Making Proud Choices!

Developers
Loretta Sweet Jemmott, Ph.D., R.N., F.A.A.N., and John B. Jemmott III, Ph.D.
Program Summary
Making Proud Choices! A Safer Sex Approach to STDs, Teen Pregnancy, and HIV Prevention Program (MPC) aims to provide adolescents with the knowledge, confidence, and skills necessary to reduce their risk of sexually transmitted diseases (STDs), HIV, and pregnancy by abstaining from sex or using condoms if they choose to have sex. The curriculum consists of eight modules delivered by trained facilitators to adolescents.
Intended Population
The curriculum is designed for high-school and middle-school youth. It was originally evaluated with African American 11- to 13-year-olds in urban areas and more recently evaluated with 9th and 10th graders of diverse races/ethnicities in urban and suburban areas.
Program Setting

Making Proud Choices! was designed to be implemented in a variety of community settings, including schools or community-based organizations. The program was evaluated in schools and in an after-school, community-based setting.

Contact and Availability Information

Program Contact Information
Email: sales@etr.org
Phone: (800) 321-4407
Website: https://www.etr.org/store/curricula/making-proud-choices/

Training Contact Information 
Kelly Gainor, M.Ed.
ebptraining@etr.org
Website: https://www.etr.org/store/curricula/making-proud-choices/

Sample of Curriculum Available for Review Prior to Purchase
Yes
Languages Available
English, Spanish
Monitoring and Evaluation Tools
Monitoring and evaluation tools available
Yes
Monitoring and evaluation tool usage required
No
Information about available monitoring and evaluation tools (if applicable)

Guidance on key characteristics, core content, facilitator fidelity logs and evaluation tools, and a logic model are available from ETR. ETR also provides pre- and post-test questionnaires.

Program Components and Core Components

Last updated in 2024

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.

Some of the components identified are noted as core components of the evidence-based program, but this does not necessarily mean that these components have been rigorously tested and show evidence of effectiveness. Most often developers denoted components as core based on theory or experience in the field. Click here for the list of evidence-based components.

For more details about program components, refer to the FAQ page.

Category Component Core Component Component present Notes Lesson number(s) / activities where present
Content College preparation No No
Content Anatomy/physiology No No
Content Other
Content Volunteering/civic engagement Yes Yes (both versions) Module 1 Activity D (41)
Content Spirituality No No
Content Morals/values Yes Yes (both versions) Module 5 Activity C (126), Module 6 Activity D (157)
Content Identity development No Optional Appendix A (266)
Content Social support/capital No No
Content Social influence/actual vs. perceived social norms Yes Yes (both versions) Module 5 Activity C (126), Module 6 Activity D (157)
Content Social competence No No
Content Parenting skills No No
Content Normative beliefs Yes Yes (both versions) Module 1 Activity C (37), Activity D (41); Module 5 Activity C (126), Module 6 Activity D (157)
Content Leadership No No
Content Gender roles No No
Content Gender identity
Content Cultural values Yes Yes (both versions) Module 5 Activity C (126), Module 6 Activity D (157)
Content Connections with trusted adults No No
Content Conflict resolution/social problem solving Yes Yes (both versions) Module 4 Activity A (93), Activity B (96); Module 7 Activity E (182), Module 8 All Activities (197)
Content Communication skills Yes Yes (both versions) Module 4 Activity A (93), Activity B (96); Module 7 Activity E (182), Module 8 All Activities (197)
Content Child development No No
Content Boundary setting/refusal skills Yes Yes (both versions) Module 7 Activity E (182), Module 8 All Activities (197)
Content Substance use cessation No No
Content Substance use - Other drugs No No
Content Substance use - Alcohol No No
Content Substance use - Abstinence No No
Content Brain development and substance use No No
Content Vocational/skills training No No
Content Supplemental academic services No No
Content School engagement No No
Content Graduating from high school No No
Content Alternative schooling No No
Content Self-regulation No No
Content Self-esteem No No
Content Self-efficacy/empowerment Yes Yes (both versions) Module 1 Activity D (41)
Content Resilience No No
Content Personal vulnerability Yes Yes (both versions) Module 7 Activity E (182), Module 8 All Activities (197)
Content Risk of STIs and Pregnancy Yes Yes (both versions) Module 2 All Activities (57), Module 3 All Activities (77), Module 4 Activity C (100), Activity D (102); Module 5 Activity A (112), Activity B (121), Activity C (126); Module 6 Activity A (138), Optional Activity B (143), Activity D (157)
Content STIs - Screening Yes Yes (both versions) Module 5 Activity A (112)
Content STIs - Prevention Yes Yes (both versions) Module 5 Activity A (112)
Content STIs - Information Yes Yes (both versions)
Content Sexual risk reduction Yes Yes (both versions) Module 2 All Activities (57), Module 3 All Activities (77), Module 4 All Activities (93); Module 5 Activity A (112), Activity B (121), Activity C (126); Module 6 Activity A (138), Optional Activity B (143), Activity D (157)
Content Motivational interviewing No No
Content Sexual risk avoidance Yes Yes (both versions) Module 2 Activity D (70), Module 4 Activity C (100)
Content Sexual orientation No Optional Appendix A (266)
Content Sexual health Yes Yes (both versions) Throughout
Content Contraception - Pills, patches, rings, and shots Yes Yes (both versions) Module 6, Activity C (145)
Content Contraception - Condoms Yes Yes (both versions) Module 5, Activity D (129); Module 7, Activity A (166), Activity B (170), Activity C (173), Activity D (176)
Content Contraception - Long-acting reversible contraceptives Yes Yes (both versions) Module 6, Activity C (145)
Content Contraception - Other Yes Yes (both versions) Module 6, Activity A (138), Activity C (145)
Content Puberty/development No Optional Appendix A (249)
Program Objectives
The primary goals of Making Proud Choices! are to increase knowledge about prevention of HIV, STDs and pregnancy, reinforce positive attitudes/beliefs about condom use, and increase confidence in participants' ability to negotiate safer sex and use condoms correctly. The program works to lower the incidence of STD/HIV risk-associated sexual behavior among youth, by inculcating a sense of pride and responsibility among its participants, providing them with the knowledge and skills they need, and motivating them to make a difference in their lives.
Program Content

