In Charge: Improving efficacy and personalizing risk

Background:Adolescents in Catholic Relief Services' (CRS) programs have accurate HIV knowledge, but have not personalized risk or demonstrated confidence to respond to risky situations. In Charge is a curriculum of five lessons for youth ages 15-24 that is unique because it uses pictures to evoke dialogue; it is wholly participatory; and through dialogue it moves youth toward certainty and empowerment. Methods:CRS implemented the curriculum in 5 Tanzanian schools with 172 participants and tested it through pre- and post- test surveys. Results: Analysis indicated that In Charge met its objectives. (a) Risk was personalized: students correctly reporting alcohol consumption as a risk factor increased from 60% to 72%; the risk of caring for people with HIV/AIDS dropped proportionately. (b) Self-efficacy improved: students stating they felt no control over life dropped from 12% to 3%; there was a corresponding 10% increase in those reporting greater control in their life (from 43% to 51%). Increases were shown in those stating they were able to resist bad influences (from 46% to 57%) and able to stand for what they believe (from 72% to 80%). Decreases were shown in those rarely able to resist bad influences (from 18% to 9%) and in those rarely able to stand for what they believe (27% to 20%). Conclusions: In Charge is successful in (a) increasing student knowledge while increasing confidence to make good decisions (b) helping students personalize risk. Personal attitudes toward self-efficacy and personal risk can produce a positive environment for positive behavior changes.