Sisters Saving Sisters
The program was designed for and evaluated in a community-based clinic setting.
Program Contact Information
Email: sales@etr.org
Phone: (800) 321-4407
Website: https://www.etr.org/ebi/programs/sisters-saving-sisters/
Training Contact Information
Kelly Gainor, M.Ed.
ebptraining@etr.org
Website: https://www.etr.org/ebi/programs/sisters-saving-sisters/
ETR provides pre- and post-tests.
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 | Graduating from high school | No | No | ||
Content | Leadership | No | No | ||
Content | Other | ||||
Content | Volunteering/civic engagement | No | No | ||
Content | Spirituality | No | No | ||
Content | Morals/values | No | No | ||
Content | Identity development | No | No | ||
Content | Social support/capital | No | No | ||
Content | Social influence/actual vs. perceived social norms | No | No | ||
Content | Social competence | No | No | ||
Content | Parenting skills | No | No | ||
Content | Normative beliefs | No | No | ||
Content | Gender roles | No | No | ||
Content | Gender identity | No | No | ||
Content | Cultural values | No | No | ||
Content | Connections with trusted adults | No | No | ||
Content | Conflict resolution/social problem solving | Yes | Yes (both versions) | Module 4, Activity B (p 98), Activity C (p 103), Activity D (p 105); Module 5, Activity A (p 116) | |
Content | Communication skills | Yes | Yes (both versions) | Module 4, Activity B (p 98), Activity C (p 103), Activity D (p 105); Module 5, Activity A (p 116) | |
Content | Child development | No | No | ||
Content | Boundary setting/refusal skills | Yes | Yes (both versions) | Module 4, Activity B (p 98), Activity C (p 103), Activity D (p 105); Module 5, Activity A (p 116) | |
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 | College preparation | 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 3, Activity D (p 84); Module 4, Activity B (p 98) | |
Content | Resilience | No | No | ||
Content | Personal vulnerability | Yes | Yes (both versions) | Module 3, Activity D (p 84); Module 4, Activity B (p 98) | |
Content | Risk of STIs and Pregnancy | Yes | Yes (both versions) | Module 1, Activity E (p 43), Activity F (p 54); Module 2, All Activities (p 59), Module 4, All Activities (p 95) | |
Content | STIs - Screening | No | Yes (current version) | Included in the updated Nicole's Choice video. | Module 1, Activity E (p 43) - HIV; Module 3, Activity B (p 77) |
Content | STIs - Prevention | Yes | Yes (both versions) | Module 1, Activity D (p 41), Activity E (p 43) and Activity F (p 54) - HIV; Module 2, Activity B (p 63), Activity c (p 65); Module 3, Activity A (p 74), Activity B (p 77), Activity C (p 79), Activity F (p 91) | |
Content | STIs - Information | Yes | Yes (both versions) | Module 1, Activity D (p 41) and Activity E (p 43) - HIV; Module 2, Activity B (p 63) - STIs | |
Content | Sexual risk reduction | Yes | Yes (both versions) | Module 1, Activity E (p 43), Activity F (p 54); Module 2, All Activities; Module 3, All Activities; Module 4, Activity B (p 98); Module 5, Activity A (p 116), Activity B (p 120), Activity C (p 123) | |
Content | Sexual risk discontinuation | Yes | Yes (both versions) | Module 1, Activity E (p 43), Activity F (p 54); Module 2, All Activities; Module 4, Activity B (p 98); Module 5, Activity A (p 116), Activity B (p 120), Activity C (p 123) | |
Content | Sexual risk avoidance | Yes | Yes (both versions) | Module 1, Activity E (p 43), Activity F (p 54); Module 2, Activity C; Module 4, Activity B (p 98); Module 5, Activity C (p 123) | |
Content | Sexual orientation | No | No | ||
Content | Motivational interviewing | No | No | ||
Content | Contraception - Pills, patches, rings, and shots | No | Optional | Birth Control Methods Demonstration Optional Activity presents information about these options. | Appendix A (p 207) |
Content | Anatomy/physiology | No | No | ||
Content | Contraception - Condoms | Yes | Yes (both versions) | Module 3, all activities (71) | |
Content | Contraception - Long-acting reversible contraceptives | No | Optional | Birth Control Methods Demonstration Optional Activity presents information about LARCs. | Appendix A (p 207) |
Content | Contraception - Other | No | Optional | Birth Control Methods Demonstration Optional Activity presents information about these options. | Appendix A (p 207) |
Content | Puberty/development | No | No |
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The curriculum is comprised of five modules:
- Module 1: Introduction and Overview
- Module 2: Understanding Personal Vulnerability
- Module 3: Developing Condom Use Skills
- Module 4: Improving Sexual Choices and Negotiation Skills
- Module 5: Role-Play, AIDS Basketball, and Review
The five-session curriculum addresses four types of core 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, sexually transmitted diseases 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 may prevent a person from negotiating condom use. In Sessions 4 and 5, participants learn and practice how to 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, they are less likely to use condoms during sexual intercourse. In Sessions 4 and 5, 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.
