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Descriptions of Evidence-Based and More Comprehensive Curricula FY10

 
 
Evidence-Based and More Comprehensive Approaches to Pregnancy-, HIV/STD-Prevention and Sexuality Education
 
This resource lists the most common, high quality pregnancy-, STD-, and HIV/AIDS-prevention; positive youth development; and sexuality education programs being implemented in U.S. states and territories with federal Teen Pregnancy Prevention Initiative and Personal Responsibility Education Program (PREP) funding. SIECUS has developed this resource to serve as a reference guide to most of the curricula described in the State Profiles.
Many of the programs included on this list are among the 28 programs identified by the U.S. Department of Health and Human Services, Office of Adolescent Health (OAH) as evidence-based models. These programs have been proven effective on the basis of rigorous scientific research to change sexual behavior, including helping young people delay sexual activity and/or, among those who are sexually active, increase their use of condoms or contraception, reduce their number of sexual partners, reduce their frequency of sexual intercourse, or reduce the incidence of pregnancy. (Please refer to the OAH website for an explanation of how the review of evidence was conducted.)
 
For more information on individual programs, please refer to the references cited and feel free to contact us.
 
Aban Aya Youth Project
Aban Aya Youth Project is an evidence-based social development program designed for African-American youth in grades five through eight.  The program’s name is derived from the Ghanian words ABAN, meaning “fence,” signifying social protection, and AYA, meaning “the unifying fern,” which signifies self-determination.[1]  The Aban Aya Youth Project consists of two components: a social development, classroom-based curriculum that focuses on reducing risky behaviors; and a school/community intervention, which includes community and parent engagement. The curriculum, designed to be implemented over the course of four years, emphasizes abstinence from sexual activity, avoiding drug and alcohol use, and non-violent conflict resolution. The curriculum draws upon African-American cultural values and uses culturally based teaching methods, such as story-telling, along with African- American history and literature. An evaluation of the program published in the Archives of Pediatrics and Adolescent Medicine found that at three-year follow-up, male program participants were significantly less likely to report having had recent sexual intercourse than peers in a control group. In addition, program participants showed an increase in the rate of condom use compared to those in the control group.[2]
 
All4You!
All4You! is an evidence-based pregnancy-, STD-, and HIV-prevention program designed for students ages 14–18 attending alternative high schools. It is adapted from two existing evidence-based programs, Be Proud! Be Responsible! and Safer Choices. The program, which includes both classroom instruction and a service learning component, aims to reduce the frequency of unprotected sex among participants.  The 14-session classroom curriculum consists of nine lessons, which address: STD-, HIV- and pregnancy-prevention, the risk of STD transmission and unintended pregnancy, negotiation skills, and condom-use skills, among other topics.  All4You! includes interactive activities such as role-playing, condom demonstration, group discussion, and educational games. The service learning component engages participants in volunteer activities. An evaluation of the program published in AIDS Education and Prevention compared the behavior of participants to that of peers in a control group six months after the intervention. Program participants reported a significantly lower frequency of having sex without a condom in the previous three months, were significantly more likely to report having used a condom at last sexual intercourse, and reported a significantly lower frequency of sexual intercourse in the previous three months than participants in the control group.[3]
 
Be Proud! Be Responsible!
Be Proud! Be Responsible! is an evidence-based HIV-prevention curriculum originally designed for urban, African-American males ages 13–18.[4] The curriculum seeks to provide young people with the knowledge, motivation, and skills necessary to reduce their risk of HIV, other STDs, and causing unintended pregnancy. It also aims to impact sexual behavior by equipping youth with negotiation, refusal, and condom-use skills. The curriculum uses a “sense-of-community” approach that emphasizes how HIV/AIDS has affected inner-city communities and discusses the importance of protecting the community in order to instill accountability, sexual responsibility, and a sense of pride in participants. Although originally designed for use with small groups of sixto 12 participants, the curriculum has been used with larger groups and is appropriate for both school-based and community-based settings.[5] An evaluation of the program published in the American Journal of Community Psychology found that the intervention reduced the number of female sexual partners participants had as well as the number of non-monogamous female sexual partners (those who were simultaneously involved with other male partners). In addition, the study found that the intervention decreased the frequency of vaginal and heterosexual anal intercourse, and increased condom use among participants.[6]
 
Be Proud! Be Responsible! Be Protective!
Be Proud! Be Responsible! Be Protective! is an evidence-based program that targets pregnant and parenting teens and focuses on the concept of maternal protectiveness to encourage adolescent mothers and soon-to-be mothers to make healthy sexual decisions; take responsibility and be accountable for their sexual activity; and decrease risky sexual behavior. The curriculum is an adaptation of Be Proud! Be Responsible! , an evidence-based HIV-prevention curriculum designed for African-American males. Be Proud! Be Responsible! Be Protective! discusses the impact of HIV/AIDS on inner-city communities and particularly addresses its impact on pregnant women and their children, providing information on preventing transmission during pregnancy and the postpartum period. The curriculum consists of eight, one-hour lessons and uses interactive activities, group discussion, and videos to educate participants. Itcovers such topics as HIV risk and prevention; family planning and parenting; communication; attitudes and beliefs about HIV/AIDS and safer sex; condom use skills; stress and emotion management; and staying healthy. The intervention can be delivered in four, two-hour sessions or over the course of eight days and is appropriate for use in school-based settings.[7] An evaluation of the program published in Family and Community Health found, at a six-month follow-up, that program participants reported having significantly fewer sexual partners during the previous three months than participants in the control group.[8]
 
