Becoming a Responsible Teen (BART) - INACTIVE

Inactive Reason

This program is inactive because it has evidence of favorable impacts that is more than 20 years old. It no longer meets the inclusion criteria for the TPPER.

Developers

Janet S. St. Lawrence, Ph.D.

Program Summary

Becoming a Responsible Teen (BART) is an HIV prevention curriculum developed for African American adolescents, that is based on ethnic pride and can be delivered in non-school, community-based settings. BART consists of eight sessions, which are 1.5 to 2 hours each. The program uses interactive group discussions and role plays that have been created by teens.

Although the focus of Becoming a Responsible Teen is HIV/AIDS prevention, the curriculum includes topics and activities relevant to teen pregnancy prevention. Teens learn to clarify their own values about sexual decisions and pressures as well as practice skills to reduce sexual risk-taking. These include correct condom use, assertive communication, refusal techniques, self-management, and problem solving. Also, abstinence is woven throughout the curriculum and is discussed as the best way to prevent HIV infection and pregnancy.

Intended Population

The program was designed for youth ages 14 to 18. It was tested with African-American youth who were ages 14 to 18. Some studies separated participants by gender while others did not.

Program Setting

The program was designed to be implemented in non-school settings, including after school or in health clinics. It was evaluated in community-based organizations, health clinics, high schools, and correctional facilities.

Contact and Availability Information

Nancy Gonzalez-Caro, MPH Evidence-Based Product Specialist
ETR
100 Enterprise Way, Suite G300
Scotts Valley, CA 95066
Ph: 800-321-4407 x237
Website: http://www.etr.org/ebi/

Sample of Curriculum Available for Review Prior to Purchase

Yes

Languages Available

English

Program Components and Core Components

The data presented on this page reflect responses from the program’s developer or distributor to a program component checklist that asked them to report on the individual components within their TPP program. The same program component checklist was sent to the developer or distributor of every active TPP program with evidence of effectiveness. The program component table provides information on seven types of program components including content, delivery mechanism, dosage, staffing, format, context, and intended population characteristics; whether the component was present or optional in the program; whether the component is considered to be core to the program; and the lesson number or activity where the component can be found in the program.

In the drop-down menu below, under “Has component,” there are four options that indicate a component as present in the program: (1) “Yes” indicates that the component is present in at least one version of the program (whether that be the program version that was evaluated, the current version, or both versions); (2) “Yes (both versions)” indicates that the component is present in both the evaluated version of the program and the current version of the program; (3) “Yes (current version)” indicates that the component is present in the current, but not the evaluated, version of the program; and (4) “Yes (evaluated version)” indicates that the component is present in the evaluated version of the program, only. Note that for dosage components, the dosage itself is described in the Notes when available.

Program component data is not available.

Program Objectives

The program seeks to prevent HIV among African-American youth by:

Increasing knowledge of HIV transmission and prevention.
Changing attitudes toward HIV prevention and safer sex.
Changing perceptions of risk and social norms regarding HIV.
Increasing behavioral intent to avoid behaviors that could lead to contracting HIV.
Clarifying values about sexual decisions and pressures.
Increasing skills to reduce sexual risk-taking including, correct condom use, assertive communication, refusal techniques, self-management, and problem solving.

Program Content

Becoming a Responsible Teen is an 8 session program focused on HIV prevention. BART incorporates Social Learning Theory and Self-Efficacy Theory. The BART curriculum has four major components designed to reflect these theories:

Information that increases adolescents’ knowledge and their awareness of risk.
Training in the skills adolescents need to translate the information into action.
Opportunities to practice and receive corrective feedback and using the skills in a safe environment before they face the challenges of using them in risky situations.
Social support to help make the desired behaviors the norm in the social environment.

The program covers core content on:

Knowledge and attitudes about HIV, how drugs and alcohol use may influence sexual decision making, and condom use.
Skills and self-efficacy related to condom use, preventing risky situations, problem solving, and communication.
Perception of risk related to HIV transmission and living with HIV.
Social/peer norms about HIV prevention, safer sex, and promoting the use of effective (assertive) communication.
Behavioral beliefs and goal-setting.
Connectedness to culture.
Values about preventing HIV, promoting safer sex, and communicating with a partner about safer sex.
Communication with parents or other adults.

The program logic model can be found on ETR's website: http://www.etr.org/ebi/programs/becoming-a-responsible-teen/.

Program Methods

The program is delivered through videos, role plays, worksheets, and practice of skills.

