-
Lori A. Rolleri, MSW, MPHNicole Lezin, MPPMJulie Taylor,
BAClaire Moore, MPHMary Martha Wilson, MATaleria R. Fuller,
PhDRegina Firpo-Triplett, MPHJanet S. St. Lawrence, PhD
Funding was made possible by Contract #GS10F0171 from the
Centers for Disease Control and Prevention (CDC).
Adaptation KitTools and Resources for Making Informed
Adaptations to BART: Becoming a Responsible Teen
Becoming aResponsible Teen
Rev. October 2011
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Becoming a Responsible Teen Adaptation Kit
Tools and Resources for Making Informed Adaptations to Becoming
a Responsible Teen
Lori A. Rolleri, MSW, MPH Nicole Lezin, MPPM
Julie Taylor, BA Claire Moore, MPH
Mary Martha Wilson, MA Taleria R. Fuller, PhD
Regina Firpo-Triplett, MPH Janet S. St. Lawrence, PhD
ETR Associates 2011
Funding was made possible by Contract # GS10F0171T from the
Centers for Disease Control and Prevention (CDC).
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ETR Associates and CDC Division of Reproductive Health, 2011
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About ETR Associates ETR Associates (Education, Training and
Research Associates), established in 1981, is a national, nonprofit
organization whose mission is to enhance the well-being of
individuals, families and communities by providing leadership,
educational resources, training and research in health promotion
with an emphasis on sexuality and health education.
ETR's Program Services Division offers comprehensive services
for the development, implementation, evaluation and dissemination
of critical public health initiatives. The division works directly
with community-based programs, state and local education agencies,
health care providers, health educators and public health
organizations.
ETR's Publishing Division produces authoritative health
education and health promotion resources that empower young people
and adults to lead healthier lives. Thousands of ETR pamphlets,
books and other materials are used in hundreds of health care
settings, schools and workplaces across the United States and
around the world.
For more information about ETR, visit www.etr.org.
About CDC's Division of Reproductive Health The CDC's Division
of Reproductive Health (DRH) promotes optimal reproductive and
infant health through leadership, scientific and programmatic
expertise, support to impact public policy, health care and
community practices, and individual behaviors. This mission is
accomplished through partnership to conduct research, support
national and state-based surveillance systems, provide technical
assistance and training, and translate research findings into
health care practices and health promotion strategies. CDC DRH
priority areas include infant and maternal health, women’s
reproductive health, global reproductive health, and unintended and
teen pregnancy prevention.
www.cdc.gov/reproductivehealth/DRH/index.htm
© 2011 by ETR Associates 4 Carbonero Way Scotts Valley, CA
95066-4200
Suggested Citation Rolleri, L.A., N. Lezin, J. Taylor, C. Moore,
M.M.Wilson, T. Fuller, R. Firpo-Triplett, and J. St. Lawrence.
2011. Becoming a Responsible Teen Adaptation Kit. Santa Cruz, CA:
ETR Associates.
http://www.etr.org/�http://www.cdc.gov/reproductivehealth/DRH/index.htm�
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Table of Contents Acknowledgments
...........................................................................................................
v
Introduction
.....................................................................................................................
1
How to Use This Kit
.........................................................................................................
5
Becoming a Responsible Teen BDI Logic Model
............................................................. 9 BDI
Logic Model at-a-Glance
....................................................................................................
11
Comprehensive BDI Logic Model
..............................................................................................
17
Becoming a Responsible Teen Core Components
........................................................ 37 Core
Content Components at-a-Glance
....................................................................................
39
Core Content Components in Depth
.........................................................................................
41
Core Pedagogical Components at-a-Glance
.............................................................................
51
Core Pedagogical Components in Depth
..................................................................................
52
Core Implementation Components at-a-Glance
........................................................................
59
Core Implementation Components in Depth
.............................................................................
60
Becoming a Responsible Teen Green/Yellow/Red Light Adaptations
............................ 63 General Adaptations
..................................................................................................................
65
Activity-Specific Adaptations
.....................................................................................................
69
Becoming a Responsible Teen Adaptation and Fidelity Monitoring
Logs ....................... 85
Glossary
......................................................................................................................
109
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Acknowledgments Many talented, experienced and energetic people
were involved in the conceptualization, development, review and
production of the Becoming a Responsible Teen Adaptation Kit.
First, we acknowledge the wisdom and innovation of Dr. Janet St.
Lawrence, the developer of the Becoming a Responsible Teen program.
Becoming a Responsible Teen is making a difference in the
reproductive health of thousands of young people in the United
States and abroad. We express special appreciation to Dr. Janet St.
Lawrence for reviewing this document and giving the writing team
critical feedback.
Funding for this adaptation kit was largely made possible by a
grant from the Division of Reproductive Health (DRH) at the Centers
for Disease Control and Prevention. The Adolescent Reproductive
Health team at CDC DRH responded to numerous requests from its
grantees for guidance on how to effectively adapt evidence-based
programs such as Becoming a Responsible Teen. Thank you, CDC, for
responding to this need. Thank you also for the vision, expertise,
patience and flexibility of several CDC DRH staff who contributed
to the conceptualization and development of these adaptation kits,
especially Claire Moore, Lorrie Gavin, Taleria R. Fuller, Catherine
Lesesne, Alison Spitz, Carla P. White and Trisha Mueller.
CDC DRH awarded funding to ETR Associates to develop adaptation
guidance for evidence-based programs in the Fall of 2006. ETR
assembled a team of multidisciplinary staff with years of
experience in developing, evaluating and disseminating
evidence-based programs, including Julie Taylor, Dr. Karin Coyle
and Dr. Douglas Kirby. Their in-depth understanding of how
evidence-based programs are constructed has been an invaluable
asset to the team.
Other senior staff at ETR served as writers and reviewers of
these kits, including Pamela Drake, Michelle Bliesner, Bayla
Greenspoon and Regina Firpo-Triplett. ETR’s top-notch editing staff
who copyedited and formatted the adaptation kits include Suzanne
Schrag, Pat Rex, Charlene Foster, Laura Patton and Dorothy
Keefe-Hungerford. ETR’s senior leadership, Marsha Weil, Francisco
Buchting and Coleen Cantwell, provided the team with ongoing
executive support and encouragement. Finally, we want to
acknowledge Lanett Beard, Logistics Specialist on this project, who
tended to numerous administrative details that made all of our jobs
much easier.
ETR was fortunate to have two trusted consultants on the
adaptation guidance team: Nicole Lezin of Cole Communications, a
brilliant writer who epitomizes the definition of team player, and
Mary Martha Wilson of Healthy Teen Network, who brought valuable
practitioner perspectives to the team, served on our writing team
and made sure the team was having fun.
An Adaptation Work Group (AWG) was established during the first
few weeks of the Adaptation Guidance project. The AWG provided
important guidance on the development of an adaptation framework,
criteria for selecting evidence-based programs, and process for
developing adaptation tools. Members of the AWG represent
behavioral scientists from CDC, and practitioners from the field.
Thank you to Joan Helmich, Forrest Alton, Polly Edwards, Mary
Prince, Kim Nolte, Mary Schauer, Lisa Barrios, Lisa Romero, Camilla
Harshbarger, Joan Kraft, Jennifer Galbraith, Kelly Lewis and Mary
Martha Wilson.
