From Promising to Evidence-Based: PPSNE's Experience Developing Teen Talk

1. From Promising to Evidence-Based: PPSNE's Experience Developing Teen Talk Erin Livensparger Regional Manager, Education and Training

2. What is Teen Talk? • 4 educational sessions covering: • Reproductive Anatomy • Contraception and • Abstinence • STI’s and Safer Sex • Healthy and Unhealthy Relationships • Includes a Tour of the Health Center • Takes Place at PP health centers • Bridgeport, New Haven, Hartford, Meriden, Stamford, New London, and Providence, RI • Provides vouchers for free reproductive health services

3. Unique Features of the Curriculum • Teen Talk has proven to be accessible to young people even in a non-traditional learning setting. • It takes place outside the classroom in an actual health center setting (or as close to a health center as possible). • The third day of activities includes a tour of an actual reproductive health center. • Teen Talk also relies on peer to peer recruitment.

4. The Adolescent Brain: A work in progress

5. Teen Talk’s Health Goals: • To decrease rates of teen pregnancy and STI/HIV among area teens aged 14-17 • By increasing the use of condoms • By increasing the use of contraception • By reducing the number of sexual partners • By reducing frequency of sex • To increase young people’s comfort with accessing reproductive health care

6. How did we do it? • Collaborated with JSI • (JSI Research & Training Institute/NETCAPP) • Held a GTO (Getting to Outcomes) Training • Used a BDI Logic model • Created Pre, Post, and Follow-up Tests • Created Fidelity Check Lists • Used a Data Planning Matrix • Tracked how many participants accessed care after participating in the 4 sessions • Involved PP Peer Educators (STARS) • Involved Local Agencies

7. Teen Talk Logic Model Activities Determinants (Risk and Protective Factors) Behaviors Health Goal • Strategies/Methods used in sessions: • Mini-lecture • Brainstorming • Small and Large group discussion • Group exercises • Problem solving matching activities • Values discussions • Quick quiz/review in the form of a ball toss • Simulation using anatomy models • Skills teaching using condoms • Short case scenarios • Role-plays • Health center field trip • Song analysis • Session 1 Activity Topics: • Language of Sexuality • Reproductive Anatomy and Physiology • Menstruation • Pregnancy • Sexual response (as a biological response and feeling) • Session 2 Activity Topics: • Attitudes/Feelings about birth control & pregnancy • Pregnancy options • Birth control methods • Condom demonstration and practice • Session 3 Activity Topics: • Condom demonstration and practice • Sexual behaviors and risks • STI information/symptoms/testing • Health center tour • Session 4 Activity Topics: • Healthy vs. Unhealthy relationships • Media influences on sex and relationships • Using information/skills learned in Teen Talk to stay healthy • Increase knowledge about: • Reproductive anatomy, puberty, pregnancy, contraception, and STD/HIV • How to access reproductive health services • Increase personal belief that: • Contraception and STD/HIV prevention is important • Condoms do not necessarily reduce sexual pleasure • Increase positive attitudes about: • Condoms/contraception • Healthy relationships • Accessing reproductive health services • Increase motivation and intent to: • Avoid pregnancy, HIV and other STDs • Avoid unhealthy relationships • Increase the use of condoms • Increase the use of contraception • Reduce number of sexual partners • Reduce frequency of sex To decrease rates of teen pregnancy and STD/HIV among area teens aged 14-17.

8. SIECUS: http://siecus.org/

9. Session 1 Learning Objectives: • After completing this lesson, participants will be able to: • Identify several group agreements for how the group will interact. • List at least three female and three male reproductive body parts. • Describe how pregnancy occurs. • Explain the menstrual cycle and identify when a woman is most fertile. • List at least two physical changes when a person becomes sexually aroused.

10. Session 2 Learning Objectives: • After completing this lesson, participants will be able to: • Identify two locations where a person can obtain methods to prevent pregnancy. • Formulate a list of four or more ways a person can prevent pregnancy. • Identify the options a woman has when she becomes pregnant. • Demonstrate steps for correct condom use.

11. Session 3 Learning Objectives: • After completing this lesson, participants will be able to: • Identify three symptoms of an STD/STI. • List two or more ways a person can prevent a STD/STI. • Identify behaviors that put a person at risk for a STD/STI, including HIV. • List three or more places where a person can go to for help if they think they have an infection. • Demonstrate steps for correct condom use.

