Best Practice

Pono Choices: A Culturally Responsive Teen Pregnancy and STI Prevention Program for Middle School Youth

State/Jurisdiction: Hawaii
Setting: School-Based
Population: Adolescent Health,
Topic Area: Health Equity, Reproductive Health,
NPMs: NPM 10: Adolescent Well-Visit

Pono Choices is a scripted, 10-module, 9.5-hour curriculum that provides middle school youth with the knowledge and skills necessary to reduce their risk of unintended pregnancy and sexually transmitted infections (STIs). The curriculum provides youth with medically accurate information within a Hawaiian place-based framework. Pono Choices draws from social learning, self-regulation, and developmental assets theories, and it has been developed through a collaborative workgroup process. The 10 lessons in the curriculum cover the following topics: Anatomy and puberty, Goal setting, Effective communication skills, Recognizing healthy and unhealthy relationships, Refusing unwanted sexual pressure, Information on how STIs are transmitted, Knowledge of birth control methods including abstinence, Correct steps for effective condom use, Practice refusing sexual pressure through scenarios and role-plays. The core components of Pono Choices are built around a set of knowledge, attitudes, and skills that have been derived from a review of evidence-based teen pregnancy and STI prevention programs. In addition, Pono Choices works from a pedagogy that believes student engagement through role-play and skill demonstration is essential. A key component unique to this curriculum is the use of cultural referents, Hawaiian practices, and connection and engagement activities involving ‘ohana. The 10 modules in the curriculum include information on abstinence, sexually transmitted infections, birth control methods, refusal skills (how to refuse unwanted sexual pressure), decision-making skills, goal setting, reproductive anatomy, puberty, and recognition of traits associated with healthy, unhealthy, and abusive relationships. Students are introduced to Hawaiian cultural terms and practices that stress positive character development and making pono choices. Knowledge, attitudes, and skills pertinent to pregnancy and STI prevention are reinforced through cultural referents. Cultural components in the curriculum include: the introduction of Hawaiian cultural values, an original cultural story, cultural practices, and locally produced videos and artwork. Hawaiian cultural values are introduced in each lesson to reinforce lesson content and are expanded on through the original cultural story, entitled “The Voyage of the Wa‘a Kaulua.” The story serves as an access point into the curriculum content from the viewpoint of two adolescents preparing for an important journey. Pono Choices embeds cultural practices in the curriculum through ‘ohana (family) activities. Students and the members of their ‘ohana have the opportunity to construct a wa‘a (canoe), braid cordage, and create a lei while reinforcing the message of pregnancy and STI prevention. Pono Choices also uses locally produced videos and historical readings. Stories are used throughout the curriculum to connect students to their community. Seeing oneself represented in the curricula is an essential part of any culturally responsive learning environment.

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