Program Success Center

for Sexual & Reproductive Health

Making Proud Choices!

Making Proud Choices! Facilitator Curriculum CoverMaking Proud Choices! California Edition CoverMaking Proud Choices! An Evidence-Based, Safer-Sex Approach to Teen Pregnancy and HIV/STD Prevention is an 8-module curriculum that provides adolescents with the knowledge, confidence and skills necessary to reduce their risk of sexually transmitted diseases (STIs), HIV and pregnancy by abstaining from sex or using condoms if they choose to have sex. The intervention is based on cognitive-behavioral theories, focus groups and the authors’ extensive experience working with youth. Making Proud Choices! is an adaptation and extension of the original Be Proud! Be Responsible! curriculum that integrates teen pregnancy prevention along with HIV/STI prevention. There is also a 10-module adaptation for youth in out-of-home care, and an adaptation for the state of California that aligns with the requirements of the California Healthy Youth Act.

Category Original Program Features Out-of-Home Youth California Edition
Format

Print or Digital

Print

Print or Digital

Setting

Community based

English or Spanish

Community based

 

Community based

English or Spanish

Program Length

8 hrs/yr | 1 year
8 sessions total
12.5 hrs/yr | 1 year
10 sessions total
10 hrs/yr | 1 year
10 sessions total
Age Group Ages 12–18 Ages 12–18 Ages 12–18
Look Inside

Table of Contents
Sample Lesson
BUY NOW

Table of Contents
Sample Lesson
BUY NOW

Table of Contents
Sample Lesson
BUY NOW

See alignment with the Tool to Assess Characteristics >>

Overview | Description | Population | Authors

Overview

Making Proud Choices! provides adolescents with the knowledge, confidence and skills necessary to reduce their risk of sexually transmitted infections (STIs), HIV and pregnancy by abstaining from sex or using condoms if they choose to have sex. It is based on cognitive-behavioral theories, focus groups and the authors’ extensive experience working with youth. Making Proud Choices! is an adaptation and extension of the original Be Proud! Be Responsible! curriculum that integrates teen pregnancy prevention along with HIV/STI prevention. The School Edition is a 14-module adaptation designed to fit a school schedule. There is also a 10-module adaptation for youth in out-of-home care, with a particular emphasis on trauma-informed language, and an adaptation for the state of California that aligns with the requirements of the California Healthy Youth Act. Making Proud Choices! California Edition is on ACLU California's list of CHYA-compliant curricular materials and resources. For additional information and resources to support implementing and meeting the requirements of the California Healthy Youth Act, California's sexual health education law (2016), visit the California Department of Education's website or the ACLU's CHYA Resources page

Downloadable MPC Summary Sheet >>

 

Description

To reduce STI 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 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 STIs. Specifically, this curriculum emphasizes that adolescents can reduce their risk for STIs, HIV and pregnancy by using a condom, if they choose to have sex.

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 STIs 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, STI and teen pregnancy, however, if they choose to have sex, they must use a condom).

A series of fun and interactive learning experiences increase participation and help adolescents understand the faulty reasoning and decision-making that puts them at risk for STIs, HIV and unplanned pregnancies. Activities 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, and incorporate social cognitive-behavioral skill-building strategies (i.e., presentation, modeling, and the practice of condom use negotiation skills).

The curriculum involves culturally sensitive video clips, games, brainstorming, role-playing, skill-building activities and small group discussions that build group cohesion and enhance learning. Each activity lasts only a brief time and involves adolescents getting out of their seats and interacting with each other. In this way, it is possible to maintain interest and attention that might fade during a lecture or lengthy group discussion.

At the completion of the program, youth will

  • Have increased their knowledge of HIV, STIs and pregnancy prevention
  • Believe in the value of safer sex, including abstinence
  • Have improved their ability to negotiate abstinence/safer-sex practices
  • Have increased their ability to use condoms correctly
  • Have stronger intentions to use condoms if they have sex
  • Have a lower incidence of HIV/STI sexual risk-taking behavior
  • Take pride in choosing responsible sexual behaviors

 

Population Served & Setting

Making Proud Choices! was designed to be used with small groups ranging from 6 to 12 participants, but it can be implemented with larger groups as well. The curriculum can be implemented in various community settings, including schools and youth-serving agencies. The School Edition was designed to be used in classroom settings, where facilitators may be limited to time constraints.

