Evaluation of the Pono Choices Middle School Sexual Health Curriculum

Official Title
Evaluation of the Pono Choices Program—A Culturally Responsive Teen Pregnancy and Sexually Transmitted Infection Prevention Program for Middle School Youth in Hawai‘i
9/2011 – 5/2016
Program Evaluations
Impact Evaluations
University of Hawai‘i; U.S. Department of Health and Human Services, Office of Adolescent Health
Classroom Observation
Data Collection, Analysis & Reporting
Randomized Controlled Trial (RCT)
Survey Design and Sampling

Youth in Hawai‘i had the lowest rate of condom use in the nation in 2011. Only 44 percent of high school students reporting using a condom in their last intercourse, compared with 60 percent nationwide. Hawai‘i also had the tenth highest teen pregnancy rate and the 12th highest Chlamydia rate in 2010. Before Pono Choices, no state-approved curriculum explicitly incorporated the values and perspectives of the Hawaiian culture into sexual health instruction.

Pono Choices is a culturally responsive teen pregnancy and STI prevention program featuring medically accurate information, character education, and traditions and practices of the Hawaiian host culture. The curriculum introduces students to Hawaiian cultural terms, practices and concepts that stress positive character development, including making “pono” or “right” choices. Hawaiian cultural values were introduced in each lesson to reinforce lesson content and expanded through an original cultural story. 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 students to their community and homework activities engaged their families.

The study recruited 36 schools, which were randomly assigned to the program and control groups. Schools assigned to the control group continued to provide the sexual health curriculum they were providing and would have continued to provide in the absence of the study. Teachers in the program schools were trained to deliver the Pono Choices curriculum and received ongoing support from program staff throughout the three semesters of implementation.

IMPAQ conducted a rigorous randomized controlled trial (RCT) study to measure program impacts. We collected baseline and follow-up surveys from all participants and conducted classroom observations to measure the quality of implementation and to ensure fidelity to the curriculum and the study design.

This project builds on an earlier teen pregnancy prevention study by Berkeley Policy Associates (BPA) and a previous RCT study they performed that evaluated a literacy program in schools in Hawai‘i, American Samoa and the Commonwealth of Northern Mariana Islands. When we acquired BPA in 2013, we took over the Pono Choices evaluation.