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After the team developed drafts of various adaptation tools and
resources (which later became part of the adaptation kits), we
assembled several groups of practitioners to provide feedback on
content, format and usability. Thank you to Erica Fletcher of the
Massachusetts Alliance on Teen Pregnancy, who coordinated six local
practitioners to review drafts of these materials in November 2007,
and to Tina Devlin, Erin Johnson and Forrest Alton of the South
Carolina Campaign to Prevent Teen Pregnancy, who brought together
eight practitioners in Columbia, South Carolina, in December 2007.
We are indebted to these individuals whose feedback helped us
streamline these kits and make them practitioner friendly.
In February 2008, our team held a final review meeting in
Atlanta, Georgia, with representatives from each of the CDC DRH
Promoting Science-Based Approaches grantees, including the National
Campaign to Prevent Teen and Unplanned Pregnancy; Healthy Teen
Network; Advocates for Youth; the Massachusetts Alliance on Teen
Pregnancy; the South Carolina Campaign to Prevent Teen Pregnancy;
the Adolescent Pregnancy Prevention Campaign of North Carolina; the
Colorado Youth Matter; the Hawaii Youth Services Network; the
Minnesota Organization on Adolescent Pregnancy, Prevention and
Parenting; the Oklahoma Institute for Child Advocacy; the
Pennsylvania Coalition to Prevent Teen Pregnancy; the Center for
Health Training Resource Group; JSI Research & Training
Institute, Inc.; Family Planning Council, TRAINING 3; and Health
Care Education and Training. The feedback we received from this
meeting helped to further streamline and simplify many of the tools
found in this kit.
It has been an honor to work with so many generous and talented
individuals from across the country. We hope you find the Becoming
a Responsible Teen Adaptation Kit a useful tool as you customize
the program for the youth you serve in your communities. This kit
was created for you, and your feedback is always welcomed. Please
contact the Project Director, Regina Firpo-Triplett, at
[email protected].
With gratitude,
Lori A. Rolleri, MSW, MPH Former Director, Adaptation Guidance
Project ETR Associates
Taleria R. Fuller, PhD Health Scientist CDC Division of
Reproductive Health
mailto:[email protected]�
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Introduction Overview of Becoming a Responsible Teen1Goal of the
Curriculum
Although the primary goal of Becoming a Responsible Teen (BART)
is to decrease HIV infection among African-American adolescents and
other youth ages 14 to 18, the curriculum also 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 skills
include correct condom use, assertive communication, refusal
techniques, self-management and problem solving. Abstinence is
woven throughout the curriculum and is discussed as the best way to
prevent HIV and pregnancy.
Target Audience The target audience for BART is
African-American, Hispanic and White adolescents, ages 14–18, in a
non-school setting.
Implementation of the Curriculum BART was designed to be used
with small groups ranging from 6 to 12 participants, but it can
also be implemented with larger numbers of youth. The curriculum
can be implemented in various community settings, including
facilities for after-school programs or youth-serving agencies.
Length The curriculum has 12 hours of content divided into
90-minute sessions. It could be implemented in eight sessions of 90
minutes each or in six two-hour sessions.
Curriculum Objectives At the completion of BART, youth will be
able to: • State accurate information about HIV and AIDS, including
means of transmission, prevention
and current community impact. • Clarify their own values about
sexual decisions and pressures. • Demonstrate skills in correct
condom use, assertive communication, refusal, information
provision, self-management, problem solving and risk
reduction.
Curriculum Sessions Session 1: Understanding HIV and AIDS
Session 2: Making Sexual Decisions and Understanding Your Values
Session 3: Developing and Using Condom Skills Session 4: Learning
Assertive Communication Skills Session 5: Practicing Assertive
Communication Skills Session 6: Personalizing the Risks Session 7:
Spreading the Word Session 8: Taking BART with You
1 This overview section on Becoming a Responsible Teen was
adapted from ETR’s Resource Center for Adolescent Pregnancy
Prevention (ReCAPP):
http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=2
http://www.etr.org/recapp/index.cfm?fuseaction=pages.ebpDetail&PageID=2�
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Types of Activities BART includes interactive group discussions
and roleplays that have been created by teens. Teens learn to
"spread the word" to their friends about HIV risks. They are
encouraged to practice skills outside the group and share the
results. The group provides creative solutions to reported
problems.
Theoretical Framework BART is based on the knowledge that
information and awareness are preconditions that set the stage for
change and that people learn by seeing others model the desired
behaviors and values. Social Learning Theory and the
Information-Motivation-Behavioral (IMB) Model for Behavior Change
provide the theoretical basis for BART.
Unique Features of the Curriculum BART has features that
distinguish it from other HIV prevention curricula:
• Teens had an active role in developing all aspects of the
curriculum. • It focuses on the needs of African American
adolescents, ages 14 to 18. • It was implemented in non-school,
community-based settings. • It was designed to be used with
gender-specific groups, each group facilitated by both a male
and female group leader. • It has been demonstrated to be
effective with both sexually experienced and sexually
abstinent youth.
Ordering a Copy of BART BART includes session outlines,
instructions for group leaders, handouts for duplication, parent
consent forms, and general guidelines for setting up the
program.
To receive more information and to order BART, contact ETR
Associates at 1-800-321-4407, www.etr.org/pub.
Evaluation Facts2Intervention
African-American adolescents, separated by gender, attended
eight weekly sessions of a sexuality education program (BART) that
included behavioral skills training. In addition to information
about AIDS and prevention of HIV infection, the youth participated
in activities to build skills in correct condom use, assertive
communication, refusal, information provision, self management,
problem solving and risk recognition. Group sizes ranged from 5 to
15, and sessions lasted from 90 to 120 minutes each. Fourteen sets
of sessions were conducted over three years in a comprehensive
community health center serving predominately low-income minority
residents in a Southern urban area of 400,000 residents.
Research Design In the study, 246 adolescents were randomly
assigned either to a control condition or to the experimental
intervention (BART). The control condition consisted of a single
two-hour session
2 These Evaluation Facts were adapted from ETR’s Resource Center
for Adolescent Pregnancy Prevention (ReCAPP):
http://www.etr.org/recapp/
http://www.etr.org/pub�http://www.etr.org/recapp/�
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that provided information about HIV/AIDS, including its nature,
prevention and impact on the local community. Interactive
discussions were interspersed with games, activities and problem
solving. The first session of the experimental intervention was
identical to the control condition.
Participants completed questionnaires before, immediately after,
and at 6-month intervals for one year after the intervention. Of
the original 246 participants, 91.5% completed the 12-month
follow-up. Measures included HIV risk, sexual behaviors,
self-efficacy, attitude toward condoms and HIV/AIDS knowledge.
Behavioral Findings Of the youth who were sexually abstinent
prior to the intervention, only 11.5% of the BART participants were
sexually active one year later compared with 31% of participants in
the control group. Among those sexually active prior to the
intervention, 42% of the control group remained so after one year
versus only 27% of the intervention group. In comparison to their
behavior before the intervention, and in comparison with those in
the control group, youth who participated in BART were more likely
to use condoms and less likely to engage in unprotected vaginal or
anal intercourse.
Other Significant Findings Despite the fact that both groups
received the same basic information component, the BART group
scored higher on the AIDS knowledge test than the control group and
maintained that lead across the 12-month follow-up period.
Moreover, youth from the intervention group were more skillful than
those in the control group in handling pressures to engage in
unprotected sex and in providing information to peers.
Research Study Citation St. Lawrence, J.S., T. Brasfield, K.W.
Jefferson, E. Alleyne, R.E. O'Bannon and A. Shirley. 1995.
Cognitive-behavioral intervention to reduce African-American
adolescents' risk for HIV infection. Journal of Consulting and
Clinical Psychology 63 (2): 221–237.