Becoming a Responsible Teen (BART)
Becoming a Responsible Teen (BART) is an evidence-based HIV/AIDS-prevention education curriculum designed for African-American youth ages 14–18.  BART teaches students to reduce sexual risk taking by promoting safer sex practices while also teaching that abstinence is the most effective way to prevent HIV and unintended pregnancy. The curriculum combines education with behavioral skills training on assertion, refusal, self-management, problem solving, risk recognition, and correct condom use.[9]  BART includes interactive activities, group discussions, and role-plays developed by teens. It is designed for implementation in community-based settings and with single-sex groups. An evaluation of the program published in the Journal of Consulting and Clinical Psychology found that it increased participant knowledge of HIV and AIDS and increased participants’ ability to manage the pressure to engage in unprotected sex as well as to provide information to their peers regarding safe sexual practices.  The program was also found to delay the initiation of sexual intercourse; reduce the frequency of sex and the incidence of unprotected sex; and reduce the incidence of unprotected anal sex.  Among male participants, the program was found to increase condom use [10]
 
The Children’s Aid Society – Carrera Adolescent Pregnancy Prevention Program
Children’s Aid Society – Carrera Adolescent Pregnancy Prevention Program (CAS – Carrera) is an evidence-based positive youth development program designed for students in grades six through 12. The program consists of seven integrated components that can be delivered in an after-school or in-school setting over the course of a year. These units include Education, Job Club, Family Life and Sexuality Education, Mental Health, Medical and Dental Services, Self Expression, and Lifetime Individual Sports.[11] The program uses a positive youth development approach to increase developmental competency and identity formation among participants in order to encourage youth to avoid early parenthood and risky sexual behavior. CAS – Carrera runs six days a week throughout the academic year and also includes a summer program component.[12] An evaluation of the program published in Perspectives on Sexual and Reproductive Health found that at a three-year follow-up female participants were significantly less likely to report a pregnancy or report being sexually active than participants in the control group.[13]
 
¡Cuídate!
¡Cuídate! is an evidence-based HIV-prevention curriculum adapted from the evidence-based curriculum, Be Proud! Be Responsible!, and tailored for use with Latino youth ages 13–18. The curriculum provides information about HIV and its transmission, addresses values and beliefs related to HIV and safer sex, and includes activities aimed to increase skills and self-efficacy for condom use, negotiating abstinence, and safer sex. The intervention consists of six, one-hour lessons and is designed for use with small, mixed-gender groups. It draws upon cultural beliefs, such as the importance of family and the responsibility of a man to care for his family, in order to provide messages that resonate with participants.  The curriculum consists of educational games, small group discussions, videos, learning exercises, and skill-building activities.  An evaluation of the curriculum published in the Archives of Pediatrics & Adolescent Medicine found that it reduced the frequency of sexual intercourse, number of sexual partners, and incidence of unprotected sex, while increasing condom use, among participants.[14]
 
Draw the Line/Respect the Line
Draw the Line/Respect the Line is an evidence-based program designed to teach youth in grades six through eight to postpone sexual involvement while providing information about condoms and contraception. The school-based curriculumconsists of 19 sessions divided between grades six through eight and includes group discussions, small group activities, and role playing exercises focused on teaching youth how to establish and maintain boundaries regarding sexual behavior. Lessons for sixth grade students address using refusal skills; lessons for the seventh grade focus on setting sexual limits, the consequences of unprotected sex, and managing sexual pressure; and eighth grade students practice refusal and interpersonal skills and receive HIV/STD-prevention education. The program also includes individual teacher consultations and parent engagement through homework activities. Although it is designed for use in the classroom, the program may also be delivered in a community-based setting. An evaluation of the program published in the American Journal of Public Health found, at a one-, two-, and three-year follow-up, that male participants were significantly less likely to report ever having had sexual intercourse or having had sexual intercourse during the previous 12 months compared to participants in the control group.[15]
 
