Pono Choices: Lessons for School Leaders From the Evaluation of a Teen Pregnancy Prevention Program.

BACKGROUND: The US Office of Adolescent Health (OAH) funded studies of teen pregnancy and sexually transmitted infection (STI) prevention programs in 2010. The results of a 5-year OAH study conducted in the state of Hawai'i with middle school youth has implications for school leaders in the selection and implementation of comprehensive sex education curricula yielding positive outcomes for youth. METHODS: A cluster randomized controlled trial was conducted across 34 middle school in the state of Hawai'i with 1783 student participants in pre-, post-, and 1-year follow-up surveys to determine effectiveness of a culturally responsive teen pregnancy prevention curriculum, called Pono Choices, specifically developed for youth in Hawai'i. RESULTS: Students receiving the Pono Choices curriculum had significantly higher rates of knowledge gains than students in control schools, although there were no statistically significant differences in initiation of sexual activity between the groups at the 1-year follow-up. Teachers implemented the curriculum at high rates of adherence to fidelity making this a model for implementation. CONCLUSIONS: Knowledge and retention of medically accurate teen pregnancy and STI prevention information can be attributed to implementation of a comprehensive program with attention to factors such as fidelity, program quality, engagement, and dosage.

Making Pono Choices: a collaborative approach to developing a culturally responsive teen pregnancy and sexually transmitted infections prevention curriculum in Hawai'i.

The overall extent of evidence-based culturally responsive health education programs targeting ethnic minority groups in Hawai'i is limited. The few that do exist were adapted from models developed with other majority ethnic groups in mind and may not always be appropriate for Native Hawaiian or Pacific Islander youth (Okamoto et al. in J Alcohol Drug Educ 54(1):56-75, 2010; Helm and Baker in J Ethn Cult Divers Soc Work 20(2):131-149, 2011; Po'a-Kekuawela et al. in J Ethn Cult Divers Soc Work 18(3):242-258, 2009). The need for a culturally responsive, evidence-based health curriculum is clear considering the large disparities reported among Hawaiian youth in health, academic achievement, and other identified risk factors. School-based health interventions are an opportunity not only to improve the physical well being of students, but also to increase their ability to learn and succeed in school. The University of Hawai'i at Manoa-Center on Disability Studies (UH-CDS) received a highly competitive grant from the US Office of Adolescent Health to develop a teen pregnancy and sexually transmitted infection (STI) prevention curriculum for Hawai'i middle school youth. The authors will detail a collaborative process that led to a culturally responsive sexual health curriculum for middle school youth designed to meet the rigorous standards of an evidenced-based review and more importantly reduce teen pregnancies and STI transmission.