Reasoned Abstinence Plus Focus group: y/o Female Hispanic and African American RAP will be presented for implementation to the SHAC of zip codes: and Abstinence-plus was found to be more effective than abstinence-only with youth already engaged in sexual activity. School-based programs allow for abstinence teaching, and condom use education, but restrict distribution of condoms when instruction occurs. Theory-of Reasoned Action, used as the theoretical framework. In coordination with the School Health Advisory Committee (SHAC) the proposed intervention will include abstinence-plus supports the AACN essentials of DNP education: – V. Health Care Policy for Advocacy in Health Care – VII. Clinical Prevention and Population Health for Improving the Nation’s Health

School Health Advisory Council Title 2, Chapter 38, Section of the Texas Education Code.. Retrieved from: tlo2.tlc.state.tx.us/statutes/ed.toc.htm tlo2.tlc.state.tx.us/statutes/ed.toc.htm

Theory of Reasoned Action Poss, J. (2001). Developing a New Model for Cross-Cultural Research: Synthesizing the Health Belief Model and the Theory of Reasoned Action. Advances in Nursing Science. 23(4), 1-15

Goals & Objectives Promote a value of safer sex, including abstinence Improve their ability to negotiate abstinence/safer-sex practices Increase their ability to use condoms correctly Have stronger intentions to use condoms if they have sex Have a lower incidence of Chlamydia/STD or sexual risk-taking behavior Take pride in choosing responsible sexual behaviors

Content outline Module 1: Getting to Know You and Steps to Making Your Dreams Come True. Module 2: The Consequences of Sex: STD/Chlamydia Module 3: Attitudes and Beliefs about Chlamydia and STD and condom use Module 4: Strategies for preventing Chlamydia infection: Stop, Think and Act Module 5: The consequences of Sex: STD and correct condom use Module 6: The consequences of sex: Chlamydia infection and complications ( PID, infertility) Module 7: Developing condom use and negotiation skills Module 8: Role-Plays: refusal and negotiation skills.

Methods for evaluation Design: questionnaires at 3,6,12 months after intervention Initial measures : Chlamydia cases and risk- associated behaviors. Secondary measures: knowledge, beliefs, norms, intentions and self efficacy

Expected outcomes The participants who receive the RAP program should have safer- sex scores compared general population group More consistent condom use and less unprotected sex in the three months after the intervention than did those in general population Higher frequency of condom use at the three, six and twelve month follow-up sessions than their counterparts in the general group RAP should similarly model the Making Proud Choices program in reaching out to sexually experienced adolescents. For instance, among participants in the intervention students in the RAP program should achieve: – less sexual intercourse in the previous three months at the six month (p<.001) and 12 month (p=.002) follow-up than their counterparts in the general populationv (p<.03). In addition, they are expected to have less unprotected sex at all three follow-up session than the control group (p<.03)

Implementation and Eval plan