Case Study: Reducing the Risk

Reducing the Risk: Building Skills to Prevent Pregnancy, HIV and STD (RTR) includes 16 well-defined lessons for 9th and 10th graders which clearly emphasize teaching refusal statements, delay statements and alternative actions students can use to abstain from sexual intercourse or protect themselves from unwanted pregnancy, HIV and other sexually transmitted infections (STIs).

At the completion of this curriculum, students will be able to:

• Evaluate the risks and consequences of becoming an adolescent parent or becoming infected with HIV or another STI.
  
  
• Recognize that abstaining from sexual activity or using contraception are the only ways to avoid pregnancy, HIV infection and other STI.
  
  
• Conclude that factual information about conception and protection is essential for avoiding teenage pregnancy, HIV infection and other STI.
  
  
• Demonstrate effective communication skills for remaining abstinent and for avoiding unprotected sexual intercourse.

For more information about the Reducing the Risk curriculum, please see information about RTR in ReCAPP's Programs That Work section.

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Reducing the Risk is based on three health behavior theories including Social Learning Theory, Social Influence Theory and Cognitive-Behavioral Theory. These three theories hypothesize that in order to reduce risk-taking behavior people need to:

• learn and personalize relevant information,
  
  
• recognize social pressures and anticipate risky situations,
  
  
• establish norms for positive behaviors, and
  
  
• learn and practice skills to act on the information and cope with social pressures.

In order to address each of these critical components of the health behavior theories, Reducing the Risk provides the youth with the following:

• Information about teen pregnancy, HIV, abstinence, birth control and the risks and consequences of teen pregnancy and HIV/STI.
  
  
• Opportunities to personalize information by having youth identify their own vulnerability to pregnancy and HIV, examine the impact of pregnancy and HIV on their own lives, and identify their personal values regarding abstaining or using birth control.
  
  
• Opportunities to recognize social pressures and anticipate risky situations by having youth examine common lines used to pressure for sex and teaching youth how to anticipate and prepare for situations in which unwanted or unprotected sex may occur.
  
  
• Consistent reinforcement of norms for abstinence or protected sex.
  
  
• Opportunities to learn and practice skills including refusal skills, delaying skills and protection skills.

Social Learning Theory concepts are used throughout the RTR curriculum. While no single lesson exclusively illustrates one concept, and numerous lessons may reinforce a single concept, the following examples demonstrate Social Learning Theory in action:

Observational Learning: Role plays in Lessons One and Three demonstrate both ineffective and effective refusals to delay or abstain from sex. Others in the class observe the role plays and learn from their fellow students' mistakes and successes.

Expectations: Lesson Two asks students to discuss myths and facts about abstinence and list their own reasons for abstaining. It also discusses the importance of communication between partners and the elements of a healthy romantic relationship. These activities aim to raise students' expectations that they, too, can successfully negotiate for abstinence or safer sex without losing their partner.

Behavioral Capability: Lessons 10 and 11 provide students with numerous opportunities to practice the skills they have been learning in previous lessons. Through partially-scripted role plays and "situations," students practice anticipating and avoiding risky situations, avoiding unprotected sex, and even helping a younger sibling make a decision about whether to become sexually active.

Students may initially be hesitant about the expectations for role play, but they soon begin to enjoy those opportunities and use them to great advantage. For impact, students need encouragement to practice their interpersonal skills in role plays. The more students effectively say no to sex or plan to use protection, the more likely it is that they will act that way outside the classroom.

Self-Efficacy: Lesson 16 provides students with many opportunities to practice and fine tune their negotiation skills. Students engage in discussion and use critical thinking skills to examine reasons for sticking with their decisions to abstain or use protection.

Reciprocal Determinism: Lessons Seven and Eight prepare students to shop for condoms and visit a health clinic, and Lesson 15 gives students an opportunity to discuss their experiences. These experiences raise students' awareness of the effect their environment has on them and vice-versa.

While students do not directly act upon their environment to create change, they overcome barriers (i.e., embarrassment, lack of information, intimidation), experience both positive and negative reinforcement from their environment, and learn to put their skills into action.

Reinforcement: Many of RTR's lessons provide reinforcement of skills and positive choices. Discussions following role plays allow for feedback from those observing. Exercises frequently ask students to think about their reasons for abstaining or using protection as well as the ways in which having a baby or contracting an STI would change their lives.

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