FLASH (Family Life and Sexual Health)
FLASH(Family Life and Sexual Health) is a set of comprehensive sexuality education curricula developed by the Seattle and King County, Washington public health department. The curricula are designed for students in grades five through 12 and divided by grade level into three separate curricula: 4/5/6 FLASH, 7/8 FLASH, and High School FLASH. There is also a version for special education students ages 11–21 in self-contained classes. Each curriculum contains approximately 20 lessons. FLASH “rests on a foundation of positive and healthy sexuality across the lifespan;” furthermore, it “focuses on the needs of public schools and diverse communities” and includes a “strong family involvement component.”[16]  The curricula focus on abstinence while also providing information on the prevention of pregnancy and sexually transmitted diseases (STDs), including HIV. Lessons cover such topics as human growth and development, sexual health, risk behavior and social factors associated with HIV/AIDS, interpersonal relationships, body image, gender roles, and sexual orientation, among others. FLASH is considered a promising model program; an examination of the most recent version of the curriculum concluded that its “concurrence with the characteristics of sex education programs that have been rigorously evaluated and found to be effective” was strong. High School FLASH is undergoing a longitudinal, randomized, behavioral evaluation in years 2011 through 2014, with results expected in 2015.[17]
 
FOCUS: Preventing Sexually Transmitted Infections and Unwanted Pregnancies among Young Women
FOCUS: Preventing Sexually Transmitted Infections and Unwanted Pregnancies among Young Women is an evidence-based intervention that addresses such issues as responsible behavior, relationships, and HIV/STD and pregnancy prevention in order to encourage young women to practice healthy behavior and responsible decision making. The program is appropriate for use with young women ages 17–22 in school-based or community-based settings, including clinics. FOCUS consists of four, two-hour sessions. Session One provides information about STDs, including HIV, and unintended pregnancy and addresses the consequences of risky sexual behavior. Session Two discusses contraception and barrier methods and teaches communication and condom negotiation skills. Session Three discusses the signs and symptoms of STD infection, including HIV/AIDS; and Session Four addresses the impact of alcohol use on sexual decision making. The sessions are primarily lecture- and discussion-based, but also incorporate some interactive activities, such as role-plays. An evaluation of the program published in Preventive Medicine found that at a 14-month follow-up, program participants who had been sexually inexperienced at the start of the intervention were significantly less likely to report having had multiple sexual partners at the time of the follow-up. The intervention was also found to be effective in reducing the number of unintended pregnancies and STD infections among participants compared to those in the control group.[18]
 
Focus on Youth: An HIV Prevention Program for African-American Youth (Focus on Youth)
Focus on Youth is an HIV-, STD-, and pregnancy-prevention program designed for African-American youth ages 12–15.  Adapted from the research-proven program, Focus on Kids, the curriculum is updated and tailored to meet the needs of African-American youth. Focus on Youth consists of eight sessions and is designed for implementation in community-based settings. It includes interactive activities, such as role playing, games, group discussions, and community projects.  The curriculum teaches information and skills related to decision making, values, accessing information, communication, negotiation, goals for the future, abstinence, contraception, pregnancy prevention, STDs, including HIV, and “facts about a healthy sexual lifestyle,” among other topics. An evaluation of the program published in the Archives of Pediatrics and Adolescent Medicine found that at a six-month follow-up, participants reported using condoms at a significantly higher rate than peers who had been in the control group.  This finding was most significant among young men who participated in the program.[19]
 
Get Real About AIDS
Get Real About AIDS is a skills-based, HIV risk-reduction curriculum designed for students in grades nine through 12. This 15-session school-based program consists of experiential activities that serve to develop participants’ refusal and communication skills as well as their skills in using condoms.  The curriculum addresses practicing safer sexual behaviors, including delaying sexual activity, using condoms, being monogamous if sexually active, and avoiding risky situations.[20] An evaluation of the program published in Preventive Medicine found that it increased knowledge of HIV and HIV prevention, reduced the number of sexual partners, and increased condom use among participants.[21]
 
It’s Your Game: Keep it Real
It’s Your Game: Keep it Real is an evidence-based HIV-, STD-, and pregnancy-prevention curriculum designed for seventh and eighth grade students. The curriculum consists of 24 classroom-based lessons designed to encourage participants to delay sexual initiation and to use condoms and contraception if and when they become sexually active.  It incorporates group activities, computer-based sessions, role modeling, journaling, and group discussion and addresses how to set personal limits for risk behaviors, how to be aware of vulnerable situations that may challenge those limits, and how to use refusal and other skills to maintain limits. Topics addressed in seventh grade include healthy friendships, setting personal limits, human growth and development, and refusal skills, among others. Eighth grade topics include healthy dating relationships, the importance of STD and pregnancy testing, and skills for using condoms and contraceptives. An evaluation of the curriculum published in the Journal of Adolescent Health found, at a ninth grade follow-up, that students who were sexually inexperienced at the start of the program were significantly less likely to report having initiated sex than sexually inexperienced participants in the control group.[22]
 
