Project IMAGE

Developers

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.

Program Summary

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.

Intended Population

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 evaluated with female adolescents with a history of STIs and physical or sexual abuse.

Program Setting

The program was designed for and evaluated in a health clinic setting.

Contact and Availability Information

Nancy Gonzalez-Caro, MPH
Evidence-Based Product Specialist
ETR
100 Enterprise Way, Suite G300
Scotts Valley, CA 95066
Ph: 800-321-4407 x237
Website: https://www.etr.org/store/curricula/project-image/

Cody Sigel, MPH, CHES
Health Education Training Coordinator
ETR
1333 Broadway, Suite P110
Oakland, CA 94612
Phone: 510-858-0995
Website: https://www.etr.org/store/curricula/project-image/
Sample of Curriculum Available for Review Prior to Purchase
Yes
Languages Available
English
Monitoring and Evaluation Tools
Monitoring and evaluation tools available
Yes
Monitoring and evaluation tool usage required
No
Information about available monitoring and evaluation tools (if applicable)

Unknown

Program Components and Core Components

Last updated in 2024

The data presented on this page reflect responses from the program’s developer or distributor to a program component checklist that asked them to report on the individual components within their TPP program. The same program component checklist was sent to the developer or distributor of every active TPP program with evidence of effectiveness. The program component table provides information on seven types of program components including content, delivery mechanism, dosage, staffing, format, context, and intended population characteristics; whether the component was present or optional in the program; whether the component is considered to be core to the program; and the lesson number or activity where the component can be found in the program.

In the drop-down menu below, under “Has component,” there are four options that indicate a component as present in the program: (1) “Yes” indicates that the component is present in at least one version of the program (whether that be the program version that was evaluated, the current version, or both versions); (2) “Yes (both versions)” indicates that the component is present in both the evaluated version of the program and the current version of the program; (3) “Yes (current version)” indicates that the component is present in the current, but not the evaluated, version of the program; and (4) “Yes (evaluated version)” indicates that the component is present in the evaluated version of the program, only. Note that for dosage components, the dosage itself is described in the Notes when available.

Some of the components identified are noted as core components of the evidence-based program, but this does not necessarily mean that these components have been rigorously tested and show evidence of effectiveness. Most often developers denoted components as core based on theory or experience in the field. Click here for the list of evidence-based components.

For more details about program components, refer to the FAQ page.

Category Component Core Component Component present Lesson number(s) / activities where present
Delivery mechanism Other
Dosage Frequency Yes
Dosage Intensity Yes
Dosage Duration Yes
Dosage Other
Staffing Deliverer: Community health worker Yes (both versions)
Staffing Deliverer: Faith-based individual No
Staffing Deliverer: Health educator Optional
Staffing Deliverer: Mental health provider Optional
Staffing Deliverer: Mentors Optional
Staffing Deliverer: Parents/family No
Staffing Deliverer: Peers No
Staffing Deliverer: Primary care provider Yes (both versions)
Staffing Deliverer: Social worker and/or counselor No
Staffing Deliverer: Teachers No
Staffing Deliverer: Other
Staffing Experience: Credentials Optional
Staffing Experience: Education Yes (both versions)
Staffing Experience: Other
Staffing Number of staff providing services
Staffing Training: Additional training required
Staffing Training: Developer-led training required
Staffing Training: Other
Staffing Other
Format Group size: Full-group activity Yes (both versions) Workshop sessions, support group sessions. Group size recommended as 4-8.
Format Group size: Independent/individual activity Yes (both versions) Individual counseling sessions
Format Group size: Small-group activity No
Format Group size: Other No
Format Mode: In-person Yes (both versions)
Format Mode: Phone (audio) No
Format Mode: Phone (text) No
Format Mode: Phone (app) No
Format Mode: Online/computer (asynchronous) No
Format Mode: Online/computer (synchronous) No
Format Mode: Other
Format Other
Context Setting: Mental health clinic
Context Setting: Residential facility
Context Setting: School-based health clinic
Context Setting: Other
Context Other
Context Context: Environmental supports
Context Context: Environmental constraints
Context Context: Other
Context Setting: After school
Context Setting: Community based Yes (both versions)
Context Setting: Correctional facility
Context Setting: Faith based
Context Setting: Health care clinic Yes (both versions)
Context Setting: Home-based case management
Program Objectives

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.

