SiHLE

Program Overview

Developer(s)

Ralph DiClemente, Ph.D., Gina Wingood, Sc.D. M.P.H., Kathy Harrington, Delia Lang, Susan Davies, Edward Hook III, M. Kim Oh, Richard Crosby, Ph.D., Vicki Stover Hertzberg, Angelita Gordon, James Hardin, Ph.D., Shan Parker, and Alyssa Robillard.

Program Summary

SiHLE - Sisters, Informing, Healing, Living, Empowering - is a peer-led, group-level, social-skills training intervention designed to reduce sexual risk behaviors among African-American female teenagers who are at high risk of HIV. In addition to HIV prevention, the program addresses relationships, dating, and sexual health within the specific context of the female African-American teenage experience. The program draws upon both cultural and gender pride to give participants the skills and motivations to avoid HIV and other STDs.

Target Population

The target population is heterosexual African-American females between the ages of 14 and 18 who have had sexual intercourse and are at risk for HIV. The program was evaluated with patients at community health agencies.

Program Setting

The program was designed for and evaluated in community-based organizations and health clinics.

Contact and Availability Information

For curriculum, materials, and pricing information, please contact:

Sociometrics Corporation
1580 W. El Camino Real, Suite 8
Mountain View, CA 94040
Ph: 650-949-3282
Email: socio@socio.com
Website: https://www.socio.com/products/pasha-sihle-health-workshops-for-young-black-women

For training and support, please contact:

Currently no formal training offered

Sample of curriculum available for review prior to purchase: No

Adaptation guidelines or kit available: No

Languages available: English

Program Components

Program Objectives

The goal of the SiHLE program is to teach social skills to reduce risky sexual behaviors among participants. The program seeks to increase assertive communication skills, condom use skills, and self-efficacy.  

Program Content

The four SiHLE sessions focus on educating teens on HIV transmission and risk reduction strategies by: 

  • Developing assertive communication skills to demonstrate care for their partners and to negotiate abstinence or safer sex behaviors (particularly condom use and involvement of partners in decision-making)
  • Building proper condom use skills (including learning how to place a condom on a partner) and positive attitudes, norms and self-efficacy about consistent condom use
  • Understanding of characteristics of healthy and unhealthy relationships and the triggers that make negotiating safer sex challenging for teens, and
  • Empowerment and self-efficacy, based on cultural and gender pride

Program Methods

The program is delivered by one facilitator and two peer mentors through group discussion, role play, activities, and games. Review of previous information is built in throughout the sessions to reinforce knowledge and offer opportunities for questions to be answered.

Implementation Requirements and Guidance

Program Structure and Timeline

The program is delivered in four sessions that are each four hours long. The ideal group size is 10 to 12 participants with one adult and two peer facilitators.

The program must be delivered in community-based settings, not in school or during school hours.

Staffing

The program requires the use of one adult and two peer facilitators, all of whom should be African American and female. Peer facilitators should be between 18- and 21-years-old who, ideally, have gone through the SiHLE program. There are specific roles for the adult and peer facilitators described in the facilitator's manual.

Program Materials and Resources

The following program materials are available through the distributor:

  • User's Guide
  • SiHLE Facilitators Manual
  • Photocopy masters of posters
  • Participant Handbook
  • Photocopy masters of additional handouts, the SiHLE Jeopardy game, session evaluations
  • 50 Domestic violence brochures
  • Prevention Minimum Evaluation Data Set (PMEDS)
  • Local Evaluator Consultant Network Directory
  • Original Evaluation Instruments

While a free sample curriculum is not available, providers may purchase an automatic digital download of the user’s guide to review program components, core competencies for facilitators, and scientific evidence of effectiveness. If providers decide to purchase the program, the price of the download is deducted.

Additional Needs for Implementation

Delivery of the program requires the use of condoms and penis models.

Fidelity

SiHLE has a fidelity toolkit/checklist and tools for monitoring program implementation. These may be accessed on the Sociometrics website: https://www.socio.com/products/pasha-sihle-health-workshops-for-young-black-women 

Training and Staff Support

Staff Training:

There is no required training for this program. In the past several organizations have offered formal training, but none are currently specified.

Technical Assistance and Ongoing Support:

Sociometrics provides telephone technical support on implementation and evaluation for one year with purchase of the program materials.

Allowable Adaptations

All adaptations must be approved by the developer, in consultation with Sociometrics.

Implementation Readiness Assessment

The review team conducted an independent assessment of the program’s readiness for implementation. This assessment is based on the team’s review of available program materials and documents. The team also requested input from program developers and distributors about the availability of implementation materials and resources.

On the basis of this assessment, the team calculated an implementation readiness score comprised of three component scores: (1) curriculum and materials, (2) training and staff support, and (3) fidelity monitoring tools and resources. The component scores are combined into a total score, which ranges from 0 to 8, with higher scores indicating the programs most ready to implement.