Program Structure and Timeline

BART program structure includes the following:

The program is delivered in 8 weekly 90-120-minute sessions.
When focusing on skill development, participants may be separated by gender.
The program should be implemented in a non-school setting.
Parental consent and support should be obtained prior to delivering the program.

Staffing

Two co-leaders, one male and one female, should facilitate the classes. Providers should select program leaders who are as similar to youth as possible and have credibility with youth.

Staff Training

It is recommended that educators who plan to teach BART receive research-based professional development to prepare them to effectively implement the curriculum with its intended target group. Training on BART is available through ETR’s Professional Learning Services. Training options include:

Two-day Training of Educators (TOE)—the learning process includes pre-work, skill-based instruction and post-training follow-up support.
Four-day Training of Trainers (TOT)—available for seasoned trainers who have experience in delivering the intervention. Completion entitles participants to use ETR’s research-based training designs to conduct TOEs for their organization or designated affiliate group. TOT attendees who have completed the four-day TOT are eligible to attend a condensed TOT course on additional EBIs.

Program Materials and Resources

Core intervention materials are the Leader's Guide, Student Workbooks, and The Monster DVD from Scenarios USA.

Additional Needs for Implementation

None specified

Fidelity

ETR provides a fidelity log, adaptation kit, a BART Student Knowledge Survey that can be administered as a pre-test/post-test, and a survey answer key. These materials can be found here: http://www.etr.org/ebi/programs/becoming-a-responsible-teen/.

Technical Assistance and Ongoing Support

ETR provides in-person and web- or phone-based technical assistance before, during and/or after program implementation. TA is tailored to the needs of the site and is designed to support quality assurance, trouble-shoot adaptation issues, and boost implementation.

ETR also provides evaluation support for EBI implementation. Services address process and outcome evaluation and include assistance with evaluation planning, instrument design and development, implementation fidelity, data management and analysis, performance measurement, continuous quality improvement (CQI) protocols, and effective tools and strategies for reporting results.

Allowable Adaptations

In-depth adaptation guidelines and tools are available through ETR at the following link: http://www.etr.org/ebi/programs/becoming-a-responsible-teen/.

Examples of allowable adaptations include updating statistics or facts; lengthening skills-based classes beyond 90-minutes without cutting the number of classes; and tailoring the content (e.g. for visual learners or particular gender or racial/ethnic groups).

Adaptation Guidelines or Kit

Yes

Reviewed Studies

Citation	High-Quality Randomized Trial	Low Study Rating	Did Not Meet Eligibility Criteria
St. Lawrence et al. 1995	✓
St. Lawrence et al. 1999	✓
Butts and Hartman 2002		✓
Malow et al. 2009			✓
Robertson et al. 2011	✓
The Policy Research Group 2015a	✓
Ruwe et al. 2016	✓
Shepherd et al. 2017		✓

Study Characteristics

Citation	Setting	Majority Age Group	Majority Racial/Ethnic Group	Gender	Sample Size
St. Lawrence et al. 1995	After school	14 to 17	African American or Black	Youth of any gender	246
St. Lawrence et al. 1999	Detention facility	14 to 17	African American or Black	Young men	361
Butts and Hartman 2002	n.a.	n.a.	n.a.	n.a.	n.a.
Malow et al. 2009	n.a.	n.a.	n.a.	n.a.	n.a.
Robertson et al. 2011	Correctional facility	14 to 17	African American or Black	Young women	333
The Policy Research Group 2015a	After school	14 to 17	African American or Black	Youth of any gender	850
Ruwe et al. 2016	After school	14 to 17	African American or Black	Youth of any gender	552
Shepherd et al. 2017	n.a.	n.a.	n.a.	n.a.	412

Study Findings

Evidence by Outcome Domain and Study

Citation	Sexual Activity	Number of Sexual Partners	Contraceptive Use	STIs or HIV	Pregnancy
St. Lawrence et al. 1995				n.a.	n.a.
St. Lawrence et al. 1999				n.a.	n.a.
Butts and Hartman 2002	n.a.	n.a.	n.a.	n.a.	n.a.
Malow et al. 2009	n.a.	n.a.	n.a.	n.a.	n.a.
Robertson et al. 2011	n.a.	n.a.			n.a.
The Policy Research Group 2015a		n.a.		n.a.	n.a.
Ruwe et al. 2016		n.a.		n.a.	n.a.
Shepherd et al. 2017	n.a.	n.a.	n.a.	n.a.	n.a.

KEY

Evidence Indication

Favorable findings

Potentially favorable findings

Indeterminate findings

Conflicting findings

Potentially unfavorable findings

Unfavorable findings

Note: n.a. indicates the study did not examine any outcome measures within that particular outcome domain, or the study examined outcome measures within that domain but the findings did not meet the review evidence standards.

