Seventeen Days (formerly What Could You Do?)

Program Overview

Developer(s)

Julie Downs, Ph.D., Pamela Murray, M.D., M.P.H., Wandi Bruine de Bruin, Ph.D., and Baruch Fischoff, Ph.D.

Program Summary

Seventeen Days (formerly called What Could You Do?) is a theory-based interactive DVD designed to educate young women about contraception and STDs. The DVD presents the viewer with different scenarios involving decision that young women face in relationships. Participants can practice what they would do in similar situations through the frequent use of "cognitive rehearsal."

Target Population

The intervention was designed for sexually active girls ages 14 to 19. The original DVD was evaluated with predominately African American teens who were patients at an urban health care clinic. A more recent study evaluated the program with White teens who were patients at health clinics in Ohio, Pennsylvania, and West Virginia.

Program Setting

The program can be implemented in any setting where participants can use the DVD privately, such as in a health care clinic setting, a classroom, a computer laboratory, or at a library where individuals could check the DVD out to use on site or at home. It was evaluated in a health clinic setting.

Contact and Availability Information

For curriculum, materials, and pricing information, please contact:

Carnegie Mellon University
Attn: Seventeen Days
SDS, Porter Hall 208
5000 Forbes Avenue
Pittsburgh, PA 15213-3890
Ph: 412-268-3249
Email: info@seventeendays.org
Website: http://www.seventeendays.org

For training and support, please contact:

See above

Sample of curriculum available for review prior to purchase: Yes

Adaptation guidelines or kit available: Yes

Languages available: English

Program Components

Program Objectives

The goal of Seventeen Days is to prevent HIV and STIs by improving young women's ability to make less risky sexual health choices. The video features six vignettes that follow different story lines with a unique set of issues and possible outcomes, identifies choice points in the story, suggests risk-reduction strategies, and allows viewers to practice what they would do.

Program Content

The intervention is based on a "mental models" (a person's thought process about how something works) approach of understanding perceptions of risk. The video addresses potential gaps in adolescent girls' mental models of STI risk. The video consists of six vignettes, a condom demonstration, and mini-documentaries, which together cover the following topics:

  • Sexual situations, in which a female character negotiated for safer outcomes
  • Risk reduction, in which the concept of relative risk was explained and applied to sexual behavior
  • Reproductive health, including anatomy, and physiology
  • Gynecological exam, including asking for birth control
  • Sexually transmitted infections, explaining viruses, bacteria and eight common STIs.
  • Hormonal birth control, including a behavioral focus on how to choose and adhere to a method

Program Methods

The program is currently delivered through the interactive DVD. A mobile app is also expected to be available beginning in April 2015. Usage of the app will be linked to a website with an educator portal for tracking milestones.

Implementation Requirements and Guidance

Program Structure and Timeline

The first viewing of the DVD is designed to be around 45 minutes, but viewing time varies depending on the participant's choices at key decision points during the video. The mini documentaries range from two to ten minutes long. Overall duration is about 3.5 hours of content.

The minimum required dosage for completing the program is for participants to view one completed vignette and the condom demonstration. The developers recommend monthly booster sessions in which participants watch one additional vignette and one mini documentary.

Staffing

A staff person is required to get the participant started with DVD viewing and to provide technical assistance with the DVD player as needed.

Program Materials and Resources

The original “What Could You Do?” video is no longer available. The new version of the video, Seventeen Days, has updated content including updated medical terminology, information about emerging tools for treatment and management of STIs, and six vignettes instead of four.

The developer offers the following materials:

  • Seventeen Days DVD (for purchase)
  • Seventeen Days mobile app (Available April 2015)
  • Seventeen Days User's Guide (Beta version, free to download)
  • Seventeen Days Quick User's Guide (Beta version, free to download)
  • Seventeen Days DVD Cover (Beta version, free to download)
  • Educator portal companion to forthcoming mobile app (with license)

Additional Needs for Implementation

Materials required for program delivery are the Seventeen Days DVD, a computer or portable device for viewing the DVD, and headphones. A space is required that will allow the participant to view the video privately and with minimal distractions.

Fidelity

Participants must be given flexibility to select which video segments to watch and to make progress at their own pace.

Participants must view one completed vignette and the condom demonstration, ideally followed by monthly booster sessions in which they watch one additional vignette and mini-documentary.

The program identifies to the viewer when they have completed their “first visit” (approximately 35 minutes in length), which corresponds to the minimum dosage. For the DVD implementation, providers would need to ask their clients when they got to this point. In the upcoming mobile app, however, providers would have access to data on whether each registered user had reached this milestone.

The DVD format currently does not permit any monitoring. However, a mobile app is under development (currently in beta format, expected in full release in late April 2015), which will include extensive tracking tools that will allow providers to monitor progress and milestones for registered users.

Training and Staff Support

Staff Training:

Training sessions are currently being developed for organizations wishing to implement the program. For more information, providers should contact the CMU team directly at info@seventeendays.org.

Technical Assistance and Ongoing Support:

Technical support resources are currently under development. For more information, please contact the CMU team at info@seventeendays.org.

