Training Evaluation Final Version

1
Prepared for Promising Futures
Prepared by Erin Parrish
MPH-Candidate, The George Washington University
School of Public Health and Health Services
Promising Futures:
FC2 Training Evaluation

2
Table of Contents
Executive Summary…………………………………………………………………3
Background…………………………………………………………………………4
Data Collection Methods……………………………………………………………4
Results………………………………………………………………………………4
Limitations…………………………………………………………………………15
Recommendations………………………………………………………………….16
Conclusion……………………………………………………………………….....16
Appendix…………………………………………………………………………...18

3
Executive Summary
Program Summary
Through media, many adolescents are continually exposed to messages of sex, drugs, and violence and
some of these youth lack positive outlets to learn and express themselves. Promising Futures is a youth
development and health education program that teaches adolescents safer sex health information and
gives them tools to be peer educators in their community. The program engages youth by using hip-
hop, dance, writing, and performance as a teaching method. The Promising Futures program gives
adolescents from middle and high schools in Washington, DC a safe and positive outlet to use their
creativity while also learning positive health messages. Youth take part for an academic year in various
health programming like comprehensive sexual education, HIV education, and healthy relationships.
Conducted in January of 2013, the FC2 (female condom) training program is a 2-day program that
taught female condom facts, use, and advantages, condom negotiation strategies, where female
condoms can be found, and how to talk about and conduct outreach for female condoms to youth. The
youth taking part in the program are part of the Promising Futures youth program that works with high
achieving youth from blue ribbon schools in Washington, DC. It consists of both in classroom,
demonstration, role play, and fieldwork activities.
Results
The FC2 training evaluation was broken into two parts – knowledge and attitudes. The purpose of the
knowledge section was to measure what the students learned about female condoms. Overall, test
scores increased – on 10 of 11 questions. While most of the questions saw a majority of responses
correct on the post-test, they still remained low or below 75% correct. The attitudes section measured
how the youth’s perceptions and opinions of female condoms changed after receiving the training. As
in knowledge, all but one of the attitude scores showed an increase on the post-test. Also like the
knowledge scores, attitudes generally remained low, despite showing increases from pre to post-test.
Conclusion
The results showed that knowledge of female condoms and attitudes can be increased toward the
positive through a classroom-based curriculum. However, changes should be made for future training
curriculum to highlight areas where students had trouble, particularly in increasing their knowledge of
basic facts for female condoms. Despite the areas for improvement, the program showed that in the
Washington, DC area youth could be prime candidates for instruction on safe sex practices
Recommendations
The primary recommendations for improvements in future female condom trainings would be to first
conduct a needs assessment with program youth to determine what they already know and would like
to learn and the format in which they learn best. More focus should be placed on thorough discussion
of what FC2 female condoms are made of, how they differ from earlier versions of female condoms
and male condoms, and the most common condom myths. Finally, more work should be conducted in
the attitudes section with time for more discussion on the youth’s opinions of female condoms and
their input on the information that would create a more positive image among youth their age.

