How Teen Pregnancy Prevention Programs Can Better Serve Latino Youth

1. How Teen Pregnancy Prevention Programs Can Better Serve Latino Youth

2. This Presentation Will Cover: Overview of Data on Latinos Putting What Works to Work: Effective and Promising Programs* Advice from the field

3. There are only 2 ways for a teen to avoid teen pregnancy: 1. Abstain from sex 2. Use contraception Both are hard. Both require motivation. Both are happening.

4. Overview of Data

5. Why focus on Latinos? HALF (51%) of Latina teens get pregnant at least once before their 20th birthday.* Teen pregnancy and birth rates are declining, but about half as fast as for the overall population Teen pregnancy has several consequences for children families and communities

6. Teen Pregnancy Rates by Race/Ethnicity, 1990-2002 (pregnancies per 1,000 girls aged 15 -19)

7. Teen Birth Rates by Race/Ethnicity 1980-2005*

10. The Latino adolescent population grew 42% between 1990 and 2002, and that number is projected to increased by another 50% by 2025. At that point Latinos will comprise 24% of the US teenage populations.

11. Effective and Promising Programs

12. What Works: Programs Communities have a variety of effective programs from which to choose. Sex and HIV education programs. Service learning programs. Combining youth development with sex education.

13. A Science-Based Program A science-based program is one that has shown to be effective in changing at least one of the following behaviors that contribute to early pregnancy, STI and HIV infection: delaying sexual initiation reducing the frequency of sexual intercourse reducing the number of sexual partners increasing the use of condoms and other contraceptives

14. A Science-Based Approach Includes: Using an experimental or quasi-experimental evaluation design Measuring knowledge, attitude and behavior Having an adequate sample size Collecting data from both groups at three months or later after intervention Using sound research methods and processes Replicating in different locations and finding similar evaluations results Publishing results in a peer-reviewed journal

15. Programs for Latino Teens Programs included in this presentation were either designed specifically for Latino teens included Latino teens as part of the program evaluation, or were found to be particularly effective with Latino teens 6 Science-based programs, 4 promising programs

16. Science-Based Programs:  Draw the Line. Respect the Line. School based program geared to 6th through 8th grade. Focuses on teaching students to set sexual limits and that not having sex is the healthiest choice. Also includes some information on condom use. Delayed sexual initiation among boys but had little effect among girls (possibly due to the fact that the program did not address the issue of young girls dating older boys). At the 36 month follow up, 19% of boys in the program had sex compared to 27% in the control group.

17. �Cu�date! Take Care of Yourself: The Hispanic Youth Health Promotion Program HIV prevention program that brings in aspects of Latino culture (importance of family, gender role expectations, etc) Emphasizes abstinence and condom use as effective methods for stopping the spread of STDs, including HIV. At 12-month follow-up survey, adolescents were less likely to report engaging in sexual intercourse, having multiple partners, or engaging in unprotected sex. Spanish speakers were more than five time more likely to have used a condom at last intercourse and had a greater proportion of protected sex compared to the control group. Science-Based Programs (cont.):

18. Science-Based Programs (cont.): Safer Choices Sex education program for high school students. Teaches that abstinence is the best way to prevent STDs and unplanned pregnancy BUT also emphasizes contraception. The program was evaluated in urban areas in Northern California and Texas with 9th and 10th graders: Latinos in the program were 43% less likely to initiate sex when compared to Latinos in the control group. They were also more likely to use condoms. Reach for Health Community Poder Latino* Reach for Health Community Poder Latino*

19. Children�s Aid Society- Carrera Program Long-term, intensive, and expensive, with many components: (1) education, (2) work-related activities (job club, individual bank accounts, career awareness), (3) self-expression through the arts and sports activities, (4) family life and sexual health education, and (5) comprehensive health care The program had positive results for females: after 3 years in the program, girls had a reduced likelihood of having sex and becoming pregnant, increased likelihood of having used a condom and a hormonal contraceptive method, and greater access to health care compared to a control group. Science-Based Programs (cont.):

20. Science-Based Programs (cont.): Reach for Health-Community Youth Service (RFH-CYS). School-sponsored program that combines service learning and skills-based health instruction, allowing for meaningful opportunities for community engagement. Two core program elements: classroom health curriculum and service learning component (includes approx 90 hours/year of community service) Did not focus on Latino youth BUT they comprised a large proportion of participants in the original evaluation site. A study of participants surveyed in seventh grade and again in tenth grade found that students who participated in the intervention were less likely that their peers in the curriculum-only group to have initiated sex by tenth grade.

