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Seventeen Days (formerly What Could You Do?)

Developers

Julie Downs, Ph.D., Pamela Murray, M.D., M.P.H., Wandi Bruine de Bruin, Ph.D., and Baruch Fischoff, Ph.D.

Program Summary

Seventeen Days (formerly called What Could You Do?) is a theory-based interactive DVD designed to educate young women about contraception and STDs. The DVD presents the viewer with different scenarios involving decision that young women face in relationships. Participants can practice what they would do in similar situations through the frequent use of "cognitive rehearsal."

Intended Population

The intervention was designed for sexually active girls ages 14 to 19. The original DVD was evaluated with predominately African American teens who were patients at an urban health care clinic. A more recent study evaluated the program with White teens who were patients at health clinics in Ohio, Pennsylvania, and West Virginia.

Program Setting

The program can be implemented in any setting where participants can use the DVD privately, such as in a health care clinic setting, a classroom, a computer laboratory, or at a library where individuals could check the DVD out to use on site or at home. It was evaluated in a health clinic setting.

Contact and Availability Information

Carnegie Mellon University
Attn: Seventeen Days
SDS, Porter Hall 208
5000 Forbes Avenue
Pittsburgh, PA 15213-3890
Ph: 412-268-3249
Email: info@seventeendays.org
Website: https://www.seventeendays.org

Sample of Curriculum Available for Review Prior to Purchase

Yes

Languages Available

English

Monitoring and Evaluation Tools

Monitoring and evaluation tools available

Monitoring and evaluation tool usage required

Information about available monitoring and evaluation tools (if applicable)

The Seventeen Days mobile app and a web browser version track time stamps of each element that viewers of the intervention choose, thus tracking their viewing progress. A fidelity monitoring tool is available on the program website: https://seventeendays.org/wp-content/uploads/2020/06/fidelity.pdf.

The monitoring is automatic when viewers use the app or web versions. Organizations using the program can choose to view those reports depending on their need.

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 only possible response option was “Yes”, and the dosage is described in the Notes when available. For more details, refer to the FAQ. 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.

Category	Component	Core Component	Component present	Notes	Lesson number(s) / activities where present
Content	Boundary setting/refusal skills	Yes	Yes (both versions)		Jessica and her friends
Content	Child development		No
Content	Communication skills		No
Content	Conflict resolution/social problem solving		No
Content	Connections with trusted adults		No
Content	Cultural values		No
Content	Gender identity		No
Content	Gender roles		No
Content	Leadership		No
Content	Normative beliefs		No
Content	Parenting skills		No
Content	Social competence		No
Content	Social influence/actual vs. perceived social norms		No
Content	Social support/capital		No
Content	Identity development		No
Content	Morals/values		No
Content	Spirituality		No
Content	Volunteering/civic engagement		No
Content	Other		No
Delivery mechanism	Method: Anonymous question box		No
Delivery mechanism	Method: Artistic expression		No
Delivery mechanism	Method: Assessment/survey		No
Delivery mechanism	Method: Booster session	Yes	Yes (both versions)		Jessica and her friends; Going to the gynecologist; I got birth control and so can you; Watch out for STIs;Hailey's condom do's and don'ts
Delivery mechanism	Method: Case management		No
Delivery mechanism	Method: Cognitive behavioral therapy (CBT)		No
Delivery mechanism	Method: Demonstration	Yes	Yes (both versions)		Hailey's condom do's and don'ts
Delivery mechanism	Method: Discussion/debrief		No
Delivery mechanism	Method: Family session		No
Delivery mechanism	Method: Game	Yes	Yes (both versions)		Watch out for STIs
Delivery mechanism	Method: Home visiting		No
Delivery mechanism	Method: Homework assignment	Yes	Yes (both versions)		Jessica and her friends; I got birth control and so can you; Watch out for STIs
Delivery mechanism	Method: In-session assignment		No
Delivery mechanism	Method: Introduction	Yes	Yes (both versions)		Introduction Video
Delivery mechanism	Method: Lecture		No
Delivery mechanism	Method: Motivational interviewing		No
Delivery mechanism	Method: Music		No
Delivery mechanism	Method: Parent-focused activity		No
Delivery mechanism	Method: Peer-to-peer		No
Delivery mechanism	Method: Public service announcement		No
Delivery mechanism	Method: Reading	Yes	Yes (both versions)		Jessica and her friends; I got birth control and so can you; Watch out for STIs;Hailey's condom do's and don'ts
Delivery mechanism	Method: Role play/Practice	Yes	Yes (both versions)		Jessica and her friends
Delivery mechanism	Method: Self-guided activity	Yes	Yes (both versions)		Jessica and her friends; I got birth control and so can you; Watch out for STIs
Delivery mechanism	Method: Service learning		No
Delivery mechanism	Method: Slide show		No
Delivery mechanism	Method: Social media		No
Delivery mechanism	Method: Spiral learning	Yes	Yes (both versions)		Jessica and her friends; I got birth control and so can you; Watch out for STIs
Delivery mechanism	Method: Storytelling		No
Delivery mechanism	Method: Text message		No
Delivery mechanism	Method: Video	Yes	Yes (both versions)		Entire program is video based
Delivery mechanism	Method: Other	Yes	Yes (both versions)	Web browser and App	Entire program is video based

Program Objectives

The goal of Seventeen Days is to prevent HIV and STIs by improving young women's ability to make less risky sexual health choices. The video features six vignettes that follow different story lines with a unique set of issues and possible outcomes, identifies choice points in the story, suggests risk-reduction strategies, and allows viewers to practice what they would do.

