Engineering an Online STI Prevention Program
Condition: Sexual Behavior; Alcohol Consumption; Sexually Transmitted Diseases
MeSH terms: Sexually Transmitted Diseases; Alcohol Drinking
Study type: Interventional

Summary: 
      The overall objective of the proposed research is to reduce the incidence of sexually
      transmitted infections (STIs) among college students. The investigators propose to accomplish
      this by using the innovative, engineering-inspired multiphase optimization strategy (MOST) to
      develop a highly effective, appealing, economical, and readily scalable internet-delivered
      behavioral intervention targeting the intersection of alcohol use and sexual risk behavior.
      The rate of STIs on college campuses is alarming: one in four college students is diagnosed
      with an STI at least once during their college experience. Sexual activity when drinking
      alcohol is highly prevalent among college students. Alcohol use is known to contribute to the
      sexual risk behaviors that are most responsible for the transmission of STIs, namely
      unprotected sex, contact with numerous partners, and "hook-ups" (casual sexual encounters).
      Few interventions have been developed that explicitly target the intersection of alcohol use
      and sexual risk behaviors, and none have been optimized. In order to reduce the incidence of
      STI transmission among this and other high-risk groups, a new approach is needed. MOST is a
      comprehensive methodological framework that brings the power of engineering principles to
      bear on optimization of behavioral interventions. MOST enables researchers to experimentally
      test the individual components in an intervention to determine their effectiveness,
      indicating which components need to be revised and re-tested. Given the high rates of alcohol
      use and sex among college students, the college setting provides an ideal opportunity for
      intervening on alcohol use and sexual risk behaviors. The proposed study will include a
      diverse population of college students on 4 campuses which will increase the generalizability
      of the findings. The specific aims are to (1) develop and pilot test an initial set of online
      intervention components targeting the link between alcohol use and sexual risk behaviors, (2)
      use the MOST approach to build an optimized preventive intervention, and (3) evaluate the
      effectiveness of the newly optimized preventive intervention using a fully powered randomized
      controlled trial (RCT). This work will result in a new, more potent behavioral intervention
      that will reduce the incidence of STIs among college students in the US, and will lay the
      groundwork for a new generation of highly effective STI prevention interventions aimed at
      other subpopulations at risk.
    

Detailed description: 
      As part of the MOST approach, the investigators will conduct a series of screening
      experiments to build an optimized intervention. The current study is the first (of two)
      screening experiments.
    

Intervention name(s): Knowledge alone; Self-efficacy alone; Perceived benefits alone; Perceived benefits and self-efficacy; Injunctive norms; Injunctive norms and self-efficacy; Injunctive norms and perceived benefits; Injunctive norms, perceived benefits, and self-efficacy; Descriptive norms alone; Descriptive norms and self-efficacy; Descriptive norms and perceived benefits; Descriptive norms,perceived benefits,self-efficacy; Descriptive and injunctive norms; Descriptive norms, injunctive norms,self-efficacy; Descriptive and injunctive norms, benefits; Descriptive and injunctive norms, benefits,efficacy; Expectancies alone; Expectancies and self-efficacy; Expectancies and Perceived Benefits; Expectancies, perceived benefits, self-efficacy; Expectancies and injunctive norms; Expectancies, injunctive norms, and self-efficacy; Expectancies, injunctive norms, benefits; Expectancies, injunctive norms, benefits, efficacy; Expectancies and descriptive norms; Expectancies, descriptive norms, and self-efficacy; Expectancies, descriptive norms, and benefits; Expectancies,descriptive norms, benefits, efficacy; Expectancies, descriptive and injunctive norms; Expectancies, descr& injun norms, efficacy; Expectancies, desc & injun norms, benefits; Expectancies,desc & injun norms,benefits,efficacy
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Increase knowledge related STIs, STI risk, alcohol impairment, condom use skills, alcohol use behavior tracking skills, testing & treatment services.; Increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.; Increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Correct misperceptions regarding approval of alcohol misuse & sexual risk taking.; Correct misperceptions regarding approval of alcohol misuse & sexual risk taking and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Correct misperceptions regarding approval of alcohol misuse & sexual risk taking and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Correct misperceptions regarding approval of alcohol misuse & sexual risk taking; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors and correct misperceptions regarding approval of alcohol misuse & sexual risk taking.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.; Correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and Increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter.; Decrease the expectation that alcohol is needed to have good sexual encounter and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.; Decrease the expectation that alcohol is needed to have good sexual encounter; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter and correct misperceptions regarding approval of alcohol misuse & sexual risk taking.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter and correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; and correct misperceptions regarding approval of alcohol misuse & sexual risk taking.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; and increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol.; Decrease the expectation that alcohol is needed to have good sexual encounter; correct misperceptions of prevalence of alcohol-induced sexual risk behaviors, alcohol use/misuse, and sexual risk behaviors; correct misperceptions regarding approval of alcohol misuse & sexual risk taking; increase perceived benefits to use protective behavioral strategies to reduce the negative consequences of engaging in sexual behaviors under the influence of alcohol; and increase self-efficacy to use protective behavioral strategies (e.g., condom negotiation skills) to reduce unprotected sex.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: multiphase optimization strategy; college students