Curriculum and Materials

Has defined curriculum with lesson plans and/or activities?Yes
Has defined core or required components?Yes
Has facilitator’s guide or instructions?Yes
Component Score3/3

Training and Staff Support

Formal pre-implementation training (by qualified trainers) available?No
Supplemental training or ongoing technical support available?Yes
Component Score1/2

Fidelity Monitoring Tools and Resources

Has defined logic model?No
Defines fidelity guidelines and benchmarks?Yes
Offers monitoring and evaluation tools?Yes
Component Score2/3

Total Implementation Readiness Score

6/8

Reviewed Studies

CitationHigh-Quality Randomized TrialModerate-Quality Randomized TrialModerate-Quality Quasi-experimentLow Study RatingDid Not Meet Eligibility Criteria

DiClemente et al. 2004

Wingood et al. 2006

Sales et al. 2010

Yes    

DiClemente et al. 2010

   Yes 

Klein and Card 2011

Yes    

Danielson et al. 2013

    Yes

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample.

Study Characteristics

CitationSettingMajority Age GroupMajority Racial/Ethnic GroupGenderSample Size

DiClemente et al. 2004

Wingood et al. 2006

Sales et al. 2010

After school/Community based14 to 17African AmericanFemale522

DiClemente et al. 2010

n.a.n.a.n.a.n.a.n.a.

Klein and Card 2011

After school/Community based14 to 17African AmericanFemale178

Danielson et al. 2013

n.a.n.a.n.a.n.a.n.a.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample.

Information on study characteristics is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.

Study Findings

Citation Sexual Activity Number of Sexual Partners Contraceptive Use STIs or HIV Pregnancy

DiClemente et al. 2004

Wingood et al. 2006

Sales et al. 2010

Uniformly positive impacts across the outcomes examined in this domain Uniformly positive impacts across the outcomes examined in this domain A mix of positive, null, and/or adverse impacts across the outcomes examined in this domain Uniformly positive impacts across the outcomes examined in this domain

DiClemente et al. 2010

n.a. n.a. n.a. n.a. n.a.

Klein and Card 2011

Danielson et al. 2013

n.a. n.a. n.a. n.a. n.a.
CitationDetails

DiClemente et al. 2004

Wingood et al. 2006

Sales et al. 2010

The program’s evidence of effectiveness was first established in a randomized controlled trial involving sexually active African American females recruited from four community health agencies in the southern United States. Study participants were randomly assigned to either a treatment group that received the intervention or a control group that received a general health promotion intervention on nutrition and exercise. Surveys were administered immediately before the intervention and at follow- ups conducted 6 and 12 months after the intervention. Biological testing for chlamydia, gonorrhea, and trichomonas was also conducted.

The study found that six months after the intervention, adolescents participating in the intervention were significantly less likely to report having a pregnancy and significantly more likely to report consistent condom use in the past 6 months. Adolescents participating in the intervention were significantly more likely to report having used a condom during last sex, reported a significantly higher percentage of condom-protected sexual intercourse acts during both the past 30 days and the past 6 months, were less likely to have had a new vaginal sex partner in the last 30 days, and reported significantly fewer episodes of unprotected sexual intercourse during both the past 30 days and the past 6 months. The study found no statistically significant impacts on self-reported condom use in the past 30 days.

The study found that twelve months after the intervention, adolescents participating in the intervention were significantly more likely to report consistent condom use in the both the past 30 days and the past 6 months. Adolescents participating in the intervention were significantly more likely to report using a condom during last sex, reported a significantly higher percentage of condom-protected sexual intercourse acts during both the past 30 days and the past 6 months, and reported significantly fewer episodes of unprotected sexual intercourse during both the past 30 days and the past 6 months. The study found no statistically significant program impacts on self-reported pregnancy in the past 6 months.

Across the two follow-up periods, adolescents participating in the intervention were significantly less likely to have a chlamydia infection. The study found no statistically significant program impacts on gonorrhea or trichomonas infections.

DiClemente et al. 2010

This randomized controlled trial received a low rating because it had high attrition and did not establish baseline equivalence for the final analysis sample.

Klein and Card 2011

This study evaluated an adapted version of the SiHLE program with a randomized controlled trial involving African American female adolescents in the San Francisco Bay Area. The adapted “Multimedia” version of the program comprised two one-hour sessions delivered individually by computer. Study participants were randomly assigned to either a treatment group that received the intervention or to a control group that received a general health education session. Surveys were administered immediately before random assignment (baseline) and three months after baseline.

The study examined changes in rates of sexual risk behaviors between the baseline and three-month follow-up surveys. However, the study did not test for differences in these outcomes between the treatment and control groups. The study also examined measures of condom-use self-efficacy, knowledge, sexual-communication self-efficacy. Findings for these outcomes were not considered for the review because they fell outside the review of the review.

Danielson et al. 2013

This study did not meet the review eligibility criteria.

Notes

Some study entries may include more than one citation because each citation examines a different follow-up period from the same study sample, or because each citation examines a different set of outcome measures on the same study sample. A blank cell indicates the study did not examine any outcome measures within the particular outcome domain or the findings for the outcome measures within that domain did not meet the review evidence standards.

Information on evidence of effectiveness is available only for studies that received a high or moderate rating. Read the description of the review process for more information on how these programs are identified.