Advancing Sexual and Reproductive Health and Rights
Perspectives on Sexual and Reproductive Health
Volume 41, Number 1, March 2009

Taking Be Proud! Be Responsible! to the Suburbs: A Replication Study 

By Elaine A. Borawski, Erika S. Trapl, Kimberly Adams-Tufts, Laura L. Hayman, Meredith A. Goodwin, Loren D. Lovegreen

CONTEXT: An important phase of HIV prevention research is replicating successful interventions with different groups and in different settings.

METHODS: Be Proud! Be Responsible!, a successful intervention originally targeting black urban males and carried out in nonschool settings, was presented in health classes at urban and suburban schools with diverse student bodies. A group-randomized intervention study, which included 1,357 ninth and 10th graders from 10 paired schools in a Midwestern metropolitan area, was conducted in 2000–2002. Half the schools received the intervention, and half received a general health promotion program. Students' reports of their sexual behavior and selected cognitive mediators were analyzed immediately following the programs and four and 12 months later.

RESULTS: Compared with students who received the control curriculum, students exposed to the intervention reported significantly greater knowledge of HIV, other STDs and condoms; greater confidence in their ability to control sexual impulses, to use condoms and to negotiate the use of condoms; and stronger intentions to use condoms. Stratified analyses revealed that the strongest intervention impacts were on knowledge and efficacy among males and students attending suburban schools. The intervention had no impact on sexual initiation, frequency of intercourse or condom use.

CONCLUSIONS: Schools are a logical and viable setting for the dissemination and acquisition of information about HIV, including prevention strategies. However, the behavioral impact of an intervention may not be easily transferable when the program is taught outside a carefully controlled, nonschool setting.

Perspectives on Sexual and Reproductive Health, 2009, 41(1):12-22




Elaine A. Borawski is associate professor, Department of Epidemiology and Biostatistics, and director, Center for Health Promotion Research, Case Western Reserve University School of Medicine, Cleveland. Erika S. Trapl is senior research associate, and Meredith A. Goodwin is research associate, both at the Center for Health Promotion Research. Kimberly Adams-Tufts is associate professor, School of Nursing, College of Health Sciences, Old Dominion University, Norfolk, VA. Laura L. Hayman is associate dean for research and professor of nursing, College of Nursing and Health Sciences, University of Massachusetts–Boston. Loren D. Lovegreen is assistant professor, Simon Fraser University, Vancouver, British Columbia.