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BackgroundTaking evidence-based interventions to scale is a challenge for prevention science. Mighty Girls is an evidence-based sexual health intervention program that combines classroom sessions with novel, cutting-edge technology (digital puppetry). The program was developed for 7th grade Latinas, but US school and community demographics rarely allow interventions targeting a single ethnic group. Additionally, digital puppetry is costly to scale up, and parent disapproval often prevents successful dissemination of adolescent sexual health programs. Intervening steps along the scaling-up pathway are needed to adapt the program prior to scaling up for dissemination. ObjectiveThe aims of this study were to create a multicultural adaptation of the Mighty Girls program using a mobile app that is less costly to disseminate and is acceptable to parents of 7th grade girls. MethodsThis study used a three-phase process to adapt Mighty Girls into Mighty Teens. All phases used purposive (nonprobability) sampling of low-income, multicultural, urban metropolitan groups (7th grade girls and their parents) within central Florida. Phase 1 involved two videotaped implementations of a multicultural adaptation of the classroom sessions, one involving focus groups (N=14) and the other serving as a single-group pretest-posttest pilot study (N=23). Phase 2 involved development of a narrative cell phone app prototype, which was subjected to usability testing (N=25). App usability and engagement were assessed qualitatively (observation, focus group, open-ended questions) and quantitatively. Phase 3 used focus groups to assess parent support for the program (N=6). Qualitative data were analyzed using descriptive content analysis. Quantitative data were analyzed using descriptive statistics and paired t tests. ResultsQualitative findings supported classroom sessions being multicultural, and identified simple changes to improve engagement and learning. Quantitative findings from the second classroom session implementation pilot study indicated a significant pre-post difference in intention to delay sexual intercourse (P=.04). App usability and appeal were supported by a System Usability Scale score of 76 (exceeding 68 per the industry standard) and 83% (20/24) of participants agreeing they would recommend the app to friends. Parents (mothers) expressed only positive regard for program goals, and classroom session and app activities. ConclusionsThis study adapted Mighty Girls into an engaging, easier-to-disseminate, multicultural program, termed Mighty Teens, that uses a narrative-generating app to support behavior change, and is likely to be accepted by parents of 7th grade girls. This study also provides evidence of the preliminary effectiveness of Mighty Teens classroom sessions. The sampling method and sample size were appropriate for adaptation, but research involving a more representative US sample is needed to confirm multicultural fit, parent receptivity, and program effectiveness. Study implications include integrating app use throughout the classroom sessions to build narrative-generating skills across the program and increasing the number of narratives produced, which should in turn increase the program’s behavior change potency.

As Hispanic persons in the U.S. are exposed to U.S. culture, changes may occur in values, attitudes, and behavior. This process of change has been called acculturation. The objectives of this research were to describe the sexual behavior of low income, urban Hispanic youth in Detroit and to evaluate the relationship of acculturation to sexual behavior. Data were drawn from a household probability sample of 711 low income, urban youth. The relationship of acculturation to sexual activity, types of intercourse, number and ethnicity of partners, condom use, and use of other methods were estimated for never married men and women. Level of acculturation was associated with sexual behavior. Specifically, women with high acculturation were much more likely to have had at least one sexual partner in the last year, to have non-Hispanic partners, to have oral and anal sex, and to have used condoms. For men, high acculturation was positively associated with oral sex and having non-Hispanic partners. Use of contraceptive methods other than condoms was not related to acculturation for either gender. For women, the strong association of acculturation with sexual activity in the last year increased women's exposure to health risks, sexually transmitted diseases, and unplanned pregnancy, although increased condom use may have reduced these risks.

SUMMARY: Threats to professional skepticism are embedded in the social relationships and interactions between auditors and management. These can affect auditor skepticism and the extent of audit procedures performed. In this study, we conduct an experiment using live simulation to create a realistic audit setting to investigate the effect of these interactions on professional skepticism. Each participant (n = 49) completed a measure of trait skepticism and conducted an audit interview with a professional actor trained to play the role of a client controller. Findings indicate that, in general, participants who interview a friendly controller (rather than an intimidating controller) are less likely to determine questionable cash disbursements to be control exceptions and less likely to recommend more intensive follow-up. However, consistent with social psychology research on construct accessibility, planned contrasts indicate that participants who score low on trait skepticism are least likely to identify control exceptions and recommend more intensive follow-up when interviewing a friendly controller. This study advances research on professional skepticism by examining the impact that type of social interaction (friendly, intimidating) has on professional skepticism using a methodology (live simulation) that allows us to simulate a realistic audit environment. Use of this methodology increases external validity and generalizability of our findings. As a result, this study corroborates concerns that the social relationships/interactions between management and the auditor can be a threat to professional skepticism, and allows us to understand better how, when, and where these threats occur. [ABSTRACT FROM AUTHOR]