Making a Difference!
Making a Difference! is an evidence-based pregnancy-, STD-, and HIV-prevention education curriculum that emphasizes abstinence from sexual activity. Adapted from the evidence-based curriculum, Be Proud! Be Responsible!, Making a Difference! aims to increase participants’ knowledge about HIV, STD, and pregnancy prevention as well as their confidence to negotiate sexual pressure and intention to abstain from sex. It is designed for use with African-American, Latino, and white adolescents ages 11–13 and can be implemented in school- or community-based settings.  The curriculumincludes interactive activities, small group discussions, and skill-building exercises, including role-plays, aimed to increase comfort and efficacy with practicing abstinence. An evaluation of the curriculum published in the Journal of American Medical Association found that at a three-month follow-up, participants in the program were less likely to report having had sexual intercourse in the three months prior than peers in the control group. Evaluation results also showed that the program helped to delay sexual initiation among program participants who were sexually inexperienced.[23]
 
Making Proud Choices!
Making Proud Choices! is an evidence-based STD-, HIV-, and pregnancy-prevention curriculum designed for use with African-American, Latino, and white adolescents ages 11–13. The curriculum aims to help youth understand the poor reasoning and decision making that can lead to STD/HIV infection and/or unintended pregnancy, as well as to increase their confidence, negotiation skills, and self-efficacy in using condoms. The program consists of eight, one-hour sessions and can be implemented in school- or community-based settings. Making Proud Choices! includes interactive and skill-building activities that are designed to “increase comfort with practicing condom use, address concerns about negative effects of practicing safer sex, and build skills in condom use and negotiation.”[24]  An evaluation of the program published in the Journal of the American Medical Association showed that program participants reported more consistent condom use and less unprotected sex as well as a higher frequency of condom use than those in the control group.[25]
 
Positive Prevention: HIV/STD Prevention Education for America’s Youth
Positive Prevention is a “research-validated” HIV/STD-prevention curriculum designed for use with middle school and high school students; students in alternative settings, including home-schooling and special education classes; and developmentally disabled adults in a classroom setting.[26]  The curriculum was developed by the Orange County, California Chapter of the American Red Cross. It addresses such topics as stereotypes and myths regarding persons living with HIV/AIDS; HIV transmission myths and facts; HIV/STD prevention, risk reduction methods, and testing; and refusal skills, among other topics. An evaluation of the program published in the American Journal of Health Education found that the curriculum “significantly increased positive attitudes toward abstaining from sexual intercourse, increased self-efficacy to abstain from sexual activity, and increased self-efficacy to use condoms” among participants.[27]
 
Power Through Choices
Power Through Choices is an HIV-, STD-, and pregnancy-prevention curriculum designed for youth ages 14–18 residing in group homes, foster homes, or other residential care settings.[28] The curriculum focuses on reducing sexual risk behaviors related to unintended pregnancy and STD/HIV infection. It engages youth in interactive exercises “to build self-empowerment and increase their decision making skills.”[29] Additionally, the program provides instruction to help youth gain and practice skills for using contraception, communicating effectively, and accessing available resources and health services.[30] Power Through Choices consists of ten, 90-minute sessions that are designed to be implemented twice a week over a period of five to six weeks. Lessons include activities, time for reflection, and group discussion.[31] An evaluation of the program pilot published in Child Welfare showed the curriculum held promise in reducing risky sexual behaviors among program participants.[32]
 
Project AIM (Adult Identity Mentoring)
Project AIM (Adult Identity Mentoring) is an evidence-based youth development program designed to help adolescents identify their future goals and consider how engaging in risky behavior may negatively impact their ability to achieve those goals. The program is based on the “Theory of Possible Selves,” which proposes that an individual’s motivation is determined by the ability to imagine his future self. Those that are capable of imagining both possible positive and negative futures are therefore more inclined to work toward their life goals.[33] The school-based intervention consists of 10 sessions which are divided into four units: 1) Legacy, Role Models, and Peers; 2) Self-Projection: Expanding Visions of Possible Selves; 3) Self-Expression through Work: Development of Possible Self; and 4) Skills of Fulfilling Positive Future Possible Selves.[34] The lessons consist of group discussions, interactive activities, and role-playing exercises to encourage youth to explore their personal interests, social surroundings, and their goals for their future adult life.[35] Project AIM is designed for use with African-American youth ages 11–14 and is also appropriate for use with Latino youth. Although it is a school-based program, it can also be implemented in community-based settings. An evaluation of the program published in the Journal of Adolescent Medicine found that at a 19-week follow-up, adolescents who participated in the program were significantly less likely to report having had sexual intercourse than participants in the control group; and, at a one-year follow-up, male participants were significantly less likely to report having had sexual intercourse than participants in the control group.[36]
 
Promoting Health Among Teens! (Abstinence-Only Intervention)
Promoting Health Among Teens! (Abstinence-Only Intervention) is an evidence-based curriculum developed to increase knowledge and awareness about STDs, including HIV, increase an understanding of how abstinence can prevent pregnancy and HIV/STDs, and build refusal and negotiation skills for practicing abstinence. Promoting Health Among Teens! aims for participants to abstain from vaginal, oral and anal intercourse until a time later in life when they are ready to handle the potential consequences of having sex and neither discourages nor encourages condom use.[37] Although originally intended for use with urban, African-American youth in small groups, the intervention can be adapted for use with larger groups and those in rural settings.[38]  The curriculum is designed as eight, one-hour modules that include group discussions, videos, role-playing, skill-building activities, games, and other experiential exercises. It is appropriate for use in both school- and community-based settings. An evaluation of the program published in the Archives of Pediatrics & Adolescent Medicine found that at a 24-month follow-up, participants who were sexually inexperienced at the time of the program were significantly less likely to have initiated sex than participants in the control group.[39]
 