Program Content

The intervention is based on a "mental models" (a person's thought process about how something works) approach of understanding perceptions of risk. The video addresses potential gaps in adolescent girls' mental models of STI risk. The video consists of six vignettes, a condom demonstration, and mini-documentaries, which together cover the following topics:

Sexual situations, in which a female character negotiated for safer outcomes
Risk reduction, in which the concept of relative risk was explained and applied to sexual behavior
Reproductive health, including anatomy, and physiology
Gynecological exam, including asking for birth control
Sexually transmitted infections, explaining viruses, bacteria and eight common STIs.
Hormonal birth control, including a behavioral focus on how to choose and adhere to a method

Program Methods

The program is currently delivered through the interactive DVD. A mobile app is also expected to be available beginning in April 2015. Usage of the app will be linked to a website with an educator portal for tracking milestones.

Program Structure and Timeline

The first viewing of the DVD is designed to be around 55 minutes, but viewing time varies depending on the participant's choices at key decision points during the video. The mini documentaries range from two to ten minutes long. Overall duration is about 3.5 hours of content.

The minimum required dosage for completing the program is for participants to view one completed vignette and the condom demonstration. The developers recommend monthly booster sessions in which participants watch one additional vignette and one mini documentary. The booster sessions are 20 to 40 minutes total.

Staffing

A staff person is required to get the participant started with DVD viewing and to provide technical assistance with the DVD player as needed.

Staff Training

Training sessions are currently being developed for organizations wishing to implement the program. For more information, providers should contact the CMU team directly at info@seventeendays.org.

Program Materials and Resources

The original “What Could You Do?” video is no longer available. The new version of the video, Seventeen Days, has updated content including updated medical terminology, information about emerging tools for treatment and management of STIs, and six vignettes instead of four.

The developer offers the following materials:

Seventeen Days DVD (for purchase)
Seventeen Days mobile app (Available April 2015)
Seventeen Days User's Guide (Beta version, free to download)
Seventeen Days Quick User's Guide (Beta version, free to download)
Seventeen Days DVD Cover (Beta version, free to download)
Educator portal companion to forthcoming mobile app (with license)

Additional Needs for Implementation

Materials required for program delivery are the Seventeen Days DVD, a computer or portable device for viewing the DVD, and headphones. A space is required that will allow the participant to view the video privately and with minimal distractions.

Fidelity

Participants must be given flexibility to select which video segments to watch and to make progress at their own pace.

Participants must view one completed vignette and the condom demonstration, ideally followed by monthly booster sessions in which they watch one additional vignette and mini-documentary.

The program identifies to the viewer when they have completed their “first visit” (approximately 35 minutes in length), which corresponds to the minimum dosage. For the DVD implementation, providers would need to ask their clients when they got to this point. In the upcoming mobile app, however, providers would have access to data on whether each registered user had reached this milestone.

The DVD format currently does not permit any monitoring. However, a mobile app is under development (currently in beta format, expected in full release in late April 2015), which will include extensive tracking tools that will allow providers to monitor progress and milestones for registered users.

Technical Assistance and Ongoing Support

Technical support resources are currently under development. For more information, please contact the CMU team at info@seventeendays.org.

Allowable Adaptations

Although the intervention was evaluated in a health care clinic setting, the developers note that it could be used in a classroom or computer laboratory where participants can use the intervention privately, or, at a library where individuals could check the DVD out to use on site or at home.

The developer notes that it is not recommended that the program be used with its current formulation in a group delivery setting, due to the theoretical benefits of individual exposure to modeling and cognitive rehearsal, as well as the privacy and agency afforded by making individual choices within the many interactive features.

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
Downs et al. 2004	✓
Eichner et al. 2015 Downs et al. 2016	✓

Study Characteristics

Citation	Setting	Majority Age Group	Majority Racial/Ethnic Group	Gender	Sample Size
Downs et al. 2004	Health clinic or medical facility	14 to 17	African American or Black	Young women	300
Eichner et al. 2015 Downs et al. 2016	Health clinic or medical facility	14 to 17	White	Young women	1317

Study Findings

Evidence by Outcome Domain and Study

Citation	Sexual Activity	Number of Sexual Partners	Contraceptive Use	STIs or HIV	Pregnancy
Downs et al. 2004		n.a.			n.a.
Eichner et al. 2015 Downs et al. 2016		n.a.		n.a.	n.a.

