Program Plan
“Mi Vida es Mio” Teen Pregnancy Prevention Program
Shadman Ahmed
Teen pregnancy is a major problem in the United States that has economic, educational, and health implications all across society. The prevalence of teen pregnancy, or adolescent pregnancy can be stated using teen birth rate. This is defined as “the number of live births to women ages 13-19 per 1000 women.” (Hamilton & Ventrua, 2012, p. 5). Though teen pregnancy rates have declined throughout the 1900’s, the United States has the highest teen pregnancy rates among industrialized countries (Hamilton & Ventrua, 2012). Hoffman states for example “the United States has two to seven times greater teen pregnancy rates among industrialized nations” (Hoffman, 2006, p. 1). The highest recorded teen birthrate 96.3 per 1000 women was in 1957. Although teen birthrates have decreased since then, there has been a recent increase in birthrates in 1991 (Azar, 2012; Russle & Lee, 2004). The teen birthrate for all races in 1991 was 61.8 per 1000 women (Hamilton & Ventrua, 2012). If this rate were to stay constant, then there would be approximately 3.4 million births to teenage mothers throughout 2010 (Hamilton & Ventrua, 2012). The rate of teenage births varies across the nation depending on the race and ethnicity of the teen mother (Waddell, Orr, Sackoff, & Santelli, 2010). According to a study conducted by Dehlendorf published in the Journal of Maternal and Child Health, Hispanics have the highest prevalence of teen births among all races and ethnicities in the U.S. (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). The Center for Disease Control and Prevention defines Hispanic or Latino as “ a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race (CDC, 2012 para. 1). The U.S. Census Bureau states that the Hispanic population is the largest and fastest growing minority population in the country (CDC, 2012). It is estimated that there are 52 million Hispanics as of 2011, which make up 16.7% of the U.S. population. The CDC estimates that by 2050, the Hispanic population will reach 132.8 million and make up 30% of the U.S. population (CDC, 2012). The population of Hispanic teens is projected to increase 50% by the 2025, and make up 25% of the entire U.S. teen population (Ryan, Franzetta, & Manlove, 2005). One fourth of the Hispanic teens in the U.S. will give birth before age 20 (Ryan, Franzetta, & Manlove, 2005). In 2009 the teenage birthrate for Hispanics was 81 per 1000 women, while the teen birthrate was 26 per 1000 women for whites (Ryan, Franzetta, & Manlove, 2005). Although overall teen pregnancy rates have been dropping for all ethnicities, the Hispanic teen pregnancy rates have been decreasing at a much slower rate (Ryan, Franzetta, & Manlove, 2005). From 1991 to 2005, Dehlendorf states that teen birthrates in whites and African Americans decreased by 50% and 48% respectively, but only 22% among Hispanics (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Abortion among Hispanic teen is less common then among teens from other races, which leads to a higher rate of Hispanic teen pregnancy (Ryan, Franzetta, & Manlove, 2005). Ryan states that in the year 2000, “22% of Hispanic teen pregnancies ended in abortion compared with 30% of pregnancies among all other teens (Ryan, Franzetta, & Manlove, 2005, p. 3).”
Program Description:
Mi Vida es Mio, (My life is mine) is a school based teen sex education pregnancy prevention program. It is targeted towards Hispanic teens in the Richmond, California. It is designed to teach Hispanic teens how to reduce the risk of teen pregnancy by influencing attitudes, beliefs, and self-efficacy towards abstinence or correct condom use. Additionally the program highlights aspects of Hispanic culture that support safe sex and redefine values that are seen as barriers. During each session of the program, students will be divided into groups of approximately 10. The program will then use culturally relevant role-playing, music, videos, and games in order to allow teens to practice skills that they are learning. The program will be conducted in English, but have Spanish-speaking instructors for those students who do not speak English fluently.
Who will benefit from “Mi Vida es Mio”?
