For those of you less familiar with my research project please allow me to bring you up to date.

In May of 1996 I designed and implemented an HIV and AIDS educational program for Grenadian Secondary School Children. The program was a joint effort between St. George’s University, the   Secondary Schools throughout Grenada, and the Ministries of Health and Education.

NEXT SLIDE -- PURPOSE OF THE PROJECT

The goal of this project has been to design an AIDS education & prevention program, and to evaluate the effectiveness of this program on the AIDS awareness of Grenadian Secondary School Children.

NEXT SLIDE -- AGE DISTRIBUTION IN GRENADA

The focus of this study was on the group most at risk from HIV.

NEXT SLIDE -- WHY FORM I-V STUDENTS?

By focusing on 12 to 15 year old students in Form one through Form five (Grades 7-12), the study was able to reach:

NEXT SLIDE -- ORIGINAL POPULATION

The 12 to 15 year olds students were selected from 16 Secondary Schools throughout Grenada. These are students in Form I through V.

NEXT SLIDE -- STUDY POPULATION

Of the 1,268 student that were selected to participate, 99% attended the pre-test seminar. Two weeks following the pretest, 85% (or 1,078 students) also participated in the post-test seminar. This includes all of the selected students who were present for both the pretest and posttest evaluations.

Of the 1,078 students retained in the research sample, 570 represented the control group, and 508 represented the experimental group. The control group was not exposed to the instructional segments, while the experimental group was exposed.

The research design for this study provided for a comparison of the control group to the experimental group.

Unfortunately, the posttest data from two of the selected schools, Wesley College and MacDonald College were mishandled by the Grenadian Postal Service, and were never recovered. Consequently, 175 students from these two schools were not included in the final analysis. Thus, the final size of the research sample for this study was 903 student subjects.

NEXT SLIDE -- POPULATION

The 903 students represent 71% of the original study population. These are impressive results when compared to the 1992 Canada Youth Study which had a 40% attrition rate.

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Of these students 508 were placed into the experimental group and 395 were placed into the control group.

NEXT SLIDE -- AGE & GENDER DISTRIBUTION

Age and gender distributions between the control and experimental groups were satisfactory. The average age of participants was 14 years old.

NEXT SLIDE -- POPULATION

Schools participating in the experimental group included:

NEXT SLIDE -- POPULATION

The schools participating in the control group included:

NEXT SLIDE -- MAP OF GRENADA

In total SIX parishes throughout the main island have been included in this study.

The Red numbers represent the experimental group, while the yellow numbers represent the control group. They include:

NEXT SLIDE -- HOW WILL STUDENTS BE SELECTED

In order to Participate in the experimental group both the student, their parent, and the school’s principal gave consent. Each of the students were given a form which they signed and had signed by their parents and the principal.

Since the control group participants were made up of students attending normally scheduled classes, no consent was required. The Ministry of Education approved their participation.

NEXT SLIDE -- GOALS

The goal of this project has 4 phases:

NEXT SLIDE -- METHODS OF EVALUATION OF CURRENT PROGRAM

In Phase 1 existing AIDS educational programs were evaluated by interviewing members in the Ministry of Education and the Ministry of Health.

The net result was that:

NEXT SLIDE -- METHODS OF DESIGNING EDUCATIONAL MATERIAL

In Phase 2 new educational material was designed to reinforce existing material by including current information about the nature of HIV & AIDS, Safer Sex, Abstinence and How to properly use a condom.

These topics were placed into a three-fold pamphlet. The pamphlets have been designed with guidelines from the CDC, CARICOM and WHO.

NEXT SLIDE -- METHODS FOR TEACHING OF NEW PROGRAM

In Phase 3 the educational material was implemented.

Each student in the experimental group received one 30 minute seminar. Seminars were held in this lecture hall with approximately 100 students attending each lecture. The lectures were interactive with both the students and lecturer participating in the learning process.

Topics covered included:

In many instances topics were taught using common experiences.

In one instance eating a coconut was used to illustrate an experience we learn by watching other people. Similarly, the knowledge about the dangers of HIV & AIDS is learned. It is not something that we are born with, but something that we must learn (a 5 minute video was presented at this point).

NEXT SLIDE -- METHODS FOR TEACHING OF NEW PROGRAM (continued...)

During the seminar students were shown two video clips. One is a three minute clip from the Magic Johnson and Arseneo Hall video on Safe Sex, and the other is a seven minute clip on Teenagers with AIDS and real life experiences.