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Janet S. St. Lawrence, Ph.D.
Dr. Janet S. St. Lawrence is Professor Emerita of Arts &
Sciences at Mississippi State University. She completed a Ph.D. in
Clinical Psychology from Nova University in Florida, followed by a
post-doctoral year as Chief Resident in the Department of
Psychiatry and Human Behavior at the University of Mississippi
Medical Center 1. Following the residency, she because an Assistant
Professor at the University of Mississippi from 1980-1987, then
Associate to full Professor at Jackson State University from 1987 -
1996. From 1996 - 2006, she was Chief of the Behavioral Research
and Interventions Branch in the Division of Sexually Transmitted
Diseases at the Centers for Disease Control and Prevention. After
retiring from the CDC, Dr. St. Lawrence returned to academe at
Mississippi State University.
Dr. St. Lawrence has received numerous awards and recognition:
The American Psychological Associations' Psychology and AIDS Award;
the Association for the Advancement of Behavior Therapy's
Outstanding Research Award; NAFEO's National Research Award; the
Mississippi Psychological Association's Research Achievement Award
(twice), and Outstanding Teaching of Psychology Award. Her research
career focuses on developing and evaluating STD/HIV risk reduction
interventions, primarily in community settings. While in clinical
practice from 1980-1996, she specialized in individuals and
families who were living with HIV/AIDS. She served on the National
Institute of Mental Health's Immunology and AIDS study section that
reviewed NIH grant applications from 1992-1995 and again on the
Behavioral and Social Prevention of HIV/AIDS Study Section from
2007-2011 and on CDC's Behavioral Science Peer Review Panel in
1994.
In addition to being the author of more than 200 books, book
chapters, and articles in professional journals, Dr. St. Lawrence
developed and evaluated Becoming a Responsible Teen, an
evidence-based HIV risk reduction program for 14 to 18 year
olds.
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How to Use This Kit What is the purpose of the Becoming a
Responsible Teen Adaptation Kit? The goal in developing the
Becoming a Responsible Teen (BART) Adaptation Kit is to provide
practitioners with practical tools and resources to guide them in
maintaining fidelity to BART’s core components and in making
effective adaptations. Most practitioners will make adaptations to
evidence-based curricula such as BART in order to have the
activities resonate better with the particular group of youth they
are serving in their communities. This is good practice and is
encouraged. However, sometimes these adaptations are made with very
little guidance, information or understanding about the
curriculum’s core components that are essential for its
effectiveness. This kit was developed to give practitioners better
clarity about how BART is designed, its core components and the
types of adaptations that are considered safe and unsafe.
What tools are found in the BART Adaptation Kit and how were
they developed? ETR Associates and the Division of Reproductive
Health (DRH) at the CDC worked together to develop the tools in
this kit using a six-step process. With the exception of the first
step, each step resulted in adaptation tools found in this kit.
Each of these tools underwent extensive reviews by frontline
practitioners in the field, behavioral scientists, and, most
important, BART’s chief developer, Dr. Janet St. Lawrence. The
steps and tools are described below.
1. Determinant-Activity Matrix: The team initially reviewed each
activity in every lesson of BART and coded them for answers to two
questions: (1) what psychosocial determinant(s) is this activity
trying to change? and (2) what teaching method is being used to
teach it? Determinants are the psychosocial and environmental
factors that have a causal influence on sexual behaviors.
Determinants can include factors such as knowledge, attitudes,
skills or conditions. Teaching methods are things such as
roleplays, videos, lectures, etc. This matrix is not included in
the kit, but it was instrumental in the development of the
Behavior-Determinant-Intervention (BDI) logic model for BART.
2. Behavior-Determinant-Intervention (BDI) Logic Model: With an
analysis of BART’s activities complete, the team built a BDI logic
model for the curriculum. The BDI logic model is a program planning
tool that guides program developers in four sequential and clearly
linked steps starting with: (1) establishing a health goal, (2)
identifying and selecting the individual or group behaviors
directly related to that health goal, (3) identifying and selecting
the determinants related to those behaviors, and (4) developing
intervention activities directly related to those determinants. In
effect, a BDI logic model uncovers the developer’s theory of
change—that is, what factors (determinants) need to be changed in
order to get teens to change their sexual behaviors. A complete BDI
logic model for BART is found in this kit, as well as a “BDI Logic
Model at-a-Glance.”
3. Core Components: With the BDI logic model complete, the team
was able to better identify BART’s core content, pedagogical and
implementation components. Core components are the essential pieces
of a curriculum that are responsible for its effectiveness. Tables
describing the core content, pedagogical and implementation
components (in comprehensive and at-a-glance versions) are found in
this kit.
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4. Green/Yellow/Red Light Adaptations: With the core components
complete, the team was then able to develop a tool for identifying
green/yellow/red light adaptations. As the metaphor suggests, this
tool tells practitioners what kind of adaptations are safe (green),
which should be made with caution (yellow), and which should be
avoided (red). The first part of this tool describes green, yellow
and red light adaptations as they apply generally to BART. The
second part is a table formatted to describe green, yellow and red
light adaptations per activity in each of BART’s eight
sessions.
5. Fidelity and Adaptation Monitoring Logs: Using the Core
Components Tables and the Green, Yellow, Red Light Adaptation
Tables, the team developed a tool called Fidelity and Adaptation
Monitoring Logs. This tool provides a place for facilitators of the
evidence-based program to record their fidelity to each session’s
core content and pedagogical components, as well as the
effectiveness of planned and unplanned adaptations made to each
model. It also provides a log to assess their overall fidelity to
the curriculum’s core implementation components. (This log is
completed after the curriculum is implemented in its entirety.)
6. Glossary: A glossary of terms is included at the end of the
kit.
How do I use the BART Adaptation Kit? Although people may not
always think of making program adaptations as “program planning,”
making effective adaptations to a curriculum involves comprehensive
planning. For example, assessments of the youth you are going to
serve and your organization’s capacity will yield important data
that you can use to inform your adaptations. An understanding about
how to select the best matching program for your youth will help
limit the number of adaptations you may need to make. Evaluating
the adaptations you make can help you improve future
implementations of BART. It’s recommended that you review a program
planning, implementation and evaluation model such as Promoting
Science-Based Approaches to Teen Pregnancy Prevention using Getting
to Outcomes 3
The kit was designed with flexibility in mind. There is no
particular order in which you must use these tools. One suggestion
is that you review the tools as they were developed (and as they
are presented in this kit) and take what you need from them. For
example, if you are interested in the underlying theory of change
used by BART and how the curriculum was put together, look at the
BART Logic Model. If you are interested in knowing what parts of
BART contribute to its effectiveness, review the Core Content,
Pedagogical and Implementation Components. If you want to make
changes, additions, deletions or adaptations to BART, look at the
Green/Yellow/Red Light Adaptations Tables. If you do not find the
exact kind of adaptation that you want to make to the program in
this section, go to the Core Components Tables and make sure that
the adaptation does not compromise or delete them. If you are
looking for a process monitoring tool, the Fidelity and Adaptation
Monitoring Logs are a good choice. Finally, if you are
before making adaptations to BART. This model was developed
specifically for practitioners working in the field of adolescent
reproductive health and will help you think about program
adaptation throughout the program planning process.
3 Lesesne, C.A., K.M. Lewis, C. Moore, D. Fisher, D. Green and
A. Wandersman. 2007. Promoting science-based approaches to teen
pregnancy prevention using Getting to Outcomes: Draft, June 2007.
