Evidence-Based Practice
Three evidence based teen pregnancy prevention programs for the Hispanic population in the United States are discussed below. A description of the program components is given along with its specific target audience. Lastly the theoretical foundations of the program are discussed along with its results at preventing teen pregnancy in the Hispanic population.
“Cuidate!”
Program Description and Components:
“Cuidate!” is a teen sexual risk reduction program designed by Dr. Antonia M. Villarruel from the University of Michigan School of Nursing. The program is designed to reduce the risk of teen pregnancy, HIV, and STIs among Hispanic teens. “Cuidate!” features an interactive format, which includes group discussions about sexual health, videos about teen pregnancy, and role-playing possible real life scenarios. The program is administered through six one-hour sessions in consecutive days over the course of a year in either Spanish or English.
Target Audience:
“Cuidate!” was specifically designed for Spanish speaking Hispanic adolescents ages 13-19. The program is designed for teens that attend urban high schools across the United States. “Cuidate!” was first implemented across high schools in northern Philadelphia.
Theoretical foundations:
“Cuidate!” uses components of Social Learning Theory and Theory of Planned Behavior to change attitudes, beliefs, and self-efficacy in order to increase abstinence and condom use among Hispanic teens. In addition it targets Hispanic cultural components such as role of family, and gender expectations to reduce cultural barriers to safe sex. Lastly it seeks to emphasize cultural values that reinforce safe sex practices.
Results:
A randomized control/ treatment evaluation of 553 Hispanic teens was conducted to show results of the program. The treatment group consisted of 263 teens that participated in “Cuidate!,” while the control group consisted of 287 teens that did not participate. These teens were evaluated using surveys at 3 months, 6 months, and 12 months after the program was administered. The program reduced the frequency of sexual intercourse among its participants. In the treatment group, 26%, 28%, and 36% of teens reported they had sexual intercourse after 3, 6, and 12-month evaluations respectively. In the control group, 31%, 33%, and 41% reported they had sexual intercourse after 3, 6, and 12-month evaluations respectively. The program also led to an increase in condom use among its participants. In the treatment group 43%, 45%, and 42% of Hispanic teens reported that they used a condom during the last time they had sex in 3, 6, and 12-month evaluations respectively. In the control group 26%, 29%, and 28% reported using a condom during the last time they had sex in the 3, 6, and 12-month evaluations respectively. Lastly, the program showed a reduction in the number of sexual partners within Hispanic teens. After the 6-month evaluation, 9% of the treatment group teens and 10% of control group teens reported having multiple partners. At the 12-month evaluation, 8% of treatment group teens and 17% of control group teens reported having multiple partners.
Sources:
Villarruel, A., Jemmott, L., & Jemmot, J. (2005). Designing a Culturally Based Intervention to
Reduce HIV Sexual Risk for Latino Adolescents. Journal of the Association of Nurses in Aids Care , 16, 23-31.
Advocates for Youth. Science Based Programs that work to Prevent Teen Pregnancy, HIV/
Sexually Trasmitted Infection Among Hispanics/ Latinos. Washington D.C. : Science and Success.
“Safer Choices”
Program Description and Components:
“Safer Choices” is a school wide sex education and teen pregnancy prevention program designed by ETR Associates, a non-profit organization in California. The program was administered in high schools in the southwest United States, predominantly Texas and California. It is given in 20 sessions, each consisting of a single class period administered during 2 years. Each of the sessions uses activities that build communication skills and improve attitudes and expectations about abstinence and condom use. In addition, sessions help teens learn how to say no to unprotected sex or any other unwanted sexual experience. This program also involves the parents of teens by giving parent/student homework assignments. Lastly, the program provides information about community resources regarding sexual health to both teens and parents.
Target Audience:
The “Safer Choices” program is designed for students in the 9th and 10th grades who attend school in urban and suburban communities. The program is also targeted towards many racial groups such as Hispanic, Black, and Asian teens. Lastly, the program targets teens that are both sexually experienced or not experienced.
Theoretical Foundations:
The “Safer Choices” program uses components of Social Cognitive Theory, Theory of Social Influences, and Models of Social Change, to add positive views and expectations regarding abstinence, condom use, and potential obstacles to contraception use.
Results:
The “Safer Choices” program was evaluated by administering surveys across 20 high schools in California and Texas. In each state respectively, 5 high schools used the “Safer Choices” program while 5 used a normal state sex education curriculum. The surveys were administered after a 31-month period of receiving either program. The treatment group consisted of the teens that received the “Safer Choices” program, while the control group consisted of teens that received the state sex education curriculum. There were 3,869 9th and 10th grade students who completed the survey. Out of these students, 50% were male. The races of the students included 29% White, 29% Hispanic, 20% Black, and 14% Asian. After the 31-month follow up, those who participated in the “Safer Choices” program reported an increase of knowledge regarding sex compared to those who participated in the state curriculum. In addition, those who participated in “Safer Choices” reported an increase in positive attitudes and greater self-efficacy towards condoms. The participants also reported having few barriers to condom use and a higher perceived risk of unprotected sex. These participants were also 1.76 times more likely to use an effective form of contraception and delay the initiation of sex compared to the control group.
