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  4. Positive Prevention PLUS – High School

Positive Prevention PLUS – High School

Developers
Kim Robert Clark, DrPH, MPH and Christine Ridley, RN, MEd
Program Summary
Positive Prevention PLUS is a 13-lesson curriculum that addresses risk factors and behaviors associated with unplanned teen pregnancy by increasing adolescent's ability to use risk-reduction skills including contraceptive use, resistance and negotiation skills, and accessing reproductive health services. The program seeks to teach adolescents to either delay/abstain from sexual activity or use birth control consistently and correctly when engaging in sexual activity.
Intended Population
The program was designed in three levels, for middle school (grades 7-8) and high school (grades 9-12.), and Special Education. A high school Independent Study Program is also available. The program was evaluated with 9th grade students.
Program Setting

The program was designed for implementation in a classroom-based setting or community based organization, and was evaluated in a high school setting.

Contact and Availability Information
 
Cardea Services
Phone: 510-835-3700
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)

Positive Prevention Plus includes pre- and post-tests, fidelity monitoring logs, a logic model, and observation forms, which are available from the developer.

Program Core Components

Last updated in 2023

The data presented on this page reflects 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 data on seven types of program components including content, delivery mechanism, dosage, staffing, format, environment, 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. For more details, refer to the FAQ.

Category Component Core Component Component present Notes Lesson number(s) / activities where present
Content School engagement No No N/A N/A
Content Anatomy/physiology No Yes (both versions) Puberty is not covered in the high school version of the curriculum, however we provide a supplemental puberty lesson for our high school instructors. Supplemental Lesson
Content Other No N/A
Content Volunteering/civic engagement No N/A
Content Spirituality No Yes (both versions) Lesson 3 and Lesson 3 Activity
Content Morals/values Yes Yes (both versions) Lessons 4, 5, 6, 10 and 13
Content Identity development Yes Yes (both versions) Lessons 1, 2, and 3
Content Social support/capital No Yes (both versions) Lessons 1, 3, 10, 11, 12 and 13
Content Social influence/actual vs. perceived social norms Yes Yes (both versions) Lesson 3, 4, 5, and 11
Content Social competence Yes Yes (both versions) Lessons 3, 4 and 11
Content Parenting skills Yes Yes (both versions) Lesson 7
Content Normative beliefs Yes Yes (both versions) Normative beliefs are taught throughout the curriculum
Content Leadership No Yes (both versions) Lesson 3 and 13
Content Gender roles Yes Yes (both versions) Lesson 2
Content Gender identity Yes Yes (both versions) Lesson 2
Content Cultural values No N/A
Content Connections with trusted adults Yes Yes (both versions) All Lessons
Content Conflict resolution/social problem solving No Yes (both versions) Lesson 11
Content Communication skills No Yes (both versions) Lesson 3 and 10
Content Child development No No N/A
Content Boundary setting/refusal skills No Yes (both versions) Lesson 3
Content Substance use cessation No No N/A
Content Substance use - Other drugs Yes Yes (both versions) Lesson 3 and 9
Content Substance use - Alcohol Yes Yes (both versions) Lesson 3 and 9
Content Substance use - Abstinence No N/A
Content Brain development and substance use No N/A
Content Vocational/skills training No No N/A N/A
Content Supplemental academic services No No N/A N/A
Content Graduating from high school No No N/A N/A
Content College preparation No No N/A N/A
Content Alternative schooling No No N/A N/A
Content Self-regulation No Yes (both versions) N/A Lesson 1
Content Self-esteem No Yes (both versions) N/A Lesson 11
Content Self-efficacy/empowerment No Yes (both versions) N/A Lesson 13
Content Resilience No No N/A N/A
Content Sexual health Yes Yes (both versions) N/A Teen sexual health is discussed throughout the curriculum
Content STIs - Treatment Yes (both versions) N/A Lesson 6,8, and 10
Content STIs - Screening Yes (both versions) N/A Lesson 6,8, and 10
Content STIs - Prevention Yes Yes (both versions) N/A Lesson 6,8, and 10
Content STIs - Information Yes Yes (both versions) N/A Lesson 6,8, and 10
Content Sexual risk reduction Yes Yes (both versions) N/A Abstinence is discussed through the curricula.
Content Sexual risk discontinuation Yes Yes (both versions) N/A Abstinence is discussed through the curricula.
Content Personal vulnerability No Yes (both versions) N/A Getting Started and Lesson 2
Content Sexual orientation Yes Yes (both versions) N/A Lesson 2
Content Maternal health No Yes (both versions) N/A Lesson 7
Content Contraception - Condoms Yes Yes (both versions) N/A Lesson 6,8 and 10
Content Contraception - Long-acting reversible contraceptives Yes Yes (both versions) N/A Lesson 6
Content Contraception - Other Yes Yes (both versions) N/A Lesson 6
Content Contraception - Pills, patches, rings, and shots Yes Yes (both versions) N/A Lesson 6
Content Reproduction Yes Yes (both versions) N/A Lesson 7
Program Objectives
The primary goal of Positive Prevention PLUS is to address risk factors and behaviors associated with unplanned teen pregnancy by increasing an adolescent's ability to use risk-reduction skills. The program seeks to teach adolescents to either abstain from sexual activity or use birth control when engaging in sexual activity by building or enhancing:
  1. Knowledge of the consequences of teen pregnancy and risk situations, contraception and health services
  2. Self-efficacy to use birth control and condoms
  3. Parent-adolescent communication
  4. Refusal skills
  5. Positive attitudes toward abstinence
Program Content
Positive Prevention PLUS is based on Social Cognitive Theory. The lesson topics consist of:
  • Getting started: classroom ground rules, vocabulary, and changes during puberty
  • Life planning
  • Exploring friendships and other relationships
  • Bullying and relationship abuse
  • Preventing unplanned pregnancies (contraception)
  • Teen pregnancy: choices and responsibilities
  • Myths and stereotypes regarding persons with HIV
  • HIV and AIDS
  • Preventing sexually transmitted infections
  • Risk recognition and risk reduction
  • Media and peer pressure
  • Accessing community services
  • Setting goals
Program Methods
Positive Prevention PLUS is delivered through: 1) direct instruction using teacher slides (provided); 2) normative discussion via large group and small group activities; 3) resistance and negation skills practice; and 4) student workbooks with daily assignments to be completed with a parent or trusted adult.
Program Structure and Timeline
The curriculum consists of thirteen 45-minute lessons intended to be taught on 13 consecutive days. It may be adapted for weekly presentations, and also as multi-hour workshops. The ideal class size is 12 to 30 students in the same age group (for example: middle school or high school). Independent Study and Special Education versions are also available.
Staffing
The program should be delivered by a credentialed health teacher or health educator who has completed the two-day Positive Prevention PLUS curriculum training.
Staff Training
The developer strongly recommends that educators who plan to teach Positive Prevention PLUS receive a two-day training.