Raising Healthy Children
Raising Healthy Children is an evidence-based youth development program that seeks to reduce risk factors, including school failure, substance abuse, and delinquency, among students in grades one through six. It promotes positive youth development by incorporating multiple components, including individual, school, and family programming. Raising Healthy Children  is designed as a multi-year, comprehensive, school-based program, and targets protective factors such as parent-child connectedness, children’s bonding with their school, academic achievement, interpersonal problem solving skills, refusal skills, and positive classroom behavior to support educational and life success. A long-term evaluation of the program began in 1981 and follow-up conducted with former program participants at age 18 found that, in comparison to the control group, they were significantly less likely to report ever having had sexual intercourse; and those who were sexually active reported significantly fewer lifetime sexual partners. At age 21 follow-up, female participants were significantly less likely to report a lifetime pregnancy or birth than females in the control group; and at age 24 follow-up both male and female participants were significantly less likely to report having ever been diagnosed with an STD compared to those in the control group.[40]
 
Reducing the Risk
Reducing the Risk: Building Skills to Prevent Pregnancy, STD and HIV is an evidence-based, pregnancy-, STD-, and HIV-prevention curriculum designed for classroom use with students in the ninth and tenth grades. It is appropriate for use with multi-ethnic populations.[41]  Reducing the Risk aims to reduce high-risk behaviors among participants and emphasizes strategies for abstaining from sex or practicing safer sex. The 16-lesson curriculum addresses both abstinence and contraception use and includes experiential activities that teach students to develop refusal, negotiation, and communication skills. An evaluation of the program published in Family Planning Perspectives found that it increased parent-child communication, especially among Latino youth, delayed the initiation of sexual intercourse, and reduced incidence of unprotected sex among lower-risk youth who participated in the program.[42]
 
Rikers Health Advocacy Program
Rikers Health Advocacy Program is an evidence-based HIV/AIDS-prevention education program designed for high-risk youth, particularly those who are incarcerated and have issues with substance abuse. The program aims to reduce HIV-risk behaviors among participants. Rikers Health Advocacy Program uses a “Problem-Solving Therapy” approach, which leads participants through the steps of identifying and defining a problem, understanding the nature of the problem, developing possible solutions, engaging in decision making, and implementing a solution. The intervention was originally designed for adolescent males ages 16–19 at Rikers Island correctional facility in New York. The program consists of four, one-hour sessions that are facilitated by a male instructor twice a week over a two-week time period. The instruction emphasizes active learning and addresses such topics as factors related to experimenting with drugs and drug use; risks related to sexual activity; the connection between drug use, sexual activity, and HIV risk; and how to access health care services and drug treatment.[43] Rikers Health Advocacy Program engages participants in discussions about HIV facts and beliefs; has participants identify attitudes or behaviors that place individuals at risk for HIV infection; and then has participants develop possible strategies for avoiding such risks, which are then evaluated by other participants. The program includes role-plays to act out the solution strategies developed for avoiding risky situations. An evaluation of the program found that program participants were more likely to use condoms during intercourse than those in the control group.[44]
 
Safer Choices
Safer Choices is an evidence-based HIV-, STD-, and pregnancy-prevention program designed for students in the ninth and tenth grades.  The program consists of experiential activities developed to build communication skills, skills for delaying sexual initiation, and condom-efficacy skills for those students who are or become sexually active. Safer Choices has five program components, including a “school health protection council” that involves students, parents, school faculty, and community members; a 20-session classroom-based curriculum; a peer team or club responsible for hosting school-wide activities; a parent education component with parent-child activities; and activities to expose and increase students’ awareness of local support services. An evaluation of the program published in the Journal of Adolescent Health found that the program was effective in delaying the initiation of sexual intercourse among Latino youth.  Additional evaluations of Safer Choices showed that among participants it increased the use of contraception, increased condom use, reduced incidence of unprotected sex, and reduced number of sexual partners with whom condoms weren’t used.[45]
 
Safer Sex
Safer Sex is a clinic-based intervention designed for female adolescents. The intervention is delivered to participants in a one-on-one setting and seeks to reduce their incidence of STD infection and improve their efficacy of condom use. The intervention is administered by a female health educator and begins with the viewing of a brief video clip that uses celebrities to dramatize buying condoms as well as negotiating condom use. The video is followed by a 30-minute discussion with the health educator, which is tailored to meet the interests and risk level of the individual participant. The discussion addresses the consequences of having unprotected sex, methods for preventing unintended pregnancy and STDs, including HIV, secondary abstinence, and condom-use skills. Participants also conduct a self-assessment to evaluate their sexual risk and are provided with written information about safer sex and contraception use. In addition, the intervention includes one-, three-, and six-month booster sessions at which time participants are invited back to the clinic for follow-up. An evaluation of the program published in the Archives of Pediatrics and Adolescent Medicine found, at a six-month follow-up, that the intervention reduced the incidence of multiple sexual partners among participants.[46]
 
