Making A Difference!

Guide to Effective Programs
for Children and Youth

MAKING A DIFFERENCE!

OVERVIEW

Making a Difference! is an abstinence-based approach to HIV/AIDS and teen pregnancy prevention. The program is directed toward empowering inner-city, African American adolescents to refrain from engaging in sex.

Participants in the Making a Difference! program were more likely to abstain from sex during the three months immediately following the intervention than were participants in an intervention unrelated to sex. This impact was no longer observable at the 6- and 12-month follow-ups, however. The program had no impact on frequency of condom use during the first six months after the intervention, but at the 12-month follow-up, program participants reported significantly more frequent condom use than participants in the non-sex-related intervention.

In a random assignment study with two experimental conditions and a control group condition, the Making a Difference! program was found to be less effective than a comparable safer-sex-based program (Making Proud Choices!) for students who had begun having sex before entering into the program.

DESCRIPTION OF PROGRAM

Target population: African American adolescents from low-income families

The Making a Difference! curriculum consists of eight culturally-appropriate, hour-long modules. These modules address facts, attitudes, and beliefs about abstinence, HIV/AIDS, and teen pregnancy. They also teach negotiation-refusal techniques. Program activities include role-playing and video-watching.

Making a Difference! is an abstinence-based adaptation and extension of the Be Proud! Be Responsible! curriculum. This particular intervention differs from Be Proud! Be Responsible! in that it deals not only with HIV/AIDS prevention, but also pregnancy prevention. Making a Difference! acknowledges that condoms reduce the risks associated with sex, but promotes abstinence as a way to eradicate those risks. The program places specific emphasis upon adolescents’ goals and dreams and on how sexual behavior has the potential to thwart those dreams.

In that Making a Difference! is an abstinence-based program, it promotes abstinence from sex as the only way to eliminate the risk for pregnancy and STDs. This intervention does not teach condom use skills. However, Making a Difference! does not present sex in a negative light and is not moralistic. A safer-sex version of the Making a Difference! curriculum is marketed under the name Making Proud Choices!

EVALUATION(S) OF PROGRAM

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: In the late 1990s, 659 black adolescents (mean age = 11.8) were recruited from 6^th and 7^th grade classes in three middles schools serving low-income communities in Philadelphia, PA. Just over one-quarter of these students lived with both of their parents.

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 gender, and then randomly assigned within age and gender to one of three interventions: an abstinence-based HIV-prevention intervention (n=220), a safer-sex-based HIV-prevention intervention (n=221), or a health promotion intervention (n=218). Participants were further assigned to a small group that was either led by one adult facilitator or two peer co-facilitators. Peer facilitators were high school students who were trained and monitored for implementation fidelity.

Each intervention consisted of eight hour-long modules. These modules were presented over the course of two consecutive Saturdays. Students assigned to the abstinence-based HIV-prevention intervention received the “Making a Difference!” curriculum and students assigned to the safer-sex-based HIV-prevention intervention received the “Making Proud Choices!” curriculum. The health promotion intervention 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. Participants completed follow-up surveys three months, six months, and 12 months after the intervention. At 12 months, 93% of participants remained in the study.

Results: The Making a Difference! abstinence-based curriculum had an immediate positive impact on participants’ knowledge of HIV and on their beliefs and intentions relating to abstinence. Students assigned to the Making a Difference! intervention expressed less favorable attitudes towards sexual intercourse and reported weaker intentions to engage in sexual intercourse during the next three months than did the students assigned to the Making Proud Choices! safer-sex intervention or the health promotion control group. Students assigned to the Making a Difference! intervention had significantly less knowledge of and less faith in the protective power of condoms than did students assigned to the Making Proud Choices! intervention.

At the 3-month follow-up, students assigned to the Making a Difference! intervention were significantly less likely to have had sex during the previous three months than were students assigned to the health promotion control group and they were marginally less likely to have had sex during that period than were students assigned to the Making Proud Choices! safe sex intervention.

By the 6-month follow-up, however, students assigned to the Making a Difference! abstinence-based intervention were no more likely to be abstaining from sex than were students assigned to the Making Proud Choices! safe sex intervention or students assigned to the health promotion control group. This lack of impact persisted at the 12-month follow-up.

Participants assigned to the Making a Difference! intervention did not report significantly more frequent condom use than participants assigned to the health promotion control group at the 3-month or 6-month follow-up, but did at the 12-month follow-up.

Researchers concluded that the Making a Difference! abstinence-based program was less effective than the Making Proud Choices! safe sex program for students who had begun having sex before the intervention began. Among already-experienced students, those assigned to the Making a Difference! intervention reported having had significantly more frequent sex at the 6-month and 12-month follow-ups than students assigned to the Making Proud Choices! intervention. Further, these students reported having had significantly more frequent unprotected sex at the 3-month and 12-month follow-ups.

The program was found to have comparable impact regardless of whether it was led by an adult facilitator or two peer facilitators.

SOURCES FOR MORE INFORMATION

Link to program curriculum: http://www.selectmedia.org/curriculum.asp?curid=1

References:

Program categorized in this guide according to the following:

Evaluated participant ages: 11-13 (6^th + 7^th graders)/Program age ranges in the guide: adolescence

Program components: school-based

Measured outcomes: reproductive health

Program information last updated 4/17/07