Center on Adolescent Sexuality, Pregnancy and Parenting

1. Center on Adolescent Sexuality, Pregnancy and Parenting Veronica E. Stovall Project Coordinator University of Missouri Extension Making Proud Choices

2. Steps to Prevention for Adolescences • Perceived Vulnerability; • Empower the Youth; • Providing them with Medically Correct Sexual Health information. • Provide them with Self Efficacy (skills) • Use condoms correctly and consistently, • Negotiate condom use. Making Proud Choices

3. Center On Adolescents Sexuality, Pregnancy and Parenting. The Mission of CASPP is to : Bring together a Multi-disciplinary Team of Professionals and Laypersons to Collaborate to provide Educational Programs and Conduct Applied Research to better understand how to Prevent and Eliminate the Negative Effects of High Risk Sexual Behaviors and Early Childbearing. Making Proud Choices

4. Programming objectives • Helping adolescents and young adults develop healthy relationships and sexual decision making skills. • This is achieved by providing services to community professionals as well as direct services to youth and their parents through regional HDFS extension faculty and community partnerships. Making Proud Choices

5. Programs We Implement • Missouri Volunteer Resource Mothers; • Maltreatment and Adolescent Pregnancy and Parenting Program; • Adolescent Mother Journaling Program; • Making Proud Choices; • Healthy Relationships and Marriage Education Training project. Making Proud Choices

6. Funding • MO Department of Elementary and Secondary Education (DESE); • MO Department of Social Services (DSS); • US Department of Health and Human Services. Making Proud Choices

7. Other Resources • Technical assistance to organizations implementing these programs; • Up-to-date research and information for professionals and educators in the field; • Assistance with grant writing. Making Proud Choices

8. Please Share with the Group • Hearts • Condoms • Ribbons Making Proud Choices

9. Three Epidemics Among Youth • Persons aged 13-29 accounted for an estimated 34 percent of new HIV infections reported in 2006 surveillance data.1 • Approximately 19 million new STD infections occur each year with 48 percent among young people aged 15 – 24. An estimated 1 in 4 teenaged girls between the ages of 14 and 19, or 3.2 million, are infected with a STD2. • Each year there are over 745,000 teenage pregnancies3. • Source • 1Available at http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/incidence.htmf#18 • 2 Available at http://www.cdc.gov/std/stats/pdf/trends2006.pdf • 3Available at http://www.guttmacher.org/pubs/fb_ATSRH.html#ref27

10. What Is Risky Sexual Behavior? • Early initiation of sexual intercourse • Unprotected intercourse • Multiple sexual partners • Sex while under the influence of drugs or alcohol

11. Risk and Protective Factors for HIV, STD, and Teen Pregnancy Risk Factors • Unprotected Vaginal and Anal Sex Protective Factors • Sexual abstinence • Consistent and correct condom* use • Abstinence from AOD** HIV STD Pregnancy * Male and female condoms ** Alcohol and other drugs

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13. Training Goals Goal To Provide Educators with knowledge of Adolescence Sexual Decision Making as it relates to their Risky Sexual Behaviors; which may lead to HIV/STD and unwanted Pregnancy, Educators will obtain those Skills necessary to Empower Young Adolescents to Change their Behavior in ways that will Reduce their Risk for STDs, HIV, and Pregnancy. To Provide Educators with the Knowledge and Skills to Implement the Making Proud Choices! curriculum Effectively and with a High Degree of Reliability. Making Proud Choices

14. Making Proud ChoicesA Safer Sex Approach to HIV/STD Teen Pregnancy Prevention • The Modules: • Module 1: Getting to Know You and Steps to Making Your Dreams Come True • Module 2: The Consequences of Sex: HIV Infections • Module 3: Attitudes and Beliefs about HIV/AIDS and Condom Use • Module 4: Strategies for Preventing HIV/ Infections STOP THINK and ACT Making Proud Choices

15. Making Proud ChoicesA Safer Sex Approach to HIV/STD Teen Pregnancy Prevention • Module 5: The Consequences of Sex: STD’s and Correct Condom Use; • Module 6: The Consequence of Sex: Pregnancy; • Module 7: Developing Condom Use and Negotiation Skills; • Module 8: Enhancing Role Plays: Refusal and Negotiation Skills. Making Proud Choices

16. Foundation of a Healthy Relationship MPC Theory to Practice KNOWLEDGE Teens need to learn relevant and correct information. Making Proud Choices Modules-2,5, & 6

17. MPC Theory to Practice PERCEIVED VULNERABILITY Teens need to believe they are VULNERABLE to being infected with HIV/ STDs and getting someone pregnant. Making Proud Choices Modules 2, 3, 4 & 5

18. MPC Theory to Practice Outcome Expectancy Beliefs Teens need to believe: -Using Condoms will not interfere with sexual pleasure; -When Partners react negatively and not approve of using a condom, they will feel confident in their ability to respond to their partner and handle the situation; Condoms can prevent HIV/STDs and that condoms and other contraceptives can prevent teen pregnancy. Making Proud Choices Module 4, 7 & 8

19. MPC Theory to Practice SKILLS Teen Needs to Learn: -Skills -Practice using the skills, -Build confidence in using skill. Making Proud Choices 4,7, & 8

20. MPC Theory to Practice Self Efficacy Teens need to build confidence in their ability to : Use condoms correctly and consistently; Negotiate condom use and get their partner to use a condom. Making Proud Choices 4, 5,7 & 8

21. Curriculum Teaching Strategies • Setting the Environment: The Group Rules; • Brainstorming; • Interactive Activities and Competitive Games • Processing a Video or Game; • Working in Small Groups; • Role Playing/Practice. Making Proud Choices