The adaptation for youth in out-of-home care can be implemented in various community and out-of-care settings, including foster homes, independent and transitional living facilities, and juvenile justice settings. Most young people entering the system bring a host of traumas, including neglect and abuse, that can impact their psychosocial and sexual development and increase the likelihood that they will engage in behaviors that place them at risk of early pregnancy and STIs. The Making Proud Choices! adaptation for youth in out-of-home care is designed to empower in-care adolescents with greater knowledge and self-respect that will encourage them to protect themselves against unintended pregnancies and STI and/or HIV infection.

 

About the Authors

Loretta Sweet Jemmott, PhD, RN, FAAN, is one of the nation’s foremost researchers in the field of HIV/AIDS, STD and pregnancy prevention, with a consistent track record of developing evidence-based sexual risk-reduction interventions. As an expert in health promotion research, she has led the nation in understanding the psychological determinants for reducing risk-related behaviors and how best to facilitate and promote positive changes in health behaviors. Her research is devoted to designing and evaluating theory-driven, culturally competent sexual risk-reduction behavioral interventions with various populations across the globe.

An outstanding translational researcher, Dr. Jemmott’s work has had global impact and changed public policy. She has partnered with community-based organizations, including churches, clinics, barbershops and schools, and transformed her NIH-funded evidence-based research outcomes for use in real-world settings. She has presented her research to the U.S. Congress and at the NIH Consensus Development Conference on Interventions to Reduce HIV Risk Behaviors. Dr. Jemmott has received numerous awards for her significant contributions to the field of HIV/STD and pregnancy prevention research, including the U.S. Congressional Merit Award, Sigma Theta Tau National Honor Society’s Episteme Award and Hall of Fame Award, and election to membership in the Institute of Medicine, an honor accorded to very few nurses.

John B. Jemmott III, PhD, received his PhD in psychology from the Department of Psychology and Social Relations at Harvard University. He holds joint faculty appointments at the University of Pennsylvania as the Kenneth B. Clark Professor of Communication in the Annenberg School for Communication, and as Professor of Communication in Psychiatry in the Perelman School of Medicine. He is also the director of the Center for Health Behavior and Communication Research at the Annenberg School for Communication.

Dr. Jemmott is a Fellow of the Association of Psychological Science, the American Psychological Association and the Society for Behavioral Medicine. He has published more than 100 articles and book chapters, and has received numerous grants from the National Institutes of Health to conduct research designed to develop and test theory-based, contextually appropriate HIV/STD risk-reduction interventions for a variety of populations in the United States and sub-Saharan Africa.

Konstance A. McCaffree, PhD, CSE is a certified sexuality educator and adjunct professor in the Center for Education Human Sexuality Program at Widener University in Chester, Pennsylvania. As a classroom teacher in the public schools, she has taught human sexuality to both elementary and secondary students for over 35 years. Her professional association work includes serving on the Board of Directors of the Sexuality Information and Education Council of the U.S. (SIECUS), as President of the Society for the Scientific Study of Sexuality (SSSS) and as an officer in the American Association of Sexuality Education, Counselors and Therapists (AASECT). She conducts workshops nationwide to help educators improve their skills in teaching sexuality education. She also conducts programs for parents, churches and community organizations to enhance their knowledge and skills in dealing with the sexuality of children and teenagers.

In recent years, Dr. McCaffree has developed curricula and implemented training programs for educators and other health professionals in South Africa, Zambia, Nigeria and the Philippines. For the past 10 years she has trained teachers and professors to implement a curriculum she developed in coordination with local educators throughout the country of Nigeria. She has used her expertise to develop training for curricula to prevent HIV/AIDS, unplanned pregnancy, and other health and social issues among children, teenagers and adults.

Pamela M. Wilson, MSW, has over 30 years of experience in the fields of sexuality education and reproductive health. Since the late 1980s she has worked as an independent consultant and trainer on many different local, national and international projects. She has taught human sexuality courses at several universities, staffed national sexuality training initiatives, and has written or co-authored over 15 curricula for a variety of audiences including teens, parents, couples, young fathers, and girls ages 9 to 18.

