Jane Dimmitt Champion, Ph.D., D.N.P., R.N., F.N.P., A.H.-P.M.H.-C.N.S., F.A.A.N.
Project IMAGE is a cognitive behavioral intervention intended to reduce subsequent STIs among ethnic minority adolescent women with a history of sexual or physical abuse and STIs. It is delivered through small group workshops and individual counseling sessions and draws on health-promoting elements of African- and Mexican-American culture.
The program was designed for African- and Mexican-American adolescents aged 14-18 who have a history of STIs and physical or sexual abuse.
The program was designed for and evaluated in a health clinic setting.
Nancy Gonzalez-Caro, MPH
Evidence-Based Product Specialist
100 Enterprise Way, Suite G300
Scotts Valley, CA 95066
Ph: 800-321-4407 x237
Health Education Training Coordinator
1333 Broadway, Suite P110
Oakland, CA 94612
|Category||Component||Core Component||Component present||Notes||Lesson number(s) / activities where present|
|Content||Cognitive behavioral therapy (CBT)||No|
|Content||Brain development and emotions||No|
|Content||Social influence/actual vs. perceived social norms||No|
|Content||Boundary setting/refusal skills||No|
|Content||Substance use cessation||No|
|Content||Substance use - Other drugs||No|
|Content||Substance use - Alcohol||No|
|Content||Substance use - Abstinence||No|
|Content||Brain development and substance use||No|
|Content||Supplemental academic services||No|
|Content||Graduating from high school||No|
|Content||Self-esteem||Yes (both versions)||Workshop 1, Activity 11|
|Content||Motivational interviewing||Yes (both versions)||Group and individual counseling sessions|
|Content||Healthy romantic relationships||Yes (both versions)||Workshop 2, Activity 2|
|Content||Healthy relationships||Yes (both versions)||Workshop 2, Activity 6, 7|
|Content||Decision making||Yes (both versions)||Workshop 2, Activity 8, 9|
|Content||Consent||Yes (both versions)||Workshop 2, Activity 7, 8|
|Content||Social media, texting and online interactions||No|
|Content||Contraception - Pills, patches, rings, and shots||Yes (both versions)||Workshop 2, Activity 2|
|Content||Contraception - Other||Yes (both versions)||Workshop 2, Activity 2|
|Content||Contraception - Long-acting reversible contraceptives||Yes (both versions)||Workshop 2, Activity 2|
|Content||Contraception - Condoms||Yes (both versions)||Workshop 2, Activity 2, 4, 5|
|Content||Values and sexuality||No|
|Content||Conflict resolution/social problem solving||No|
Project IMAGE seeks to reduce HIV/STI high-risk behaviors and STIs among ethnic minority adolescent women by helping them recognize the risk of STI transmission, learn strategies to reduce sexual risk behavior, and improve communication and decision-making skills. The intervention stresses contraceptive use and choice of sexual partner.
Project IMAGE is an adaptation of Project SAFE, an intervention for ethnic minority women based on the AIDS Risk Reduction Model. It consists of three main components: workshops, support groups, and individual counseling sessions.
Component 1 - Workshop Sessions: Two small group sessions are conducted using the principles of motivational interviewing and focus on the following topics:
- Awareness and Perception of Risk. The first session helps participants recognize the risks of STIs. They receive information on disease transmission and protection methods and strategies.
- Commitment to Change: Strategies to Reduce Risk Behavior. In the second session, participants receive information on sex, drugs, STIs, HIV, contraception, and how to prevent infection and unintended pregnancy. They also learn how to make decisions about sex and improve communication skills.
Component 2 - Support Group Sessions: Support groups are led by a trained facilitator who uses principles of motivational interviewing to discuss topics such as interpersonal relationships, contraceptive use, and health risk behaviors. The topics and discussion are tailored to the particular needs of each group.
Component 3 - Individual Counseling Sessions: The individual sessions are initiated by the participant and conducted by a trained facilitator. Each session focuses on the expressed needs of the participant and may include referral to other services.
- Two small group workshop sessions
- Three to five support group sessions
- Two or more individual counseling sessions.
• Slide Presentation PowerPoints
• Participant Handouts
• Curriculum DVDs
• Pamphlets on various STDs
It is recommended that clinic staff selected to implement Project IMAGE receive research-based professional development to prepare them to effectively implement the curriculum with its intended target group. Training on Project IMAGE is available through ETR’s Professional Learning Services. Training options include:
- Two-day Training of Educators (TOE)—the learning process includes pre-work, skill-based instruction and post-training follow-up support.
- Four-day Training of Trainers (TOT)—available for seasoned trainers who have experience in delivering the intervention. Completion entitles participants to use ETR’s research-based training designs to conduct TOEs for their organization or designated affiliate group. TOT attendees who have completed the four-day TOT are eligible to attend a condensed TOT course on additional EBIs.
Champion and Collins 2012
|Project IMAGE was evaluated with a randomized controlled trial involving African- and Mexican-American adolescent women recruited from a community-based health clinic. All study participants had a history of physical or sexual abuse and sexually transmitted infection. About half the women were randomly selected for a treatment group that received the Project IMAGE program and half were selected for a control group that received abuse and enhanced clinical counseling. The study conducted STI testing before the program started (baseline) and again 6 and 12 months later.
The study found that at both the 6- and 12-month follow-ups, adolescents who were assigned to the treatment group were statistically significantly less likely to experience any new STI than adolescents who were assigned to the control group.