Atlanta, GA: CDC Division of Reproductive Health. (Unpublished
manual.)
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looking for a particular resource to help you make an
adaptation, access the Companion Resources. (See below for more
information.)
The following table illustrates the different purposes of the
sections of the adaptation kit.
BDI Logic Model
Core Components
Green/Yellow/Red Light Adaptations
Fidelity & Adaptation Logs
Companion Resources (see below)
I want to better understand the underlying theory of change used
by BART and how the curriculum was put together.
I want to understand what parts of BART are essential.
I want to make effective adaptations to BART without
compromising fidelity.
I need a process monitoring tool to track my fidelity to core
components and the planned and unplanned adaptations I make.
I want recommendations for resources that might help me in
making effective adaptations.
Companion Resources. The Companion Resources are a useful
supplement to this adaptation kit. Here you will find links to the
latest health information and research that you can use to update
information in the curricula and make informed decisions about
program planning, assessment and evaluation. You will also find
ideas for alternate activities, information about specific ethnic
and cultural groups, which is broken down by group and will be
invaluable if you want to adapt a curriculum for another youth
population, and many other handy resources. These include: a list
of websites specifically for teens, a compilation of print
materials on fidelity and adaptation, and links to information on
teaching skills such as classroom management and leading group
discussions. This companion piece is available at:
http://www.etr.org/recapp/index.cfm?fuseaction=pages.AdaptationsHome.
For more information about this adaptation kit, please contact
Regina Firpo-Triplett at ETR Associates, [email protected].
http://www.etr.org/recapp/index.cfm?fuseaction=pages.AdaptationsHome�mailto:[email protected]�
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Becoming a Responsible Teen
BDI Logic Model
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BDI Logic Model at-a-Glance What is a “BDI Logic Model”? The
Behavior-Determinant-Intervention (BDI) logic model is a program
planning and analysis tool developed by Douglas Kirby.4 A BDI logic
model graphically shows the links or connections between the health
goal of a curriculum or program, the adolescent sexual behaviors
directly related to that health goal (e.g., condom use), the
determinants5
The BDI logic model graphically depicts the developer’s theory
of change for a program, i.e., what needs to be changed in order
for teens to engage in healthy sexual behaviors.
(e.g., knowledge, attitude, skills) that influence those sexual
behaviors, and the intervention activities specifically designed to
change those determinants (e.g., roleplays, large-group discussion,
etc.).
For more information about BDI logic models, visit
http://www.etr.org/recapp/documents/BDILOGICMODEL20030924.pdf
How do I use the Becoming a Responsible Teen BDI Logic Model?
The Becoming a Responsible Teen (BART) BDI logic model is a useful
tool for practitioners preparing to implement and/or adapt BART.
The logic model can help you better understand the rationale/logic
behind the learning activities found in BART by showing how these
activities were intentionally designed to change important
determinants of adolescent sexual behavior. This understanding will
help you implement BART with greater fidelity and purpose. If you
better understand the link between learning activities and
determinants, you are more likely to recognize their value.
The BDI logic model is the foundation for identifying BART’s
core content and pedagogical components. If you are considering
adaptations to BART, the BDI logic model can serve as a map to
guide adaptations so that changes or additions are consistent and
responsive to the “logic” presented in the model and the core
content and pedagogical components derived from it.
BART’s BDI Logic Model at-a-Glance is presented first to offer a
quick overview of the logic in the BART curriculum. Immediately
following, you will find the in-depth version of BART’s BDI logic
model.
4 Kirby D. 2004. BDI logic models: a useful tool for designing,
strengthening and evaluating programs to reduce
adolescent sexual risk-taking, pregnancy, HIV and other STDs.
Santa Cruz, CA: ETR Associates.
5 Determinants of behaviors are sometimes also called risk and
protective factors.
Intervention Activities Determinants Behaviors Health Goal
http://www.etr.org/recapp/documents/BDILOGICMODEL20030924.pdf�
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Definitions of Common Determinants Found in Evidence-based Sex
and STD/HIV Education Programs Attitude An attitude is a state of
mind, feeling or disposition. Attitudes are often expressed in the
way people think, feel and act. They demonstrate an individual’s
opinions, dispositions, perspectives or positions on a particular
issue or topic. Attitudes are somewhat different from values.
Belief A belief is an individual’s perception that a proposition
or premise is true. For example, in the Theory of Planned Behavior,
normative beliefs are perceptions about the normative expectations
of others, and behavioral beliefs are perceptions about the likely
consequences of specific behaviors.
Communication with a Parent or Adult This type of communication
is the act of giving, receiving and understanding messages between
a parent/adult and a teen. Messages may include information or
education, value sharing, support or encouragement, advice, etc.
Messages may be relayed via oral, written or nonverbal methods.
Connectedness to Culture Culture can relate to a person’s
ethnicity, race, religion, geography, socio-economic status, age,
gender, and sexual orientation or identity. Feeling connected to
culture may include awareness, understanding, acceptance and pride
about the norms, values, beliefs and history of that culture and
how it affects sexual decision making.
Empowerment Empowerment is a process through which individuals
feel competent and confident that they have the needed competencies
to successfully undertake a course of action and carry out a
behavioral plan.
Intentions An intention is a decision, determination or plan to
behave in a particular way in specific situations. Even if a person
intends to do something, it doesn’t mean that she/he will actually
do it. For example, a person who is thinking about quitting smoking
intends or plans to quit but may or may not actually follow through
on that intention.
Knowledge Knowledge refers to the awareness and understanding of
information, statistics, facts, principles, frameworks, and the
characteristics/descriptions, causes and consequences related to a
problem (e.g., unintended pregnancy or HIV infection).
Motivation Motivation is the desire to carry out a course of
action or a behavior.
Outcome Expectations Outcome expectations refer to the
individual’s beliefs about what will result from engaging in a
certain behavior and the desirability of those results. The
behavior could result in negative consequences or positive
consequences. For example, a teen may have negative outcome
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Becoming a Responsible Teen Adaptation Kit BDI Logic Model
at-a-Glance
ETR Associates and CDC Division of Reproductive Health, 2011
13
expectations for using condoms because she believes her
boyfriend will get mad at her or that using condoms will ruin the
pleasure of sex. Alternatively, another teen might have positive
outcome expectations for using condoms because he knows that his
girlfriend will appreciate him, that he will protect himself from
pregnancy or an STD and/or that condoms can be fun to use. See
definition of “Attitude.”
Perception of Risk Perception of risk relates to an individual’s
understanding and belief about the likelihood that he/she could
experience negative consequences, such as unintended pregnancy or
STD/HIV, by engaging or not engaging in certain behaviors (e.g.,
having sex with a condom, having sex without a condom). Perception
of risk may reflect perceived susceptibility or vulnerability,
severity and seriousness of some possible outcome.
Skill Skill refers to the ability to do something adequately or
well (e.g., to use a condom correctly, refuse sex, or negotiate
condom use with a partner). Having the skill to do something means
that the individual understands the correct steps required for
executing the action and knows how to execute those steps. However,
knowing how to do something does not mean that a person will behave
or act in the desired way in real-life situations. See definition
of “Self-Efficacy.”
Self-Efficacy Self-efficacy is a person’s confidence in his/her
ability to perform particular behaviors well enough to control
events that affect his/her life. If someone has high self-efficacy,
then she believes she can perform behaviors well enough to change
her environment and achieve a goal, and, as a result, she has more
confidence. She is then more likely to try to perform the behavior
or achieve a goal again. Conversely, if she has low self-efficacy,
she believes she can’t achieve that goal, has less confidence, and
is less likely to try.