4
Background
Washington, DC has the highest rate of HIV/AIDS in the country at 2.7% of the total population
currently infected.1 While the number of new infections has decreased in recent years, 24% since 2006,
the current rate still exceeds the World Health Organization’s definition of an epidemic level of 1%
prevalence.1 It is well known that condoms, besides abstinence, are the best form of prevention of
STIs. Additionally, while rates of other STIs are also decreasing,1 Washington, DC is still among those
with the highest rates for STIs like Chlamydia, gonorrhea, and syphilis.2 Despite this, condom use is
relatively low in the general Washington, DC population, particularly among women – 42.9% and
33.8% among men and women respectively.3 The high rates of STIs in the city and low use of
traditional prevention methods like male condoms, show that promotion is very much needed in the
city, along with alternative methods.
The female condom is a growing method of STI and pregnancy prevention aimed at women.
Manufactured similar to a male condom, it is made specifically to fit to a woman’s vagina and offer
protection from STIs transmitted through seminal as well as skin-to-skin contact.4 While still relatively
unknown and not widely used,5 female condom outreach is beginning to grow. In Washington, DC a
number of organizations have instituted programs to conduct health outreach education specifically for
female condoms and to distribute them for free at various health centers, salons, and other local
establishments.6 Promising Futures is on such organization that trains youth to be peer and community
health educators on a number of important health issues like female condom use.
Data Collection Methods
Pre- and post-tests were developed to assess knowledge and attitudes toward FC2s, providing the
ability to measure changes that can be attributed to the training program. The knowledge section uses
twelve multiple choice, true/false, and open ended questions to test what the youth already knew about
FC2s and condom use prior to training and what they learned from the training. Attitudes toward FC2s
are measured using nine likert-scale statements ranging from strongly disagree to strongly agree. For
each question or statement, the youth were asked to select the best response. The evaluation tool can be
found in the appendix.
Eight students participated in the FC2 training and were given pre-tests immediately prior to and post-
tests immediately following training. Answers to both sections were compiled in MS Word and Excel
2007. Responses were compiled in the form of frequency distributions with pre- and post-test
responses shown alongside each other, which can be found in the
Results
Knowledge Section
The knowledge section provides a baseline and post-training level of knowledge of female condoms
and condom negotiation among the youth. This allows for a measure of the increase in knowledge that
can be directly attributed to the training program and whether the training program achieved its
objectives. The training was broken down into five lessons: FC2 Facts, FC2 Demonstration, Changing
Attitudes, Condom Negotiation, and Advocacy and Outreach in Practice with learning objectives in
each lesson. Multiple choice and true/false questions were written to encompass these objectives.

5
Percentages of correct responses were calculated by dividing the total number correct by the total
number of answers given. Below are the results for the pre- and post-tests.
% Correct Median (n) Mode (n)
Question 1: Describe the FC2, what it is made from
and its size. Correct Answer:C
Pre-Test:25%
Post-Test:37.5%
Pre-Test:B
Post-Test B
Pre-Test:B (4)
Post-Test:B (5)
Question 2: True or False, the FC1 (original female
condom) was made of two sheets of polyurethane
welded together and a newer version, the FC2, is
made from a mold dipped into a synthetic rubber
called nitrile. Correct Answer:A
Pre-Test:50%
Post-Test:62.5%
Pre-Test:A&B
Post-Test:A
Pre-Test:A (4)
Post-Test:A (5)
Question 3: Two common myths of the FC2 are.
Correct Answer:B
Pre-Test:0%
Post-Test:33.3%
Pre-Test:A
Post-Test:C
Pre-Test:A (5)
Post-Test:C (5)
Question 4: True or false, the FC1 received
complaints for being too noisy, sounding like a
plastic bag. The FC2 has the same issue and receives
the same complaints. Correct Answer:B
Pre-Test:75%
Post-Test:87.5%
Pre-Test:B
Post-Test:B
Pre-Test:B (6)
Post-Test:B (7)
Question 5: Advantages of the FC2 are. Correct
Answer:B
Pre-Test:30%
Post-Test:66.7%
Pre-Test:A
Post-Test:B
Pre-Test:A (6)
Post-Test:B (6)
Question 6: Two ways the FC2 can be a fun part of a
healthy relationship are. Correct Answer:A
Pre-Test:55.6%
Post-Test:75%
Pre-Test:A
Pre-Test:A
Pre-Test:A (5)
Post-Test:A (6)
Question 7: Can the FC2 be used while the user is
menstruating? Correct Answer:A
Pre-Test:50%
Post-Test:37.5%
Pre-Test:A&B
Post-Test:B
Pre-Test:A&B (4)
Post-Test:B (5)
Question 8: Can the FC2 be used if one of the users
has a latex allergy? Correct Answer:A
Pre-Test:50%
Post-Test:75%
Pre-Test:A&B
Post-Test:A
Pre-Test:A&B (4)
Post-Test:A (6)
Question 9: True or false, the FC2 is more exciting
than the male condom because users feelincreased
sensation. Correct Answer:A
Pre-Test:37.5%
Post-Test:100%
Pre-Test:B
Post-Test:A
Pre-Test:B (5)
Post-Test:A (8)
Question 11: Effective strategies when doing
community health outreach are. Correct Answer:C
Pre-Test:50%
Post-Test:71.4%
Pre-Test:B&C
Post-Test C
Pre-Test:C (5)
Post-Test:C (5)
Question 12: Where can one find FC2s? Correct
Answer:D
Pre-Test:75%
Post-Test:87.5%
Pre-Test:D
Post-Test:D
Pre-Test:D (6)
Post-Test:D (7)
Question 1: Describe the FC2, what it is made from and its size.
Correct Answer: C
0
1
2
3
4
5
6
a. It is made from
latex and has the
same length and
width as the male
condom
b. It is made from
polyurethane and
has the same length
as the male condom
but is wider.
c. It is made from a
synthetic rubber
called nitrile and
has the same length
as the male
condom.
d. It is made from a
synthetic rubber
called nitrile and
has the same length
and width as the
male condom.
Pre-Test
Post-Test

