Be Proud! Be Responsible!

BE PROUD! BE RESPONSIBLE!

OVERVIEW

Be Proud! Be Responsible! was developed to lower the prevalence of HIV/AIDS within inner-city, African American communities. The curriculum aims to help young people make "proud and responsible" decisions about their sexual behaviors.

This cognitive-behavioral program has repeatedly been shown to have an impact on participants' knowledge of HIV/AIDS and on their attitudes and intentions regarding risky sexual behaviors (such as intentions to use condoms). Furthermore, the program has been shown to reduce sexual activity and decrease sexual partners in adolescent males. Another study found that program participants reported less frequent unprotected sex and were less likely to engage in anal sex. An additional study found that the program increased positive attitudes towards abstinence and self-efficacy regarding the avoidance of unsafe or unwanted sex. Participants were also more likely to talk to parents about issues regarding sex then participants in the control group. This program has not been found to have an impact on whether participants practice abstinence.

DESCRIPTION OF PROGRAM

Target population: Low income African American adolescents

The Be Proud! Be Responsible! program was designed to increase HIV/AIDS-related knowledge and weaken problematic attitudes toward risky sexual behavior within the inner-city, African American community. The curriculum consists of six culturally-appropriate, hour-long modules. These modules address facts, attitudes, and beliefs surrounding HIV and AIDS. They also teach condom use skills and negotiation-refusal techniques. The intervention is designed to be informative and entertaining and includes group discussion, games, mini-lectures, videos, condom demonstrations, role-plays, and other interactive activities.

Two extended versions of the Be Proud! Be Responsible! curriculum exist. Making Proud Choices! is the safer-sex-based extension and Making a Difference! is the abstinence-based extension.

EVALUATION(S) OF PROGRAM

Note: The following studies evaluated early versions of the Be Proud! Be Responsible! program. When these studies were conducted, the curriculum was still in development and was not referred to by its current name. These summaries employ the current program name for purposes of clarity.

Jemmott, J.B., Jemmott, L.S., Fong, G.T. (1992). Reductions in HIV Risk-Associated Behaviors among Black Male Adolescents: Effects of an AIDS Prevention Initiative. American Journal of Public Health, 82, 372-377.

Evaluated population: In 1988, 157 black male adolescents (mean age = 14.64) from Philadelphia, PA were recruited to participate in this study. 44% of participants were recruited from among outpatients at a local medical clinic, 32% were recruited from students attending assemblies at a local high school, and 24% were recruited at a local YMCA.

Approach: Participants completed baseline surveys on their recent sexual behavior. They also responded to questions about their attitudes and intentions regarding risky sexual behavior and their knowledge of AIDS and STDs. While they completed these measures, participants were stratified by age, and then randomly assigned within age to either an AIDS-prevention intervention (n=85) or a career-opportunities intervention (n=72).

Participants assigned to the AIDS-prevention intervention were placed into small groups and received the entirety of the "Be Proud! Be Responsible!" curriculum in a single, five-hour-long session. Participants assigned to the career-opportunities intervention also took part in a five-hour-long small-group session, but their program dealt solely with career-related matters. All small-group sessions were led by college-educated black adults.

Immediately following the intervention, participants were again surveyed on their attitudes and intentions regarding risky sexual behavior and on their knowledge of AIDS and STDs. Three months later, participants completed follow-up surveys.

Results: The Be Proud! Be Responsible! curriculum had an immediate positive impact on participants' knowledge of AIDS and STDs and on their attitudes and intentions regarding risky sexual behaviors. The impact on knowledge and intentions remained significant at the three-month follow-up.

The curriculum also had an impact on participants' sexual behaviors. Compared with participants who took part in the career-opportunities intervention, participants who received the Be Proud! Be Responsible! curriculum reported engaging in less risky sexual behavior during the three months immediately following the intervention. Though these adolescents were not significantly more likely to have practiced abstinence during those three months, they did report having had sex less frequently and with fewer women. They also reported fewer occasions of sex without a condom and were less likely to have had anal sex.

Jemmott, J.B., Jemmott, L.S., Fong, G.T., & McCaffree, K. (1999). Reducing HIV Risk-Associated Sexual Behavior Among African American Adolescents: Testing the Generality of Intervention Effects. American Journal of Community Psychology, 27(2), 161-187.

Evaluated population: In the late 1990s, 496 black adolescents (mean age = 13.2) were recruited from public schools in Trenton, NJ, to participate in this study.

Approach: Study participants completed baseline surveys on their recent sexual behavior. They also responded to questions about their attitudes and intentions regarding risky sexual behavior and their knowledge of AIDS and STDs. While they completed these measures, participants were stratified by age and gender, and then randomly assigned within age and gender to either and HIV risk-reduction intervention (n=269) or a general health promotion intervention (n=227). Participants were further assigned to a small group that was either homogeneous or heterogeneous in gender and that was led by either a male or female facilitator who was either black or white. Facilitators all received eight hours of training.

Participants assigned to the HIV risk-reduction intervention received the entirety of the "Be Proud! Be Responsible!" curriculum in a single, five-hour-long session. Participants assigned to the general health promotion intervention also took part in a five-hour-long small-group session, but their program dealt with non-sexual health concerns.