22. Group Rules Developing guidelines as a group builds group cohesion and increases the likelihood that the rules will be followed. Module 1 Making Proud Choices Making Proud Choices

23. Brain Storming Remember in Brainstorming you just say whatever comes to mind about a particular issue or question. Module 1 Making Proud Choices Making Proud Choices

24. Harm and Reduction Framework Key Components • People will continue to Engage in Behaviors that Society may Disapprove of like Early Sexual Activity and Drugs; • Rather than Responding to these Behaviors with Punishment and Prohibition, We need to Build Trust by Helping Teens Minimize the Potential Hazards associated with their Behaviors, therefore, Making Proud Choices

25. Harm Reduction Framework Key Continues • Your Program Should Help Youth see the Risks They are Taking and Recommend Safer Behaviors including Abstinence but Start Where the Youth is Now and Attempts to Move Him/ Her in a Positive Direction. Making Proud Choices

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27. Americans Overwhelmingly Favor Broader Sex Education • 93% of parents reported their child has benefited from sex education; • 94% of parents say that sex education should cover contraception; • Only 15% of Americans want abstinence-only education taught in the classroom. • The Guttmacher Institute 2005 Making Proud Choices

28. What Type of SexEducation is Right for Your Teen? • Abstinence-only Education; • Abstinence plus or Abstinence Based Sexual Education; • Comprehensive Sexual Education; • Holistic Sex Education. Making Proud Choices

29. What is Adolescence? • What period do you think of when you hear the word” adolescence”? Decide when you think it begins and ends. • What words or images come to your mind when you hear the word “teenager”? Make a list. Making Proud Choices

30. Adolescence • It also refers to the age period between childhood and adulthood. Phases of Adolescences • TWEENS: 11-14 years (Early) • TEENS: 13-16 years. (Middle) • EMERGING ADULTHOOD: 16-18 (Late) Making Proud Choices

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32. Puberty Begins • Puberty is a period of rapid physical growth and sexual maturation; • The sequence of physical changes is universal, but the timing varies (typically lasting 3-5 years). • Age of onset ranges between 8-15 years. Making Proud Choices

33. Adolescence • Awkward period between sexual maturational and the attainment of adult roles and responsibilities; • Begins with the domain of physical/biological changes related to puberty, but it ends in the domain of social roles; • Encompasses the transition from the status of a child (one who requires monitoring) to that of an adult. (responsible for behavior) Making Proud Choices

34. Adolescence • Adolescence is much broader and longer than the teenage years alone (has changed significantly over the past 150 years); • Adolescence now stretches across more than a decade, with puberty onset often beginning by age 9-12 and adult roles delayed until mid twenties (Worth man, 1995). Making Proud Choices

35. Young people are at high risk of unintended pregnancy and STDs for many years Intend no more children First intercourse Spermarche First marriage First birth MEN 33.2 26.7 14.0 28.5 16.9 AGE 10 15 20 25 30 35 30.9 25.1 26.0 17.4 12.6 WOMEN Menarche First intercourse Intend no more children First marriage First birth Making Proud Choices

36. Puberty Romantic Motivation Sexual Interest Emotional Intensity Sleep Cycle Changes Appetite Risk for Affective Disorders (girls) Increase in risk seeking, and novelty seeking Age/Experience Planning Logic, Reading Inhibitory Control Problem Solving Understanding Consequences Affect regulation Goal Setting and pursuit Judgment and abstract thinking Adolescence Making Proud Choices

37. Puberty T/F 1 in 7 Caucasian girls starts to develop breasts or public hair by age 8 1 in 2 African American girls starts to develop breasts or pubic hair by age 12 Average age of menarche (first menstruation) has fallen from 20-10. African American girls are about 6 months earlier Making Proud Choices

38. Adolescent Brain Still Under Construction Teens (left) used less of the prefrontal (upper) region than adults (right) when reading emotions. Making Proud Choices

39. FRONTAL LOBE • As the “prefrontal cortex” area of the frontal lobe matures, through experience and practice, teens can reason better, develop more impulse control, and make better judgments • Prefrontal cortex is one of the last areas of the brain to fully develop • Increased need for struc- ture, mentoring, guidance. Making Proud Choices

40. Incarcerated Youth Risky Behaviors Continue 39% had used alcohol and/or other drugs before sex: 64% had not used a barrier form of protection during last intercourse. Educational Training and Research 2008 Making Proud Choices

41. Factors that Influence Risky Sexual Behaviors • Environmental Factors: • Community Characteristics; • Family Characteristics; • Peer Characteristics; • Characteristics of Romantic partners. Making Proud Choices

42. Factors that Influence Risky Sexual Behaviors • Individual Factors: • Biological Factors-age, physical development and gender; • Race/ethnicity; • Connection to family; • Connection to school and success in school; • Connection to faith communities; • Connection to other community organization; • Child Abuse i.e Physical, Sexually, Neglect Making Proud Choices

43. Factors that Influence Risky Sexual Behaviors • Involvement in gangs; • Alcohol and drug use; • Aggression; • Involvement in problem or sensation-seeking behavior; • Paid work; • Involvement in Sports; • Cognitive and personality traits; • Sexual beliefs, attitudes and skills. Making Proud Choices

44. How do these changes affect teens? • Adolescents are uniquely vunerable to risk taking: • Novelty & sensation seeking increase dramatically at puberty • Development of self-regulation lags behind Making Proud Choices

45. What Can Adults Do? • Expect inconsistency in responsibility taking and in decision making; • Provide opportunities for “safe: risk taking; • Avoid criticizing /comparing to others; • Encourage enough sleep; • Encourage/model healthy eating; • Encourage /model activity • Provide honest answers about sex. Making Proud Choices

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