Video-Based Microskills Training Intervention to Improve Health Education to Reduce Risk Behaviors in Youth

Abstract: SkillTalk Sexual risk behaviors continue to place adolescents at risk for HIV infection, other sexually transmitted infections (STIs), and unintended pregnancy. U.S. adolescents account for about 50% of the cases of STIs each year, and 21% of new HIV cases are in youth 15-24, which is unsurprising given that only 54% of teens report using a condom at last sex. In the effort to reduce teen pregnancy, HIV and STIs, both teachers and parents play vital roles. At school: A variety of sexual health education programs and curricula are being provided in schools across the U.S. Regardless of the curriculum, whether evidence-based or teacher designed, the quality of the instructor skills to lead the curriculum activities is vital. Unfortunately, the vast majority of those who teach sexual health education are not sexuality educators (physical education teachers actually account for the largest number of those providing sexuality education) and have not received formal training. At home: research reflects both the importance of parent/adolescent communication about sexual health, but also the varied challenges parents face broaching these topics with comfort and confidence in their knowledge. The goal of this Phase II project is to fully develop and evaluate the effectiveness of a robust Microskills video training library (SkillTalk). The library is designed for a) teachers of sexual health for 14-18 year olds to help improve skills and confidence in implementing sexual and reproductive health curricula; and b) parents of adolescents to help improve skills and confidence in communicating about sexual health topics. The resource will provide video modeling of critical educator and parent Microskills (the smaller skills that make up a larger skill needed for effective education) in a way that is highly engaging, instructionally sound, and encourages repeat and continued use for reinforcement. When complete, the site will include 500+ Microskill video clips, grouped into skill clusters, such as engaging youth in sensitive discussions and creating a safe and inclusive learning environment, that each model a Microskill in 30–120 seconds. Other features include tailored video recommendations, accompanying instructions/printable learning materials, like and comment functions, a learning community (teachers only) that allows user video upload and encourages educators to constructively assess the skills demonstrated in the video. Phase II will enable 1) video development with the creation of approximately 500 videos added to the site with input from a diverse group of sexual and reproductive health training experts, parents and subject matter experts recruited from across the country; 2) site enhancements such as the creation of user learning communities, user submitted videos of Microskill demonstrations, links to current information resources, and assessments to focus learning on most needed skills; and 3) a randomized controlled evaluation to assess the effectiveness of SkillTalk to: enhance educators’ demonstratable skills for teaching sexual health topics; improve parental communication; and impact student outcomes.PUBLIC HEALTH NARRATIVE The U.S. teen pregnancy rate is still one of the highest in the developed world, substantially higher than in other western industrialized nations, with 40% of U.S. high school students engaging in sexual intercourse, and 10% having four or more sexual partners. Half of the 20 million new STIs reported each year are among young people, and those aged 13-24 account for 21% of all new HIV diagnoses in the U.S. Yet condom use among this group has declined by nearly 8% in the last decade, with condom use at last intercourse reported by just 53.8% of sexually active teens. All of which create an ongoing public health concern, and challenges to address for both sexual educators in schools and parents in the home. In schools, the positive impact of sexual health education programs relies on effective implementation, which is, in turn, impacted by the training and skills of the educator. Teachers are not routinely trained on the topic during credentialing and most have not been trained on the skills required for implementation of the complex elements of teaching sexual health topics, thus reducing program impact. In the home, many parents report discomfort communicating with their children about various sexual health topics, and uncertainty about their knowledge of key sexual and reproductive health topics. This project will teach both educators and parents the skills they need through a series of “Microskills” training videos; teachers can also participate in an educator community providing the opportunity for peer review of their skills-in-training. This resource may lead to improved implementation of sexual health lessons in schools, greater support of parent/child sexual health conversations in the home, and ultimately, a reduction in teen sexual risk behaviors and rates of teen pregnancy and STIs.