Scaling Effective Behavioral Interventions with MPC Avatar-Based Virtual Training

ABSTRACT
Teen pregnancy and sexually transmitted infections (STIs) remain a problem in the U.S. Although 15-24 year
olds are only 25% of the U.S. sexually active population, they account for over 50% of the 20 million new cases
of STIs each year. While historically low, the U.S. teen pregnancy rate remains one of the highest in the
developed world and racial/ethnic and geographic disparities in teen birth rates persist. The long-term goal of
this project is to support school and community-based educators working to reduce the ongoing problem of teen
pregnancy and STIs in the U.S. Making Proud Choices! (MPC) is one of the most used, evidence-based
HIV/STI/teen pregnancy risk-reduction programs. However, MPC must be implemented with fidelity to achieve
outcomes, and educators must be trained to ensure MPC is implemented well. Unfortunately, lack of affordable,
accessible training options make it difficult for educators to implement the program with fidelity. This project
proposes a cost-effective, easily implemented solution through avatar-based virtual training. These trainings
simulate real-life, two-way exchanges, allowing trainees to practice and get immediate feedback on core
concepts from a student audience programmed to display a range of reactions. This asynchronous training can
be used anytime and anywhere, unlike live remote training. In sum, avatar-based training can help schools and
community organizations overcome limitations of in-person training, provide sustainable, widespread access to
training in efficacious prevention programs, and dramatically improve sexual health outcomes for youth at a
reasonable cost.
In Phase I, we developed a novel, online avatar-based training prototype for select components of MPC. In a
pilot test with 53 participants comparing avatar-based and in-person training, results showed that a) the avatar-
based training was no different, and in many cases better, than the in-person training on improving facilitator
quality and instruction adherence; and b) participants positively rated the trainings’ high levels of acceptability,
usability and applicability to teaching youth about sexual health and safety. For this Phase II project, we will fully
develop and test the 10-module version of the online, avatar-based MPC training. The project has three specific
aims: 1): Develop a full-scale avatar-based MPC virtual training for educators of this STI/pregnancy risk reduction
program; 2): Evaluate the training’s impact on 165 educators of 9th-12 grade students, assessing their
STI/pregnancy prevention knowledge, teaching skills and curriculum fidelity compared to live training and no
training/curriculum only conditions; and 3): Evaluate the impact of exposure to educators from the two treatment
groups on students’ knowledge, attitudes and beliefs regarding safer sex practices.

Grant Number: 5R44HD094406-03
NIH Institute/Center: NIH
Principal Investigator: Mia Barrett