Core Elements

Maintaining Fidelity  

It is important to understand a few key terms and concepts to successfully implement RCL. These include fidelity, or adhering closely to the program design during implementation. Fidelity is the degree to which a program is implemented as designed. Factors that may influence fidelity include intentional changes to the program in response to conditions on-the-ground, and unintentional program modifications.

Core Elements are required elements of an intervention or program that embody the theory and internal logic of the intervention and most likely produce its main effects. These elements define the intervention and must be kept intact to maximize the chances that it will produce outcomes like those demonstrated in the original research.

Key Characteristics are important, but not essential, attributes of an intervention’s recommended activities and delivery methods. They may be modified to be culturally appropriate and fit the risk factors, behavioral determinants, and behaviors of the target population and the unique circumstances of the venue, agency, and other stakeholders. Modification of key characteristics should be done with care and not compete with or contradict the core elements, theory, and internal logic of the intervention.

Core Elements and Key Characteristics of the 8 Peer-Group Sessions

Core Elements 

1. Deliver intervention to youth in community-based settings.
2. Use two skilled facilitators to model communication, negotiation, and refusal skills for the youth.
3. Use “friendship” or venue-based groups (i.e., friends, family members, a basketball team, a scout troop, church group, an existing youth group) to strengthen peer support.
4. Use culturally appropriate interactive activities proven as effective learning strategies to help youth capture the important constructs of the theory.
5. Include a “family tree” to contextualize and personalize abstract concepts, such as decision making and risk assessment.
6. Enable participants to learn and practice a decision-making model such as SPIRIT (Stop and Relax, Problem Identification, Identify Solutions, Review Solutions, I Choose, Try and Treat Yourself).
7. Train participants in assertive communication and refusal skills specifically related to negotiation of abstinence or safer sex behaviors.
8. Teach youth proper condom use skills.

Key Characteristics

• The program is delivered to peer groups of 8 to 12 youth.
• New members should not join after the third session.
• Participants meet for at least 100–145 minutes for each session.
• Culturally and linguistically based activities are embedded for your target population.
• Groups contain members of the same sex and age group.

Core Elements and Key Characteristics of the Youth/Parent-Trusted Adult Session

Core Elements 

1. Deliver session one-on-one to parents/trusted adults and the youth, at their home or a private location selected by the participants, and at a time convenient to them.
2. Use a facilitator whom the parents/trusted adults find credible, and who is skilled at building rapport with parents and youth at the beginning of the session.
3. Deliver the session after the youth peer-group sessions.
4. Enable parent/trusted adults and youth to learn and practice communication skills.
5. Teach parent/trusted adults and youth proper condom use skills.
6. Distribute and instruct parent/trusted adults and youth through a Resource Guide that includes the following topics:
   • Basic components of good communication and how to talk to your youth
   • Importance of parental monitoring
   • Steps for proper condom use
   • STI and HIV facts, including prevalence data among AI/AN youth

Key Characteristics

• Use a video that shows the challenges and importance of parents monitoring and talking to their youth about sex, abstinence, STIs, HIV/AIDS, and condoms.
• Facilitator must sit down and watch the video with the parent/trusted adult and youth; youth and parent/trusted adult should watch the video together.