This program is targeted towards Hispanic teens in the Richmond California from ages 13-18 attending high school. Besides influencing perceptions, beliefs, and attitudes regarding teen pregnancy, the program specifically aims to reduce overall sexual activities, reduce the number of sex partners, reduce unprotected sex, and increase condom use. Unlike most sex education courses, “Mi Vida es Mio” uses cultural components of the Hispanic culture such as machismo, marianismo, familismo, and respecto. “Machismo” is the idea that men show power by strength and control in decision making and the well being of their partners (Villarruel, Jemmott, & Jemmott, 2006). The program will reinforce this idea to male Hispanic teens that their positive decisions will affect themselves and their partners. The idea of marianismo is that women are to be abstinent until marriage (Villarruel, Jemmott, & Jemmott, 2006). Afterwards women are to stay faithful to their partners while catering to the needs of their partners (Villarruel, Jemmott, & Jemmott, 2006). The program will reinforce this idea and show that remaining abstinent is culturally acceptable even if other teens show that engaging in sexual activity is a part of popular culture. The idea of respecto means showing respect for one’s self and their partners (Villarruel, Jemmott, & Jemmott, 2006). The program reinforces this idea that both partners should respect the other partner’s view on either wanting to remain abstinent to using safe sex methods. The idea of familismo means taking care of one’s family (Villarruel, Jemmott, & Jemmott, 2006). The program will show that by not becoming pregnant teens can pursue higher education, in order to help support their families financially.
Where will “Mi Vida es Mio” be implemented?
Mi Vida es Mio will be implemented in Richmond High School in Richmond, CA. According to its 2010-2011 School Accountability Report Card (SARC) (SARC, 2011), there are a total of 1,684 total students enrolled in grades 9-12. Out of those students, 81.1% of them are Hispanic (SARC, 2011).
When will “Mi Vida es Mio” be implemented?”
Mi Vida es Mio will be implemented during the freshman and junior year of the high school students. The program will last 2 weeks, and each session will consist of a 1-hour class period. The reason for implementing the program during the freshman year of high school is that students are adjusting to a new academic and social environment by entering high school. As freshman students interact with older classmates such as seniors, they may be peer pressured into sexual activity. Seniors might use the logic that engaging in sexual activity will allow freshman to fit into the culture. The program looks to equip teens with skills towards sexual activity prior to these hypothetical situations. Additionally, baseline measurements can be taken prior to implementation of the program during the freshman year, in order to establish a starting point for improvement. The baseline measurement will also determine the skills and mindset of freshman students regarding sexual activity and relationships. The reason for implementing the program during the junior year as well as freshman year is because students are starting to get acclimated to high school culture. This will also allow an opportunity to gauge the long-term progress of the program from freshman year to junior year.
How will “Mi Vida es Mio” be implemented?
According to the SARC report, Richmond High School has only one “Teen Health” course that is offered to students. This course is offered only during their freshman year. By appealing to the board of education, “Mi Vida es Mio” will be added as a component to that health class, in addition to it being offered during the students’ junior year. School staff that already administers the school’s current health program will serve as facilitators of the program. The facilitators of the program will function to deliver all components of the program including evaluations. Facilitators need to have a basic knowledge of the Hispanic culture along with the risks of pregnancy. The facilitators will perform demonstrations on how to use correct contraception correctly by utilizing anatomical models. Lastly, facilitators will show the videos regarding sexual activity and teen pregnancy.
Overall Program Goal
The overall goal of the “Mi Vida es Mio” is to reduce teen pregnancy rates among Hispanic teens in Richmond High School. Since measuring pregnancy rates it is long term or may not be possible, this program only measures attitudes, beliefs, and self-efficacy of Hispanic teens’ ability to perceive the risks of teen pregnancy and how to prevent them. The program will involve community partners such as local mental health providers, school counselors, and local businesses. Local mental healthcare providers and businesses can donate financially or send clinicians to act as guest speakers. The school counselors can help program facilitators administer evaluation surveys and keep track of pregnancy rates. For example, if the school does not have a definite way to measure teen pregnancy rates, the school counselors can begin to develop a database of students who become pregnant. The success of the program will be measured using a survey based on questions from the CDC youth risk behavior survey (CDC, 2012). These include questions such as: “Have you ever had sexual intercourse”, “How old were you when you had sexual intercourse or the first time” “How many sex partners have you had within the last year”, “During your last sexual encounter did you use protection (CDC, 2012).” The preliminary survey administered prior the program implementation will be compared to national and state standards to determine a baseline measurement. The survey results obtained after the junior year will again be compared to national and state standards to see if there was an improvement.