The two-day teacher/staff training is provided by by Cardea Services for $3750, and includes an orientation to sexual health education, values and attitudes; state laws (if applicable), and previews and teach-backs of all lessons. 
 
The training hours are 8am to 3pm.
Program Materials and Resources
Available tools and resources for the program are:
  • High school sexual health curriculum (three-hole punched with tabs, shrink-wrapped)
  • High school sexual health workbooks in English and Spanish
  • Family home assignments
  • Black line masters for overhead transparencies
  • Masters for student activity cards
  • All teacher support materials downloadable from the Positive Prevention PLUS website, including slides, sexting powerpoint, Safe Surrender video clips, STI photos, and parent materials in Spanish and English
Additional Needs for Implementation
Additional materials for implementation include student workbooks or duplicated student worksheets, duplicated activity cards, video about persons infected with HIV, sample contraceptives, supplies for Exchanging Body Fluid activity, and a projector with sound.
Fidelity
Pre-Post tests, fidelity monitoring logs, logic model, and observation forms are available from the developer.
Technical Assistance and Ongoing Support
Technical assistance is available by contacting:
Cardea Services  
Phone: 510-835-3700
Website: http://www.cardeaservices.org/
E-mail: positive.prevention@cardeaservices.org
Allowable Adaptations
The developer provides guidelines for "green light, orange light, and red light" lesson modifications based on the curriculum's logic model as well as suggested adaptations for transitional and high risk youth.
Adaptation Guidelines or Kit
Yes
Study Findings

Evidence by Outcome Domain and Study

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

LaChausse, R. (2015). Evaluation of the Positive Prevention PLUS Teen Pregnancy Prevention Program. USDHHS, Office of Adolescent Health. TP2AH000007.

LaChausse, R. G. (2016). A clustered randomized controlled trial of the positive prevention PLUS adolescent pregnancy prevention program. American Journal of Public Health, 106, S91-S96. doi:10.2105/AJPH.2016.303414

 		Potentially favorable evidence n.a. Potentially favorable evidence n.a. Indeterminate evidence
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

LaChausse, R. (2015). Evaluation of the Positive Prevention PLUS Teen Pregnancy Prevention Program. USDHHS, Office of Adolescent Health. TP2AH000007.

LaChausse, R. G. (2016). A clustered randomized controlled trial of the positive prevention PLUS adolescent pregnancy prevention program. American Journal of Public Health, 106, S91-S96. doi:10.2105/AJPH.2016.303414

"This study evaluated the program using a clustered randomized controlled trial involving 21 high schools within six school districts in southern California. Eleven schools were randomly assigned to a treatment group that offered the Positive Prevention PLUS – High School program in 9th grade classes. Ten schools were randomly assigned to a control group that offered their regular instruction. Surveys were administered immediately before the program (baseline) and roughly one, six, and 12 months after the end of the program.

The study found that six months after the program ended, students in the schools that offered the program were significantly less likely to report they ever have had sexual intercourse and that they have had sex in the past three months without using birth control. This study found no statistically significant program impacts on having being pregnant (or gotten someone pregnant) at the time of the six-month follow-up."

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.