Changes in knowledge, communication, and risk-taking behaviors among college students delivering a theater-based sexual health intervention: A qualitative study of the AMP! Sex Squad Public

Abstract

Individuals between the ages of 18 and 24 are at an increased risk of acquiring HIV and other sexually transmitted infections. This age group accounts for a disproportionate number of HIV infections annually, compared to individuals of other ages. Arts-based interventions have been shown to be effective in delivering health messages and promoting behavior change among audience members. The AMP! Sex Squad is a peer-based arts intervention that is developed and delivered by college students to inform high school students about topics ranging from contraception, to HIV/AIDS, to relationship violence. This study was interested in understanding the impact of participation as a performer in the Sex Squad on sexual health knowledge, communication and risk-taking behavior. Eight in-depth qualitative interviews were conducted with current and previous Sex Squad participants. Respondents described an increase in their self-efficacy for discussing topics related to sexual health, which resulted from increased knowledge gained from participation in the Sex Squad, their exposure to alternate perspectives around gender and sexuality, and the opportunity to practice and observe their peers in a creative setting. Performance was an important component of the intervention that was cited by respondents as helping to build their confidence and empowering them to share and apply the knowledge and skills they gained in the Sex Squad in their relationships with their social networks. This qualitative study suggests that peer-based arts interventions have an impact on the sexual health knowledge, communication and risk-taking behavior, and they may be an important opportunity for intervention to alleviate the disproportionate burden of HIV/AIDS among 18 to 24 year olds.

Table of Contents

Introduction........................................................................................................ 1

HIV and Youth in the United States.................................................................. 1
Arts-based Health Interventions...................................................................... 2
Social Cognitive Theory as a Theoretical Framework.......................................... 3
Study Purpose and Aims................................................................................ 4

Literature Review................................................................................................. 4

Sexual Health and College Students................................................................. 4
Entertainment-Education as a Rationale for Arts-Based Health Interventions........... 6
Theater-based Behavioral Interventions........................................................... 7
Theater-Based Interventions and Social Cognitive Theory.................................... 7
Theater-based HIV Interventions..................................................................... 8
Utilizing Peer Education for HIV Interventions.................................................... 9
Opinion Leaders and the Diffusion of Innovations............................................... 10
Observational Learning and Social Cognitive Theory........................................... 11
Exploring Outcomes for Peer Educators in Theater-based HIV Interventions............ 13

Methods............................................................................................................. 14

AMP! Sex Squad.......................................................................................... 14

Recruitment and Sampling............................................................................. 14

Data Collection............................................................................................ 15

Data analysis.............................................................................................. 17

Results and Analysis............................................................................................. 20

The Sex Squad Experience............................................................................. 21

Peer-based Theater Education........................................................................ 23

Technical versus Systemic Sexual Health Knowledge.................................. 25

Interpersonal Communication About Sexual Health............................................. 27

Comfort Sharing Sexual Health Knowledge........................................................ 27

Partner Communication.......................................................................... 30

Serving as a Resource........................................................................... 32

Sexual Risk-Taking Behavior........................................................................... 34

Characterizing Physical Risk.................................................................... 34

Sexual Risk and Emotional Well-Being....................................................... 36

Decision Making About Risk..................................................................... 37

Conceptualization of Sexual Health................................................................... 39

Discussion............................................................................................................ 41

Social Cognitive Theory as a Theoretical Framework............................................ 43

Limitations................................................................................................... 44

Public Health Significance and Areas for Future Research...................................... 46

Appendices........................................................................................................... 48

Appendix I: In-Depth Interview Guide................................................................ 48

Appendix II: Coding Tree................................................................................. 50

Appendix III: Codebook................................................................................... 52

References............................................................................................................ 55

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	theater-based interventions sexual health Social Cognitive Theory entertainment-education college students peer-education HIV/AIDS
Committee Chair / Thesis Advisor	Comeau, Dawn L, Emory University
Committee Members	Gordon, Robert, University of California Los-Angeles Art and Global Health Center
Partnering Agencies	University, college or educational institution (other than Emory)

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