Short-term objectives (prior to program evaluation and after freshman year)
· Establish a base line measurement and evaluate current perceptions of Hispanic teens. Surveys will be handed out during freshman orientation to incoming freshman.
· Recruit and train facilitators
· Get program approved by the school board of directors
· Obtain donations from local stakeholders such as mental healthcare providers in order to alleviate administrative costs
Long-term objectives (after junior year of implementation)
· After the junior year of implementation, the surveys will be conducted to determine if there was an improvement in risk perception and sexual activity from prior to freshman in addition to after freshman year.
· A 25% improvement in responses is desirable. Improvement would be defined as a decrease in sexual activity, or a change towards positive perceptions regarding the skills to use contraception in addition to saying no to undesirable sexual activity.
· Results of the surveys will be distributed to school administrators, board of education directors, and local stakeholders in order to demonstrate the program’s success. This will provide a reason to implement the program as a permanent part of the health curriculum in addition to getting more funding.
Logic Model and Description
A. Resources
The resources can be classified as the tangible resources to implement the program, and the labor of the program facilitator and stakeholders.
Examples of tangible resources include: name tags, posters, pens, DVD player, CD player, demonstration models, condoms, and lubricant. The funds acquired from stakeholders can also be applied towards the tangible resources and future implementation of the program. Additional resources include writing proposals to local stakeholders in order to provide reasons for them to contribute. Besides financially, stakeholders can provide tangible materials such as posters, printers, and additional resources regarding teen pregnancy. Stakeholders such as mental healthcare clinics can discuss the program with patients who have questions about teen sexuality.
B. Activities
The initial priority prior to implementing the program is to get a baseline measurement of the students’ perception towards teen pregnancy and sexual activity. These results will then be used to demonstrate the problem to the educational board of directors in order to get the program approved. Since the current sex education program does not reinforce aspects of Hispanic culture, “Mi Vida es Mio” may be more appealing. The results has to show that teens lack proper knowledge about pregnancy along with the skills to prevent pregnancy.
C. Outputs
The major outputs of the program are to have a solid culturally based teen pregnancy prevention program that can be continually used at Richmond High School. In addition, partnerships with stakeholders can help implementation along with provide resources for future school based programs at Richmond High School.
D. Outcomes
The main outcome of the program is to see a 25% improvement in the perception and skills of teens towards sexual activity and teen pregnancy. Additionally teens should have the skills to say no to unwanted sexual activity, along with the skills to use contraception effectively.
E. Impacts
The main intended impact of the program is to reduce teen pregnancy among students at Richmond High School
Evidence-Based Intervention
This program is based off of the “Cuidate!” program developed by Dr. Antonia Villarruel from the University of Michigan School of Medicine. As opposed to this program, the “Cuidate!” program is community based instead of school based (Villarruel, Jemmott, & Jemmott, 2006). Dr. Villarruel conducted the “Cuidate!” program in Philadelphia, Pennsylvania among 553 Hispanic youth (Villarruel, Jemmott, & Jemmott, 2006). In addition, the “Cuidate!” program was conducted in Mexico among 829 Hispanic youth (Villarruel, Jemmott, & Jemmott, 2006). After the program was administered, evaluation surveys indicated a decrease in sexual activity and an increase towards positive perception of contraception use among teens (Villarruel, Jemmott, & Jemmott, 2006). Teens reported fewer sex partners and an increase in consistent condom use (Villarruel, Jemmott, & Jemmott, 2006). Additionally the teens who were sexually inexperienced at the start of the program, stated that the remained abstinent (Villarruel, Jemmott, & Jemmott, 2006). The program proposed her uses the constructs of the “Cuidate!” program, but looks to implement it in a school environment. By implementing the program in a school environment, the evaluation of the program can be more accurate. The cohort of students being evaluated can be followed from freshman year of implementation, through junior year, as opposed to a community that would have a much larger cohort.
