1. Creating an Adaptation Master List for CAPP and PREP providers in New York State Jutta Dotterweich, Training Coordinator ACT for Youth Center of Excellence

2. Outline 1.Why it is important to talk about adaptations 2.Challenges to fidelity 3.Developing a master list of adaptations 4.Sample adaptations and documentation 5.Summary & Resources

3. The Challenge To get the desired outcomes, the program needs to be implemented with fidelity = true to its core components ContentPedagogyImplementation

4. What gets in the way They are not perfect! Material might be outdated Culturally not adequate or relevant Not available or adequate for youth groups with special needs or characteristics

5. Why Create a Master List? Many adaptations can be predicted and planned for It provides guidance to all educators implementing the program Documentation is critical for tracking fidelity It saves time!!!

6. A Coordinator’s Task: Developing the Master List Develop master list (use fidelity list) Sent to COE for review Finalize master list Use as new fidelity checklist

7. Common Content Changes Update health & statistical information Language changes Cultural adjustments Not assuming heterosexual relationships Program setting restrictions Add information

8. Activity Date Activity Was Carried Out (MM/DD/YY) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (if any) Pre- Approved? Y=YES N=NO A: Welcome and Program Overview Y/N B: Talking Circle Y / N C: Creating Group Rules NoUse group agreements instead of group rules Reason: more engaging Yes Module 1: Getting to Know You and Steps to Making Your Dreams Come True MPC 2012

9. Activity Date Activity Was Carried Out (MM/DD/YY ) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (If Any) Pre- Approved? Y = YES N = NO A: Myths and Facts about HIV, STDs and Pregnancy No See A.5 Below Reason: use language inclusive to transgender youth Yes B: Birth Control Activity N Y C: The Subject Is: HIV (DVD) NY Please use this space if you have comments on this module or any of its activities: A.5.2 – “A girl can get pregnant the first time she has sexual intercourse. Pregnancy can occur the first time someone has sex.” A.5.3 – “Having anal sex is high risk poses a higher risk for getting HIV or an STD.” A.5.7 – “If a pregnant woman female has HIV or an STD, there is a chance she they may give it to her their baby.” A.5.11 – “Using a latex (or polyurethane) condom safer sex barriers…” A.5.12 – “If a girl female misses her their period, she is they are definitely pregnant.” A.5.15 – “You can get HIV or and STD by giving oral sex to a guy male (your mouth on his their penis).” Module 2: Building Knowledge About HIV, STDs And Pregnancy BPBR 2012

10. Activity Date Activity Was Carried Out (MM/DD/YY) if not carried out write “O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (if any) Pre- Approved? Y=YES N=NO A: STD Facts and “The Subject is STDs” DVD No Add third category of STDs: parasites; use slides to describe 3 categories of STDs Reason: add information not included in the curriculum Yes B: The Transmission Game NoWhen discussing card D, add Herpes and Syphilis Reason: people can contract more than one STD at a time Yes Module 3: The Consequences of Sex: Sexually Transmitted Diseases MPC 2012

11. Activity Date Activity Was Carried Out (MM/DD/Y Y) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (If Any) Pre- Approved? Y = YES N = NO A: Discussing Condoms and Condom Use Skills No Omitted condom demonstration and practice; instead discussed steps of putting condoms on correctly using condom cards as visuals; gave out wallet cards with web sites and local clinics Reason: school district does not allow condom demonstrations in the classroom Yes B: How to Make Condoms Fun and Pleasurable NoChanged words to “How to Make Condoms Safe and Comfortable” Reason: teacher objects to words: fun and pleasurable Yes Module 5: Building Condom Use Skills BPBR 2012

12. Common Pedagogy Changes Add/increased use of visual material and other props Modify teaching strategies for activity Replace videos Reduce activity (omit practice/skill building)

13. Activity Date Activity Was Carried Out (MM/DD/YY) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (If Any) Pre- Approved? Y = YES N = NO A: Program Introduction and Overview Y / N B: Group Introduction Y/N C: Creating Group Rules Y / N D: Discussing HIV, STDs and Pregnancy NoPlayed Who Wants to Be a Millionaire Power Point game. Reason: The students then have multiple choice questions and are reviewing the exact information – make the activity more interactive Yes Module 1: Introduction to HIV, STDs And Pregnancy BPBR 2012