Following each seminar there was a 15 minute question & answer period with open dialogue.

NEXT SLIDE -- PAMPHLET, PIN & POSTER

At the conclusion of the seminar, all participants received pamphlets in combination with posters and pins.

A sample of the shirt pins is seen here, in the middle. Each is cast in solid steel. The red ribbon is an international indication of public unity, while the writing under each pin "Grenada is AIDS aware" was used to foster a more local willingness to unify and prevent the spread of HIV.

In addition, each participant received a full-sized copy of the poster seen on your right. The photograph on the poster includes faces from many races. They represent a ‘normal’ group of individuals, yet any one of them may be infected, hence -- "They all have the signs of HIV infection." This poster was also used during the seminars to ask the question: "How do you know which person is infected?" In response they were taught that you cannot tell if a person is HIV infected by just looking at them. You must do a blood test to know if you are infected with HIV.

Members of the control group also received both the posters and the pamphlets.

NEXT SLIDE -- METHODS FOR INVESTIGATING NEW PROGRAM

In order to evaluate the benefit of these efforts Phase 4 was used as an investigational tool.

Initially, all students in both the experimental and control groups received a Pre-test to evaluate their existing knowledge about HIV and AIDS.  The test included 22 questions with 4 domains. Each domain included a set of relevant questions.

NEXT SLIDE  -- METHODS FOR INVESTIGATING NEW PROGRAM (Continued...)

Student were given 15 minutes to complete the questionnaire.  The answer choices were fill-in type with three alternatives; Yes, No, and Don’t Know.  All students were given identical instructions and were not given any assistance in completing the questions.

Following the end of each exam period all questionnaires were collected and immediately placed in a sealed envelopes. Results were not evaluated until after all pre-test and post-test were collected.  This was to avoid any prejudice in conducting the seminars.

With the exception of two negatively phrased questions, students were well capable of handling these task. There were no difficulties or complications.

The score distribution will be discussed under the results section.

NEXT SLIDE  -- METHODS FOR INVESTIGATING NEW PROGRAM (Continued...)

Following the Pre-test all student in the experimental group were exposed to the educational seminar described above.  Two weeks following the seminar, all students received a post-test to evaluate changes in their knowledge about HIV & AIDS. The post-test questions were identical to the pre-test questions. Post-tests were completed in the students’ respective schools.

Changes between the pre-tests and post-tests answers were later compared in order to evaluate the effectiveness of this program.

NEXT SLIDE  -- METHODS FOR INVESTIGATING NEW PROGRAM (Continued...)

The data between the experimental and control groups were compared in relation to four sets of Independent Variable including:

NEXT SLIDE  -- METHODS FOR INVESTIGATING NEW PROGRAM (Continued...)

The Dependent Variable was defined as pretest-to-posttest score gains in each of the 4 domains.  For example, the four research hypothesis for domain 1 are stated in the following manner:

  1. Pretest-to-posttest score gains related to the nature of HIV & AIDS were greater for subjects who experienced the Education Program than for those who did not.
  2. Variations in pretest-to-posttest score gains related to the nature of HIV & AIDS were not affected by participant gender.
  3. Variations in pretest-to-posttest score gains related to the nature of HIV & AIDS were not affected by participant age, and
  4. Variations in pretest-to-posttest score gains related to the nature of HIV & AIDS were not affected by participant school affiliation.

Statistical analysis was used to answer 16 hypotheses in total. This included 4 domains with 4 hypotheses for each domain.

NEXT SLIDE -- CRITERIA

Hypothesis 1 which compares pretest-to-posttest score gains between the experimental and control groups was tested in a positive form.  There were two criteria for accepting this hypothesis:

First, the pretest-to-posttest score gains for the experimental group had to be greater than that for the control group, and

Second, the variations in pretest-to-posttest score gains between the two groups had to be statistically significant. The criteria for the rejection of the null was set at less than five-percent.

In other words, the chances that a set of findings are a mathematical accident, as opposed to a valid outcome, is less than one chance in 20.

This 5% value is widely applied in the fields of public health and the social sciences. Both of these fields are strongly related to the current study.

NEXT SLIDE -- CRITERIA (Continued...)

Since hypotheses 2, 3, & 4 were tested in the null form they had slightly different criteria for acceptance:

Specifically, the first criteria states that the pretest-to-posttest score gains between the control and experimental group should not be associated with participant's gender, age or school affiliation.  Similar to hypothesis one, The criteria for the rejection of the null was set at less than 5%.