Sexual Health and Adolescent Risk Prevention (SHARP)
Sexual Health and Adolescent Risk Prevention (SHARP) is an evidence-based program designed to reduce sexual risk behaviors among high-risk adolescents in juvenile detention centers. The intervention aims to increase condom use and reduce alcohol-related sexual behavior among participants by increasing their knowledge of STDs, including HIV, improving condom-use skills, and teaching them to set long-term goals for reducing their sexual risk behavior. Designed as a three-hour, one-time intervention, the program consists of a learning component followed by group discussion. A trained facilitator administers the program to a small group of same-sex participants. The program includes activities such as a videogame and condom-use demonstration. An evaluation of the program published in Pediatrics found that at a six-, nine-, and 12-month follow-up participants reported more consistent condom use than those in the control group.[47]
 
SiHLE (Sisters Informing, Healing, Living and Empowering)
SiHLE(Sisters Informing, Healing, Living, and Empowering) is an evidence-based HIV- and STD-prevention education program designed for African-American females ages 14–18 who are sexually active and at high risk for HIV. It is a peer-led, social skills training intervention based on social cognitive theory and the theory of gender and power.[48] The program consists of four, four-hour sessions that are administered on consecutive Saturdays in a community-based setting. Sessions are led by an African-American female adult and two peer-facilitators, ages 18–21. The sessions are designed to reinforce ethnic and gender pride and address HIV-prevention strategies, the transmission of STDs, communication and negotiation skills, condom-use skills, self-efficacy, healthy relationships, and personal empowerment. The program incorporates group discussion, lectures, games, and role-playing. Participants also complete homework assignments that provide opportunity for reflection and skills practice. An evaluation of the program published in the Journal of the American Medical Association found that at a six-month follow-up, program participants were significantly less likely to report being pregnant and significantly more likely to report having used condoms consistently in the previous six months than participants in the control group. In addition, at a twelve-month follow-up participants were significantly more likely to report consistent condom use in the previous 30 days and having used a condom during last sexual intercourse than participants in the control group.[49]
 
Tailoring Family Planning Services to the Special Needs of Adolescents
Tailoring Family Planning Services to the Special Needs of Adolescents is a pregnancy prevention protocol that provides clinic-based contraception education, counseling, and services to meet the specific needs of adolescent clients. Administered in family planning clinics and other reproductive health care settings, the intervention offers age- and developmentally appropriate information, increased counseling time, information about medical exams, and reassurances of confidentiality for clients under the age of 18. The protocol includes a Personal Information Form, which helps health providers identify female adolescents who are at high risk of becoming pregnant. The two-part intervention consists of the original appointment and a six-week follow-up appointment. It is designed for use with suburban and rural white female adolescents ages 17 and younger. An evaluation of the study published in Family Planning Perspectives found, at a six-month follow-up, that clients who received the intervention were significantly more likely to report using a contraceptive method. Long-term findings show that the intervention also reduced pregnancy rates among participants.[50]
 
Teen Health Project
Teen Health Projectis a community-level, HIV risk-reduction program designed for young people ages 12–17 living in low-income housing developments. The purpose of the program is to reduce sexual activity, increase condom use and negotiation skills, and reduce risky sexual behavior among participants. The initial component of the program consists of two, three-hour workshops focusing on HIV/STD prevention and building skills. Some participants in the workshops are then nominated to the Teen Health Project Leadership Council which meets on a weekly basis during a six-month period to implement community activities and organize HIV-prevention activities for their peers. In addition, Teen Health Project includes a parent component which consists of a 90-minute HIV/AIDS education workshop that provides information to parents about risk reduction and talking to their children about sexual health issues. An evaluation of the program published in AIDS found, at a 12-month follow-up, that sexually inexperienced youth who participated in the program were significantly more likely to have remained abstinent; and, at an 18-month follow-up, sexually active youth who participated in the program were significantly more likely to report condom use at the time of last sexual intercourse than participants in the control group.[51]
 
Teen Outreach Program (TOP)
Teen Outreach Program (TOP) is an evidence-based youth development program that engages young people in experiential learning activities in order to “prepare for successful adulthood and avoid problem behaviors.”[52] The program is designed for youth ages 12–17 and focuses on reducing rates of school failure, school suspension, and teen pregnancy. TOP consists of a nine-month curriculum that addresses such topics as relationships, peer pressure, decision making, values clarification, goal-setting, adolescent development, and sexual health.[53] It also includes a 20-hour community service component that engages participants in activities to enhance knowledge and develop skills, including self-efficacy, communication, conflict-management, and self-regulation. TOP can be delivered as an in-school, after-school, or community-based program. An evaluation of the program published in Child Development found that young women, ages 15–19, who participated in TOP were significantly less likely to report a pregnancy during the program than participants in the control group.[54]
 
