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Evidence-Based Programs

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Rikers Health Advocacy Program (RHAP)

Overview of the Curriculum

Rikers Health Advocacy Program (RHAP) is designed to produce problem-solving skills for HIV/AIDS prevention among high-risk youth, particularly drug users and youth in correctional facilities. The program features a "Problem-Solving Therapy" approach, which focuses on problem orientation, defining and formulating a problem, generating alternative solutions, decision making, and implementing a solution.

Curriculum Sessions

Small-Group Intervention:
The program was originally delivered to a small group of male participants in Rikers correctional facility setting. The intervention consists of four one-hour sessions delivered by a male instructor, biweekly over two weeks. Participants are engaged through sharing and discussion of facts and beliefs about HIV. They identify particular attitudes or behaviors that require modification and suggest potential solutions, which are then evaluated by other participants.

Active learning is emphasized, with opportunities for youths to define high-risk attitudes and behaviors, suggest alternative actions, and engage in role play and rehearsal activities for implementation of the suggested solutions. The facilitator guides eight-person groups in discussing the following topics: general HIV education information; factors related to drug initiation or drug use; the meaning and consequences of sexual activity; the relationship between drug use and sexual activity and HIV risk; and how to seek health care services, social services, and drug treatment.

Unique Features of the Curriculum

Small-group sessions were offered at the New York City Department of Correction's Adolescent Reception and Detention Center on Rikers Island. RHAP is appropriate for school- or community-based programs serving high risk teens, especially drug users and incarcerated youth. Although it was initially targeted toward males, the curriculum is equally pertinent for females. Single-sex discussion groups are recommended.

Theoretical Framework

RHAP adapts techniques of Problem Solving Therapy. This therapy's goals are to:

  • Increase patients' understanding of the link between their current symptoms and their current problems in living
  • Increase patients' ability to clearly define their problems and set concrete and realistic goals
  • Teach patients a specific, structured problem-solving procedure

Ordering and Training Information

Ordering: The RHAP curriculum package includes a user's guide, protocol handbook, and evaluation instruments. The package comes in a digitized format and a paper format. Materials can be purchased through Sociometrics Corporation as a package or individually online at www.socio.com/passt10.php.

Or contact:
Program Archive on Sexuality, Health, and Adolescence (PASHA)
Sociometrics Corporation
170 State Street, Suite 260
Los Altos, CA 94022-2812
Tel. (650) 949-3282
Fax (650) 949-3299
Email: socio@socio.com

The Program Archive on Sexuality, Health, and Adolescence (PASHA), funded by the National Institute of Child Health and Human Development and the Office of Adolescent Health in the Department of Health and Human Services, is a collection of effective program replication kits designed to reduce teen pregnancy and STI/HIV/AIDS in adolescents.

Training: There is no formal training required for this program. However, it is recommended that group leaders are the same gender as program participants, feel comfortable working with high-risk populations, and are knowledgeable about the curriculum and strategies for facilitating group discussion.

Evaluation Fact Sheet

Intervention

Rikers Health Advocacy Program (RHAP) is designed to produce problem-solving skills for HIV/AIDS prevention among high-risk youth, particularly drug users and youth in correctional facilities. The program features a "Problem-Solving Therapy" approach, which focuses on problem orientation, defining and formulating a problem, generating alternative solutions, decision making, and implementing a solution.

Behavioral Findings

A field study of the curriculum compared the attitudes and behaviors of RHAP participants with those of a comparison group of teens, selected from a waiting list for the program. Both samples were predominantly African-American and Hispanic. Following the intervention, program participants were more likely to use condoms during intercourse, compared to the comparison group of teens. Specifically, at the 5-month follow-up: adolescents who had engaged in heterosexual sex (prior to arrest) and who participated in the intervention reported significantly higher frequency of condom use during vaginal, oral, or anal sex compared to the comparison group of teens.

Research Design

The target population was high-risk youth, particularly drug users and youth in correctional facilities. Study participants were incarcerated, inner-city adolescent males, ages ranging between 16 and 19 years. They were 64% African American, 33% Hispanic, and 2% white.

References

Magura, S., Kang, S. Y., & Shapiro, J. L. (1994). Outcomes of intensive AIDS education for male adolescent drug users in jail. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 15(6), 457–463.