Allowable Adaptations

Although the intervention was evaluated in a health care clinic setting, the developers note that it could be used in a classroom or computer laboratory where participants can use the intervention privately, or, at a library where individuals could check the DVD out to use on site or at home.

The developer notes that it is not recommended that the program be used with its current formulation in a group delivery setting, due to the theoretical benefits of individual exposure to modeling and cognitive rehearsal, as well as the privacy and agency afforded by making individual choices within the many interactive features.

Implementation Readiness Assessment

The review team conducted an independent assessment of the program’s readiness for implementation. This assessment is based on the team’s review of available program materials and documents. The team also requested input from program developers and distributors about the availability of implementation materials and resources.

On the basis of this assessment, the team calculated an implementation readiness score comprised of three component scores: (1) curriculum and materials, (2) training and staff support, and (3) fidelity monitoring tools and resources. The component scores are combined into a total score, which ranges from 0 to 8, with higher scores indicating the programs most ready to implement.

Curriculum and Materials

Has defined curriculum with lesson plans and/or activities?Yes
Has defined core or required components?Yes
Has facilitator’s guide or instructions?Yes
Component Score3/3

Training and Staff Support

Formal pre-implementation training (by qualified trainers) available?No
Supplemental training or ongoing technical support available?No
Component Score0/2

Fidelity Monitoring Tools and Resources

Has defined logic model?Yes
Defines fidelity guidelines and benchmarks?Yes
Offers monitoring and evaluation tools?No
Component Score2/3

Total Implementation Readiness Score

5/8

Reviewed Studies

CitationHigh-Quality Randomized TrialModerate-Quality Randomized TrialModerate-Quality Quasi-experimentLow Study RatingDid Not Meet Eligibility Criteria

Downs et al. 2004

Yes    

Eichner et al. 2015

Downs et al. 2016

Yes    

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample.

Study Characteristics

CitationSettingMajority Age GroupMajority Racial/Ethnic GroupGenderSample Size

Downs et al. 2004

Health clinic14 to 17African AmericanFemale300

Eichner et al. 2015

Downs et al. 2016

Health clinic14 to 17WhiteFemale1,317

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample.

Information on study characteristics is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.

Study Findings

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

Downs et al. 2004

A mix of positive, null, and/or adverse impacts across the outcomes examined in this domain Uniformly null impacts across the outcomes examined in this domain A mix of positive, null, and/or adverse impacts across the outcomes examined in this domain

Eichner et al. 2015

Downs et al. 2016

Uniformly null impacts across the outcomes examined in this domain Uniformly null impacts across the outcomes examined in this domain
CitationDetails

Downs et al. 2004

The program was evaluated in a randomized controlled trial conducted in four clinic-based healthcare sites in Pittsburgh, PA. Adolescents participating in the study were randomly assigned to one of three groups: (1) a treatment group that watched the intervention video, (2) a control group that received the same information from the video but as a book, and (3) a control group that received commercially-available brochures on STD risk. Study data were collected with surveys administered immediately before the intervention and at follow-ups conducted 3 and 6 months after the intervention ended. Biological testing for chlamydia was conducted at the 6-month follow-up.

Three months after the program ended, participants who watched the intervention video were more likely to report having been abstinent in the past three months. In addition, six months after the program ended, participants who watched the intervention video were less likely to report having been diagnosed with an STD. The study found no statistically significant program impacts on rates of abstinence in the past three months, self-reported condom use in the past three months, or the biological tests for chlamydia at the 6-month follow-up.

The study also examined program impacts on measures of STD knowledge and self-reported condom failures. Findings for those outcomes were not considered for the review because they fell outside the scope of the review.

Eichner et al. 2015

Downs et al. 2016

A more recent study evaluated the program using a randomized controlled trial that involved 1,317 young women who sought treatment at health clinics in Ohio, Pennsylvania, and West Virginia. The young women participating in the study were randomly assigned to either a treatment group that watched a 2.5 hours video with the Seventeen Days program content, or to a control group that watched a video providing information on how to reduce driving risks, the Driving Skills for Life video. The study administered surveys immediately before random assignment (baseline), and again three and six months after the baseline.

Three and six months after the baseline, the study found no evidence of statistically significant program impacts on rates of abstinence, defined as not having vaginal sex in the last three months, and on rates of safe sexual behavior, defined as either abstaining from vaginal sex or as having sex using a condom every time in the last three months.

The study also examined program impacts on measures of pregnancy and having an STI. Findings for those outcomes were not considered for the review because they did not meet the review standards. Specifically, attrition for the sample on which those outcomes were measured was high and therefore those findings received a Moderate rating. That rating is not consistent with the overall rating of the study (High). Attrition was assessed separately for the pregnancy and STI tests because they were administered in a different data collection effort–vaginal swab tests kits-- than the surveys used to measure abstinence and contraceptive use at the 3- and 6-month follow-ups.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample. A blank cell indicates the study did not examine any outcome measures within the particular outcome domain or the findings for the outcome measures within that domain did not meet the review evidence standards.

Information on evidence of effectiveness is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.