HORIZONS

Program Overview

Developer(s)

Ralph J. DiClemente, Ph.D., Gina M. Wingood, Sc.D. M.P.H., Eve S. Rose, M.S.P.H., Jessica M. Sales, Ph.D., Delia L. Lang, Ph.D. M.P.H., Angela M. Caliendo, M.D. Ph.D., James W. Hardin, Ph.D., and Richard A. Crosby, Ph.D.

Program Summary

HORIZONS is a clinic-based STI/HIV intervention for African American adolescent females that teaches assertive communication skills and proper condom use, and fosters cultural and gender pride. The program is delivered through two 4-hour small group sessions followed by four 15-minute booster phone calls over the following year.

Target Population

The program is designed for African American females ages 15 to 21, who are sexually active, single, and trying to avoid pregnancy. The program was evaluated first with 18 to 19 year-old African American females, and more recently with younger females, who were 14 to 17 years old.

Program Setting

The program was developed to be delivered in a community-based or health clinic setting. The program was evaluated in a health clinic setting.

Contact and Availability Information

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

Sociometrics Corporation
1580 W. El Camino Real, Suite 8
Mountain View, CA 94040
Ph: 650-949-3282
Email: socio@socio.com
Website:  https://www.socio.com/products/pasha-horizons-sti-hiv-sexual-risk-reduction-intervention-for-african-american-girls

For training and support, please contact:

See above

Sample of curriculum available for review prior to purchase: No

Adaptation guidelines or kit available: No

Languages available: English

Program Components

Program Objectives

HORIZONS seeks to reduce STIs by: 1) improving STI/HIV risk-reduction knowledge; 2) improving condom use skills; 3) improving communication with male partners about safer sex practices; 4) reducing the frequency of douching; and 5) facilitating male partners' access to STI screening/treatment.

Program Content

The group sessions are interactive and help train teens in assertive communication skills to negotiate abstinence or safer sex. The program also teaches condom use skills, and participants must complete homework assignments involving the male partner. The program materials are targeted to motivate gender and ethnic pride.

Four follow-up booster; calls reinforce the prevention information provided in the group

Participants are also given a $20 voucher redeemable by their male partner(s) toward the cost of STI services.

Program Methods

HORIZONS is delivered through small, interactive group workshops that include games, group discussion, condom demonstration,  and brief follow-up phone calls. 

Implementation Requirements and Guidance

Program Structure and Timeline

The program is designed to be delivered in a health clinic or a community-based setting to groups of up to twelve youth. The core program includes two 4-hour group sessions, 15-minute follow-up phone conversations held at three to four weeks, 10 to 12 weeks, 6 to 7 months, and 9 to 10 months after the second workshop, and vouchers for STD services.

Staffing

The group sessions should be facilitated by two skilled African American female health educators.

Program Materials and Resources

The following program materials are available through the distributor:

  • HORIZONS User's Guide
  • HORIZONS Facilitator's Manual (2 copies for each health educator)
  • Journal Pages copy maters (2 packets - 1 per workshop)
  • Handouts copy masters (2 packets - 1 per workshop)
  • Game Pieces (2 packets - 1 per workshop)
  • Poster copy masters (2 packets - 1 per workshop)
  • Phone Sessions Manual
  • Training Manual
  • Fidelity Kit
  • Local Evaluator Consultant Network Directory
  • Set of Original Evaluation Instruments
  • Prevention Minimum Evaluation Data Set (PMEDS)

While a free sample curriculum is not available, providers may purchase an automatic digital download of the user’s guide to review program components, core competencies for facilitators, and scientific evidence of effectiveness. If providers decide to purchase the program, the price of the download is deducted.

Additional Needs for Implementation

Materials required for the delivery of the program include condoms, personal lubricants, and penis models.

Fidelity

HORIZONS has a fidelity toolkit/checklist and tools for monitoring program implementation. These may be accessed on the Sociometrics website: https://www.socio.com/products/pasha-horizons-sti-hiv-sexual-risk-reduction-intervention-for-african-american-girls

Training and Staff Support

Staff Training:

There is no required training for this program. Providers interested in training should contact Sociometrics.