Theory
One of the main theories this program encompasses is Bandura’s Social Learning Theory (Coreil, 2010). Bandura’s theory states that individual learning is influenced by personal factors, behavior, and environmental influences (Coreil, 2010). For example, the environment that the teen is in may not allow them access to contraception. Additionally, the family environment might not perceive using contraception as culturally acceptable (Villarruel, Jemmott, & Jemmott, 2006). Bandura also states that learning is influenced by outcome expectancies and self-efficacy (Coreil, 2010). An example of the outcome expectancy this program attempts to manipulate is that if teens say no to sex, their partners might leave them (Villarruel, Jemmott, & Jemmott, 2006). Self-efficacy is a person’s confidence in their ability to perform a certain behavior (Coreil, 2010). This program aims to build teens’ skills and confidence in using contraception and saying no to unwanted sex. Another theory encompassed by this program is the theory of planned behavior. According to this theory, a person’s intentions will lead to their action through attitudes and norms (Coreil, 2010). For example if a teen feels that abstinence is a social norm and they have a positive outlook on it, they are more likely to abstain from sex (Villarruel, Jemmott, & Jemmott, 2006). These theories are used as constructs of this program because both of these theories look at the social environment as the primary force for teen behavior. Teens are continually trying to seek approval of others in order to fit into the social environment (Villarruel, Jemmott, & Jemmott, 2006). By using the Social Learning Theory and Theory of Planned behavior, the program focuses to provide skills to teens in order for them to be successful in their respective social environments.
Conclusion
This program shows the susptibilty of the Hispanic population to the problem of teen pregnancy. The program looks to change the outlook of sex and teen pregnancy of Hispanic teens in a predominantly Hispanic high school in Richmond California. By the utilization of cultural values of the Hispanic culture, this program attempts to decrease the rate of teen pregnancy in the Hispanic population. The program also looks to involve community partners such as local mental healthcare providers along with school administrators, in order to establish a new culturally based teen pregnancy prevention program at Richmond High School. The success of the program is measured using a survey based on the CDC’s Youth Risk Behavior Survey in order to establish a baseline measurement for improvement. Though the exact rates of teen pregnancy are difficult to measure, the survey looks to measure teens’ perceptions on pregnancy and sexual activity. The program assumes that as the attitudes of teens towards sexual activity and pregnancy change, the rates of pregnancy will decrease. Lastly the program seeks to establish a database within Richmond High School so the exact numbers of teens becoming pregnant can be measured.
Works Cited CDC. (2012). Hispanic or Latino Populations. Retrieved October 9, 2012, from Center
for Disease Control: http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html
CDC. (2012, August). Youth Risk Behavior Surveillance System. (C. f. Prevention,
Producer) Retrieved from www.cdc.gov/Healthy Youth/yrbs/index.htm
Coreil, J. (2010). Social and Behavioral Foundations in Public Health (Vol. Edition 3).
California, USA: Sage Publications, Inc.
Dehlendorf, C., Marchi, K., Vittinghoff, E., & Braveman, P. (2009). Sociocultural
determinants of Teenage Childbearing Among Latinas in California. Journal of Maternal and Child Health (14), 194-201.
Hamilton, B., & Ventrua, S. (2012, April). Birth Rates for U.S. Teenagers Reach
Historic Lows for All Age and Ethnic Groups. National Center for Health Statistics (89).
Hoffman, S. (2006). By the numers: The Public Costs of Teen Chidbearing. The
National Campaign to Prevent Teen Pregnancy , pp. 1-50.
SARC. (2011). School Accountability Report Card: Richmond High School.
Ryan, S., Franzetta, K., & Manlove, J. (2005, February). Hispanic Teen Pregnancy and Birth Rates: Looking Behind the Numbers. Child Trends , 1-8.
