The goal of Making Proud Choices! is to empower adolescents to change their behavior in ways that will reduce their risk of an unplanned pregnancy or becoming infected with HIV and other STDs. Specifically, this curriculum emphasizes that adolescents can reduce their risk for STDs, HIV, and pregnancy by using a condom if they choose to have sex.
Making Proud Choices! is an adaptation and extension of the original Be Proud! Be Responsible! curriculum that integrates teen pregnancy prevention along with HIV/STD prevention.
The curriculum has 8 hours of content divided into eight 1-hour modules. It can be implemented in eight sessions of 60 minutes each or in four 2-hour modules. In community settings, it can be implemented in a 2-day format (four modules each day), 4-day format (two modules each day) or an 8-day format (one module each day).
Curriculum modules include:
- Module 1: Getting to Know You and Steps to Making Your Dreams Come True
- Module 2: The Consequences of Sex: HIV Infection
- Module 3: Attitudes About Sex, HIV and Condom Use
- Module 4: Strategies for Preventing HIV Infection: Stop, Think and Act
- Module 5: The Consequences of Sex: STDs
- Module 6: The Consequences of Sex: Pregnancy
- Module 7: Developing Condom Use and Negotiation Skills
- Module 8: Enhancing Refusal and Negotiation Skills
To reduce STD and pregnancy risk-related sexual behaviors, adolescents not only need an awareness of personal vulnerability, but also positive attitudes towards condom-use skills and confidence in their ability to use condoms. The Making Proud Choices! curriculum is designed to meet those needs.
The program has four major components:
- The first component focuses on goals, dreams and adolescent sexuality.
- The second is knowledge, covering information about the etiology, transmission, and prevention of HIV, other STDs and teenage pregnancy.
- The third focuses on beliefs and attitudes.
- The fourth focuses on skills and self-efficacy, covering negotiation-refusal skills and condom use skills and providing time for practice, reinforcement, and support.
The role of sexual responsibility and accountability is stressed, and the curriculum teaches participants to make responsible decisions regarding their sexual behavior, to respect themselves and others, and the importance of developing a positive image. Participants discuss what constitutes sexual responsibility, such as condom use and learn to make responsible decisions regarding their sexual behavior (i.e. that abstinence is the best way to prevent HIV, STD and teen pregnancy, however, if they choose to have sex, they must use a condom).
Making Proud Choices! is especially effective with sexually experienced adolescents, who reported less sexual intercourse and less unprotected sex at follow-up sessions than the control group.
In the research study, the 8-hour curriculum Making Proud Choices! was implemented in a small-group setting with African-American male and female adolescents, between the ages of 11 and 13, on two consecutive Saturdays in three different middle schools.
In this randomized control trial, 659 sixth- and seventh-grade African-American male and female adolescents, mean age 11.8, were stratified by gender and age and randomly assigned to receive one of three 8-hour curricula: an abstinence curriculum, a safer sex curriculum or a health promotion curriculum (which served as the control group). The adolescents received the curriculum in small groups of six to eight students led by either an African-American adult facilitator (mean age 40) or two peer African-American co-facilitators (mean age 16).
The participants completed questionnaires before, immediately following the curricula, 3, 6 and 12 months after the intervention. Of the original 659 participants, 97% returned to complete the 3-month follow-up questionnaire, 94% completed the 6-month and 93% completed the 12-month follow-up. The primary measures were HIV risk-associated sexual behaviors. The secondary measures were variables from the Theory of Planned Behavior and the Social Cognitive Theory, including knowledge, beliefs, norms, intentions and self-efficacy regarding abstinence and condom use.
The participants who received the Making Proud Choices! safer-sex curriculum reported:
- More consistent condom use and less unprotected sex in the 3 months after the intervention than did those in the control group.
- Higher frequency of condom use at the 3-, 6- and 12-month follow-up sessions than did those in the control group.
Making Proud Choices! was especially effective with sexually experienced adolescents, For instance, among participants who were sexually experienced at baseline, those in the safer-sex groups reported less sexual intercourse in the previous 3 months at the 6-month (p < .001) and 12-month (p = .002) follow-up than the control group (p < .03). In addition, they reported less unprotected sex at all three follow-up session than the control group (p < .03).
The adult and peer facilitators were equally effective. There were no differences in intervention effects on behavior with adult facilitators as compared with peer-co-facilitators.
Compared to those in the control group, adolescents who received the Making Proud Choices! curriculum scored higher in condom use knowledge; believed more strongly that condoms can prevent pregnancy, STDs and HIV; believed more strongly that using condoms would not interfere with sexual enjoyment; expressed greater confidence that they could have condoms available when they needed them; and reported greater confidence that they could exercise sufficient impulse control to use condoms and greater self-efficacy for using condoms.
Jemmott, J. B. III, Jemmott, L. S., & Fong, G. T. (1998). Abstinence and safer sex HIV risk-reduction interventions for African American adolescents: A randomized controlled trial. Journal of the American Medical Association, 279 (19): 1529-1536.
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