12. Session 4 Learning Objectives: • After completing this lesson, participants will be able to: • Identify 2 characteristics of a healthy relationship. • Name 1 way to bring up using condoms with a partner. • Demonstrate 1 way to bring up using condoms with a partner.

13. How many teens made appointments? • 2007 – in New Haven • 59 out of 70 teens received vouchers • 31 of them have made appointments • 24 kept those appointments • 2008 – in NH, NL, and BP • 84 out of 115 teens received vouchers • 27 of them have made appointments • 22 kept those appointments

14. Pre, Post, and Follow-up • We assessed: • Who is responsible for birth control? • How confident are you at using a condom? • How confident are you that you can say no to sex? • How do you define a healthy relationship? • What do you know about birth control methods? • What do you know about reproductive health services? • What do you know about STI’s?

15. 2011 Data We saw an increase in Knowledge: • The % of youth who correctly identify male and female body parts by clinical names increased by roughly 13% • The knowledge about how STIs affect the body increased. Youth were able to better answer questions about symptoms of STIs 10% of the time • We also saw a 3% increase in them knowing that STDs can be asymptomatic • Their knowledge regarding the range of contraceptive methods increased across the board from 3%for using condoms to 34% for using a diaphragm

16. 2011 Data We saw a positive change in their Attitudes and Behaviors: • We saw an11% increase in feeling like they could negotiate condom use if they needed to • There was a 33% increase in their feeling comfortable talking with a partner about condoms in general • They also expressed more confidence in feeling like they could delay sex if they don’t want to have it – after Teen Talk 16% more participants said they could delay sex if they wanted to

17. Teen Feedback: • “I thought I knew what I needed until I came here and I think they (my friends) would learn a lot from it like I did.” – Teen • “It teaches things most health classes in school don’t.” –Teen • Because of this program, I… “get birth control and use it like when your getting ready to have intercourse, use a condom.” – Teen

18. Diverse Reach • In the 5 sessions of Teen Talk in New Haven during calendar year 2011, with 128 students participating. • Of these students • 82% were female • 18% were male • 62% identified as Black • 16% as Latino • 13% as multiracial • Seventy-seven percent received free or reduced price lunches at school.

19. Support • PP Medical Providers noted that teens in Teen Talk were more informed • The second time we ran Teen Talk a Parent filled her mini-van with teens and brought them for next three rounds • A Grandmother drove her granddaughter and friend each night • Many Residential Programs bused youth to Planned Parenthood – this triggered us to apply for State PREP money

20. State PREP Funding Agency: US Department of Health and Human Services: Administration for Children and Families awarded funding to the State of Connecticut Department of Public Health Geographical Area: State of the Connecticut Focus Population: 13-19 year olds in Department of Child and Families care Activities: To develop and implement an educational intervention covering abstinence and contraception to reduce pregnancy, sexually transmitted infections including HIV/AIDS…AKA Teen Talk

21. Lessons Learned & Future Directions • Working with JSI/NETCAPP to make Teen Talk into a Promising Program • Use the power of friends • Buses run late, school breaks are hard, rain not shine • Keep in mind regional differences when expanding • Educator style and fidelity is important • Don’t underestimate the Data Planning Matrix • Spanish • Working on a training for new Teen Talk educators

22. They are not giving you a hard time…they’re having a hard time.

23. Teen Talk para Latinos http://www.youtube.com/watch?v=-YAikz0LGTw

24. Giving Thanks • Myriam, Stephanie, and Amy at JSI • Renée Best, JaquiOropeza, Erika Boulware, Tasha Blanco-Douglas, Mariel Orengo, and Ivelisse Silva • Susan Hellen and Emily Gold • Pierrette Silverman and Kimball Cartwright • Jeremy Stone, Ruth Fontilla, and Lisa Marella • CDC • Healthy Teen Network • STARS (Students Teaching About Responsible Sexuality)

25. It is more important to be kind, than right

26. How to reach me Erin Livensparger Planned Parenthood of SNE 345 Whitney Avenue New Haven, CT. 06511 Erin.Livensparger@ppsne.org 203-752-2852