Making Pround Choices!

Guide to Effective Programs
for Children and Youth

MAKING PROUD CHOICES!

OVERVIEW

Making Proud Choices! is a safer-sex approach to HIV/AIDS and teen pregnancy prevention. The program is directed toward empowering inner-city, African American adolescents to use condoms if they choose to have sex.

Making Proud Choices! was found to have a positive impact on frequency of condom use over 12 months. The program had a particularly strong impact on students who were sexually experienced before they received the intervention. These students were found to decrease not only unprotected sex, but sex in general following involvement in the program when compared with students who received a comparable, but abstinence-based intervention (Making a Difference!) and with students in a control group who received an intervention unrelated to sexual health.

The program had no impact on whether participants practiced abstinence.

DESCRIPTION OF PROGRAM

Target population: African American adolescents from low income families

The Making Proud Choices! curriculum consists of eight culturally-appropriate, hour-long modules. These modules address facts, attitudes, and beliefs surrounding HIV/AIDS and teen pregnancy. They also teach condom use skills and negotiation-refusal techniques. Program activities include role-playing and video-watching.

Making Proud Choices! is an 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 Proud Choices! acknowledges that abstinence from sex is preferred, but highlights condom use as a way to reduce the risk of STDs and pregnancy. The program places specific emphasis upon adolescents’ goals and dreams and on how sexual behavior has the potential to thwart those dreams.

An abstinence-based version of the Making Proud Choices! curriculum is marketed under the name Making a Difference!

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 middle 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 Proud Choices! safe sex curriculum had an immediate positive impact on participants’ knowledge of HIV and condoms. Compared with students assigned to the other interventions, students assigned to the Making Proud Choices! intervention had significantly greater knowledge following program completion. This increased knowledge did not translate to increased intent to use condoms.

Nonetheless, at the first follow-up, students assigned to the Making Proud Choices! safe sex intervention reported significantly more frequent condom use and significantly less frequent unprotected sex than students assigned to the health promotion intervention. The program’s impact on frequency of condom use remained significant at the 6-month and 12-month follow-ups.

Subgroup analyses revealed the Making Proud Choices! safe sex curriculum to have been particularly successful with students who were already sexually active before the program began. Among already-experienced students, those assigned to the Making Proud Choices! safe sex intervention reported having had sex significantly less frequently than students assigned to the Making a Difference! abstinence-based intervention or the health promotion control group at the 6-month and 12-month follow-ups. Further, they reported having had unprotected sex significantly less frequently than students assigned to the health promotion control group at every follow-up and significantly less frequently than students assigned to the Making a Difference! abstinence-based intervention 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=3

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