Scaling Effective Behavioral Interventions with MPC Avatar-Based Virtual Training

ABSTRACT Teen pregnancy and sexually transmitted infections (STIs) remain a problem in the U.S. Although 15-24 year olds are only 25% of the U.S. sexually active population, they account for over 50% of the 20 million new cases of STIs each year. While historically low, the U.S. teen pregnancy rate remains one of the highest in the developed world and racial/ethnic and geographic disparities in teen birth rates persist. The long-term goal of this project is to support school and community-based educators working to reduce the ongoing problem of teen pregnancy and STIs in the U.S. Making Proud Choices! (MPC) is one of the most used, evidence-based HIV/STI/teen pregnancy risk-reduction programs. However, MPC must be implemented with fidelity to achieve outcomes, and educators must be trained to ensure MPC is implemented well. Unfortunately, lack of affordable, accessible training options make it difficult for educators to implement the program with fidelity. This project proposes a cost-effective, easily implemented solution through avatar-based virtual training. These trainings simulate real-life, two-way exchanges, allowing trainees to practice and get immediate feedback on core concepts from a student audience programmed to display a range of reactions. This asynchronous training can be used anytime and anywhere, unlike live remote training. In sum, avatar-based training can help schools and community organizations overcome limitations of in-person training, provide sustainable, widespread access to training in efficacious prevention programs, and dramatically improve sexual health outcomes for youth at a reasonable cost. In Phase I, we developed a novel, online avatar-based training prototype for select components of MPC. In a pilot test with 53 participants comparing avatar-based and in-person training, results showed that a) the avatar- based training was no different, and in many cases better, than the in-person training on improving facilitator quality and instruction adherence; and b) participants positively rated the trainings’ high levels of acceptability, usability and applicability to teaching youth about sexual health and safety. For this Phase II project, we will fully develop and test the 10-module version of the online, avatar-based MPC training. The project has three specific aims: 1): Develop a full-scale avatar-based MPC virtual training for educators of this STI/pregnancy risk reduction program; 2): Evaluate the training’s impact on 165 educators of 9th-12 grade students, assessing their STI/pregnancy prevention knowledge, teaching skills and curriculum fidelity compared to live training and no training/curriculum only conditions; and 3): Evaluate the impact of exposure to educators from the two treatment groups on students’ knowledge, attitudes and beliefs regarding safer sex practices.