“I had like this 5 boyfriends and now I’m left with two”. Stepping Stones program: Evaluation of the design, implementation, and perceived outcomes.

Abstract

The Stepping Stones Program (SSP) is a HIV prevention program used in Elandsdoorn, South Africa. In this study, this program is evaluated using the model of Planned Health Education from Green en Kreuter (2005) and the Intervention Mapping Protocol of Bartholomew et al. (2006) to give recommendations to make the program more evidence-based. First, a potential effectiveness analysis was done, using a document analysis. A behavioural determinants analysis, using the ASE-model was performed to see how risky sexual behaviour is influenced by certain determinants. Further an implementation analysis and perceived effectiveness analysis were carried out. The research represents a mixed method approach. With use of the document analysis, questionnaires for students and interviews for life skill facilitators (LSF) were made. Results show that the program does not comply to all the methodological conditions for effectiveness, therefore is not yet potentially effective. Also, multiple determinants influenced risky sexual behaviour. The program was not carried out as planned and both students and life skill facilitators perceived the program as effective. Despite the need for further research, this study has provided useful recommendations to improve the SSP to make it more evidence-based.