6
Question 2: True or False, the FC1 (original female condom) was made of two sheets of polyurethane
welded together and a newer version, the FC2, is made from a mold dipped into a synthetic rubber
called nitrile.
Correct answer: A
Question 3: Two common myths of the FC2 are:
Correct answer: B
0
1
2
3
4
5
6
a. True b. False
Pre-Test
Post-Test
0
1
2
3
4
5
6
a. It will be
uncomfortable to insert
and wear due to the
inner and outer rings.
It's an ineffective form
of protection from
STIs.
b. It will be too noisy
like the FC1. It will be
too difficult to insert.
c. They're difficult to
find at the drug store. It
could disappear inside
my body.
Pre-Test
Post-Test

7
Question 4: True or false, the FC1 received complaints for being too noisy, sounding like a plastic
bag. The FC2 has the same issue and receives the same complaints.
Correct answer: B
Question 5: Advantages of the FC2 are:
Correct answer: B
0
1
2
3
4
5
6
7
8
a. True b. False
Pre-Test
Post-Test
0
1
2
3
4
5
6
7
a. It is empowering for
females because they can
insert the FC2
themselves. It is safe for
those with latex allergies.
It is cheaper than a male
condom.
b. It can be inserted up to
6 hours prior to sex. It is
safe for those with latex
allergies. It is
empowering for females
because they can insert
and use the FC2
themselves.
c. It can be inserted up to
6 hours prior to sex. It
doesn't feel tight or
constricting. It is easier
to find in stores than the
male condom.
Pre-Test
Post-Test

8
Question 6: Two ways the FC2 can be a fun part of a healthy relationship are:
Correct answer: A
Question 7: Can the FC2 be used while the user is menstruating?
Correct answer: A
0
1
2
3
4
5
6
7
a. Your partner can
watch and help you
inser the FC2. It can
enhance intimacy
because your partner
doesn't need to pull out
immediately following
intercourse.
b. It needs to be
inserted immediately
before sex, so you and
your partner can make
it a part of foreplay.
The inner and outer
rings can be
stimulating for both
males and females.
The material of the
FC2 is thicker than
male condoms, so it
can make intercourse
last longer. The inner
and outer rings can be
stimulating for both
males and females.
Pre-Test
Post-Test
0
1
2
3
4
5
6
a. Yes b. No
Pre-Test
Post-Test

9
Question 8: Can the FC2 be used if one of the users has a latex allergy?
Correct Answer: A
Question 9: True or false, the FC2 is more exciting than the male condom because users feel increased
sensation.
Correct Answer: A
0
1
2
3
4
5
6
7
a. Yes b. No
Pre-Test
Post-Test
0
1
2
3
4
5
6
7
8
9
a. True b. False
Pre-Test
Post-Test

10
Question 10: What are 3 responses one can make during condom negotiation when a partner doesn’t
want to use a condom?
Pre-Test Answers:
 I will wear the condom instead.
 We don’t have sex without protection.
 I will be careful.
 I have a (FC2).
 We can make it fun.
 I already have a condom in.
 Only way we can have sex.
 It’s about my health.
 I want us to be safe.
 I am not risking getting an STI.
 I’m not ready to have a child.
 It is better for us to use it instead of not using it.
 We can get pregnant if we don’t.
 We need to protect ourselves against STIs and HIV.
 It is a safe practice.
 No condom no sex!
 We are not having sex!
 I am doing it!
 Put it on, or don’t get it on.
 It’s cool, you said you were too big for condoms, guess you’re too small for this one.
Post-Test Answers:
 I don’t want to wear one.
 It feels good.
 Please baby
 It’s about safety.
 Skin to skin disease are prevented.
 It’s stimulating for the both of us.
 You can fit it.
 It’s more lubricated.
 It can increase intimacy
 You will not have to pull out as soon as you lose an erection
 Increased pleasure for both parties due to ring and the outer part to put around the lips of the
vagina.
 No condom no sex.
 I don’t have to have sex.
 Don’t like the fact about no condom.
 It’s more intimate
 We can cuddle afterwards.
 It is less restricting on the male.
 Foreplay.
 No glove, no love.
 Honestly, how will it hurt you?
 The quicker you put it on, the quicker you put it on.