What Could You Do?
What Could You Do? is an evidenced-based, STD risk-reduction program that uses an interactive video to encourage safer sexual behaviors among female high school students. The program is designed as a one-on-one intervention, with each participant viewing the video individually. It aims to increase participants’ knowledge of STDs along with reducing their sexual risk behavior and risk of STD infection. The video includes vignettes featuring ethnically diverse young women involved in realistic scenarios related to sexual risk behavior, where the viewer must choose what action the character should take from different options. The vignettes give viewers the opportunity to practice how they would respond in different situations. The video covers sexual situations, risk reduction, reproductive health, and STDs. In addition, the video associates condom use with positive outcomes, such as pleasure and reassurance. What Could You Do? can be used in a physician’s office or clinic setting and could potentially be used in other settings, such as schools, as long as there was enough privacy for the viewer. An evaluation of the program published in Social Science & Medicine found that at a six-month follow-up to the intervention, participants were almost twice as likely not to have been diagnosed with an STD as those in the control group.[55]
 
Wise Guys Male Responsibility Curriculum
Wise Guys is a teen pregnancy prevention curriculum designed for adolescent males ages 11–17. The curriculum was developed by the Family Life Council of Greensboro, North Carolina. Wise Guys focuses on equipping youth to “make wiser and more responsible decisions” about their sexual health.[56] The curriculum includes 10 lessons that address self-esteem, personal and family values, goal-setting, stereotypes of masculinity, communication skills, reproductive anatomy, puberty, STDs, including HIV, delaying sexual intercourse, the consequences of teenage pregnancy/early parenthood, and other topics.[57] Wise Guys is appropriate for use in both school- and community-based settings.
 
 