Villarruel, A., Jemmott, J., & Jemmott, L. (2006). A randomized controlled trial testing
HIV prevention intervention for Latino Youth. Archives of Pediatrics and Adolescent Medicine , 8 (160), 772-777.
Waddell, E., Orr, M., Sackoff, J., & Santelli, J. (2010). Pregnancy Risk among, Black,
White, and Hispanic Teen Girls in New York City Public Schools. Journal of Urban Health , 87 (3), 426-439.
Shadman Ahmed
Teen pregnancy is a major problem in the United States that has economic, educational, and health implications all across society. The prevalence of teen pregnancy, or adolescent pregnancy can be stated using teen birth rate. This is defined as “the number of live births to women ages 13-19 per 1000 women.” (Hamilton & Ventrua, 2012, p. 5). Though teen pregnancy rates have declined throughout the 1900’s, the United States has the highest teen pregnancy rates among industrialized countries (Hamilton & Ventrua, 2012). Hoffman states for example “the United States has two to seven times greater teen pregnancy rates among industrialized nations” (Hoffman, 2006, p. 1). The highest recorded teen birthrate 96.3 per 1000 women was in 1957. Although teen birthrates have decreased since then, there has been a recent increase in birthrates in 1991 (Azar, 2012; Russle & Lee, 2004). The teen birthrate for all races in 1991 was 61.8 per 1000 women (Hamilton & Ventrua, 2012). If this rate were to stay constant, then there would be approximately 3.4 million births to teenage mothers throughout 2010 (Hamilton & Ventrua, 2012). The rate of teenage births varies across the nation depending on the race and ethnicity of the teen mother (Waddell, Orr, Sackoff, & Santelli, 2010). According to a study conducted by Dehlendorf published in the Journal of Maternal and Child Health, Hispanics have the highest prevalence of teen births among all races and ethnicities in the U.S. (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). The Center for Disease Control and Prevention defines Hispanic or Latino as “ a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race (CDC, 2012 para. 1). The U.S. Census Bureau states that the Hispanic population is the largest and fastest growing minority population in the country (CDC, 2012). It is estimated that there are 52 million Hispanics as of 2011, which make up 16.7% of the U.S. population. The CDC estimates that by 2050, the Hispanic population will reach 132.8 million and make up 30% of the U.S. population (CDC, 2012). The population of Hispanic teens is projected to increase 50% by the 2025, and make up 25% of the entire U.S. teen population (Ryan, Franzetta, & Manlove, 2005). One fourth of the Hispanic teens in the U.S. will give birth before age 20 (Ryan, Franzetta, & Manlove, 2005). In 2009 the teenage birthrate for Hispanics was 81 per 1000 women, while the teen birthrate was 26 per 1000 women for whites (Ryan, Franzetta, & Manlove, 2005). Although overall teen pregnancy rates have been dropping for all ethnicities, the Hispanic teen pregnancy rates have been decreasing at a much slower rate (Ryan, Franzetta, & Manlove, 2005). From 1991 to 2005, Dehlendorf states that teen birthrates in whites and African Americans decreased by 50% and 48% respectively, but only 22% among Hispanics (Dehlendorf, Marchi, Vittinghoff, & Braveman, 2009). Abortion among Hispanic teen is less common then among teens from other races, which leads to a higher rate of Hispanic teen pregnancy (Ryan, Franzetta, & Manlove, 2005). Ryan states that in the year 2000, “22% of Hispanic teen pregnancies ended in abortion compared with 30% of pregnancies among all other teens (Ryan, Franzetta, & Manlove, 2005, p. 3).”
Program Description:
Mi Vida es Mio, (My life is mine) is a school based teen sex education pregnancy prevention program. It is targeted towards Hispanic teens in the Richmond, California. It is designed to teach Hispanic teens how to reduce the risk of teen pregnancy by influencing attitudes, beliefs, and self-efficacy towards abstinence or correct condom use. Additionally the program highlights aspects of Hispanic culture that support safe sex and redefine values that are seen as barriers. During each session of the program, students will be divided into groups of approximately 10. The program will then use culturally relevant role-playing, music, videos, and games in order to allow teens to practice skills that they are learning. The program will be conducted in English, but have Spanish-speaking instructors for those students who do not speak English fluently.