Sisters Saving Sisters aims to create a youth-centered, positive learning environment for adolescent girls. The program engages participants in activities such as role-playing where all participants learn, practice and receive feedback on their negotiation and refusal skills in various role-play scenarios. They handle and practice correct placement of condoms using anatomical models. The curriculum also discusses the barriers to condom use such as alcohol and drug use.
The program's activities incorporate social cognitive-behavioral skill-building strategies (i.e., presentation, modeling, and the practice of abstinence negotiation skills). The curriculum involves culturally appropriate video clips, games, brainstorming, role-playing, skill-building activities and small group discussions that build group cohesion and enhance learning. Each activity lasts a brief time, and most are active exercises in which the adolescents get out of their seats and interact with each other.
- They must have attended the 2-day training and be well trained in the program.
- They must be able to use highly participatory and interactive skills.
- They must be able to work with youth and relate to them and their life circumstances.
- They must believe in the teens and believe in their resilience.
Staffing should consist of 1 facilitator for 6 to 8 youth as well as support staff to assist if the program is delivered in larger class size settings.
It is highly recommended that educators who plan to teach Sisters Saving Sisters receive research-based professional development to prepare them to effectively implement and replicate the curriculum with fidelity for the intended target group.
Training on Sisters Saving Sisters is available through ETR's Professional Learning Services. 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/).
- Facilitator Curriculum
- Activity Set (hand-outs, posters, role-play cards)
- Curriculum DVDs
- Nicole's Choice
- The Hard Way
- The Subject Is: HIV (Safer Sex)
- The Subject Is: STDs (Safer Sex)
- Wrap It Up & Condom Animation
The developers provide specific fidelity guidelines consisting of core components, key characteristics and logic model. Fidelity monitoring checklists are also available. Adaptation guidance can be found on ETR’s Program Success Center website: http://www.etr.org/ebi/programs/sisters-saving-sisters/
Developers have identified three areas where there may be challenges to fidelity:
- Peer-facilitation: Two peers should not implement this intervention. The best way to use peers is to have a peer co-facilitate with an adult facilitator.
- Integration into a normal classroom setting: In normal classroom settings, the time frame is about 45 minutes. The Sisters Saving Sisters intervention modules are each 55 minutes long. Therefore, to identify strategies on how to integrate the program into a classroom setting with fidelity, providers must request technical assistance.
- Implementing this curriculum with large groups of more than 15 students: This intervention was evaluated with adolescent females in small groups of about 6 to 8 youth in a group. For larger group settings, providers may need additional training.
- The "Sisters Saving Sisters" curriculum was designed to be used with smaller groups ranging from two to eight participants, but can be implemented with larger numbers, in consultation with the developer.
- It is appropriate for various community settings, including schools, and youth agencies.
- The five-hour intervention may be delivered in different ways, such as 1 module a day for 5 days or 1-2 modules per day over 3-4 days.
- The original study used Latina and African-American female facilitators. The program may be implemented using facilitators of different ethnic or professional backgrounds, so long as the facilitators are trained, possess the skills and characteristics of a good facilitator, and have experience working with teens.
- Teens of different racial and ethnic groups may participate, and changing the names and settings of the situations in the role-plays to reflect the culture of participants is allowed.
Citation | High-Quality Randomized Trial | Moderate-Quality Randomized Trial | Moderate-Quality Quasi-Experiment | Low Study Rating | Did Not Meet Eligibility Criteria |
---|---|---|---|---|---|
Jemmott et al. 2005 |
✓ |
Citation | Setting | Majority Age Group | Majority Racial/Ethnic Group | Gender | Sample Size |
---|---|---|---|---|---|
Jemmott et al. 2005 |
Health clinic or medical facility | 14 to 17 | African American or Black | Young women | 682 |
Evidence by Outcome Domain and Study
Citation | Sexual Activity | Number of Sexual Partners | Contraceptive Use | STIs or HIV | Pregnancy |
---|---|---|---|---|---|
Jemmott et al. 2005 |
n.a. |
|
|
|
n.a. |
Citation | Details |
---|---|
Jemmott et al. 2005 |
The program was evaluated using a randomized controlled trial involving adolescents recruited from a family planning clinic in Philadelphia, PA. Study participants were randomly assigned to one of three groups: (1) a treatment group that received the Sisters Saving Sisters intervention, (2) a treatment group that received an informational session on HIV/STD risk reduction without any skill-building activities, or (3) a control group that received a general health promotion program on risk behaviors for cancer, heart disease, and stroke. This report focuses only on the comparison of the group receiving Sisters Saving Sisters versus the health-promotion control group. Surveys were administered before the intervention and at follow- ups conducted 3, 6, and 12 months after the intervention. Biological testing for chlamydia, gonorrhea, and trichomonas was also conducted. |