[1]“ABAN AYA Youth Project: Preventing High-Risk Behaviors Among African American Youth in Grades 5–8,” Sociometrics, accessed 1 July 2011, <http://www.socio.com/srch/summary/pasha/full/passt24.htm>.
[2]“Aban Aya Youth Project” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=593&PageTypeID=2>.
[3]“Pregnancy Prevention Intervention Implementation Report: Be Proud! Be Responsible!” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/all_4_you.html>.
[4]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 1 July 2011, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 56–59.
[5]“Be Proud! Be Responsible!” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=1&PageTypeID=2>; see also “Pregnancy Prevention Intervention Implementation Report: Be Proud! Be Responsible!” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/be_proud_responsible.html>.
[6]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections, 56–59.
[7]“Be Proud! Be Responsible! Be Protective!” Evidence-Based Programs Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 5 May 2010, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=607&PageTypeID=2>.
[8]“Pregnancy Prevention Intervention Implementation Report: Be Proud! Be Responsible! Be Protective!,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/be_proud_responsible_protective.html>.
[9]“Becoming A Responsible Teen,” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 5 May 2010, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=2&PageTypeID=2>.
[10]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 30 March 2010, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 76–78.
[11]“Our Program,” The Children’s Aid Society – Carrera Adolescent Pregnancy Prevention Program, accessed 1 July 2011, <http://stopteenpregnancy.childrensaidsociety.org/our-program>.
[12]Ibid.
[13]“Pregnancy Prevention Intervention Implementation Report: Children’s Aid Society (CAS) – Carrera,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/cas_carrera.html>.
[14]“Cuidate!” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 5 May 2010, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=577&PageTypeID=2>; see also Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections, Second Edition(Washington, DC: Advocates for Youth, 2008), accessed 30 March 2010, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 76–79.
[15]“Draw the Line/Respect the Line,” Emerging Answers (Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy, 2007), accessed 1 July 2011, <http://www.thenationalcampaign.org/ea2007/desc/draw_pr.pdf>; see also “Draw the Line/Respect the Line,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/draw_the_line_respect_the_line.html>.
[16]“Questions About the Family Life and Sexual Health (F.L.A.S.H.) Curriculum,” Public Health – Seattle and King County, accessed 3 May 2010, <http://www.kingcounty.gov/healthservices/health/personal/famplan/educators/FLASH/questions.aspx>.
[17]Ibid.
[18]“FOCUS: Preventing Sexually Transmitted Infections and Unwanted Pregnancies among Young Women,” Evidence-Based Program, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 15 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=608&PageTypeID=2>; see also “FOCUS: Preventing Sexually Transmitted Infections and Unwanted Pregnancies among Young Women,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/focus.html>.
[19]“Focus on Youth: An HIV Prevention Program for African-American Youth” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 5 May 2010, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=125&PageTypeID=2>.
[20]“Get Real About AIDS,” Evidence-Based Program, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 15 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=126&PageTypeID=2>.
[21]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 30 March 2010, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 8–9.
[22]“It’s Your Game: Keep it Real,” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=574&PageTypeID=2>.
[23]“Making a Difference!” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=127&PageTypeID=2>.
[24]“Making Proud Choices!” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 15 April 2010, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=128>.
[25]Ibid.
[26]“Positive Prevention: HIV/STD Education for America’s Youth,” American Red Cross, accessed 4 May 2010, <http://www.positiveprevention.com/>.
[27]Ibid.
[28]“Power Through Choices,” Massachusetts Alliance on Teen Pregnancy, accessed 18 August, 2011, <http://www.massteenpregnancy.org/sites/default/files/PTC%20Overview.pdf>.
[29]“Power Through Choices – Sexuality,” NRCYS Online Catalog, accessed 5 May 2010, <http://www.nrcys.ou.edu/catalog/product.php?productid=116>.
[30]“Power Through Choices,” Massachusetts Alliance on Teen Pregnancy.
[31]Ibid.
[32]Preventing Teen Pregnancy Among Marginalized Youth: Developing a Policy, Program, and Research Agenda for the Future, (Baltimore, MD: Healthy Teen Network, 8 September 2008), accessed 5 May 2010, <http://www.healthyteennetwork.org/index.asp?Type=B_PR&SEC={2AE1D600-4FC6-4B4D-8822-F1D5F072ED7B}&DE={235FD1E7-208D-4363-9854-4E6775EB8A4C}>.
[33]“Adult Identity Mentoring (Project AIM)” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=573>; see also “Project AIM: Adult Identity Mentoring, A Youth Development Intervention for HIV Risk Reduction,” Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, accessed 18 August 2011, <http://www.cdc.gov/hiv/topics/prev_prog/rep/packages/pdf/aim.pdf>.
[34]“Adult Identity Mentoring (Project AIM)” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=573>.
[35]“Adult Identity Mentoring (AIM),” Promising Practices, San Bernardino County Department of Public Health, accessed 1 July 2011, <http://www.healthysanbernardinocounty.org/modules.php?op=modload&name=PromisePractice&file=promisePractice&pid=3633>.
[36]“Pregnancy Prevention Intervention Implementation Report: Adult Identity Mentoring (Project AIM),” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/adult_identity_mentoring_project_aim.html>.
[37]Ibid.
[38]“Promoting Health Among Teens! Abstinence-Only,” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=575&PageTypeID=2>.
[39]“Pregnancy Prevention Intervention Implementation Report: Promoting Health Among Teens! Abstinence-Only Intervention,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/promoting_health.html>.
[40]“Raising Healthy Children,” Evidence-Based Program, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 23 August 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=611&PageTypeID=2>.
[41]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 30 March 2010, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 22.
[42]Ibid., 23–24.
[43]“Rikers Health Advocacy Program (RHAP)” Evidence-Based Program, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 23 August 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=612&PageTypeID=2>.
[44]Ibid.
[45]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 30 March 2010, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 26–28.
[46]“Pregnancy Prevention Intervention Implementation Report: Safer Sex,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/safer_sex.html>.
[47]“Sexual Health and Adolescent Risk Prevention (SHARP)” Evidence-Based Program, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 23 August 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=613&PageTypeID=2>.
[48]“Sisters Informing, Healing, Living, Empowering (SiHLE),” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=567&PageTypeID=2>.
[49]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 1 July 2011, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 98–101; see also “Pregnancy Prevention Intervention Implementation Report: Sisters Informing, Healing, Living, and Empowering (SiHLE),” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/sihle.html>.
[50]Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections (Washington, DC: Advocates for Youth, 2008), accessed 1 July 2011, <http://www.advocatesforyouth.org/storage/advfy/documents/sciencesuccess.pdf>, 102–105.
[51]“Teen Health Project,” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 1 July 2011, <http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=576&PageTypeID=2>.
[52]Saras Chung and Annie Philipps, Promoting Mental Health and Well-being in Adolescents: Recommendations for Wyman’s Teen Outreach Program, (Eureka, MO: Wyman Teen Outreach Program, 2010), accessed 1 July 2011, <http://www.wymantop.org/pdfs/TOP_Positive_Well-Being.pdf>, 3.
[53]Ibid, 9.
[54]“Pregnancy Prevention Intervention Implementation Report: Teen Outreach Program,” Programs for Replication – Intervention Implementation Reports, U.S. Department of Health and Human Services, accessed 1 July 2011, <http://www.hhs.gov/ash/oah/prevention/research/programs/teen_outreach_program.html>.
[55]“What Could You Do?,” Evidence-Based Programs, Resource Center for Adolescent Pregnancy Prevention (ReCAPP), ETR Associates, accessed 25 August 2011, <http://www.etr.org/RECAPP/index.cfm?fuseaction=pages.ebpDetail&PageID=617&PageTypeID=2>.
[56]“Welcome,” Wise Guys, accessed 15 August 2011, <http://www.wiseguysnc.org/default.asp>.
[57]“Curriculum Chapter Synopsis,” Wise Guys, accessed 15 August 2011, <http://www.wiseguysnc.org/ch_synopsis.htm>.
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