The Pathways for African American Success: Does Delivery Platform Matter in the Prevention of HIV Risk Vulnerability Among Youth?

Purpose: Technology provides new possibilities for disseminating effective prevention programming to underserved families, such as those residing in rural communities. The present study is an evaluation of a technology-delivered HIV risk prevention program designed for rural African-American families, Pathways for African American Success (PAAS), to determine its promise for increasing access to evidence-based youth risk prevention programs among those in the greatest need. Methods: Four hundred and twelve parent/youth dyads were randomly assigned to one of three conditions: (1) in-person facilitator-led PAAS small group, (2) self-directed PAAS technology, or (3) a literature control with home-mailed educational materials. Results: Compared with families in the literature control condition, families assigned to the PAAS technology or small group conditions demonstrated significantly stronger intervention induced parent-child protective processes (e.g., enhanced discussion quality, clearly articulated norms, and parental expectations about risk engagement) and lower youth intentions to engage in risky behaviors 6 months postintervention. Although some important nuances were noted, this study suggests that the PAAS technology-delivered modality is just as efficacious as the in-person facilitator-led, small group modality in dissuading HIV-related risk behaviors among rural African-American youths. Conclusions: Implications for having a menu of service delivery models that address the diverse needs and contexts of families are discussed, including the promise of technology as an alternative modality for reaching populations often characterized as difficult to reach and to engage in family-based preventive interventions. (C) 2019 Society for Adolescent Health and Medicine. All rights reserved.