Program

Feb 28, 2013

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.

An evaluation of Making Proud Choices! revealed positive program impacts on  condom use and unprotected sex. 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 also the frequency of sex in general.

Another evaluation compared the Making Proud Choices! program, with the Making a Difference!  program, two combined Making a Difference! and Making Proud Choices! programs, and a control group.  The Making Proud Choices! program did not demonstrate any program impacts.  The comprehensive groups were significantly less likely to report multiple partners than the control group.

DESCRIPTION OF PROGRAM

Target population: Urban 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. The latter curriculum is based on the idea that participants should be proud of themselves and their community, and that they should make and focus attention on healthy goals.  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 sexually transmitted diseases (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. The goals of the program are to increase HIV/AIDs knowledge, to combat negative beliefs about condom use, and to promote condom use self-efficacy.

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

EVALUATIONS 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 African American adolescents (mean age = 11.8) were recruited from 6th and 7th 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. About 53 percent of the participants were female.  One-quarter reported having had sex, and 15 percent reported having had sex in the prior three months.

Approach:  Participants completed baseline surveys about 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 intervention groups: the Making Proud Choices! safer-sex group (n=221), the Making a Difference! abstinence-based group (n=220), or a health promotion control group that focused on non-sexual health concerns (n=218). Each intervention consisted of eight hour-long modules. These modules were presented over the course of two consecutive Saturdays.   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. Participants were given $40 for completing the intervention.

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 also completed 3-, 6-, and 12-month follow-up surveys that asked about the frequency of sexual intercourse, the frequency of condom use, consistent condom use (use of condoms on all instances of sexual intercourse), and the frequency of unprotected sex over the previous three months. At 12 months, 93 percent of participants remained in the study.

Results: Compared with those assigned to the control group, participants assigned to the Making Proud Choices! intervention had better HIV risk-reduction knowledge and condom use knowledge.  They also had more positive condom use beliefs and improved awareness of condom availability. Compared with those in the control group, those in the Making Proud Choices! group also had marginally improved condom use self-efficacy. There were no immediate program impacts on intentions to use condoms or on beliefs about condom use skills.

At the 3-month follow-up, participants in the Making Proud Choices! group were less likely than those in the control group to report having unprotected sex in the prior three months, and they also reported fewer instances of unprotected sex.  They also were more likely than those in the control group to report consistent condom use in the prior three months, and they reported marginally higher condom use frequency. The latter impact continued at both the 6- and 12-month follow-ups; those in the Making Proud Choices! group reported more frequent condom use in the prior three months than those in the control group.  At the 6-month follow-up, only, those in the Making Proud Choices! group reported marginally less frequent sexual intercourse than those in the control group.

Subgroup analyses revealed the Making Proud Choices! safer-sex curriculum to have been particularly successful among those who were already sexually active before the program began. Compared with the control group at both the 3-and 12-month follow-ups, sexually-experienced adolescents in the Making Proud Choices! group were less likely than the sexually-experienced adolescents in the control group to report having unprotected sex in the prior three months (this was only marginal at 12-months), and they reported fewer instances of unprotected sex.  At the 6- and 12-month follow-up, they reported less frequent sex.

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

References

Jemmott, J.B., Jemmott, L.S., & Fong, G.T. (1992). Reductions in HIV risk-associated sexual behaviors among black male adolescents: Effects of an AIDS prevention intervention. American Journal of Public Health, 82, 372-377.

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.

 

Website

Implementation kit: http://www.selectmedia.org/programs/choices.html. The full implementation kit cost is $648.

Contact Information

Loretta Jemmott

University of Pennsylvania School of Nursing
Room 239 Fagin Hall
418 Curie Blvd.
Philadelphia, Pennsylvania 19104-4217
(215) 898-8287
 jemmott@nursing.upenn.edu

ETR’s Training Department at: training@etr.org.

KEYWORDS:  Adolescents (12-17), Middle School, Males and Females (Co-ed), Black/African American, Urban, School-based, Manual is Available, Cost Information is Available, Skills Training, Condom Use and Contraception, Sexual Activity, Reproductive Health – Other

 

Program information last updated 2/28/13.

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