Intervention Summary

Joven Noble

Joven Noble is a youth development, support, and leadership enhancement curriculum designed to strengthen protective factors among male Latino youth ages 10-24. The curriculum aims to promote the character development of young men and facilitate continued "rites of passage" development with the goals of reducing and preventing unwanted or unplanned pregnancies, substance abuse, community violence, and relationship violence. The curriculum also promotes responsible and respectful behavior in relationships with significant others.

Joven Noble is based on the philosophy that male youth need other men and women, their family, and community to care for, assist, heal, and guide them, and successfully prepare them for true manhood. The intervention is informed by positive youth development theory, the risk and protective factors model, acculturation, and Latino cultural values. Delivered by facilitators in 10 weekly sessions, the curriculum focuses on four core teachings: conocimiento (acknowledgment), which addresses social and cultural attachment; entendimiento (understanding), which addresses social and behavioral factors such as violence and aggression as well as the ability of youth to focus on goals; integración (integration), which addresses factors in the broader culture that may lead to feelings of isolation and sadness; and movimiento (movement), which addresses how the physical and emotional aspects of teenagers' lives intersect. Sessions involve a mixture of activities and teaching methods (e.g., testimony by role models, skits) relating to a young person's self, family, and community while focusing on the four core teachings. After completing the program, youth are encouraged to join an extended kinship group for ongoing support and development.

The intervention has been implemented with low-income high school students as well as youth in probation and community alternative justice programs. Joven Noble facilitators are required to participate in training before implementing the program and are encouraged to join a network for the ongoing sharing of resources and implementation techniques.

Descriptive Information

Areas of Interest	Mental health promotion Substance use disorder prevention
Outcomes	1: HIV risk knowledge 2: Cultural knowledge and beliefs 3: Cultural esteem 4: Psychosocial stress exposure 5: Attitudes toward couple violence
Outcome Categories	Family/relationships Mental health Social functioning Physical aggression and violence-related behavior
Ages	13-17 (Adolescent)
Genders	Male
Races/Ethnicities	Hispanic or Latino Race/ethnicity unspecified
Settings	Outpatient Correctional School Other community settings
Geographic Locations	Urban
Implementation History	Established in East Los Angeles, California, the intervention is currently being used in more than 20 States. To date, more than 5,000 individuals have participated in the intervention.
NIH Funding/CER Studies	Partially/fully funded by National Institutes of Health: No Evaluated in comparative effectiveness research studies: No
Adaptations	Program materials are available in English and Spanish.
Adverse Effects	No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories	Universal Selective

Quality of Research

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Tello, J., Cervantes, R. C., Cordova, D., & Santos, S. M. Joven Noble: Evaluation of a culturally focused youth development program. Journal of Community Psychology, 38(6), 799-811.

Study 2

Tello, J., Cervantes, R. C., & Santos, S. Evaluation of the Joven Noble youth development program: San Jose study. Beverly Hills, CA: Behavioral Assessment.

Outcomes

Outcome 1: HIV risk knowledge
Description of Measures	HIV risk knowledge was measured with a scale developed by researchers to evaluate the intervention. The scale contained 10 true/false items, such as "A person with HIV can appear healthy" and "It is possible to contract HIV when getting a tattoo." Correct answers were scored as 1 and incorrect answers as 0, and scores were tallied for a total score ranging from 0 to 10, with higher scores indicating greater knowledge.
Key Findings	In a study that assessed youth before and after they received the intervention, the youth had an increase in HIV knowledge from pre- to posttest (p < .001).
Studies Measuring Outcome	Study 1
Study Designs	Preexperimental
Quality of Research Rating	2.5 (0.0-4.0 scale)

Outcome 2: Cultural knowledge and beliefs
Description of Measures	Cultural knowledge and beliefs were measured with a scale developed by researchers to evaluate the intervention. The scale contained 17 multiple-choice items. One item began, "A person is more likely to be the victim of homicide," with the response options being "as a result of gang violence," "through drug deals gone bad," "as a result of domestic violence," or "as a result of alcohol-related accidents." Another item began, "An hombre con palabra (a man of his word)," with the response options being "keeps his word," "tries not to bring harm to anyone," "takes responsibility for his actions," or "all of the above." Answers that researchers considered correct based on the curriculum goals were scored as 1 and answers considered incorrect were scored as 0, and scores were tallied for a total score ranging from 0 to 17, with higher scores indicating greater cultural knowledge and beliefs.
Key Findings	In a study that assessed youth before and after they received the intervention, the youth had an improvement in cultural knowledge and beliefs from pre- to posttest (p < .001). In another study, youth who received the intervention had an improvement in cultural knowledge and beliefs from pre- to posttest (p < .001), while youth in the no-treatment control group had a smaller but still significant improvement (p < .05).
Studies Measuring Outcome	Study 1, Study 2
Study Designs	Quasi-experimental, Preexperimental
Quality of Research Rating	2.6 (0.0-4.0 scale)

Outcome 3: Cultural esteem
Description of Measures	Cultural esteem was measured with a scale developed by researchers to evaluate the intervention. The scale, developed from items in the Hispanic Stress Inventory, contained 11 statements such as "I am proud to be Latino" and "It would be better for me to forget about my culture and become more Americanized." Respondents indicated their level of agreement with the statements using 4-point Likert scales ranging, for example, from 3 (strongly agree) to 0 (strongly disagree). Scores were tallied for a total score ranging from 0 to 33, with higher scores indicating greater cultural esteem.
Key Findings	In a study that assessed youth before and after they received the intervention, the youth had an increase in cultural esteem (p < .01) from pre- to posttest.
Studies Measuring Outcome	Study 1
Study Designs	Preexperimental
Quality of Research Rating	2.6 (0.0-4.0 scale)