She has worked on multiple evidence-based intervention projects, including providing consultation and training on an evidence-based program designed to help family planning clinics in central Pennsylvania become more youth friendly (Tailoring Family Planning to the Special Needs of Youth). She also worked closely with Dr. Loretta Sweet Jemmott to adapt the evidence-based curriculum Making Proud Choices for youth in out-of-home care, and, as a certified trainer, has trained approximately 100 facilitators in five states to implement the intervention. She has also worked with EngenderHealth to begin the development of an evidence-based HIV prevention curriculum for couples in Tanzania.

 

Length | Elements | Staffing | Notification

Length of Program

The original 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).

The School Edition has about 9-1/2 hours of content divided into fourteen 40-minute modules. It can be implemented in fourteen sessions of 40 minutes each or in any other format that is conducive for the needs of the school or organization in which the curriculum is being implemented (i.e.: seven sessions of 80 minutes); however, the modules should be implemented consecutively.

The adaptation for youth in out-of-home care has 12.5 of content divided into ten 75-minute modules. Ideally, implementation should be as concentrated as possible and completed in no more than 5 weeks total. It can be implemented using a 5-day format (two modules per day) or a 5-week format (2 modules per week). Some agencies have implemented this version of the curriculum in 3 days or over a weekend at a fun retreat setting—a format that will only work with lots of time built in for recreation. When the program for this target population stretches beyond 5 weeks, it’s challenging (but not impossible) to maintain attendance.

The California Edition has 10 hours of content divided into nine 60-minute modules and a 60-minute pre-module on healthy realtionships and sexual identity to be taught before the evidence-based program modules begin. It also includes additional content on affirmative consent, dating violence and sexual exploitation, and was designed to meet the requirements of the California Healthy Youth Act. It can also be used by agencies and schools that wish to provide additional comprehensive sexual health education content to the youth they serve.

 

Program Elements

Core intervention materials include:

  • Facilitator Curriculum
  • Activity Set (cards, posters, handouts)
  • Curriculum DVDs
    • The Subject Is: HIV (Safer Sex Version)
    • The Hard Way
    • Nicole’s Choice
    • The Subject Is: STDs (Safer Sex Version)
    • Tanisha and Shay
    • Wrap It Up & Condom Negotiation
  • Student Workbooks (classroom set of 30)

The Making Proud Choices implementation set for both editions includes the facilitator's guide, activity set, a classroom set of 30 student workbooks and 6 DVDs. The curriculum requires the use of a monitor with DVD capabilities or internet access for showing the videos online.

Student workbooks are recommended for every student. Additional workbook sets of 5 and 30 are available.

An optional LGBTQ Supplement is also available from ETR. It includes a lesson that can be taught before implementing the intervention as well as suggestions for acceptable adaptations to make evidence-based programs more inclusive of LGBTQ youth.

 

Staffing Requirements

This curriculum is designed to be taught by classroom teachers or family life educators. Educators interested in implementing this program should be skilled in using interactive teaching methods and guiding group discussions, and should be comfortable with the program content.

It is highly recommended that educators who plan to teach Making Proud Choices! receive research-based professional development to prepare them to effectively implement and replicate the curriculum with fidelity for the intended target group. Training on Making Proud Choices! is available through ETR's Professional Learning Services.

 

Parent/Guardian Notification

It is essential to inform parents and guardians regarding the nature and scheduling of this or any sexual health education program. Prior to implementation of the curriculum, families should receive written notice describing the goals of Making Proud Choices! and the nature of the content to be covered. Parents also should be given an opportunity to view the curriculum and related materials if they wish. The vast majority of parents want their children to receive appropriate instruction and be given the information and skills they need to protect their sexual health, but parents/guardians also must be allowed the chance to opt out or exclude their children from participating in the program, if they wish.

