An Evaluation of Achieving Condom Empowerment (ACE)-Plus in Foster Care Agencies in New York City

Abstract

Objectives

To test the ACE-Plus curriculum, a two-session program that teaches males in foster care and/or preventive services about correct and consistent condom use, and engagement with female partners to obtain and use contraception.

Methods

Nine foster care agencies in New York City randomly assigned 223 males aged 16–20 to the ACE-Plus intervention or a benign program. Youth completed surveys at baseline, 3-month follow-up, and 9-month follow-up. Regression analyses assessed the effects of program participation on condom use, use of hormonal birth control method, use of birth control by female sex partner(s), obtaining birth control with a sex partner(s), and communication about birth control with a sex partner(s).

Results

At 3-month follow-up, treatment youth were significantly more likely than control youth to report communicating with their sexual partner(s) about birth control (p = .0062). While not statistically significant, treatment youth were more likely to report obtaining birth control with a sex partner(s) than control youth at 3-month follow-up. Impact estimates for the remaining behavioral outcomes favored the control group, though not significantly. Implementation data suggest the program was delivered with fidelity.

Conclusion

Based on these mixed results, perhaps more developmental research into this short-duration intervention for this high-needs population is necessary.

Keywords:

• Condom use
• foster care youth
• males
• communication
• partners

Acknowledgments

The authors would like to express their appreciation to the staff at Cicatelli Associates, Inc. (CAI) for their assistance throughout this evaluation, Dr. Richard Crosby – the ACE-Plus curriculum developer, as well as the staff at the foster care agencies who were directly involved with the youth enrolled in this study. Without their efforts, this evaluation would not have been possible.

Notes

1 https://www1.nyc.gov/assets/acs/pdf/data-analysis/2019/ReportOnYouthInFC2019.pdf

2 ACE-Plus is an adaptation of an original curriculum called ACE which promoted consistent condom use using a single session intervention. The efficacy of ACE has been documented in a peer-reviewed 2014 article in the American Journal of Public Health (2014).

3 https://tppevidencereview.youth.gov/FindAProgram.aspx

Additional information

Funding

This publication was prepared under Grant Number TP2AH000025-01-00 from the Office of Population Affairs (OPA), U.S. Department of Health & Human Services (HHS). The views expressed in this publication are those of the authors and do not necessarily represent the policies of HHS or OPA.