Background:
Sexually active adolescents have the highest rates of STD of any age group. Interactive media represent one method of targeting knowledge, attitude, and behavioral change among this target audience. Relatively little research has been conducted into the use of interactive media for augmenting HIV/STD prevention efforts in schools.

Objective:
To develop prototype HIV/STD awareness and risk reduction classroom activities, interactive modules, and lesson plans and to evaluate the efficacy and usability of the resulting materials in a preliminary field trial.

Method:
Design, focused on increasing awareness and addressing common misconceptions, was guided by a review of existing materials, consultant input, end-user focus groups, and advisory panel reviews. Multiple development iterations were conducted using rapid prototyping and user-centered design. The final materials were reviewed by teachers (n=17) and evaluated in a single-session, pre-post field trial with adolescents (n=41).

Result:
Adolescents using the interactive modules showed a statistically significant increase in knowledge and target attitudes and rated the media higher than the experimentally hypothesized value of 3.5 (scale of 1-5) on all usability items. Teachers rated the prototypes highly on all usability items and overwhelmingly indicated that the materials would be useful in their classrooms, and they would recommend them to colleagues. Open-ended comments from both audiences were generally positive and provided important feedback for further research and development, especially regarding the acceptability and appropriateness of content.

Conclusion:
Multimedia modules can be engaging and effective for HIV/STD knowledge and attitude change among adolescents and are acceptable to teachers.

Implications:
Additional work should focus on increasing and sustaining observed changes in target outcomes and in broadening those outcomes to include additional behavioral objectives and concomitant behavioral assessment. School-based curricula should be both directive and flexible. Allowing teachers themselves to tailor the inclusion of content may offer one solution to difficult issues of acceptability and scientific thoroughness and accuracy.