Adapting an effective sexual education program for use in Puerto Rico

Objective

To pilot-test the feasibility and usability (acceptability, credibility, cultural appropriateness, understandability, and motivation) of “It's Your Game” (IYG) as a phase 1 adaptation assessment prior to implementation into Puerto Rican middle schools.

Methods

Students participated in group- and computer-based activities from the IYG curriculum during two 2-hour sessions in Spring 2008. Classroom lessons were in Spanish; computer activities in English. Quantitative and qualitative methods were used to determine the feasibility of program adoption in Puerto Rico. Students completed usability surveys and qualitative data were recorded post-participation.

Results

Seventy-three 7th graders participated. Usability analysis of computer-based activities indicated that the majority found IYG easy to use (66%), credible, correct, and trustworthy (98%), and understandable (91%). Regarding acceptability, 68% rated the activities as fun and 94% rated them as helping them make healthy choices about friendship and sexuality. Qualitative feedback indicated that students felt the technology used was a very good way to learn; “it is better than hearing a teacher saying the things”. However, the pace of the spoken English was too fast to follow and the video embedded in the program did not adequately represent their cultural environment.

Conclusion

It is critical to implement effective theory-based HIV/STI/pregnancy prevention programs for students in Puerto Rico. Specific adaptation steps include: 1) Translating curriculum and computer-based activities into Puerto Rican Spanish, 2) adapting role model videos to contain Puerto Rican youth, and 3) incorporating cultural Latino concepts of familismo and gender roles (e.g., machismo, marianismo) into the program.