Social Norms Social norms are standards of acceptable behavior
or attitudes within a community or peer group. Social norms come in
two varieties—actual norms and perceived norms. Actual norms are
the true social norms for a particular attitude or behavior. For
example, if the majority of a group of sexually active individuals
uses some form of birth control, then the actual norm for the group
is to use birth control. Going without birth control is
"non-normative" in that group. Perceived norms are what an
individual believes to be the social norm for a group. If, for
example, a young man believes that most of his peers do not use
condoms, for that young man, the perceived norm is non-use of
condoms.
Values Values are principles or beliefs that serve as guidelines
in helping people make decisions about behaviors or life choices.
They reflect what an individual believes about the “rightness” or
the “wrongness” of things. Values tell us what a person believes
about something.
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
14
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ing a Responsible Teen Adaptation K
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I Logic Model at-a-G
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BDI Logic Model at-a-Glance
Decrease HIV infection among African-American adolescents ages
14 –18.
(continued)
• Who Is at Risk for HIV and Why? (Session 1, Activity 2)
• Introduction to HIV Terms (Session 1, Activity 3)
• Exploring Drug Risks for HIV (Session 2, Activity 6
• Using Condoms Correctly (Session 3, Activity 4)
• Problem-Solving Skills (Session 4, Activity 3)
• Assertive Communication Review (Session 5, Activity 1)
• Getting Out of Risky Situations (Session 7, Activity 2)
KNOWLEDGE about: • HIV (definitions, transmission,
testing and prevention) • how drugs and alcohol use may
influence sexual decision making
• correct and consistent condom use
• problem-solving skills • communication styles • avoiding
situations that could
lead to unhealthy sexual decisions
• Delay onset of sexual intercourse
• Increase use of condoms • Decrease unprotected oral, anal
and vaginal intercourse • Decrease frequency of sex • Decrease
number of sexual
partners
ATTITUDES about: • talking about HIV and sex • obtaining condoms
• HIV prevention and safer sex,
including condom use • using effective (assertive)
communication • people who have HIV • protecting oneself and
others
from HIV • making a difference by sharing
with others information and skills related to preventing HIV
• Introduction to BART (Session 1, Activity 1)
• Attitudes and Risks (Session 3, Activity 1)
• Overcoming Embarrassment About Buying Condoms (Session 3,
Activity 3)
• Video: Are You With Me? (Session 4, Activity 2) Different
Communication Styles (Session 4, Activity 4)
• Meeting People with HIV (Session 6, Activity 1)
• Spreading the Word Practice (Session 7, Activity 4)
• What Are You Doing to Protect Yourself? (Session 8, Activity
2)
BART Intervention Activities Designed to Change Determinants
Determinants of Teen Sexual Behaviors Addressed in BART
BART’s Health Goal
Teen Behaviors Directly Related to BART’s Health Goal
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
15
Becom
ing a Responsible Teen Adaptation K
it BD
I Logic Model at-a-G
lance
BDI Logic Model at-a-Glance (continued) €
Decrease HIV infection among African-American adolescents ages
14 –18.
SOCIAL/PEER NORMS about: • supporting the prevention of
HIV and promoting safer sex (including condom use)
• promoting use of effective (assertive) communication
• refusing sex
• Who Is at Risk for HIV and Why? (Session 1, Activity 2)
• Countering Barriers to Using Condoms (Session 3, Activity
5)
• Spreading the Word Demonstration (Session 7, Activity 3)
• Assertive Communication in the Real World (Session 7, Activity
1)
• Negotiating Safer Sex (Session 4, Alternative Activity 2)
• Ways to Say NO (Session 5, Activity 3)
(continued)
PERCEPTION OF RISK/ VULNERABILITY related to: • susceptibility
to HIV infection • consequences of HIV infection
(how life would be altered) (“It could happen to me”)
• Who is at Risk for HIV and Why? (Session 1, Activity 2)
• Deciding Your Level of Risk (Session 1, Activity 5)
• Meeting People with HIV (Session 6, Activity 1)
SKILLS AND SELF-EFFICACY related to: • obtaining condoms and
using
them correctly • negotiating condom use • using effective
(assertive)
communication • refusing sex • communicating about HIV
prevention to others • preventing risky situations and
handling those that arise
• Overcoming Embarrassment About Buying Condoms (Session 3,
Activity 3)
• Using Condoms Correctly (Session 3, Activity 4)
• Negotiating Safer Sex (Session 4, Alternate Activity 2)
• Assertive Communication Tips (Session 5, Activity 2)
• Ways to Say No (Session 5, Activity 3)
• Spreading the Word Practice (Session 7, Activity 4)
• Getting Out of Risky Situations (Session 7, Activity 2)
• Delay onset of sexual intercourse
• Increase use of condoms • Decrease unprotected oral, anal
and vaginal intercourse • Decrease frequency of sex • Decrease
number of sexual
partners
BART Intervention Activities Designed to Change Determinants
Determinants of Teen Sexual Behaviors Addressed in BART
BART’s Health Goal
Teen Behaviors Directly Related to BART’s Health Goal
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
16
Becom
ing a Responsible Teen Adaptation K
it BD
I Logic Model at-a-G
lance
BDI Logic Model at-a-Glance (continued)
INTENTIONS: • to avoid behaviors that could
lead to HIV infection
• Deciding Your Level of Risk (Session 1, Activity 5)
Decrease HIV infection among African-American adolescents ages
14 –18.
• Delay onset of sexual intercourse
• Increase use of condoms • Decrease unprotected oral, anal
and vaginal intercourse • Decrease frequency of sex • Decrease
number of sexual
partners
CONNECTEDNESS TO CULTURE: • Reinforcing African-American
values supporting individual responsibility/pride and caring for
the greater community
• Who Is at Risk for HIV and Why? (Session 1, Activity 2)
• AIDS and African Americans (Session 2, Activity 3)
•
VALUES about: • preventing HIV and promoting
safer sex • communicating with a partner
about safer sex • using knowledge and skills
gained through BART to make a difference to family members,
friends and peers
• Assertive Communication Tips (Session 5, Activity 2)
• Assertive Communication in the Real World (Session 7, Activity
1)
• Spreading the Word Demonstration (Session 7, Activity 3)
COMMUNICATION with parents or other adults about: • what has
been learned in BART • what adults can do to support
them in learning about and preventing HIV infection
• Support Systems (Session 2, Activity 7)
BART Intervention Activities Designed to Change Determinants
Determinants of Teen Sexual Behaviors Addressed in BART
BART’s Health Goal
Teen Behaviors Directly Related to BART’s Health Goal
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Associates and C
DC
Division of R
eproductive Health, 2011
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ing a Responsible Teen Adaptation K
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omprehensive BD
I Logic Model
Comprehensive BDI Logic Model BART Intervention Activities
Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
KNOWLEDGE • 1.2 Who Is at Risk for HIV and Why—
Activity includes a short lecture on definitions associated with
HIV/AIDS.
18–23 1. HIV Definitions, Transmission, Testing and
Prevention
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 1.3 Introduction to HIV Terms—Activity that uses strips of
paper with important words on them to review definitions associated
with HIV, includes a lecture on HIV progression and incubation and
large-group discussion on how you can and cannot get HIV, and how
to protect yourself from getting HIV.
24–32
• 1.4 Facts and Myths—Team game that clears up myths about HIV
transmission and AIDS.