Theory | Logic Model | Evidence Summary | Reference

Theory

Three overriding themes provide the curriculum with a unique approach that has proven to be successful with young adolescents:

  1. The Community and Family Approach: Making Proud Choices! emphasizes how HIV, other STIs and unintended adolescent pregnancy have affected the community, while addressing the significance of protecting the family and community as a motive to change individual behavior. The focus on the implications for the family and community to motivate change is different from the traditional exclusive focus on individualistic HIV knowledge and individualistic attitudes toward risky behavior. In this connection, the intervention incorporates the “Be Proud! Be Responsible!” theme to encourage adolescents to be proud of themselves and to use condoms to prevent the sexual transmission of HIV, not only for their own sake, but for the sake of their families and community.
  2. The Role of Sexual Responsibility and Accountability: Many young adolescents do not express their sexual feelings in a responsible or accountable way. This is evident by the high incidence of STIs and pregnancy among adolescents. It is also illuminated by their self-reports of inconsistent condom use and multiple sexual partners. Young adolescents need to learn how to become sexually responsible and accountable. 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, STI and teen pregnancy, however, if they choose to have sex, they must use a condom).
  3. The Role of Pride: Adolescence is a difficult period of development. It is a time of confusion, mixed emotions and uncertainty. Adolescents are bombarded with sexual messages from various sources, such as TV, music, magazines, friends and their boyfriends/girlfriends. They receive pressure from their peers and boyfriends/girlfriends to have sex. They struggle with issues of self-esteem, self-respect and self-pride. Therefore they need to feel good about themselves, their decisions to practice safer sex and their behaviors. The curriculum addresses these feelings by emphasizing that one can feel proud and responsible in making safer sex choices. The adolescents’ sense of pride, self-confidence and self-respect regarding their choice to practice safer sex is encouraged and reinforced during the role-plays and other skill-building activities.

 

Logic Model

The program logic model can be found here:

Logic Model (pdf)

School Edition Logic Model (pdf)

 

Evidence Summary

Research Design

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).

Data Gathering

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.

Findings

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.

Process Evaluation Findings for the Youth in Out-of-Home Care Adaptation

As of October 2013, more than 330 youth in care across five states had received the adapted curriculum, Making Proud Choices! for Youth in Out-of-Home Care. Preliminary results from the process evaluation indicate:

  • Both youth and facilitators overwhelmingly enjoy the class and feel that the messages resonate with youth in foster care.
  • In youth satisfaction surveys, 88% of youth report that the program helped them learn more about preventing pregnancy, and 89% report that it helped them learn more about STI prevention.
  • 84% of participants reported that they would recommend the class to a friend.
  • All five states (California, Minnesota, North Carolina, Rhode Island and Hawaii) have established a wide and collaborative network of public and private partnerships which include child welfare agencies, state health and human services departments, as well as teen pregnancy prevention and other youth-serving organizations.

 

Reference

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.

Adaptation Guidelines | Online Implementation | Fidelity Log | Pre/Post Tests | Policy

Adaptation Guidelines

ETR is a leader in developing adaptation guidelines to enable professionals to adapt evidence-based intervention programs for implementation in underserved communities, while maintaining fidelity to the intervention's core components. ETR works with program developers to ensure that these tools are of the highest quality and meet the different needs of the field and end users, e.g., teachers, trainers, program managers/staff, research teams, and funders.

Click the links below to view Adaptation Guidelines for Making Proud Choices

Adaptation Green/Yellow/Red Guidelines (pdf)

Core Components (pdf)

For answers to Frequently Asked Questions about program adaptations, please visit our Program Support Help Desk.

Read ETR's Adaptations Policy.

 

Tools for Online Implementation

ETR has developed the following tools to facilitate implementation of the curriculum, particularly in virtual settings:

  • Virtual Implementation Guidance for Making Proud Choices!
  • Making Proud Choices! PowerPoint Slides
  • Jeopardy PowerPoint Template
  • Alternative Video Guidance

Click HERE to request access to the online implementation tools.

 

Fidelity Log

Click the links below for the logs for Making Proud Choices! Fifth Edition.

