Pono Choices is a culturally responsive sexual health education curriculum developed in Hawaii that is designed to provide young adolescents with the knowledge, attitudes, beliefs, and skills necessary to reduce their risk of sexually transmitted infections (STIs) and pregnancy. This 10-module curriculum incorporates medically accurate information, character education, and a strong focus on Hawaiian cultural values using social learning, self-regulation, and developmental asset theories. The curriculum introduces students to Hawaiian cultural terms, practices, and concepts that stress positive character development, including making “pono” choices.

Pono Choices was developed through a collaboration among the University of Hawaii Center on Disability Studies, Planned Parenthood of Hawaii, and Alu Like (a Native Hawaiian organization). Cultural responsiveness is supported through:

• Introduction of Hawaiian cultural values.
• An original cultural story.
• Cultural practices.
• Locally produced videos.

The story served as an access point into the curriculum content from the viewpoint of two adolescents preparing for an important journey. Stories throughout the curriculum connected the students to their community and homework activities engaged their families.

Evaluation conducted by an independent evaluator (Impaq International) showed that “[p]rogram participants increased their knowledge, improved their attitudes toward healthy sexual behaviors, increased their skills, and showed increased intent to abstain from sex or engage in safe sex.”¹ Based on these results, the Association of Maternal and Child Health Programs (AMCHP) designated Pono Choices a Best Practice in its MCH Innovations Database in 2018.

Jen Pomroy and Archie Achuara are currently teaching the Pono Choices curriculum at the Island School on Kauai. As both teachers began implementing the curriculum over the past two years, they recognized that Pono Choices was a sexual health education curriculum comprehensive in scope that would give youth the information and tools to prevent teen pregnancy and STIs as well as other risky behaviors. Every year, an average of 35 to 45 students in 7th and 8th grade complete the curriculum. Pono Choices instruction is supplemented with the Glencoe’s Teen Health curriculum  as well as other resources from various local and national organizations. Ms. Pomroy and Mr. Archuara are researching other teen pregnancy and STI curricula in order to expand sexual health education into the local high school as well.    

To ensure Pono Choices continues to be implemented in an effective and relevant manner, both teachers continue to look for professional training opportunities on best practices in teen pregnancy and STIs, as well as resources from local and national organizations. They also hope to expand their network by connecting with more Pono Choices facilitators.

In 2019, AMCHP selected an application from the University of Hawaii to provide training and support to Pono Choices facilitators on the island of Kauai through its annual Replication Projects technical assistance opportunity. Hawaii Youth Services Network, a statewide coalition of youth-serving agencies with a long history of organizational capacity-building on the topic of teen pregnancy, was selected to provide the training and support to facilitators. Hawaii Youth Services Network was provided with the contact information for 11 Pono Choices facilitators from 6 schools who were involved in the original testing and evaluation of the curriculum. (There were additional facilitators in other parts of the state, but the scope of the grant was limited to the island of Kauai.)

When the original grant ended, the University of Hawaii continued to maintain a website with the Pono Choices curriculum materials and free online training; however, the University of Hawaii no longer provided support to existing facilitators and regular communication was halted for several years due to lack of funding. When Hawaii Youth Services Network contacted the facilitators on Kauai who had been part of the original Pono Choices project from 2010 through 2015, only two, both from the same school, were currently implementing the curriculum.

Hawaii Youth Services Network contacted former facilitators on Kauai individually to invite them to receive training and support for Pono Choices implementation and tried to recruit new facilitators through its extensive contacts with schools and nonprofit organizations. Kauai is a rural island with a population of only 60,000; thus, the number of potential implementation sites is small. 

Efforts to re-engage former facilitators or recruit and train new facilitators were unsuccessful, even though gift card incentives were offered for each meeting, training was free, and times/locations were convenient and accessible. A complicating factor is that when Pono Choices was originally debuted in Hawaii’s schools, an anti-sex education group targeted the curriculum. Fears that parents and community members would negatively react to the curriculum, coupled with meager funding to support implementation, were key reasons why efforts to engage more facilitators were not successful.

The two facilitators who did fully participate in Pono Choices support and training sessions stated that the training and supports they received increased their skills and motivation to continue to implement Pono Choices. In order to expand usage of Pono Choices and support facilitators, the following recommendations need to be integrated into plans:

• Include in recruitment, implementation, and support plans a detailed mitigation plan for managing any negative response to either the curriculum or sexual health education in general. 
• Include a plan for building community, school, and public policymaker support for pregnancy and STI prevention education in general and for the Pono Choices curriculum specifically.
• Provide training to schools and organizations using the curriculum on strategic communication for controversy management.
• Provide funding to support implementation of the curriculum. Even if other sources are covering the facilitator salaries or fees, there are other costs needed to support implementation, such as supplies, photocopying, workbooks, and community outreach and controversy management efforts. In particular, COVID-19 has brought new economic burdens that have resulted in major financial challenges for organizations, which means that schools or community organizations will need additional funding support.

[1] Barker, L.T., Abe, Y., Chang, V. and McLelland, C. (2016). Summary of the evaluation of the Pono Choices program – A culturally responsive teen pregnancy and sexually transmitted infection prevention program for middle school youth in Hawaii.  https://impaqint.com/sites/default/files/files/Summary%20of%20the%20Evaluation%20of%20the%20Pono%20Choices%20Program.pdf