Detailed Findings

Citation	Details
St. Lawrence et al. 1995	The program's evidence of effectiveness was first established in a randomized controlled trial involving low-income African American adolescents recruited from a community-based health center in the southern United States. Study participants were randomly assigned to either a treatment group that received the program or a control group that participated in a one-session program on HIV-AIDS education. Surveys were administered immediately before random assignment (baseline), immediately after the intervention, and 6 and 12 months after the intervention ended. The study found that, averaged across the three follow-up surveys, adolescents who were assigned to the treatment group reported statistically significantly fewer occasions of unprotected oral and anal intercourse and more occasions of condom-protected intercourse. The study found no statistically significant program impacts measures of the number of sexual partners, number of occasions of unprotected vaginal intercourse, or number of occasions of condom-protected anal intercourse. For the 12-month follow-up survey, the study found that for subgroups of youth defined by sexual activity at baseline, those in the treatment group were statistically significantly less likely to have had sex in the past two months. The study also examined program impacts on the percentage of intercourse occasions that were unprotected. Findings for this outcome were not considered for the review because they did not meet the review evidence standards. Specifically, the outcome was measured for a subgroup of youth defined by sexual activity at follow up. The study also examined program impacts on measures of condom attitudes, AIDS knowledge, self-efficacy, assertion skills, and substance use. Findings for these outcomes were not considered for the review because the outcomes fell outside the scope of the review.
St. Lawrence et al. 1999	A subsequent study by the same group of researchers evaluated the effectiveness of the program among a different target population of incarcerated male adolescents. The study used a randomized controlled trial involving adolescents recruited from a state reformatory in the southern United States. The study randomly assigned participants to either a treatment group that received the program in six one-hour sessions over three weeks or a control group that received an anger management intervention. Surveys were administered immediately before random assignment (baseline) and again six months after study participants were released from the correctional facility. The study found that at the time of the six-month follow-up survey, there were no statistically significant program impacts on measures of the frequency of unprotected and condom-protected sexual activity in the past three months, or on having had oral intercourse, the number of sex partners, or the percentage of intercourse occasions protected by condoms. These findings are not directly comparable with those reported in the prior study of the program (St. Lawrence et al. 1995) because of differences in the definition of the outcome measures and the analytic methods used to estimate program impacts.
Butts and Hartman 2002
Malow et al. 2009
Robertson et al. 2011	This study evaluated an adapted version of the program designed for incarcerated adolescent females. The study used a cluster randomized controlled trial involving female adolescents recruited from a correctional facility in the southern United States. The study randomly assigned small groups of newly admitted detainees to either a treatment group that received the adapted program or a control group that received a health education curriculum. Surveys were administered immediately before the program started (baseline), immediately after the program ended, and nine months after participants were released from the correctional facility. The study found that at the time of the nine-month follow-up survey, there were no statistically significant program impacts on measures of (1) the frequency of unprotected vaginal or anal sex or (2) the incidence of STIs (chlamydia and gonorrhea).
The Policy Research Group 2015a	A more recent study evaluated the program using a randomized controlled trial that involved 850 adolescents recruited from youth summer employment programs in New Orleans. Adolescents were randomly assigned to either a treatment group that received BART or a control group that received Healthy Living, a general health and nutrition program. The study collected outcome data before the program started (baseline) and six months after the end of the program. Six months after the program ended, the study found no evidence of statistically significant program impacts on measures of frequency of sexual activity and inconsistency of condom use in the past three months.
Ruwe et al. 2016	A separate recent study evaluated a cultural adaptation of BART designed for Haitian teens living in the U.S. called Haitian-American Responsible Teen (HART). The study examined the effectiveness of HART using a randomized controlled trial that involved 552 youth of Haitian descent attending 9th through 11th grades in schools located in the greater Boston area. Adolescents were randomly assigned to either a treatment group that received the eight lessons of the BART curriculum plus two additional lessons as part of the adaptation one lesson on anatomy and the other on post-traumatic stress disorder or a control group that received a fitness and nutrition program. Surveys were administered before the program started (baseline), and again immediately, six, and 12 months after the program ended. The study examined program impacts on ever having sex, having sexual intercourse in the past three months, and having sex without using a condom or using any birth control method in the past three months. Six months after the end of the program, the study found no evidence of statistically significant program impacts on any of the sexual behavior outcome measures that were examined.
Shepherd et al. 2017	This study received a low study quality rating because there was only one subject or cluster in either the treatment or control condition.

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Becoming a Responsible Teen (BART) - INACTIVE

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