Adaptation of an Evidence-Based Behavioral Group Intervention to Reduce Risk for Sexually Transmitted Infections among Local Female Adolescents in Hawaii

Abstract

Epidemiological data demonstrate teen girls in Hawai‘i are at significant and increasing risk for sexually transmitted infections (STIs). These data also indicate that teen girls in Hawai‘i are engaging in higher rates of high-risk sexual behavior than their male counterparts. Despite this compelling evidence, there is a paucity of published research on effective STI prevention protocols that target local female adolescents. In light of public health needs, the specific aim of this study was to adapt an evidence-based, group-level STI behavioral prevention intervention targeting local teen girls in Hawai‘i. This adaptation was achieved using the Local Adaptation Procedures, which provided methodological adaptation steps that accommodate the logistics of conducting community-based research in Hawai‘i. The current investigation consisted of three studies. In Study 1, a group behavioral intervention, Girl Power, was selected for adaptation based on a critical comparative review of the STI prevention intervention literature targeting female adolescents and consultation with key community stakeholders. The aim of Study 2 was to adapt Girl Power based on themes derived from the content analyses of four focus groups conducted among local teen girls. The themes guided modifications of the intervention and yielded the adapted intervention, Girl Power Hawai‘i. The aim of Study 3 was the final production of Girl Power Hawai‘i, and involved two theater tests of the adapted intervention among a sample of local teen girls and key community stakeholders. The purpose of theater testing was to pretest modules from the adapted intervention. Content analysis of participants’ evaluations of demonstrated content guided the final production of Girl Power Hawai‘i. The local adaptation of Girl Power represents an important contribution to the adolescent sexual health intervention literature by addressing a significant gap in services targeting the needs of female adolescents at risk for STI and related behavioral health issues. This empirical qualitative research provided the critical first steps in ensuring the relevance and acceptability of Girl Power Hawai‘i among local teen girls, resulting in a STI intervention that can be readily implemented by community-based organizations in Hawai‘i. Future research should focus on examining the effectiveness of the adaptation, including feasibility- and pilot-testing with partnering CBOs, and subsequent community-based, participatory dissemination RCTs.