Be Proud! Be Responsible! Be Protective!
Be Proud! Be Responsible! Be Protective!
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Deborah Koniak-Griffin, RN, Ed.D, F.A.A.N., Loretta Sweet Jemmott, Ph.D., R.N., F.A.A.N., and John B. Jemmott III, Ph.D.
Overview of the Curriculum
"Be Proud! Be Responsible! Be Protective!" is an adaptation of the "Be Proud! Be Responsible!" program targeting adolescent mothers or pregnant girls. The curriculum emphasizes the role of maternal protectiveness in motivating adolescents to make healthy sexual decisions and decrease risky sexual behavior. It also encourages adolescents to take on sexual responsibility and accountability and increases awareness of the effects of HIV/AIDS on inner city communities and their children.
The intervention aims to affect knowledge, beliefs, and intentions related to condom use and sexual behaviors such as initiation and frequency of intercourse. It also addresses the impact of HIV/AIDS on pregnant women and their children, the prevention of disease during pregnancy and the postpartum period, and special concerns of young mothers.
"Be Proud! Be Responsible! Be Protective!" is an eight-part curriculum that provides adolescents with the knowledge, motivation, and skills necessary to change their behaviors in ways that will reduce their risk of contracting STDs, HIV, and unplanned or repeat pregnancies. To change behavior, adolescents need not only information and a perception of personal vulnerability, but also the skills and the confidence in their ability to act safely. The curriculum consists of eight 60-minute modules, which can be presented over one to eight days and include the following:
Module I: Introduction to STDs, HIV/AIDS and Their Relationship to Teen Motherhood
The first module: 1) informs participants about the program; 2) helps them become comfortable, cohesive and productive in groups; 3) generates enthusiasm about being proud and responsible decision makers; 4) promotes the goal of protecting themselves and their community; 5) gives them factual information about HIV and AIDS; 6) gives them factual information about the risks of early motherhood to both mother and child and how these risks are increased with repeat pregnancies; and 7) helps participants recognize that behaviors leading to a repeat pregnancy (unprotected sex) increase their chances of heterosexual exposure to HIV.
Module II: Building Knowledge About HIV and Unplanned Pregnancy
The second module: 1) clarifies myths about the causes, transmission, and prevention of HIV while providing correct factual information; and 2) reinforces their knowledge about safer sex behaviors and methods to prevent unplanned repeat pregnancies.
Module III: Understanding Vulnerability to HIV Infection and Unplanned Repeat Pregnancy
The third module: 1) helps participants realize that they are vulnerable to HIV infection and unplanned repeat pregnancy; 2) examines who is responsible for safer sex behavior; 3) examines various opinions about HIV and safer sex behaviors.
Module IV: Understanding Vulnerability to HIV Infection and Unplanned Repeat Pregnancy (Part 2)
The fourth module: 1) helps participants realize that they are vulnerable to HIV infection and unplanned repeat pregnancy; 2) examines various opinions about HIV and safer sex behaviors; 3) clarifies the risk level for a variety of behaviors; and 4) helps participants identify their personal level of risk for HIV infection and unplanned repeat pregnancy.
Module V: Attitudes and Beliefs about HIV, AIDS, and Safer Sex
The fifth module: 1) highlights the impact of attitudes and beliefs on risky sexual behavior; 2) weakens negative beliefs and attitudes that foster risky sexual behaviors; 3) builds participants’ sense of responsibility for reducing the risk of HIV infection and unplanned pregnancy; and 4) reinforces their knowledge about safer sex behaviors and methods to prevent unplanned pregnancy.
Module VI: Attitudes and Beliefs about HIV, AIDS, and Safer Sex (Part 2)
The sixth module: 1) encourages planning for bringing a child into the world; 2) reinforces their knowledge about safer sex behaviors and methods to prevent unplanned pregnancy; and 3) reinforces goal-setting skills.
Module VII: Building Condom Use Skills
The seventh module: 1) reinforces pride and responsibility in avoiding HIV risk-associated behaviors; 2) assesses barriers to condom use while providing strategies to reduce these barriers; 3) examines the relationship of attitudes and condom use behaviors; 4) reinforces knowledge, comfort, and skills on how to use condoms correctly and how to make them fun and pleasurable; and 5) reinforces participants’ understanding of the consequences of unprotected sex.
Module VIII: Building Negotiation and Refusal Skills
The eighth module: 1) increases participants’ communication and negotiation skills and enhances their ability to resist situations that may place them at risk for contracting an STD, including HIV infection, and having an unplanned repeat pregnancy, 2) increase participants’ desire to practice safer sex, including abstinence; 3) builds skills to negotiate safer sex, including abstinence; 4) review and reinforce HIV and pregnancy prevention facts and skills learned, allows them to rehearse skills and to receive performance feedback; and 5) reinforces participants’ sense of pride in making safer sex decisions.
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Overview of the Original Study Design
The original study by Koniak-Griffin, Lesser, Nyamathi, Uman, Stein, and Cumberland (2003), was a randomized control trial conducted to test the effects of the "Be Proud! Be Responsible! Be Protective!" intervention. In the study, the eight-hour curriculum was implemented in four 2 hour sessions in four school districts of Los Angeles County. While the original sample was 572 pregnant adolescents and young mothers, the study reports on the 87% (n=497) of participants that provided data at all 5 time points. The participants were between the ages of 14 and 20 years of age (mean age 16.67 years, 77.7% were Latina, and 18.2% were African American).
Schools with pregnant minor or young parents’ programs were randomly assigned to receive one of two curricula: "Be Proud! Be Responsible! Be Protective!" or the health promotion control intervention.
The participants completed questionnaires before, immediately after, and 3, 6, and 12 months after the intervention. Of the original 572 participants, 92% attended the 12-month follow up (n=525). The mean age the primary outcome was an index of risky sexual behaviors in the previous 3 months, which included sexual intercourse frequency, multiple partners, number of sex partners involved with other men, consistent condom use, and heterosexual anal sexual in-tercourse.
The participants who received the "Be Proud! Be Responsible! Be Protective!" intervention had a significantly greater increase in behavioral intentions to use condoms at the 12 month follow-up compared to the control group (p<.05). They also reported significantly fewer sexual partners than those in the control group at the 6 month follow-up (p<.05). In addition, the BPBRBP participants had significantly better scores on AIDS knowledge compared to the control group (p<.001).
Other Significant Findings
The adolescents who received the "Be Proud! Be Responsible! Be Protective!" intervention had higher self-efficacy to use condoms and demonstrated greater condom use knowledge.
For a more detailed description of the study flow for a typical visit, please refer to the sample schedule of the day in the appendix. The schedule of the day is a project management tool that clearly outlines the sequence of events expected to occur throughout the session and details project staff assignments for each activity to clarify roles and responsibilities.
For More In-Depth Information:
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