21. Poder Latino: A Community AIDS Prevention Program.* School and community based program geared urban Latino youth aged 14 to 20 Includes use of (1) TV and radio public service announcements (PSAs), (2) workshops held in school and health and community centers, (3) community-wide and parent education, and (4) neighborhood canvassing of informational condom kits Program has been shown to delay sexual initiation. At the 18 month follow-up, male participants were 92% less likely to initiate sex than a comparison group of males. (They did not have the same findings with girls). * Quasi-experimental project design Science-Based Programs (cont.):

22. Promising Programs A promising program is one that has not been as rigorously evaluated but has some of the characteristics of programs shown to be effective including: assessing the relevant needs and assets of the young people targeted designing activities consistent with community values and available resources a Pilot-tested program a focus on at least one of three health goals (the prevention of HIV, other STDs and/or unintended pregnancy) attempting to create a safe environment for youth to participate employing activities, instructional methods and behavioral messages that are appropriate to the youths� culture, developmental age, and sexual experience.

23. Promising Programs (cont.) Wise Guys/J�venes Sabios Comprehensive ten to twelve session program that targets young Latino males between the ages of 11 and 17 Encourages abstinence, provides information on contraception, and works to promote responsible decision making. Facilitators communicate openly about issues concerning self, values, future goals, and sexuality.

24. Pathways/Senderos in New Britain, CT The program operates as a non-profit and serves 50 youth a year, who are 10-18 years old, and mostly Latino. Program services are offered five days/week after school and all day during the summer. Three program components: 1) education 2) career and 3) family life/sexual health. Overall philosophy is to create a vision of hope and future for the youth while emphasizing personal responsibility and doing well in school. Includes a small business, opening a savings account (a successful part of the program), parent outreach worker Outcomes: 100% high school graduation rate; 50% of youth go onto higher education. Only 2 pregnancies in 11.5 years. Promising Programs (cont.)

25. Hablando Claro: (Annie E. Casey Foundation�s Plain Talk) Implements a community-level communication strategy and helps parents have meaningful conversations with their children.� �Walker and Talkers� or Promotoras program: they hire community residents, train them to become leaders in their community, and discuss sexuality and have home health parties (like Tupperware parties) to address these issues.� It is highly regarded and has been implemented across the country.

26. Como Planear Mi Vida: Life Planning Course for Latinos Focuses on establishing goals for the future, exploring the steps needed to achieve those goals and how making decisions about sex and relationships can affect those plans. Program also focuses on resume building and communication skills. Promising Programs (cont.)

27. Advice from the field * Establish relationships with teens and parents. Work with, not against, parents Learn about cultural differences to improve your program so they�ll work as a motivator, not a barrier. Faith leaders can play an important role. They can be a bridge between marginalized families and community service organizations. Don�t leave out fathers and sons. Find creative ways to ensure their participation.

28. Advice from the field Involve teens in all aspects of program planning especially if you don�t have Latino staff members. Hire and train staff who understand Latino culture and the challenges facing Latino youth. Know that acculturation affects behavior and be sensitive to this. Recognize that programs alone can�t solve the problem -- you must involve the entire community. Encourage young people to set goals and promote educational achievement. Pregnancy prevention is only one piece of the puzzle.

29. Latino teens need more information� 74% of sexually experienced Latina girls and 62% of Latino boys wish they had waited longer to have sex. 94% of Latino teens think it is important to be given a strong message that they should not have sex until they are at least out of high school. 70% of Latino teens want more information about both abstinence and contraception.

30. Parents Need Help Parents and teens agree: When it comes to talking about sex, parents often don�t know what to say, how to say it, or when to start.

31. What You Can Do Use science-based programs and evaluate for behavior change. Teen pregnancy is not just a �girl� thing � work with teen boys and young men. Involve other sectors: businesses, educators, faith communities, child welfare community. Support and encourage parents to do more to help. Recognize the powerful role of media.

32. Resources

33. Thank You! For more information: Visit our websites: www.teenpregnancy.org/espanol www.TheNationalCampaign.org www.stayteen.org