Who will benefit from “Mi Vida es Mio”?
This program is targeted towards Hispanic teens in the Richmond California from ages 13-18 attending high school. Besides influencing perceptions, beliefs, and attitudes regarding teen pregnancy, the program specifically aims to reduce overall sexual activities, reduce the number of sex partners, reduce unprotected sex, and increase condom use. Unlike most sex education courses, “Mi Vida es Mio” uses cultural components of the Hispanic culture such as machismo, marianismo, familismo, and respecto. “Machismo” is the idea that men show power by strength and control in decision making and the well being of their partners (Villarruel, Jemmott, & Jemmott, 2006). The program will reinforce this idea to male Hispanic teens that their positive decisions will affect themselves and their partners. The idea of marianismo is that women are to be abstinent until marriage (Villarruel, Jemmott, & Jemmott, 2006). Afterwards women are to stay faithful to their partners while catering to the needs of their partners (Villarruel, Jemmott, & Jemmott, 2006). The program will reinforce this idea and show that remaining abstinent is culturally acceptable even if other teens show that engaging in sexual activity is a part of popular culture. The idea of respecto means showing respect for one’s self and their partners (Villarruel, Jemmott, & Jemmott, 2006). The program reinforces this idea that both partners should respect the other partner’s view on either wanting to remain abstinent to using safe sex methods. The idea of familismo means taking care of one’s family (Villarruel, Jemmott, & Jemmott, 2006). The program will show that by not becoming pregnant teens can pursue higher education, in order to help support their families financially.
Where will “Mi Vida es Mio” be implemented?
Mi Vida es Mio will be implemented in Richmond High School in Richmond, CA. According to its 2010-2011 School Accountability Report Card (SARC) (SARC, 2011), there are a total of 1,684 total students enrolled in grades 9-12. Out of those students, 81.1% of them are Hispanic (SARC, 2011).
When will “Mi Vida es Mio” be implemented?”
Mi Vida es Mio will be implemented during the freshman and junior year of the high school students. The program will last 2 weeks, and each session will consist of a 1-hour class period. The reason for implementing the program during the freshman year of high school is that students are adjusting to a new academic and social environment by entering high school. As freshman students interact with older classmates such as seniors, they may be peer pressured into sexual activity. Seniors might use the logic that engaging in sexual activity will allow freshman to fit into the culture. The program looks to equip teens with skills towards sexual activity prior to these hypothetical situations. Additionally, baseline measurements can be taken prior to implementation of the program during the freshman year, in order to establish a starting point for improvement. The baseline measurement will also determine the skills and mindset of freshman students regarding sexual activity and relationships. The reason for implementing the program during the junior year as well as freshman year is because students are starting to get acclimated to high school culture. This will also allow an opportunity to gauge the long-term progress of the program from freshman year to junior year.
How will “Mi Vida es Mio” be implemented?
According to the SARC report, Richmond High School has only one “Teen Health” course that is offered to students. This course is offered only during their freshman year. By appealing to the board of education, “Mi Vida es Mio” will be added as a component to that health class, in addition to it being offered during the students’ junior year. School staff that already administers the school’s current health program will serve as facilitators of the program. The facilitators of the program will function to deliver all components of the program including evaluations. Facilitators need to have a basic knowledge of the Hispanic culture along with the risks of pregnancy. The facilitators will perform demonstrations on how to use correct contraception correctly by utilizing anatomical models. Lastly, facilitators will show the videos regarding sexual activity and teen pregnancy.