33–34
• 1.5 Deciding Your Level of Risk—Activity that uses a traffic
light game to clarify which behaviors are high risk, some risk and
no risk, as well as a worksheet that asks youth to individually
think about behaviors that will and will not lead to HIV infection,
followed by large-group discussion.
35–37
• 1.6 Spreading the Word—Homework assignment has youth share the
information they learned today with others and correct myths they
hear about HIV.
38
• 2.1 Definitions Review—Large-group discussion/review of HIV
definitions.
60
• 2.2 HIV Transmission Review—Large-group discussion on how to
avoid HIV transmission, including specific behaviors that can lead
to HIV.
61
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
18
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 2.3 AIDS and African Americans—Large-group discussion/review
about how HIV is affecting African Americans in general and lecture
about how it is affecting African Americans in a given state.
62–63 1. HIV Definitions, Transmission, Testing and Prevention
(continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 2.4 HIV Feud Game—Team game in which youth match behaviors
with risk level cards (can be done in two different ways).
64–65
• 2.5 “Seriously Fresh”—Video about a group of African-American
friends’ experiences with HIV, followed by large-group discussion
of specific questions.
66–67
• 6.2 Discussion and Debrief—Large-group discussion about the
presentations by HIV-positive guest speaker(s).
231
• 8.1 Final Review of HIV Facts—Team myth/fact game reviews
information about HIV.
268–270
• 8.2 What Are You Doing to Protect Yourself?—Includes a short
lecture reminding youth to keep themselves safe, that they have
choices, and that they should keep practicing what they have
learned in BART.
271–272
• 2.6 Exploring Drug Risks for HIV—Large-group discussion about
drug use and how it can put one at risk for HIV, followed by a
lecture about how the use of drugs and/or alcohol can affect the
immune system.
70 2. How Drugs and Alcohol Use May Influence Sexual Decision
Making
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
19
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 3.2 Learning the Facts About Condoms—Lecture with some
large-group discussion about condoms in general, lubricants and how
to store condoms.
156–157 2. How Drugs and Alcohol Use May Influence Sexual
Decision Making (continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18 • 3.3 Overcoming Embarrassment About
Buying Condoms—Large-group discussion that explores where to get
condoms and strategies for overcoming embarrassment about buying
them.
158–159 3. Condom Use
• 3.4 Using Condoms Correctly—Lecture and demonstration of how
to put on and remove a condom correctly, followed by youth
practice, while facilitators circulate and give feedback.
160–162
• 4.1 Correct Condom Use Review—Review of basic information
about condoms and beginning discussion on talking about condoms
with a partner.
170
• 4.3 Problem-Solving Skills—Lecture about a six-step
problem-solving framework, followed by a brainstorm and large-group
discussion about each of the six steps.
176–179 4. Problem-Solving Skills
• 7.1 Assertive Communication in the Real World—Activity that
includes a review of the problem-solving steps, with an emphasis on
the value of communicating about safer sex with a partner.
238–240
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
20
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
• 4.4 Different Communication Styles—Facilitators roleplay three
communication scenarios that demonstrate passive, aggressive and
assertive communication. Participants discuss observations and why
they think each style works or doesn’t work, and facilitators
explain the styles. Then facilitators present three more roleplay
scenarios at the end of the activity, and youth have to identify
the communication style being demonstrated.
180–185 5. Communication Styles (Assertive, Passive and
Aggressive)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
BEHAVIORAL BELIEFS • 5.1 Assertive Communication Review—
Large-group discussion reviews the definitions and
characteristics of the three communication styles.
194–196 1. Communication Styles (Assertive, Passive and
Aggressive) (continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18 • 7.1 Assertive Communication in the Real
World—Large-group discussion reviews assertive communication
skills, including benefits.
238–240
• 7.2 Getting Out of Risky Situations—Large-group discussion
about how to get out of risky situations, including walking away,
and lecture about how to use self-talk to stay safe. Includes a
handout titled “10 Steps to Put Good Intentions into Practice.”
241–245 2. Avoiding Situations That Could Lead to Unhealthy
Sexual Decisions
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
21
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
ATTITUDES • 1.1 Introduction to BART—Includes a
large-group discussion about how youth felt when they found out
someone they knew had HIV.
14–17 1. Comfort in Talking about HIV and Sex
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18 • 3.3 Overcoming Embarrassment About
Buying Condoms—Activity that includes a large-group discussion
about where to obtain condoms, brainstorm about obstacles to
purchasing condoms and ways to overcome these obstacles, and
visualization exercise where youth imagine successfully buying
condoms.
158–159 2. Comfort about Obtaining a Condom
• 3.3 Overcoming Embarrassment about Buying Condoms—Activity
that includes a large-group discussion about where to obtain
condoms, brainstorm about obstacles to purchasing condoms and ways
to overcome these obstacles, and a visualization exercise in which
youth imagine successfully buying condoms.
158–159 3. Positive Attitude about Condom Use
• 3.5 Countering Barriers to Using Condoms—Activity in which
youth brainstorm a list of excuses that teens give for not using
condoms, followed by a large-group discussion to come up with
counterarguments for each of the excuses.
163–164
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
22
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 3.1 Attitudes and Risks—Activity includes an opportunity for
youth to ask questions and share experiences of talking to
friends/family about what they have learned in BART, followed by a
review of the “Seriously Fresh” video, especially the part about
using condoms, and a short lecture about African-American teen sex
statistics and the importance of using condoms.
54–155 4. Positive Attitude about Safer Sex 1. Delay onset of
sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 3.3 Overcoming Embarrassment About Buying Condoms—Youth
brainstorm ways to overcome embarrassment about purchasing condoms,
followed by an exercise in which they imagine successfully buying
condoms and then discuss.
158–159
• 3.5 Countering Barriers to Using Condoms—Activity in which
youth brainstorm a list of excuses that teens give for not using
condoms, followed by a large-group discussion to come up with
counterarguments for each of the excuses.
163–164
• 4.2 Video: Are You With Me?—Video that demonstrates ways to
negotiate safer sex, followed by large-group discussion about
discussing condom use with a partner.
171–172 5. Positive Attitude about HIV Prevention
• 4.3 Problem-Solving Skills—Brainstorm and large-group
discussion about each of the six steps of the problem-solving
framework, followed by a short lecture about the importance of both
partners in a relationship taking responsibility for having safer
sex.
176–179
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
23
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 7.3 Spreading the Word Demonstration—Activity in which youth
brainstorm ways to bring up safer sex with family and friends so
that they can be HIV prevention peer leaders in their community.
Includes a handout of tips about how to spread the word effectively
and demonstration roleplays.
246–248 5. Positive Attitude about HIV Prevention
(continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 7.4 Spreading the Word Practice—Small groups practice
roleplays on spreading the word about HIV to others.
249–250
• 8.2 What Are You Doing to Protect Yourself?—Large-group
discussion about how BART has affected participants, followed by a
short lecture reminding youth to keep themselves safe, that they
have choices, and that they should keep practicing what they have
learned.
271–272
• 4.4 Different Communication Styles—Facilitators roleplay three
communication scenarios that demonstrate passive, aggressive and
assertive communication. Participants discuss observations and why
they think each style works or doesn’t work, and facilitators
explain the styles. Then facilitators present three more roleplay
scenarios at the end of the activity, and youth have to identify
the communication style being demonstrated.
180–185 6. Comfort in Using Effective (Assertive)
Communication
• 7.1 Assertive Communication in the Real World—Large-group
discussion in which youth are asked to share some examples from the
past couple of weeks when they used assertive communication.
