Haitian American Responsible Teen (HART): A randomized clinical trial of a culturally-adapted curriculum for teen pregnancy and HIV prevention

Youth from Haiti have been exposed to many of the risk factors for teenage pregnancy, including extreme poverty, family separation, chaotic immigration patterns, unstable homes, corporal punishment, natural disasters and other adverse childhood experiences known to impair normal physical and psychological development.  Access to culturally competent preventive services may help prevent these adverse outcomes.  With support from the Office of Adolescent Health, we conducted a randomized controlled trial of a culturally-adapted comprehensive sexual health education curriculum among youth of Haitian descent.  Haitian American Responsible Teen (HART) is an adaptation of “Becoming a Responsible Teen” (BART), an evidence-based intervention designed for African-American youth.  HART’s primary adaptations include the creation of culturally appropriate cases and discussion questions; the addition of 2 lessons on reproductive anatomy and Post Traumatic Stress Disorder (PTSD); and delivery in 2 languages (Haitian Creole and English). The comparison group received 8 lessons from a nutrition curriculum and the PTSD session.  We recruited 637 participants from 9 high schools in Metropolitan Boston and 2 community-based organizations. Self-reported survey data were collected using validated pencil-and-paper survey instruments. Rate of return of completed applications varied from 42% to 87%.  Among the students who returned completed applications, 80% or more took the pretest in all schools.  Results of pre- and post-tests and 6 and 12 month outcomes will be presented, and compared to outcomes reported for the BART intervention.  Variations in these outcomes will be discussed, including possible lessons learned in adapting a curriculum for an ethnically distinct population group.