Sources:
Advocates for Youth. Science Based Programs that work to Prevent Teen Pregnancy, HIV/
Sexually Trasmitted Infection Among Hispanics/ Latinos. Washington D.C. : Science and Success.
“Children’s Aid Society Carrera Program”
Program Description and Components:
The Children’s Aid Society Carrera Program is a community based holistic youth teen pregnancy prevention program that was created by Dr. Michael A. Carrera. The “Carrera Program” consists of everyday after school activities 5 days a week that last 3-5 hours. These activities consist of comprehensive abstinence and contraceptive sex education, career exploration, and academic tutoring. Participants also attend art workshops and sports activities. These students were broken up into groups and rotated through the various activities throughout the week. The program also provides free access to mental, dental, and reproductive healthcare along with family involvement. The program consists of 6 major components which include staff treating participants like family, reinforcing positive skills of each participant, providing individual case management, continued long term contact with participants, parent and family involvement, while administering everything from a single facility. Participants also learn how to be responsible adults by obtaining personal financial management skills, positive career awareness, and employment experience. The academic tutoring component consists of SAT preparation, and assistance with college applications.
Target Audience:
The “Carrera Program” targets socio economically disadvantaged youth in New York City. These youth primarily consist of Hispanic women ages 13-15.
Theoretical Foundations:
The “Carrera Program” does not use a direct theoretical model to prevent teen pregnancy, but instead utilizes a holistic approach by empowering teens with real life physical, social, and financial skills to become functioning members of society. Along with sex education and access to comprehensive healthcare, these teens are shown that they can obtain a higher education while maintaining a healthy lifestyle.
Results:
The “Carrera Program” was evaluated by using surveys administered to students who participated in the “Carrera Program” and those who did not participate after a 3-year follow-up. The surveys were given to 600 students of which 484 responded. Of those who responded, 50% were male. The respondents were 54% black and 46% Hispanic. There was a 22% increase in knowledge regarding sex among the participants of the “Carrera Program” compared to an 11% increase in the control group. In addition, 75% of the participants reported that they had an increased resistance to sex compared to 36% of the control group. Lastly, 36% of the participants reported an increased use of contraception during their last sexual experience compared to 26% in the control group.
Sources:
Advocates for Youth. Science Based Programs that work to Prevent Teen Pregnancy, HIV/
Sexually Trasmitted Infection Among Hispanics/ Latinos. Washington D.C. : Science and Success.
The Children's Aid Society. (n.d.). Carrera Adolescent Pregnancy Prevention Program .
Retrieved October 23, 2012, from childrensaidsociety.org: http://www.childrensaidsociety.org/carrera-pregnancy-prevention
Though each of the programs mentioned about shows evidence in preventing teen pregnancy, an ideal teen pregnancy prevention program for the Hispanic population in the United States would use components of the “Carrera Program” and the “Cuidate!” program. Although the “Safer Choices” program targets multi ethnic youth, it is not designed specifically for the Hispanic population, nor does it address Hispanic cultural components like the “Cuidate!” program does. Furthermore, “Safer Choices” only teaches sex education and communication skills and does not look at other factors that may lead to teen pregnancy. On the other hand, the “Carrera Program” looks to address multiple factors that may lead to teen pregnancy besides lack of sex education. These factors include lack of financial resources and inadequate access to healthcare. With a combination of the “Cuidate!” and “Carrera” programs, Hispanic teens would be able to obtain sex education designed specifically for their culture, access to healthcare, access to employment, and financial management skills. These two programs focus on addressing the major cultural and social determinants of teen pregnancy in the U.S. Hispanic population.
Works Cited Advocates for Youth. Science Based Programs that work to Prevent Teen Pregnancy, HIV/
Sexually Trasmitted Infection Among Hispanics/ Latinos. Washington D.C. : Science and Success.
The Children's Aid Society. (n.d.). Carrera Adolescent Pregnancy Prevention Program .
Retrieved October 23, 2012, from childrensaidsociety.org: http://www.childrensaidsociety.org/carrera-pregnancy-prevention
Villarruel, A., Jemmott, L., & Jemmot, J. (2005). Designing a Culturally Based Intervention to
Reduce HIV Sexual Risk for Latino Adolescents. Journal of the Association of Nurses in Aids Care , 16, 23-31.