11
Question 11: Effective strategies when doing community health outreach are:
Correct Answer: C
Question 12: Where can one find FC2s?
Correct answer: D
Overall, the post-test results show that the training program was successful in increasing the youth’s
knowledge of the FC2 with increases on 10 of 11 questions on the post-test. Additionally, eight of
eleven questions had a majority of correct responses marked on the post-test. Most notably, “Question
9: True or false, the FC2 is more exciting than the male condom because users feel increased
sensation” saw a 62.5% increase with all youth answering correctly in the post-test. Large increases
were also seen in “Question 3: Two common myths of FC2s are” where there were no correct
0
1
2
3
4
5
6
a. Go into technical details
to provide as much
informtaion as possible.
Practicce active listening
and pay attention to what
the other person is saying
before you speak. Don't be
pushy.
b. Be clear in your
message. Use the time
while the other person is
talking to think about
what you'll say next. Wear
professional dress, so
you'll be taken more
seriously.
c. Be clear in your
message. Use plain and
non-technical language.
Be non-judgmental.
Pre-Test
Post-Test
0
1
2
3
4
5
6
7
8
a. At the
drugstore.
b. At local
advocacy
organizations.
c. At local
salons,
barbershops, and
other local stores.
d. All of the
above.
Pre-Test
Post-Test

12
responses in the pre-test and 33.3% of the responses in the post-test were correct as well as “Question
5: Advantages of FC2s are,” which saw a 36% increase in correct responses. Only one question saw a
decrease in correct responses – “Question 7: Can the FC2 be used while the user is menstruating.”
Attitudes Section
The attitudes section also provides a baseline and post-training measurement that allows for
determination of whether the training was successful in increasing positive attitudes and opinions
toward female condoms among the youth. The attitude section of the evaluation contains nine
statements that asked the youth to select how they feel about each statement from strongly disagree to
strongly agree. Each statement was originally scored on a 1-5 scale, with a score of 1 indicating the
youth strongly disagree with the statement and a score of 5 indicating that the youth strongly agree
with the statement. For the purposes of comparing scores, a score of 1 indicates poor perception and a
score of 5 indicates a positive perception. Statements 2, 3, 4, 8, and 9 were written in the reverse
direction, so scores for these statements were reverse coded. Scores for each statement are included
below.
Pre-Test
Score
Post-Test
Score
Mean
Score
Statement 1: I would be interested in using the FC2 if I were
to have sex.
3.875 4.125 4
Statement 2: The FC2 is inconvenient. 3.75 4.5 4.125
Statement 3: The FC2 is weird. 3.625 3.625 3.625
Statement 4: I would rather use a male condom than an FC2. 2.875 3.375 3.125
Statement 5: I would advocate for FC2 use among my friends
and family.
3.5 4.43 3.965
Statement 6: The FC2 is a good, effective option for
protection of both males and females.
4.5 4.625 4.563
Statement 7: The FC2 offers protection from STIs that the
male condom doesn’t.
2.375 4.43 3.403
Statement 8: I don’t know where to get FC2s. 3.875 4.625 4.25
Statement 9: I think it’s much easier to just get male
condoms.
2.125 3.25 2.688
Statement 1: I would be interested in using the FC2 if I were to have sex.
0
1
2
3
4
5
Strongly
Disagree
Disagree Unsure Agree Strongly
Agree
Pre-Test
Post-Test

13
Statement 2: The FC2 is inconvenient.
Statement 3: The FC2 is weird.
Statement 4: I would rather use a male condom than an FC2.
0
1
2
3
4
5
Strongly
Disagree
Agree
Pre-Test
Post-Test
0
1
2
3
4
5
6
Strongly
Disagree
Agree
Pre-Test
Post-Test
0
1
2
3
4
Strongly
Disagree
Agree
Pre-Test
Post-Test