Making Proud Choices! draws on three theories of change: (1) social cognitive theory, (2) the theory of reasoned action, and (3) the theory of planned behavior. This framework relies on the concept of self-efficacy or perceived behavioral control beliefs (beliefs about the ability to conduct the behavior). The framework also relies on the outcome expectancies (beliefs about the consequences of the behaviors). The curriculum uses trauma-informed approaches and is inclusive of LGBTQI+ youth.

The curriculum and core content address four types of behavioral beliefs and outcome expectancies:

  • Goals and dreams beliefs—the belief that unprotected sex can interfere with one’s goals and dreams for education and a career. In Session 1, the participants engage in a goals and dreams activity and discuss obstacles to goals and dreams. Having unprotected sex is listed and discussed as an obstacle. This belief is also incorporated throughout the curriculum.
  • Prevention beliefs—the belief that condoms can reduce the risk of pregnancy, STDs, and HIV/AIDS. This belief is incorporated throughout the curriculum.
  • Partner-reaction beliefs—the belief that one’s boyfriend/girlfriend would not approve of condom use and will react negatively to it. This belief might prevent a person from negotiating condom use. In Sessions 7 and 8, participants learn how to get out of a risky situation, set physical limits, and use negotiation and refusal skills to communicate with their partners about safer sex.
  • Hedonistic beliefs—the belief that condom use interferes with sexual pleasure. For example, many people believe that condoms reduce physical sensations during sexual activity or ruin the mood. Therefore, people are less likely to use condoms during sexual intercourse. In Sessions 7 and 8, youth learn that sex is still fun and pleasurable when a condom is used and are taught how to incorporate this belief into role-play scenarios.