238–240
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
24
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 6.1 Meeting People with HIV—Presentation by an HIV-positive
speaker, followed by an opportunity for youth to ask questions.
Facilitator emphasizes the behaviors that put one at risk for
HIV.
230 7. Reduced Stigma about People Who Have HIV
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 1.1 Introduction to BART—Includes a large-group discussion
about how youth felt when they found out someone they knew had
HIV.
14–17 8. Motivation to Protect Self and Others from HIV
• 1.2 Who Is at Risk for HIV and Why?—Lecture, with some
large-group discussion, about who is at risk for HIV, behavior that
puts one at risk, and how AIDS is affecting the African-American
community, using multiple pie charts to show statistics. The
“Strength for Prevention” activity consists of a lecture and
large-group discussion about seven principles of Kwanzaa and how
these principles can be protective against HIV infection. Youth
then discuss what they can do to prevent HIV in their
community.
18–23
• 1.3 Introduction to HIV Terms—Activity includes a large-group
discussion about how to protect yourself from getting HIV.
32
• 2.5 Video: Seriously Fresh—Video about a group of
African-American friends’ experiences with HIV, followed by
large-group discussion of specific questions.
66–67
• 2.5A Personalizing HIV Risks—Youth complete a worksheet about
how HIV would change their lives and then discuss.
68–69
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
25
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 6.1 Meeting People with HIV—Presentation by an HIV-positive
speaker, followed by an opportunity for youth to ask questions.
Facilitator emphasizes the behaviors that put one at risk for
HIV.
230 8. Motivation to Protect Self and Others from HIV
(continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 8.2 What Are You Doing to Protect Yourself?—Activity concludes
with a short motivational discussion reminding youth to keep
themselves safe, that they have choices, and that they should keep
practicing what they have learned.
271–272
• 1.6 Spreading the Word—Homework assignment has youth share the
information they learned today with others and correct myths they
hear about HIV.
38 9. Motivation or Empowerment to Make a Difference by Sharing
with Others Information and Skills Related to Preventing HIV
• 2.3 AIDS and African Americans—Large-group discussion about
how teens can make a difference in their community in preventing
HIV.
62–63
• 2.7 Support Systems—Activity concludes by encouraging youth to
pass the information they have learned thus far on to others.
71–72
• 3.1 Attitudes and Risk—Activity includes an opportunity for
youth to ask questions and share experiences of talking to
friends/family about what they have learned in BART.
154–155
(continued)
-
ETR
Associates and C
DC
Division of R
eproductive Health, 2011
26
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 7.3 Spreading the Word Demonstration—Activity in which youth
brainstorm ways to bring up safer sex with family and friends so
that they can be HIV-prevention peer leaders in their community.
Includes a handout of tips about how to spread the word effectively
and demonstration roleplays, followed by youth feedback.
246–248 9. Motivation or Empowerment to Make a Difference by
Sharing with Others Information and Skills Related to Preventing
HIV (continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 8.1 Final Review of HIV Facts—Includes large-group discussion
in which youth are encouraged to pass along information about HIV
prevention to others in their community.
268–270
SKILLS & SELF-EFFICACY • 3.3 Overcoming Embarrassment
about
Buying Condoms—Activity that includes a large-group discussion
about where to obtain condoms, brainstorm about obstacles to
purchase condoms and ways to overcome these obstacles, and
visualization exercise in which youth imagine successfully buying
condoms.
158–159 1. Obtaining Condoms 1. Delay onset of sexual
intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 3.4 Using Condoms Correctly—Lecture and demonstration of how
to put on and remove a condom correctly, followed by youth
practice, while facilitators circulate and give feedback.
160–162 2. Using a Condom Correctly
• 4.2A Negotiating Safer Sex—After facilitators perform a
roleplay demonstration about saying no to sex and negotiating
condom use, youth complete a worksheet titled “What I Can Do to
Stay Safe,” followed by large-group discussion.
173–175 3. Negotiating Condom Use
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
27
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 5.4 Assertive Communication Demonstration—Facilitators act out
three roleplays demonstrating assertive communication, while youth
discuss each roleplay using their “Assertive Communication Tips”
handout and provide feedback.
200–202 3. Negotiating Condom Use (continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 5.1 Assertive Communication Review—Large-group discussion
examines experiences youth had in the last week when they used or
could have used assertive communication.
194–196 4. Using Effective (Assertive) Communication
• 5.2 Assertive Communication Tips—Lecture and handout offer
tips on being assertive and reinforce the importance of staying
safe.
197–198
• 5.5 Assertive Communication Practice—Activity in which youth
practice what they’ve learned about assertive communication through
roleplaying eight different scenarios (some dealing with sex and
some with drug use) in groups of three and giving each other
feedback.
203–205
• 4.2A Negotiating Safer Sex—Facilitators perform roleplay
demonstrations about saying no to sex and negotiating condom use,
then youth complete a worksheet titled “What I Can Do to Stay
Safe.”
173-175 5. Refusing Sex
• 5.3 Ways to Say NO—Large-group discussion about ways to say NO
and reinforcement of assertive responses is followed by discussion
of a handout with suggestions about how to say no.
199
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
28
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 7.4 Spreading the Word Practice—Youth use roleplays to
practice spreading the word about HIV.
249-250 6. Communicating about HIV Prevention to Others
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 1.5 Deciding Your Level of Risk—Activity uses a traffic light
game to clarify which behaviors are high risk, some risk and no
risk, as well as a worksheet that asks youth to individually think
about behaviors that will and will not lead to HIV infection,
followed by large-group discussion.
35–37 7. Preventing Risky Situations and Handling Those That
Arise
• 4.3 Problem-Solving Skills—Lecture about a six-step
problem-solving framework includes a brainstorm and large-group
discussion about each of the six steps, followed by a short lecture
about the importance of both partners in a relationship taking
responsibility for having safer sex.
176–179
• 7.2 Getting Out of Risky Situations—Large-group discussion
about how to get out of risky situations, including walking away,
and lecture about how to use self-talk to stay safe. Includes a
handout titled “10 Steps to Put Good Intentions into Practice.”
241–245
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
29
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
PERCEPTION OF RISK • Who Is at Risk for HIV and Why—Lecture,
with some large-group discussion, about who is at risk for HIV,
behavior that puts one at risk, and how AIDS is affecting the
African-American community, using multiple pie charts to show
statistics.
18–23 1. Susceptibility to HIV Infection 1. Delay onset of
sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 1.3 Introduction to HIV Terms—Activity that includes a lecture
on HIV progression and incubation and large-group discussion on how
you can and cannot get HIV, and how to protect yourself from
getting HIV.
24–32
• 1.5 Deciding Your Level of Risk—Activity uses a traffic light
game to clarify which behaviors are high risk, some risk and no
risk, as well as a worksheet that asks youth to individually think
about behaviors that will and will not lead to HIV infection,
followed by large-group discussion.
35–37
• 2.3 AIDS and African Americans—Large-group discussion/review
about how HIV is affecting African Americans in general and lecture
about how it is affecting African Americans in a given state.
62–63
• 2.4 “HIV Feud”—Team game in which youth match behaviors with
risk level cards (can be done in two different ways).
64–65
• 2.5 Video: Seriously Fresh—Video about a group of
African-American friends’ experiences with HIV, followed by
large-group discussion of specific questions.
66–67
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
30
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 6.2 Discussion and Debrief—Large-group discussion about the
presentations by HIV-positive guest speaker(s).
231 1. Susceptibility to HIV Infection (continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 1.1 Introduction to BART—Includes a large-group discussion
about how youth felt when they found out someone they knew had
HIV.