Technical Assistance and Ongoing Support:

Sociometrics provides telephone technical support on implementation and evaluation for one year with purchase of the program materials.

Allowable Adaptations

All adaptations must be approved by the developer, in consultation with the distributor.

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?Yes
Supplemental training or ongoing technical support available?Yes
Component Score2/2

Fidelity Monitoring Tools and Resources

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

Total Implementation Readiness Score

7/8

Reviewed Studies

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

DiClemente et al. 2009

Sales et al. 2012

Yes    

Latham et al. 2010

    Yes

DiClemente et al. 2014

Steiner et al. 2014

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

DiClemente et al. 2009

Sales et al. 2012

Health clinic18 or 19African AmericanFemale715

Latham et al. 2010

n.a.n.a.n.a.n.a.n.a.

DiClemente et al. 2014

Steiner et al. 2014

Phone calls and health clinic visits14 to 17African AmericanFemale429

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

DiClemente et al. 2009

Sales et al. 2012

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

Latham et al. 2010

n.a. n.a. n.a. n.a. n.a.

DiClemente et al. 2014

Steiner et al. 2014

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

DiClemente et al. 2009

Sales et al. 2012

The program’s evidence of effectiveness was first established in a randomized controlled trial involving sexually active African American females recruited from three health clinics in Atlanta, Georgia. Participants were randomly assigned either to a treatment group that received the HORIZONS program or to a control group that received the current standard of care, consisting of a one-hour STD/HIV prevention group session. Surveys were administered before the program began (baseline) and at six and 12 months after completion of the program. Data collection also included testing for chlamydia, gonorrhea, and trichomonas.

The study found that both 12 months after the program ended, and when averaging data across the two follow-up periods, youth participating in the program reported a significantly higher proportion of condom-protected sex acts, and were significantly more likely to report consistent condom use and condom use at their last sexual encounter. The study also found that youth in the treatment group were significantly less likely to test positive for chlamydia 12 months after the program ended. The study found no statistically significant impacts on gonorrhea or trichomonas infection. For the 6-month follow-up survey, the study found that youth participating in the program reported a significantly higher proportion of condom-protected sex acts in the 14 days and 60 days preceding the survey. The study found no statistically significant impacts on consistent condom use or condom use at last sexual encounter.

The study also examined program impacts on measures of STD/HIV knowledge, condom self-efficacy, partner communication, and frequency of douching. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.

Latham et al. 2010

This study did not meet the review screening criteria.

DiClemente et al. 2014

Steiner et al. 2014

This study used a randomized controlled trial to evaluate the effectiveness of an implementation strategy used to deliver the HORIZONS program. The study was conducted with sexually active African American females recruited from three health clinics in Atlanta, Georgia. About half the study participants were randomly assigned to a treatment group that was offered telephone-based counseling every 8 weeks for 36 months after the end of the HORIZONS program. Participants assigned to the control group also received follow-up phone calls after the end of the HORIZONS program, but the content of their calls was limited to general health promotion. Because participants in both research groups received the HORIZONS program, the study does not provide evidence on the overall effectiveness of the program. Rather, the study provides evidence on an implementation strategy used to deliver the program. Surveys were administered before the program began (baseline) and at 6, 12, 18, 24, and 36 months after the HORIZONS program ended. At each assessment, participants also provided self-collected vaginal swab specimens for STI testing.

The study found that averaged across all follow-up periods, participants offered the PMI were significantly less likely to test positive for chlamydia than those who received follow-up calls covering only general health promotion. The study also found that participants in the PMI group reported a significantly higher proportion of condom-protected sex acts in the last six months and the last 90 days. The study found no statistically significant impact on the number of sexual partners in the previous six months or in the risk of gonococcal infection. The study also examined program impact on episodes of sex while high on drugs and/or alcohol. Findings for this outcome were not considered for the review because they fell outside the scope of the review.

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.