The curriculum modules cover the following topics:

  • Module 1. “Getting to Know You and Steps to Making Your Dreams and Goals Come True” introduces the curriculum, sets up the theme of proud and responsible behavior, establishes group rules, and asks participants to identify short-term and long-term goals and dreams.
  • Module 2. “The Consequences of Sex: HIV Infection” includes information on HIV etiology, transmission, and prevention, as well as myths about HIV.
  • Module 3. “Attitudes and Beliefs About HIV and Condom Use” includes two videos on HIV transmission risk and interactive discussion about the videos.
  • Module 4. “Strategies for Preventing HIV Infection: Stop, Think, and Act,” introduces participants to problem-solving skills through role-plays using the “Stop, Think, and Act” framework for decision making.
  • Module 5. “The Consequences of Sex: STDs and Correct Condom Use” introduces myths and facts about STD transmission. Module 5 includes a condom demonstration by the facilitator and participant practice of condom application with a penis model. The module explores attitudes about condom use. The key theme of the module is that participants can protect themselves against STDs by correctly using condoms every time they have sex.
  • Module 6. “The Consequences of Sex: Pregnancy” introduces myths and facts about pregnancy, includes a demonstration of birth control methods, and explores attitudes about contraception. The key theme of the module is that participants can protect themselves against pregnancy and STDs by correctly using condoms along with another birth control method every time they have sex.
  • Module 7. “Developing Condom Use Skills and Negotiation Skills” teaches participants negotiation skills to address partner pressure and discusses ways to make condoms pleasurable.
  • Module 8. “Enhancing Condom Use Skills and Negotiation Skills” further teaches problem-solving and negotiation skills to participants using the “SWAT” technique (say no effectively, state why, propose an alternative, and talk it out) in role-plays.
Program Methods
Making Proud Choices! aims to create a youth-centered, positive learning environment. It uses role-plays in which all participants practice and receive feedback on their negotiation skills. The program also relies on small group activities, viewing and processing videos, visual presentations, and targeted instruction for multiple learning styles.
Program Structure and Timeline
The curriculum consists of eight modules, each of which is one hour. Instructors should deliver the modules in the order presented and should ideally complete the modules in two weeks. Ideal group size is eight students per facilitator. ETR can provide guidance on adapting the program for a school setting with 14 40-minute sessions. There is also a version of this curriculum that includes additional content to align with the requirements of the California Healthy Youth Act.
 
Staffing
Providers are expected to use one to three facilitators (depending on number of participants), a program manager, and one or more support staff. Facilitators should be health educators, social workers, nurses, and others who provide social services programs to youth. Facilitators should also have the following qualities:
  • Be able to use highly participatory and interactive skills.
  • Be able to work with youth and relate to them and their life circumstances. 
  • Believe in the teens and believe in their resilience. 
  • Have a comprehensive understanding of adolescent development; the developing sexual needs of youth; and the relevance of HIV/AIDS, STDs, and pregnancy for youth.
Staffing should consist of one facilitator for eight to 10 youth, and support staff to assist when implementing the program in larger class size settings.
Staff Training

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 group.

Training on Making Proud Choices! is available through ETR’s Professional Learning Services. Training options include a two-day Training of Educators with follow-up support, as well as interactive virtual training options. 

Visit http://www.etr.org/ebi/training-ta/types-of-services/training-of-educators/ for more information or submit a Training & TA Request Form (http://www.etr.org/solutions/professional-development/training-ta-request-form/).

Program Materials and Resources

The curriculum package consists of:

  1. Facilitator curriculum
  2. Activity set (role-play cards and posters)
  3. Student workbooks (classroom set of 30)
  4. Six curriculum DVDs:
    • Tanisha & Shay
    • The Hard Way
    • Nicole’s Choice
    • The Subject Is: HIV
    • The Subject Is: STDs
    • Wrap it Up and Condom Use Animation
  5. One seat for an interactive virtual curriculum training for the facilitator

The distributor also provides access to a table of contents, an optional LGBTQ supplement, and sample lesson on its website: http://www.etr.org/ebi/programs/making-proud-choices/.

Additional Needs for Implementation
The curriculum requires a TV monitor and DVD player.
Fidelity

Specific recommendations related to implementing the program with fidelity are as follows:

  • Facilitators should deliver the curriculum modules in the order presented.
  • Delivery of the intervention must be highly participatory.
  • Making Proud Choices! was designed to be used with small groups ranging from six to 12 participants (but can be implemented with larger groups with increased staffing, see Allowable adaptations).
Technical Assistance and Ongoing Support
ETR provides in-person and web- or phone-based technical assistance before, during, and/or after program implementation. Technical assistance is tailored to the needs of the site and is designed to support quality assurance, troubleshoot adaptation issues, and boost implementation. Contact ETR’s Professional Learning Services through http://www.etr.org/ebi/training-ta/.
Allowable Adaptations
Adaptation guidance for Making Proud Choices! is available on ETR’s Program Success Center website: http://www.etr.org/ebi/programs/making-proud-choices/.
Adaptation Guidelines or Kit
Yes
Reviewed Studies
Citation High-Quality Randomized Trial Moderate-Quality Randomized Trial Moderate-Quality Quasi-Experiment Low Study Rating Did Not Meet Eligibility Criteria