14. Activity Date Activity Was Carried Out (MM/DD/YY) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (If Any) Pre- Approved? Y = YES N = NO A: Myths and Facts about HIV, STDs and Pregnancy Y/N B: Birth Control Activity No Show devices from a Birth Control Kit, add a notes page to the birth control activity, and discuss additional types of birth control and their effectiveness rates. Activity is followed by a short quiz. Reasons: increased student engagement, increased retention (quiz), teacher request, updated BC method information Yes Module 2: Building Knowledge About HIV, STDs And Pregnancy BPBR 2012

15. Activity Date Activity Was Carried Out (MM/DD/Y Y) if not carried out write“O ” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (if any) Pre- Approved? Y=YES N=NO A: Myths and Facts about Pregnancy Y / N B: Tanisha & Shay DVD No Replaced video with Reflections by Scenarios USA http://www.scenariosusa.org/films/hiv- aids/reflections/ Reason: setting restrictions (objections to a few scenes in the video) Yes Module 2: The Consequences of Sex: Pregnancy MPC 2012

16. Activity Date Activity Was Carried Out (MM/DD/YY) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (If Any) Pre- Approved? Y = YES N = NO A: The Subject Is: STDs (DVD) Y /N B: Understanding Messages About Sex Y/ N C: Attitudes About Contraception NoI created a handout that had all of the statements on it. Youth in the class were instructed to write if they agreed or disagreed with the statements (no names); collected handouts; handed out to class at random. Then asked class to stand on the agree side if their paper said agree and disagree side if their paper said disagree. Then they discussed the reasons. Reason: youth were not moving or would only move if their peers moved; gave them the opportunity to see how many people in the class agreed or disagreed with a statement without singling out individual young people. Yes Module 4: Attitudes And Beliefs About HIV, Condom Use And Safer Sex BPBR 2012

17. Adaptations for Specific Groups Activity Date Activity Was Carried Out (MM/DD/YY ) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (if any) Pre- Approved? Y=YES N=NO A: Myths and Facts about Pregnancy No Add myths/facts for older youth (14-17): -Certain positions, places, and times of the month you have sex, make it impossible to get pregnant. (MYTH) -A girl can get pregnant the first time she has sexual intercourse. (FACT) -Douching or rinsing out the vagina with something, can prevent pregnancy (MYTH) -Vaseline makes a good lubricant for condoms during sex and prevents pregnancy. (MYTH) Reason: More relevant myths/fact discussion due to different knowledge and experience level Yes Module 2: The Consequences of Sex: Pregnancy MPC 2012

18. Adaptations for Specific Groups R Activity Date Activity Was Carried Out (MM/DD/YY ) if not carried out write“O” Was Activity Carried Out According to Directions in the Facilitator’s Curriculum? Y=YES N=NO (describe changes in next column) If Changed, WHAT was changed and WHY? Please be specific: describe things you left out, added, or changed and WHY. Were Changes (if any) Pre- Approved? Y=YES N=NO A: Myths and Facts about Pregnancy No Yes Add myths/facts for older youth (14-17): -Certain positions, places, and times of the month you have sex, make it impossible to get pregnant. (MYTH) -A girl can get pregnant the first time she has sexual intercourse. (FACT) -Douching or rinsing out the vagina with something, can prevent pregnancy (MYTH) -Vaseline makes a good lubricant for condoms during sex and prevents pregnancy. (MYTH) Reason: More relevant myths/fact discussion due to different knowledge and experience level Yes Y/N Module 2: The Consequences of Sex: Pregnancy MPC 2012

19. Steps to keep in mind Use the correct fidelity checklist: www.actforyouth.net/capptools www.actforyouth.net/capptools Mark the fidelity list as a Master list (agency/date)Sample: Adaptation Master List - FIDELITY CHECKLIST CAMBA (11/13) Be specific in describing the modification Explain why you are making the change Mark it as approved (last column: Yes) Submit to Jutta for approval before implementing

20. Summary Adaptations are unavoidable, even needed → plan ahead A master list will simplify the paperwork (less writing)and direct educators to make the same changes It documents your changes correctly → improves evaluation reports It saves time! Remember to send it to the COE for review

21. Additional Resources Adapting Evidence-Based Programs http://www.actforyouth.net/health_sexuality/sexual_health/pro gramming/evidence.cfm Planning and Preparing for Core Strategy 1 http://www.actforyouth.net/health_sexuality/sexual_health/co mmunity/capp/strategies/ Fidelity Checklists for Specific Programs www.actforyouth.net/capptools