NEXT SLIDE -- RESULTS

For Domain 1, The Nature of HIV & AIDS, the pretest-to-posttest score gains were greater for the experimental group than the control group. A mean score gain of 34.1 compared to 2.1, with a statistical significant of 1.2%.  The score gains were not affected by gender, age, or school affiliation.

For Domain 2, The Potential to Become Infected With HIV Through Sexual Contact, the pretest-to-posttest score gains were greater for the experimental group than the control group. A mean score gain of 98.3 compared to 31.0, with a statistical significant of 0.8%.  The score gains were not affected by age or school affiliation, however, they were affected by gender.

In one of the five questionnaire items associated with this domain, female participants made greater score gains than male participants. Consequently, the criteria for the acceptance of this hypothesis were partly met.

For Domain 3, in reference to – The Potential to Become Infected with HIV through Contact with Bodily Fluids Other Than Semen or Vaginal Fluid, the pretest-to-posttest score gains were greater for the experimental group than the control group. A mean score gain of 40.6 compared to 5, with a statistical significant of 0.9%.  The score gains were not affected by age or school affiliation, however they were affected by gender, however they were affected by gender.

In two of the four questionnaire items associated with this domain, female participants again made greater score gains than male participants. Consequently, the criteria for the acceptance of this hypothesis were NOT met.  This was specifically in reference to questions about getting HIV from saliva or tears. More females correctly identified these as false sources of infection.

For Domain 4, in reference to – Common myths about HIV & AIDS, the pretest-to-posttest score gains were greater for the experimental group than the control group. A mean score gain of 41.8 compared to 8.8 , with a statistical significant of 2.2%.  The score gains were not affected by gender, age, or school affiliation.

NEXT SLIDE -- SECONDARY FINDINGS

The overall score gain was significantly in favor of the experimental group. This is even more evident in the secondary findings.  When evaluating individual questions, the experimental group performed best overall, with the following breakdowns:

In the pre-test they scored 80% in 8 of 22 compared to 10 of 22 in the control group. In other words, in completing the pre-test questionnaires both groups performed similarly. However, in the post-test questionnaires the experimental group improved significantly over the control group.

In the post-test the experimental group scored 90% in 17 of 22 compared to 9 of 22 in the control group. Hence, there was a significant improvement in the experimental group and no significant change in the control group.

Furthermore, in the post-test the control group continued to score 80% or less in 8 of the 10 questions that were originally answered incorrectly.  While the experimental group scored 80% or less in only 2 of the 10 post-test questions that were originally answered incorrectly.

NEXT SLIDE -- SECONDARY FINDINGS (Continued...)

The problem areas in both groups remained with the negatively worded questions. Two questions clearly posed a problem for many of the participants.

Question 21 states: You will NOT get HIV from sex when you use a latex condom.

Here there was a 42.5% correct response rate on the pre-test, and a 54.5% correct response rate on the post-test.

Question 22 states: You will NOT get HIV from kissing an infected person.

Here there was a 32.5% correct response rate on the pre-test, and a 57.5% correct response rate on the post-test.

Since these were negatively worded, it is possible that the grammar posed a difficulty to the students.

NEXT SLIDE -- SECONDARY FINDINGS (Continued...)

With respect to each questionnaire item, the score gain between the control group and the experimental group were statistically significant in all but two cases.  In the 20 cases where the score gain differences were statistically significant, the greatest score gains were always associated with the experimental group.

In the two cases where the score gain changes were not statistically significant, the greater gains were still associated with the experimental group, just not enough of a difference.  In reference to the following two questions, most students answered them correctly. These are:

NEXT SLIDE -- THE FUTURE

It is reassuring to know that these results correlate the effectiveness of the new teaching program with changes in the experimental group’s knowledge base about HIV & AIDS.  The benefits include a more Aware population of future adults who are better equipped to deal with an uncertain future.

Modern times have brought us closer together. People travel all over the globe and bring with them increased risks and dangers of HIV infection.  It is important to Acknowledge the problem that:

This problem can spread like wild-fire, therefore it is important to, protect the future of the Grenadian people by, educating the children about the risks of infection and giving them clear and long-term solutions, such as clinics and sex awareness programs.

NEXT SLIDE -- QUOTE

In closing I would like to thank my research advisors Dr. Patrick Rooney, Dr. Allen Pensick, Dr. Randall House, Dr. Roger Bohman, and Mrs. Karen Timberlake. Also my warmest appreciation to the principals, teachers and students without whom this study would not have been possible.

Thank You very much. The End.