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The Centers for Disease Control and Prevention (CDC) estimates that 1.2 million adults and adolescents in the United States (US) live with HIV infection (CDC, March 2012). The North Carolina Department of Health and Human Services (NC DHHS) estimates that 35,000 adults and adolescents have HIV, including those unaware of their infection status. In 2010, 1,487 individuals were diagnosed and reported living with HIV in NC. Orange County, NC, home to AMP! NC's intervention and comparison sites, ranked 49th highest of 100 NC counties, reporting a 2010 HIV incidence rate (the number of new infections per population in one year) of 6.2 per 100,000 population. While the majority of HIV cases are found among adults, the proportion of adolescents (13-24) living with HIV in NC has increased from 15.9% of all reported HIV cases in 2006 to 22.9% in 2010. Youth incidence rates in 2010 were 5% among those aged 15-19, and 17% among those aged 20-24. The sharp increase in incidence at the state level between the 15-19 and 18-24 age groups reflects the national trend. The increasing rates of HIV indicate a need for an increased HIV education and testing options, particularly among high school-aged youth. AMP! is an Arts-based, Multiple intervention, Peer-education program specifically created by the UCLA Art & Global Health Center (UCLA AGHC) to educate youth about sexual health in their communities. The three components of the intervention include 1) a live performance delivered by undergraduate student performers using a near-peer model; 2) In-class presentations delivered by undergraduate students in which HIV-positive individuals speak to students about their experiences; and 3) a condom skills workshop facilitated by college students. AMP! is designed to increase teens' level and retention of HIV/AIDS knowledge; inform teens about high-risk behaviors associated with HIV transmission; reduce stigma towards people living with HIV/AIDS; and increase the rate of testing for HIV and other STIs among young people. In the fall of 2012, UCLA AGHC recruited a Capstone team from the Health Behavior Department of the University of North Carolina (UNC) Gillings School of Global Public Health to adapt the program for implementation in North Carolina. The Capstone team completed a series of deliverables to inform the adaptation, assist with implementation, and guide future iterations of AMP!. These include two literature reviews on HIV prevention in schools and the use of interactive theater as a tool for HIV prevention, a summary of how AMP! aligns with NC Essential Standards for the state Reproductive Health and Safety Unit, a short-term evaluation plan for AMP!, evaluation tools for the NC AMP! pilot study, and a long-term evaluation plan for AMP! based on the CDC evaluation framework. From this work, the Capstone team learned how to translate public health research, language, theories, and practices to professionals from different disciplines. The Capstone team also learned how to effectively collaborate with partners in multiple sites. Completing each deliverable allowed the team to hone skills in program planning, stakeholder engagement, quantitative and qualitative research methods, and translating scientific evidence into best practice. UCLA AGHC will use the program evaluation plan and tools to 1) standardize future AMP! iterations across sites, 2) measure AMP!'s impact, and 3) communicate the empirical evidence to a wider audience, including school district officials, public policy makers, parents, and funders who can provide the crucial support for this work to continue. The Capstone team's work developing a plan for evaluating AMP! will provide artists and public health professionals working in HIV/STI prevention among youth with a rigorously evaluated program that can be implemented and adapted in other settings. |