Jemmott et al. 1998

 		✓

Cole et al. 2022

 		✓

Benton et al. 2022

 		✓
Study Characteristics
Citation Setting Majority Age Group Majority Racial/Ethnic Group Gender Sample Size

Jemmott et al. 1998

 		After school 13 or younger African American or Black Youth of any gender

439

Cole et al. 2022

 		In school, classroom based 14 to 17 African American or Black Youth of any gender

2810

Benton et al. 2022

 		n.a. n.a. n.a. n.a. n.a.
Study Findings

Evidence by Outcome Domain and Study

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

Jemmott et al. 1998

 		Indeterminate evidence n.a. Favorable evidence n.a. n.a.

Cole et al. 2022

 		Potentially favorable evidence Indeterminate evidence Indeterminate evidence Indeterminate evidence Indeterminate evidence

Benton et al. 2022

 		n.a. n.a. n.a. n.a. n.a.
KEY
Evidence Indication
Favorable findings
Two or more favorable impacts and no unfavorable impacts, regardless of null findings
Potentially favorable findings
At least one favorable impact and no unfavorable impacts, regardless of null findings
Indeterminate findings
Uniformly null findings
Conflicting findings
At least one favorable and at least one unfavorable impact, regardless of null findings
Potentially unfavorable findings
At least one unfavorable impact and no favorable impacts, regardless of null findings
Unfavorable findings
Two or more unfavorable impacts and no favorable impacts, regardless of null 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

Jemmott et al. 1998

The program was evaluated in a randomized controlled trial involving middle school students in Philadelphia, PA. Students were randomly assigned to either a treatment group that received the program or to a control group that received a general health-promotion curriculum on diet, exercise, cancer awareness, and smoking. Both the control and intervention programs were delivered outside of regular school hours over two consecutive Saturdays. Surveys were administered immediately before the program (baseline), immediately after the program, and three, six, and 12 months after the program.

The study found that three months after the program ended, adolescents participating in the intervention were less likely to report having had unprotected sexual intercourse in the previous 3 months, and reported a lower frequency of unprotected sexual intercourse.

The study also examined program impacts on measures of condom use consistency. Findings for these outcomes were not considered for the review because they did not meet the review evidence standards. Specifically, findings were reported only for subgroups of youth defined by sexual activity at follow up. The study also examined program impacts on attitudes toward abstinence, as well as condom use knowledge, skills, and beliefs. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.

Cole et al. 2022

The program was evaluated using a cluster randomized controlled trial involving male and female youth recruited from 15 high schools in Mobile, Alabama; Detroit, Michigan; St. Louis, Missouri; and Cincinnati, Ohio. Schools were randomly assigned in each of three years to a treatment group that received the Making Proud Choices! Program or a control group that received business-as-usual services. Surveys were administered immediately before the program (baseline), and six months after the end of the program.



The study found that six months after the end of the program, youth participating in MPC reported having had sex significantly fewer times in the past three months compared with youth in the control group (effect size = -0.10). The study found no statistically significant program impacts on the other eligible outcomes examined: ever had sex, any sex in the past three months, count of vaginal sex partners in past three months, any sex without a condom in past three months, times having any sex without a condom in past three months, sex without birth control in past three months, times having sex without birth control in past three months, ever pregnant, any STI.



The study also examined program impacts on measures of knowledge of HIV or STIs, pregnancy, condoms, and other forms of contraception; beliefs about sexual activity as a teen, communication with partners, and condom use; attitudes about condom use; skill and self-efficacy related to condom use, condom use negotiation, and refusal. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.

Benton et al. 2022

This study was ineligible because it did not meet review's screening criteria.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample. A blank cell indicates the study did not examine any outcome measures within the particular outcome domain or the findings for the outcome measures within that domain did not meet the review evidence standards.

Information on evidence of effectiveness is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.