KEY

Evidence Indication

Favorable findings

Potentially favorable findings

Indeterminate findings

Conflicting findings

Potentially unfavorable findings

Unfavorable 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

Citation	Details
Downs et al. 2004	The program was evaluated in a randomized controlled trial conducted in four clinic-based healthcare sites in Pittsburgh, PA. Adolescents participating in the study were randomly assigned to one of three groups: (1) a treatment group that watched the intervention video, (2) a control group that received the same information from the video but as a book, and (3) a control group that received commercially-available brochures on STD risk. Study data were collected with surveys administered immediately before the intervention and at follow-ups conducted 3 and 6 months after the intervention ended. Biological testing for chlamydia was conducted at the 6-month follow-up. Three months after the program ended, participants who watched the intervention video were more likely to report having been abstinent in the past three months. In addition, six months after the program ended, participants who watched the intervention video were less likely to report having been diagnosed with an STD. The study found no statistically significant program impacts on rates of abstinence in the past three months, self-reported condom use in the past three months, or the biological tests for chlamydia at the 6-month follow-up. The study also examined program impacts on measures of STD knowledge and self-reported condom failures. Findings for those outcomes were not considered for the review because they fell outside the scope of the review.
Eichner et al. 2015 Downs et al. 2016	A more recent study evaluated the program using a randomized controlled trial that involved 1,317 young women who sought treatment at health clinics in Ohio, Pennsylvania, and West Virginia. The young women participating in the study were randomly assigned to either a treatment group that watched a 2.5 hours video with the Seventeen Days program content, or to a control group that watched a video providing information on how to reduce driving risks, the Driving Skills for Life video. The study administered surveys immediately before random assignment (baseline), and again three and six months after the baseline. Three and six months after the baseline, the study found no evidence of statistically significant program impacts on rates of abstinence, defined as not having vaginal sex in the last three months, and on rates of safe sexual behavior, defined as either abstaining from vaginal sex or as having sex using a condom every time in the last three months. The study also examined program impacts on measures of pregnancy and having an STI. Findings for those outcomes were not considered for the review because they did not meet the review standards. Specifically, attrition for the sample on which those outcomes were measured was high and therefore those findings received a Moderate rating. That rating is not consistent with the overall rating of the study (High). Attrition was assessed separately for the pregnancy and STI tests because they were administered in a different data collection effort—vaginal swab tests kits—than the surveys used to measure abstinence and contraceptive use at the 3- and 6

Downs et al. 2004

The program was evaluated in a randomized controlled trial conducted in four clinic-based healthcare sites in Pittsburgh, PA. Adolescents participating in the study were randomly assigned to one of three groups: (1) a treatment group that watched the intervention video, (2) a control group that received the same information from the video but as a book, and (3) a control group that received commercially-available brochures on STD risk. Study data were collected with surveys administered immediately before the intervention and at follow-ups conducted 3 and 6 months after the intervention ended. Biological testing for chlamydia was conducted at the 6-month follow-up.

Three months after the program ended, participants who watched the intervention video were more likely to report having been abstinent in the past three months. In addition, six months after the program ended, participants who watched the intervention video were less likely to report having been diagnosed with an STD. The study found no statistically significant program impacts on rates of abstinence in the past three months, self-reported condom use in the past three months, or the biological tests for chlamydia at the 6-month follow-up.

The study also examined program impacts on measures of STD knowledge and self-reported condom failures. Findings for those outcomes were not considered for the review because they fell outside the scope of the review.

Eichner et al. 2015

Downs et al. 2016

A more recent study evaluated the program using a randomized controlled trial that involved 1,317 young women who sought treatment at health clinics in Ohio, Pennsylvania, and West Virginia. The young women participating in the study were randomly assigned to either a treatment group that watched a 2.5 hours video with the Seventeen Days program content, or to a control group that watched a video providing information on how to reduce driving risks, the Driving Skills for Life video. The study administered surveys immediately before random assignment (baseline), and again three and six months after the baseline. Three and six months after the baseline, the study found no evidence of statistically significant program impacts on rates of abstinence, defined as not having vaginal sex in the last three months, and on rates of safe sexual behavior, defined as either abstaining from vaginal sex or as having sex using a condom every time in the last three months. The study also examined program impacts on measures of pregnancy and having an STI. Findings for those outcomes were not considered for the review because they did not meet the review standards. Specifically, attrition for the sample on which those outcomes were measured was high and therefore those findings received a Moderate rating. That rating is not consistent with the overall rating of the study (High). Attrition was assessed separately for the pregnancy and STI tests because they were administered in a different data collection effort—vaginal swab tests kits—than the surveys used to measure abstinence and contraceptive use at the 3- and 6

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Seventeen Days (formerly What Could You Do?)

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