949) and DHHS Agency for Children and Families Grant (Award# HHS-2011-ACF-ACYF-AT-0157) and through the collaboration of tribes in Alaska, Arizona, and the Pacific Northwest, with Public Health Advisors Lori de Ravello, MPH and Scott Tulloch of the Indian Health Service, consultants Carol Kaufman, PhD. and William Lambert, PhD., and Zsolt L. Levai who facilitated manuscript development.

Compliance With Ethical Standards

Conflict of Interest

The authors have no conflicts of interest to disclose.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Ross Shegog
    • 1
  • Stephanie Craig Rushing
    • 2
  • Gwenda Gorman
    • 3
  • Cornelia Jessen
    • 4
  • Jennifer Torres
    • 1
  • Travis L. Lane
    • 3
  • Amanda Gaston
    • 2
  • Taija Koogei Revels
    • 4
  • Jennifer Williamson
    • 4
  • Melissa F. Peskin
    • 1
  • Jina D’Cruz
    • 5
  • Susan Tortolero
    • 1
  • Christine M. Markham
    • 1
  1. 1.Center for Health Promotion and Prevention Research, The University of Texas School of Public HealthThe University of Texas Health Science Center HoustonHoustonUSA
  2. 2.Northwest Portland Area Indian Health BoardPortlandUSA
  3. 3.Inter Tribal Council of Arizona, Inc.PhoenixUSA
  4. 4.Division of Community Health ServicesAlaska Native Tribal Health ConsortiumAnchorageUSA
  5. 5.Center for Disease Control (CDC), Office of Public Health Scientific Services (OPHSS)Center for Surveillance, Epidemiology and Laboratory Services (CSELS)Dekalb County, AtlantaUSA

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