Outcome 4: Psychosocial stress exposure
Description of Measures	Psychosocial stress exposure was measured with a 35-item scale developed by researchers to evaluate the intervention. For each item, the respondent answered "yes" or "no" to indicate the occurrence of specific family stress events and personal experiences, such as having problems in school, being arrested, being in a gang, using drugs, having a parent who uses alcohol, and having a marriage in the family. "Yes" responses were scored as 1 and "no" responses as 0, and scores were tallied for a total score ranging from 0 to 35, with lower scores indicating less stress exposure.
Key Findings	Youth who received the intervention had a decrease in psychosocial stress exposure from pre- to posttest (p < .01), while youth in the no-treatment control group had no significant change.
Studies Measuring Outcome	Study 2
Study Designs	Quasi-experimental
Quality of Research Rating	2.5 (0.0-4.0 scale)

Outcome 5: Attitudes toward couple violence
Description of Measures	Attitudes toward couple violence were measured with a scale adapted by researchers to evaluate the intervention. The scale contained 11 statements such as "Girls sometimes deserve to be hit by the boys they date" and "A boy who makes his girlfriend jealous on purpose deserves to be hit." Respondents indicated their level agreement with the statements using a Likert scale. Scores were tallied, with lower total scores indicating a less permissive attitude toward couple violence.
Key Findings	Youth who received the intervention had an improvement in attitudes toward couple violence from pre- to posttest (p < .001), while youth in the no-treatment control group had no significant change.
Studies Measuring Outcome	Study 2
Study Designs	Quasi-experimental
Quality of Research Rating	2.5 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study	Age	Gender	Race/Ethnicity
Study 1	13-17 (Adolescent)	100% Male	75.4% Hispanic or Latino 24.6% Race/ethnicity unspecified
Study 2	13-17 (Adolescent)	100% Male	87.9% Hispanic or Latino 12.1% Race/ethnicity unspecified

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

Reliability of measures
Validity of measures
Intervention fidelity
Missing data and attrition
Potential confounding variables
Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome	Reliability of Measures	Validity of Measures	Fidelity	Missing Data/Attrition	Confounding Variables	Data Analysis	Overall Rating
1: HIV risk knowledge	2.5	2.0	3.0	2.0	2.0	3.5	2.5
2: Cultural knowledge and beliefs	2.5	2.0	3.5	2.0	2.0	3.5	2.6
3: Cultural esteem	2.5	2.0	3.5	2.0	2.0	3.5	2.6
4: Psychosocial stress exposure	2.5	2.0	3.0	2.0	2.0	3.5	2.5
5: Attitudes toward couple violence	2.5	2.0	3.0	2.0	2.0	3.5	2.5

Study Strengths

The measurement instruments designed to evaluate the intervention have acceptable reliability and face validity. The investigators put in place a well-designed set of mechanisms to enhance intervention fidelity. The sample size in both studies was large enough to permit stable statistical calculation of the findings. The inclusion of a control group in one study represented a theoretical strength, although the potential benefit of this design was not realized analytically.

Study Weaknesses

The construct and content validity of the instruments lack support from independent evaluations. Both studies had some attrition, and the information provided on attrition is inadequate to assess accurately its magnitude or impact on the study results. Neither study employed a design to minimize potential confounding factors. One study lacked a control or comparison group; the other was conducted with a quasi-experimental design, but statistical tests for group-by-time differences were not reported. Further, neither study included analytical steps to control for potential confounds.

Readiness for Dissemination

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Behavioral Assessment, Inc. Joven Noble study protocol.

Tello, J. El Joven Noble (The Noble Youth): A rites of passage, character development program. Curriculum.

Tello, J. El Joven Noble (The Noble Youth): A rites of passage, character development program. Facilitator manual.

Tello, J. El Joven Noble (The Noble Youth): A rites of passage, character development program. Handouts.

Tello, J. Facilitating Joven Noble groups [Handouts].

Tello, J. Joven Noble curriculum fidelity agreement.

Tello, J. Joven Noble Monterey training [PowerPoint slides].

Tello, J. Joven Noble presentation [PowerPoint slides].

Tello, J. La cultura cura [PowerPoint slides].

Tello, J. National Compadres Network: Circulo process [Handouts].

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

Availability of implementation materials
Availability of training and support resources
Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation Materials	Training and Support Resources	Quality Assurance Procedures	Overall Rating
2.8	2.7	2.5	2.6

Dissemination Strengths

Materials include a facilitator manual that contains background information; a detailed, easy-to-use curriculum with a complete array of supporting materials; and handouts for participants. Training from the developer is required in order to receive the facilitator manual and other materials, and it is followed by weekly phone consultation. The developer also offers follow-up training and technical assistance. Pre- and posttests are provided to support outcome monitoring, and the developer is available to assist in interpreting data to help improve program delivery.

Dissemination Weaknesses

Little guidance is provided for implementation planning. Materials suggest that sites employ a curriculum coordinator but do not fully describe the appropriate individual to fill this role. No information is given to ensure that implementation lessons are shared and used across sites participating in the support network. The pre- and posttests may not suit the variety of age and literacy levels of the youth the program is aimed at helping. Little written guidance is provided on interpreting the data that are collected to improve program delivery.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description	Cost	Required by Developer
4-day, on-site training (includes curriculum and other implementation materials, on-site consultation, phone and email consultation, and pre- and posttests)	$750 per participant or $20,000 for up to 30 participants, plus travel expenses	Yes
On-site training and technical assistance in organizational capacity building, cultural competence, and trauma-informed services	Approximately $2,000 per day, depending on training needs, plus travel expenses	No

Replications

No replications were identified by the developer.