Overall Program Goal
The overall goal of the “Mi Vida es Mio” is to reduce teen pregnancy rates among Hispanic teens in Richmond High School. Since measuring pregnancy rates it is long term or may not be possible, this program only measures attitudes, beliefs, and self-efficacy of Hispanic teens’ ability to perceive the risks of teen pregnancy and how to prevent them. The program will involve community partners such as local mental health providers, school counselors, and local businesses. Local mental healthcare providers and businesses can donate financially or send clinicians to act as guest speakers. The school counselors can help program facilitators administer evaluation surveys and keep track of pregnancy rates. For example, if the school does not have a definite way to measure teen pregnancy rates, the school counselors can begin to develop a database of students who become pregnant. The success of the program will be measured using a survey based on questions from the CDC youth risk behavior survey (CDC, 2012). These include questions such as: “Have you ever had sexual intercourse”, “How old were you when you had sexual intercourse or the first time” “How many sex partners have you had within the last year”, “During your last sexual encounter did you use protection (CDC, 2012).” The preliminary survey administered prior the program implementation will be compared to national and state standards to determine a baseline measurement. The survey results obtained after the junior year will again be compared to national and state standards to see if there was an improvement.
Short-term objectives (prior to program evaluation and after freshman year)
· Establish a base line measurement and evaluate current perceptions of Hispanic teens. Surveys will be handed out during freshman orientation to incoming freshman.
· Recruit and train facilitators
· Get program approved by the school board of directors
· Obtain donations from local stakeholders such as mental healthcare providers in order to alleviate administrative costs
Long-term objectives (after junior year of implementation)
· After the junior year of implementation, the surveys will be conducted to determine if there was an improvement in risk perception and sexual activity from prior to freshman in addition to after freshman year.
· A 25% improvement in responses is desirable. Improvement would be defined as a decrease in sexual activity, or a change towards positive perceptions regarding the skills to use contraception in addition to saying no to undesirable sexual activity.
· Results of the surveys will be distributed to school administrators, board of education directors, and local stakeholders in order to demonstrate the program’s success. This will provide a reason to implement the program as a permanent part of the health curriculum in addition to getting more funding.
Logic Model and Description
A. Resources
The resources can be classified as the tangible resources to implement the program, and the labor of the program facilitator and stakeholders.
Examples of tangible resources include: name tags, posters, pens, DVD player, CD player, demonstration models, condoms, and lubricant. The funds acquired from stakeholders can also be applied towards the tangible resources and future implementation of the program. Additional resources include writing proposals to local stakeholders in order to provide reasons for them to contribute. Besides financially, stakeholders can provide tangible materials such as posters, printers, and additional resources regarding teen pregnancy. Stakeholders such as mental healthcare clinics can discuss the program with patients who have questions about teen sexuality.
B. Activities
The initial priority prior to implementing the program is to get a baseline measurement of the students’ perception towards teen pregnancy and sexual activity. These results will then be used to demonstrate the problem to the educational board of directors in order to get the program approved. Since the current sex education program does not reinforce aspects of Hispanic culture, “Mi Vida es Mio” may be more appealing. The results has to show that teens lack proper knowledge about pregnancy along with the skills to prevent pregnancy.
C. Outputs
The major outputs of the program are to have a solid culturally based teen pregnancy prevention program that can be continually used at Richmond High School. In addition, partnerships with stakeholders can help implementation along with provide resources for future school based programs at Richmond High School.
D. Outcomes
The main outcome of the program is to see a 25% improvement in the perception and skills of teens towards sexual activity and teen pregnancy. Additionally teens should have the skills to say no to unwanted sexual activity, along with the skills to use contraception effectively.