Immediately after the intervention, participants were again surveyed on their attitudes and intentions regarding risky sexual behavior and on their knowledge of AIDS and STDs. 93% of participants completed follow-up surveys three months later and 93% completed a six-month follow-up

Results: The Be Proud! Be Responsible! Curriculum had an immediate positive impact on participants' knowledge of HIV and their beliefs and intentions regarding condom use. This impact remained significant at the three-month and six-month follow-ups.

At the three-month follow-up, no significant behavioral differences were observed between the students who received the Be Proud! Be Responsible! curriculum and those who did not. At the six-month follow-up, however, significant differences emerged. Compared with participants who took part in the career-opportunities intervention, participants who received the Be Proud! Be Responsible! curriculum had engaged in less risky sexual behavior. Though these adolescents were not significantly more likely to have practiced abstinence during the previous three months, they did report having had unprotected sex less frequently. They also reported having had anal sex less frequently and with fewer partners.

The impact of the Be Proud! Be Responsible! curriculum was found to be unrelated to the race of the facilitator, the gender of the facilitator, the gender of the participants, and the gender composition of the intervention group

Jemmott, J.B., Jemmott, L.S., & Fong, G.T. (1998). Abstinence and safer sex HIV risk-reduction interventions for African American adolescents. Journal of the American Medical Association, 279(19), 1529-1536.

Evaluated population: 659 black adolescents in sixth or seventh grade living in low income areas in Philadelphia, Pennsylvania served as the sample for this evaluation. The sample was 53% female, and 27% of the adolescents lived with both of their parents.

Approach: Participants were randomly assigned to one of three study conditions: 1) the Making a Difference! abstinence-based curriculum, 2) the Making Proud Choices! safer-sex themed curriculum, or 3) the control condition, which was an informational program focusing on health issues in the black community.

Each intervention consisted of 8, 1-hour modules implemented over the course of two consecutive Saturdays. Participants were surveyed on their sexual behavior before the interventions, immediately after the interventions, and at 3-, 6-, and 12-month follow-ups.

Results: Results indicated that individuals in the abstinence intervention were significantly less likely than control group participants to report having had sexual intercourse in the three months following the intervention, but this difference disappeared at the 6- and 12-month follow-ups. Individuals in the safer-sex intervention reported significantly more consistent condom use than individuals in the control group at the 3-month follow up and higher frequency of condom use at the 6- and 12-month follow-ups.

Kennedy, M.G., Mizuno, Y., Hoffman, R., Baume, C., & Strand, J. (2000). The effect of tailoring a model HIV prevention program for local adolescent target audiences. AIDS Education and Prevention, 12(3), 225-238.

Note: Though this study reviews implementations at five evaluation sites, only two of those sites instituted a random assignment design. Therefore, we will only summarize the evaluated population, approach, and results from the two sites that meet the appropriate experimental design standards.

Evaluated population: 680 adolescents across two evaluation sites served as the samples for this study. 380 participants resided in Sacramento, California. Within this sample, 45% of participants were male. The race/ethnicity distribution was as follows: 25% white, 18% black, 39% Hispanic, and 18% of other descent. The Nashville, Tennessee site provided 300 participants, 41% of whom were male. The race/ethnicity distribution at this site was as follows: .3% white, 77% black, 17% Hispanic, and 5% of other descent.

Approach: Participants were randomly assigned to participate in one of two conditions: 1) the Be Proud! Be Responsible! HIV prevention workshop prior to the collection of their post-test data, or 2) a wait-list control condition in which they would attend the Be Proud! Be Responsible! workshop following the collection of their post-test data.

The length of the intervention varied between 5 and 9 hours, depending on the site.

Participants were administered a questionnaire addressing an array of sex constructs including: intentions to use condoms, attitudes towards condoms, self-efficacy regarding the avoidance of unsafe or unwanted sex, skills avoiding unwanted sexual interactions, sexual knowledge, abstinence beliefs and attitudes, and the use of friends, parents or sex partners as social support and knowledge resources.

Data were collected at three points in time for the intervention group: before participating in the workshop, immediately following the workshop, and at a one-month follow-up assessment. The wait list control group provided data at two points in time: following the intervention group's completion of the workshop, and at the one-month follow-up point.

Results: At the Sacramento site, the intervention group reported significantly greater intentions to use condoms than did the control group. The control and experimental group did not significantly differ on any other outcome measures. In Nashville, intervention participants were more likely to believe in and have positive attitudes towards abstinence, had higher levels of self-efficacy regarding the avoidance of unsafe or unwanted sex, and were more likely to talk to parents about issues regarding sex. There were no significant differences between the control and experimental group on any other outcomes.

SOURCES FOR MORE INFORMATION

Link to program curriculum: http://selectmedia.org/products-page/?category=6

cost ranges from $145-$358

References:

Program categorized in this guide according to the following:

Evaluated participant ages: 13-18 (7^th-12^th graders)/Program age ranges in the guide: adolescence, youth

Program components: school-based, clinic/provider-based

Measured outcomes: reproductive health

KEYWORDS: Reproductive Health, Sexual activity, STD/HIV/AIDS, Condom Use, Self-Efficacy, Black or African American, White or Caucasian, Hispanic or Latino, Adolescence (12 to 17), Urban, High-Risk, School-based, Clinic/Provider-based, Middle School, Gender-specific (Male Only), coed, manual, cost.

Program information last updated 6/12/09