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

Because minority adolescents and those living in impoverished areas have an increased risk of contracting HIV and other STDs,1 prevention programs directed at urban, at-risk youth have received considerable attention.2 As a result, many such interventions have been developed, the most successful ones being well controlled, theoretically derived, community-based and culturally sensitive.2–5 However, the generalizability of these successful interventions to other settings (e.g., school classrooms) and populations (e.g., white adolescents and black suburban adolescents) has not been established.6 One successful intervention with the above prescribed characteristics is Be Proud! Be Responsible! (BPBR), developed by Jemmott et al.7 Originally designed for inner-city, black males,8 the six-session ethnocentric curriculum has been found to significantly reduce levels of risky sexual behaviors (for up to at least 12 months) in this intended audience, as well as influence the cognitive mechanisms (e.g., knowledge, efficacy) that are theoretically linked to behavioral changes.8–12 The program has been replicated among other minority youth and females, and in international settings, with continued success.7 However, published evaluations of BPBR have been largely limited to its use with young adolescents (average age, 11–13) and with urban, minority youth receiving the intervention in nonschool environments (e.g., Saturday programming) and in small groups (6–8).8–12 The intervention has not been tested within school settings, taught by teachers or other school personnel, and little information exists on its effectiveness when extended beyond the urban environment. Its effectiveness in diverse settings, where program fidelity may be variable and the delivery less controllable, and where participants include young people who may be unlikely to volunteer for a weekend program, is important to assess. This article presents the results of a school-based, group-randomized replication of BPBR with enrolled students from five pairs of large urban and suburban high schools in the Midwest. Schools were paired by socioeconomic status and racial composition; one school of each pair implemented the BPBR curriculum, while its matching school implemented a health promotion curriculum focused on good nutrition, physical activity and stress reduction, developed by the Cleveland Health Museum. The primary aim of this study was to determine if BPBR would be effective when taught within a high school health curriculum by school personnel (e.g., health teachers and school nurses). The secondary aim was to determine whether the curriculum would be effective among white youth, as well as among black suburban youth. On the basis of the original intent and focus of the curriculum, we hypothesized that the program would be more effective among urban, black, male adolescents than among suburban, female or white adolescents.