14
Statement 5: I would advocate for FC2 use among my friends and family.
Statement 6: The FC2 is a good, effective option for protection of both males and females.
Statement 7: The FC2 offers protection from STIs that the male condom doesn’t.
0
1
2
3
4
5
6
Strongly
Disagree
Agree
Pre-Test
Post-Test
0
1
2
3
4
5
6
7
Strongly
Disagree
Agree
Pre-Test
Post-Test
0
1
2
3
4
5
Strongly
Disagree
Agree
Pre-Test
Post-Test

15
Statement 8: I don’t know where to get FC2s.
Statement 9: I think it’s much easier to just get male condoms.
While attitudes toward the female condom were generally high in the pre-test, an increase in
acceptance was found on all but one statement. Notable scores were found in “Statement 2: The FC2 is
inconvenient,” “Statement 6: The FC2 is a good, effective option for protection of both males and
females,” and “Statement 8: I don’t know where to get FC2s”, where positive perceptions were among
the highest. Not all statements saw positive perceptions on the post-test. “Statement 3: The FC2 is
weird,” “Statement 4: I would rather use a male condom than an FC2,” and “Statement 9: I think it’s
much easier to just get male condoms” all scored around the neutral mark on post-test with Statement 3
seeing no change.
Limitations
The curriculum was developed without conducting a needs assessment, which could have enabled a
curriculum designed specifically to meet the needs and interests of the students. The FC2 training
program was small, working with only eight youth. The small program size, coupled with the makeup
of the youth in the program – high achieving students from blue ribbon schools – does not allow us to
generalize the results to the broader youth population in Washington, DC. The program was also short,
0
1
2
3
4
5
6
Strongly
Disagree
Agree
Pre-Test
Post-Test
0
1
2
3
4
Strongly
Disagree
Agree
Pre-Test
Post-Test

16
two 2-hour sessions, which limited the amount of information that could be taught and the format in
which we could teach.
Conclusion
Overall, the results show the program was effective in increasing knowledge and positive attitudes of
FC2s among the youth who participated in the program. The results do show where improvements can
be made in future FC2 trainings. While knowledge of FC2s generally increased, the youth had
difficulty describing what FC2s are made of and naming the most common FC2 myth with both pre-
and post-tests showing the majority of youth gave the wrong answer. The youth also had difficulty
with correctly identifying how FC2s can be used and results actually showed a decrease in correct
responses to the question of whether FC2s can be used while the user is menstruating.
The FC2 outreach training program overall showed that it successfully increased knowledge and
positive attitudes toward FC2s. This allows the youth a broader spectrum of options for practicing safer
sex in their own lives as well as the power to become safer sex advocates in their community.
Recommendations
1. Conduct a needs assessment to determine what information the youth will see as most valuable
and in what formats they learn best.
2. The results from the knowledge section show that more emphasis should be placed on
describing the FC2, how it differs from its earlier version, how and when it can be used, and its
most common myths.
3. Attitudes toward FC2s were generally high and increased after participation in the training. The
most notable areas for improvement are the likelihood of FC2 use, perception of FC2 as weird,
and ability to get access to FC2s vs. male condoms. To work on these issues, future trainings
could place a greater emphasis on the Changing Attitudes lesson with discussion on perceptions
of female condoms during the beginning and end of training, including what information would
improve their opinion toward FC2s. Future trainings should also more thoroughly cover where
FC2s are available, particularly where youth could access them free of charge.

17
References
1. DC Department of Health. HIV/AIDS, Hepatitis, STD, and TB Epidemiology Annual Report
2011. Washington, DC; 2011.
2. Centers for Disease Control and Prevention. National Center for HIV/AIDS, Viral Hepatitis,
STD, and TB Prevention Atlas. Available at http://www.cdc.gov/nchhstp/Atlas/. Copyright
2013. Accessed March 14, 2013.
3. DC Department of Health. Behavioral Risk Factor Surveillance Survey 2010 Annual Health
Report. Washington, DC; 2012.
4. Palmore J, Kizaric R. Safer is Sexy: Resource Kit for Professionals, 2011. The Female Health
Company. Available at
http://www.fc2femalecondom.com/healthprofessionals/trainingmaterial.html.
5. Daniels K, Mosher W, Jones J. Contraceptive Methods Women Have Ever Used: United States,
1982-2010. National Health Statistics Reports. 2013 Feb(62).
6. DC’s Doin’ It! Resources. Available at http://www.dcdoinit.com/resources. Accessed March
14, 2013.