14–17 2. Severity of Being Infected with HIV
• 2.5 Video: Seriously Fresh—Video about a group of
African-American friends’ experiences with HIV, followed by
large-group discussion of specific questions.
66–67
• 6.1 Meeting People with HIV—Presentation by an HIV-positive
speaker, followed by an opportunity for youth to ask questions.
Facilitator emphasizes the behaviors that put one at risk for
HIV.
230
SOCIAL/PEER NORMS • 1.2 Who Is at Risk for HIV and Why?—
The “Strength for Prevention” activity consists of a lecture and
large-group discussion about seven principles of Kwanzaa and how
these principles can be protective against HIV infection. Youth
then discuss what they can do to prevent HIV in their
community.
18–23 1. Preventing HIV
• 1.6 Spreading the Word—Homework assignment has youth share the
information they learned today with others and correct myths they
hear about HIV.
38
• 2.3 AIDS and African Americans—Large-group discussion about
how teens can make a difference in their community in preventing
HIV.
62–63
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
31
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 2.7 Support Systems—Activity concludes by encouraging youth to
pass the information they have learned thus far on to others.
71–72 1. Preventing HIV (continued) 1. Delay onset of sexual
intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18 • 7.4 Spreading the Word Practice—Youth
use roleplays to practice spreading the word about HIV.
249–250
• 8.1 Final Review of HIV Facts—Includes large-group discussion
in which youth are encouraged to pass along information about HIV
prevention to others in their community.
268–270
• 8.3 What Are You Doing to Educate Others?—Short lecture that
reviews what youth learned over the last eight weeks in BART and
discussion about what can happen when they share what they’ve
learned. Includes a diagram showing the multiplicative effects of
talking about HIV with others.
273–274
• 3.5 Countering Barriers to Using Condoms—Activity in which
youth brainstorm a list of excuses that teens give for not using
condoms, followed by a large-group discussion to come up with
counterarguments for each of the excuses.
163–164 2. Using Condoms
• 4.2A Negotiating Safer Sex—After facilitators perform a
roleplay demonstration about saying no to sex and negotiating
condom use, youth complete a worksheet titled “What I Can Do to
Stay Safe,” followed by large-group discussion.
173–175
(continued)
-
ETR
Associates and C
DC
Division of R
eproductive Health, 2011
32
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 4.3 Problem-Solving Skills—Includes a short lecture about the
importance of both partners in a relationship taking responsibility
for having safer sex.
246–248 3. Promoting Safer Sex 1. Delay onset of sexual
intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18 • 7.3 Spreading the Word Demonstration—
Activity in which youth brainstorm ways to bring up safer sex
with family and friends so that they can be HIV prevention peer
leaders in their community. Includes a handout of tips about how to
spread the word effectively and demonstration roleplays, followed
by youth feedback.
180–185
• 4.4 Different Communication Styles—Facilitators roleplay three
communication scenarios that demonstrate passive, aggressive and
assertive communication. Participants discuss observations and why
they think each style works or doesn’t work, and facilitators
explain the styles. Then facilitators present three more roleplay
scenarios at the end of the activity, and youth have to identify
the communication style being demonstrated.
180–185 4. Using Effective (Assertive) Communication
• 5.1 Assertive Communication Review—Large-group discussion
examines experiences youth had in the last week when they used or
could have used assertive communication.
194–196
• 7.1 Assertive Communication in the Real World—Large-group
discussion in which youth are asked to share some examples from the
past couple of weeks when they used assertive communication.
238–240
(continued)
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ETR
Associates and C
DC
Division of R
eproductive Health, 2011
33
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 5.3 Ways to Say NO—Large-group discussion about ways to say NO
and reinforcement of assertive responses is followed by discussion
of a handout with suggestions about how to say no.
199 4. Using Effective (Assertive) Communication (continued)
CULTURE
• 1.2 Who Is at Risk for HIV and Why?—Lecture, with some
large-group discussion, about who is at risk for HIV, behavior that
puts one at risk, and how AIDS is affecting the African-American
community, using multiple pie charts to show statistics. The
“Strength for Prevention” activity consists of a lecture and
large-group discussion about seven principles of Kwanzaa and how
these principles can be protective against HIV infection. Youth
then discuss what they can do to prevent HIV in their
community.
18–23 1. Connectedness to Culture 1. Delay onset of sexual
intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 2.3 AIDS and African Americans—Large-group discussion about
how teens can make a difference in their community in preventing
HIV.
62–63
• 8.1 Final Review of HIV Facts—Includes large-group discussion
in which youth are encouraged to pass along information about HIV
prevention to others in their community.
268–270
(continued)
-
ETR
Associates and C
DC
Division of R
eproductive Health, 2011
34
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 8.3 What Are You Doing to Educate Others?—Short lecture that
reviews what youth learned over the last eight weeks in BART and
discussion about what can happen when they share what they’ve
learned. Includes a diagram showing the multiplicative effects of
talking about HIV with others.
273–274 1. Connectedness to Culture (continued)
VALUES
• 1.2 Who Is at Risk for HIV and Why?—The “Strength for
Prevention” activity consists of a lecture and large-group
discussion about seven principles of Kwanzaa and how these
principles can be protective against HIV infection. Youth then
discuss what they can do to prevent HIV in their community.
18–23 1. Preventing HIV and Promoting Safer Sex
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18
• 5.2 Assertive Communication Tips—Lecture and handout offer
tips on being assertive and reinforce the importance of staying
safe.
197–198
• 7.1 Assertive Communication in the Real World—Activity
includes a review of the problem-solving steps, with an emphasis on
the value of communicating about safer sex with a partner.
238–240 2. Communicating with a Partner about Safer Sex
• 1.6 Spreading the Word—Homework assignment has youth share the
information they learned today with others and correct myths they
hear about HIV.
38 3. Using Knowledge and Skills Learned through BART to Make a
Difference with Family Members, Friends and Peers
• 2.3 AIDS and African Americans—Large-group discussion about
how teens can make a difference in their community in preventing
HIV.
62–63
(continued)
-
ETR
Associates and C
DC
Division of R
eproductive Health, 2011
35
Becom
ing a Responsible Teen Adaptation K
it C
omprehensive BD
I Logic Model
Comprehensive BDI Logic Model (continued)
BART Intervention Activities Designed to Change Determinants
Pages Determinants of Teen Sexual Behaviors Addressed in
BART
Teen Behaviors Directly Related to BART’s Health Goal
BART’s Health Goal
• 2.7 Support Systems—Activity concludes by encouraging youth to
pass the information they have learned thus far on to others.
71–72 3. Using Knowledge and Skills Learned Through BART to Make
a Difference with Family Members, Friends and Peers (continued)
1. Delay onset of sexual intercourse
2. Increase use of condoms
3. Decrease unprotected oral, anal and vaginal intercourse
4. Decrease frequency of sex
5. Decrease number of sexual partners
Decrease HIV infection among African-American adolescents ages
14 –18 • 3.1 Attitudes and Risks—Activity includes
an opportunity for youth to ask questions and share experiences
of talking to friends/family about what they have learned in
BART.
154–155
• 7.3 Spreading the Word Demonstration—Activity in which youth
brainstorm ways to bring up safer sex with family and friends so
that they can be HIV prevention peer leaders in their community.
Includes a handout of tips about how to spread the word effectively
and demonstration roleplays.
246–248
• 8.1 Final Review of HIV Facts—Includes large-group discussion
in which youth are encouraged to pass along information about HIV
prev