Making Proud Choices! Facilitator Log Sheets (pdf)

Making Proud Choices! School Edition Facilitator Log Sheets (pdf)

Making Proud Choices! for Youth in Out-of-Home Care Facilitator Log Sheets (pdf)

Making Proud Choices! California Edition Facilitator Log Sheets (pdf)

Making Proud Choices! California School Edition Facilitator Log Sheets (pdf)

 

Pre/Post Tests

Classroom teachers can use pre/post tests to examine whether short-term knowledge learning objectives have been met. A simple pretest-posttest assessment design can be used to measure pre-instruction levels and post-instruction changes in student learning. The sample pre-test provided here is from the research study and gathers demographic data on participants in addition to assessing attitudes and sexual health knowledge.

Your ability to detect student change using this survey may vary and can be affected by numerous factors (e.g., number and content of lessons students receive, student scores at pretest, student motivation and interest in topic and survey, etc.) Improvement between pretest and posttest can be viewed as supportive, but not definitive, evidence of the curriculum's impact on short-term knowledge learning objectives. A well-designed evaluation study (e.g., using a strong experimental design with a well-matched comparison group and adequate sample size) with more extensive measurement would be needed to provide stronger evidence of curriculum impact.

Making Proud Choices! Pre- and Post-Questionnaire (pdf)

Learn more about how ETR can help with your evaluation needs >>

NOTE: Due to Covid-19, ETR is offering our Trainings in a virtual format only at this time. The virutal training addresses both in-person and online implementation of the program and our trainers will model the virtual delivery of activities.

Training of Educators (TOE)

For over 30 years, ETR has been building the capacity of community-based organizations, schools, school districts, and state, county and local agencies in all 50 states and 7 U.S. territories to implement and replicate evidenced-based programs (EBPs) to prevent teen pregnancy, STD/STI and HIV. Our nationally recognized training and research teams work in partnership with clients to customize training and technical assistance (TA) to address the needs of their agencies and funding requirements.

Virtual TOE mapETR’s Virtual Training of Educators (TOE) for Making Proud Choices! equips sexual health facilitators with the knowledge and skills necessary to implement the program with youth.

All trainings align with ETR’s distributive learning process, an interactive experience that takes place over time. Core to this research-based approach is the acquisition of knowledge and development of skills, followed by the implementation of the program and educator self-reflection. During this process, ETR trainers engage learners through teaching strategies, interactive activities, modeling and follow-up support.

Training Components

The virtual TOE for Making Proud Choices! has the following components:

  • Priming Activities prior to Live Session 1 help participants ground themselves in the theory that informed the development of the program as well as the research detailing the program’s impact on the sexual health behaviors of youth.
  • Live Sessions take place in three 2.5-hour sessions over a 3-week period. Using engaging interactive activities along with a variety of virtual tools and strategies, the trainer models best practices for providing sexual health education and demonstrates effective teaching strategies for both in-person and virtual implementation.
  • Intersession Activities are completed between live sessions and take around 30 minutes. They enable participants to continue the learning process by completing various tasks such as reviewing program content and completing an Action Planning document.
  • Practice Session follows the completion of the third live session and is a core part of ETR’s distributive learning approach. After completing the practice session, participants submit a Practice Session Reflection document to the trainer and receive their Certificate of Completion.
  • Follow-up Support is part of every ETR training and is provided for 3 months after the last live session. During this time, the trainer provides additional resources via email and is available to answer questions, address challenges and brainstorm solutions tailored to each participant’s needs.

Participants in all trainings are required to commit to each component as it is a necessary to ensure that they feel confident and prepared to implement the program with youth.

Training Goal

Educators will have the knowledge, skills and confidence to effectively implement the program with youth.

Training Objectives

  1. Share accurate information related to:
    • Key findings from student outcomes of the EBP evaluation
    • Facts about STI and HIV prevention methods
    • Facts about pregnancy prevention methods
  2. Increase youth proficiency to:
    • Set and evaluate goals
    • Utilize refusal skills
    • Utilize negotiation skills
    • Utilize problem-solving skills
    • Assess and avoid risky situations
    • Avoid sex or say no to unprotected sex
    • Obtain and use condoms correctly
  3. Effectively use teaching strategies:
    • Brainstorming
    • Roleplay
    • Small-group work
    • Large-group discussion
    • Video processing
  4. Answer student questions accurately and sensitively.
  5. Identify activity objectives and core program content to inform adaptations to lessons and specific activities.
  6. Identify the impact of personal values on teaching.
  7. Create an action plan to implement the program.