18
Appendix
The following questions will test your knowledge of the FC2.
Read each question carefully and circle the answer you think is the best response.
1. Describe the FC2, what it is made from and its size.
a) It is made from latex and has the same length and width as the male condom.
b) It is made from polyurethane and has the same length as the male condom but is wider.
c) It is made from a synthetic rubber called nitrile and has the same length as the male condom
but is wider.
d) It is made from a synthetic rubber called nitrile and has the same length and width as the
male condom.
2. True or false, the FC1 (original female condom) was made of two sheets of polyurethane
welded together and a newer version, the FC2, is made from a mold dipped into a synthetic
rubber called nitrile.
a) True
b) False
3. Two common myths of the FC2 are:
a) It will be uncomfortable to insert and wear due to the inner and outer rings. It’s an
ineffective form of protection from STIs.
b) It will be too noisy like the FC1. It will be too difficult to insert.
c) They’re difficult to find at the drug store. It could disappear inside my body.
4. True or false, the FC1 received complaints for being too noisy, sounding like a plastic bag. The
FC2 has the same issue and receives the same complaints.
a) True
b) False
5. Circle the answer in which each statement is correct. Advantages of the FC2 are.
a) It is empowering for females because they can insert and use the FC2 themselves. It is safe
for those with latex allergies. It is cheaper than a male condom.
b) It can be inserted up to 6 hours prior to sex. It is safe for those with latex allergies. It is
empowering for females because they can insert and use the FC2 themselves.
c) It can be inserted up to 6 hours prior to sex. It doesn’t feel tight or constricting. It is easier
to find in stores than the male condom.
6. Circle the answer in which each statement is correct. Two ways the FC2 can be a fun part of a
healthy relationship are:
a) Your partner can watch and help you insert the FC2. It can enhance intimacy because your
partner doesn’t need to pull out immediately following intercourse.
Appendix 1

19
b) It needs to be inserted immediately before sex, so you and your partner can make it a part of
foreplay. The inner and outer rings can be stimulating for both males and females.
c) The material of the FC2 is thicker than male condoms, so it can make intercourse last
longer. The inner and outer rings can be stimulating for both males and females.
7. Can the FC2 be used while the user is menstruating?
a) Yes
b) No
8. Can the FC2 be used if one of the users has a latex allergies?
a) Yes
b) No
9. True or false, the FC2 is more exciting than the male condom because users feel increased
sensation.
a) True
b) False
10. What are 3 responses one can make during condom negotiation when a partner doesn’t want to
use a condom?
1.
2.
3.
11. Circle the answer in which each statement is correct. Effective strategies when doing
community health outreach are:
a) Go into technical details to provide as much information as possible. Practice active
listening and pay attention to what the other person is saying before you speak. Don’t be
pushy.
b) Be clear in your message. Use the time while the other person is talking to think about what
you’ll say next. Wear professional dress, so you’ll be taken more seriously.
c) Be clear in your message. Use plain and non-technical language. Be non-judgmental.
12. Where can one find FC2s?
a) At the drugstore
b) At local advocacy organizations
c) At local salons, barbershops, and other local stores
d) All of the above.
The following questions will test your attitude toward the FC2.

20
Read each question carefully and circle the answer you think is the best response.
1. I would be interested in using the FC2 if I were to have sex.
a) strongly disagree b) disagree c) unsure d) agree e) strongly agree
2. The FC2 is inconvenient.
3. The FC2 is weird.
4. I would rather use a male condom than an FC2.
5. I would advocate for FC2 use among my friends and family.
6. The FC2 is a good, effective option for protection of both males and females.
7. The FC2 offers protection from STIs that the male condom doesn’t.
8. I don’t know where to get FC2s.
9. I think it’s much easier to just get male condoms.

Training Evaluation Final Version

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