Program Content

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: 

  1. 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.
  2. 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.

Program Methods
The program is delivered through small group discussions, support groups, and individual counseling.
Program Structure and Timeline
The intervention is organized as follows:
  • Two small group workshop sessions
  • Three to five support group sessions
  • Two or more individual counseling sessions.
The small group workshop sessions last 3-4 hours, and are delivered ideally one week apart, to groups of 4-8 participants.
 
Support group sessions last one hour, and are delivered weekly starting one week after the completion of the workshop sessions to groups of 4-8 participants.
 
Individual counseling sessions vary depending on the participant's needs.
Staffing
One female leader (community health worker or women’s sexual health professional) is recommended to lead each Project IMAGE workshop. Support groups and counseling sessions should be led by women’s sexual health professionals. Facilitators should ideally have a background in social work, primary health care, or psychology.
Staff Training

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:

  1. Two-day Training of Educators (TOE)—the learning process includes pre-work, skill-based instruction and post-training follow-up support.
  2. 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.
Program Materials and Resources
• Facilitator’s Manual
• Slide Presentation PowerPoints
• Participant Handouts
• Curriculum DVDs
• Pamphlets on various STDs
Additional Needs for Implementation
Core intervention materials include a Leader's Guide, slide presentations and DVDs.
Fidelity
Fidelity benchmarks and other materials related to fidelity and adaptation are in development and will be found here: https://www.etr.org/store/curricula/project-image/.
Technical Assistance and Ongoing Support
ETR provides in-person and web- or phone-based technical assistance before, during and/or after program implementation. TA is tailored to the needs of the site and is designed to support quality assurance, trouble-shoot adaptation issues, and boost implementation. ETR also provides evaluation support for EBI implementation. Services address process and outcome evaluation and include assistance with evaluation planning, instrument design and development, implementation fidelity, data management and analysis, performance measurement, continuous quality improvement (CQI) protocols, and effective tools and strategies for reporting results.
Allowable Adaptations
Examples of allowable adaptations include updating statistics or facts and tailoring the content for visual learners or particular racial/ethnic groups.
Adaptation Guidelines or Kit
Yes
Reviewed Studies
Citation High-Quality Randomized Trial Moderate-Quality Randomized Trial Moderate-Quality Quasi-Experiment Low Study Rating Did Not Meet Eligibility Criteria

Champion and Collins 2012
Study Characteristics
Citation Setting Majority Age Group Majority Racial/Ethnic Group Gender Sample Size

Champion and Collins 2012

 		Health clinic or medical facility 14 to 17 Hispanic or Latino Young female

409
Study Findings

Evidence by Outcome Domain and Study

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

Champion and Collins 2012

 		n.a. n.a. n.a. Favorable evidence n.a.
KEY
Evidence Indication
Favorable findings
Two or more favorable impacts and no unfavorable impacts, regardless of null findings
Potentially favorable findings
At least one favorable impact and no unfavorable impacts, regardless of null findings
Indeterminate findings
Uniformly null findings
Conflicting findings
At least one favorable and at least one unfavorable impact, regardless of null findings
Potentially unfavorable findings
At least one unfavorable impact and no favorable impacts, regardless of null findings
Unfavorable findings
Two or more unfavorable impacts and no favorable impacts, regardless of null findings
Note: n.a. indicates the study did not examine any outcome measures within that particular outcome domain, or the study examined outcome measures within that domain but the findings did not meet the review evidence standards.
Detailed Findings
Citation Details

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.

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.

Language directly from the program model developer or authors.