E. Impacts
The main intended impact of the program is to reduce teen pregnancy among students at Richmond High School
Evidence-Based Intervention
This program is based off of the “Cuidate!” program developed by Dr. Antonia Villarruel from the University of Michigan School of Medicine. As opposed to this program, the “Cuidate!” program is community based instead of school based (Villarruel, Jemmott, & Jemmott, 2006). Dr. Villarruel conducted the “Cuidate!” program in Philadelphia, Pennsylvania among 553 Hispanic youth (Villarruel, Jemmott, & Jemmott, 2006). In addition, the “Cuidate!” program was conducted in Mexico among 829 Hispanic youth (Villarruel, Jemmott, & Jemmott, 2006). After the program was administered, evaluation surveys indicated a decrease in sexual activity and an increase towards positive perception of contraception use among teens (Villarruel, Jemmott, & Jemmott, 2006). Teens reported fewer sex partners and an increase in consistent condom use (Villarruel, Jemmott, & Jemmott, 2006). Additionally the teens who were sexually inexperienced at the start of the program, stated that the remained abstinent (Villarruel, Jemmott, & Jemmott, 2006). The program proposed her uses the constructs of the “Cuidate!” program, but looks to implement it in a school environment. By implementing the program in a school environment, the evaluation of the program can be more accurate. The cohort of students being evaluated can be followed from freshman year of implementation, through junior year, as opposed to a community that would have a much larger cohort.
Theory
One of the main theories this program encompasses is Bandura’s Social Learning Theory (Coreil, 2010). Bandura’s theory states that individual learning is influenced by personal factors, behavior, and environmental influences (Coreil, 2010). For example, the environment that the teen is in may not allow them access to contraception. Additionally, the family environment might not perceive using contraception as culturally acceptable (Villarruel, Jemmott, & Jemmott, 2006). Bandura also states that learning is influenced by outcome expectancies and self-efficacy (Coreil, 2010). An example of the outcome expectancy this program attempts to manipulate is that if teens say no to sex, their partners might leave them (Villarruel, Jemmott, & Jemmott, 2006). Self-efficacy is a person’s confidence in their ability to perform a certain behavior (Coreil, 2010). This program aims to build teens’ skills and confidence in using contraception and saying no to unwanted sex. Another theory encompassed by this program is the theory of planned behavior. According to this theory, a person’s intentions will lead to their action through attitudes and norms (Coreil, 2010). For example if a teen feels that abstinence is a social norm and they have a positive outlook on it, they are more likely to abstain from sex (Villarruel, Jemmott, & Jemmott, 2006). These theories are used as constructs of this program because both of these theories look at the social environment as the primary force for teen behavior. Teens are continually trying to seek approval of others in order to fit into the social environment (Villarruel, Jemmott, & Jemmott, 2006). By using the Social Learning Theory and Theory of Planned behavior, the program focuses to provide skills to teens in order for them to be successful in their respective social environments.
Conclusion
This program shows the susptibilty of the Hispanic population to the problem of teen pregnancy. The program looks to change the outlook of sex and teen pregnancy of Hispanic teens in a predominantly Hispanic high school in Richmond California. By the utilization of cultural values of the Hispanic culture, this program attempts to decrease the rate of teen pregnancy in the Hispanic population. The program also looks to involve community partners such as local mental healthcare providers along with school administrators, in order to establish a new culturally based teen pregnancy prevention program at Richmond High School. The success of the program is measured using a survey based on the CDC’s Youth Risk Behavior Survey in order to establish a baseline measurement for improvement. Though the exact rates of teen pregnancy are difficult to measure, the survey looks to measure teens’ perceptions on pregnancy and sexual activity. The program assumes that as the attitudes of teens towards sexual activity and pregnancy change, the rates of pregnancy will decrease. Lastly the program seeks to establish a database within Richmond High School so the exact numbers of teens becoming pregnant can be measured.
Works Cited CDC. (2012). Hispanic or Latino Populations. Retrieved October 9, 2012, from Center
for Disease Control: http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html
CDC. (2012, August). Youth Risk Behavior Surveillance System. (C. f. Prevention,
Producer) Retrieved from www.cdc.gov/Healthy Youth/yrbs/index.htm
Coreil, J. (2010). Social and Behavioral Foundations in Public Health (Vol. Edition 3).
California, USA: Sage Publications, Inc.
Dehlendorf, C., Marchi, K., Vittinghoff, E., & Braveman, P. (2009). Sociocultural
determinants of Teenage Childbearing Among Latinas in California. Journal of Maternal and Child Health (14), 194-201.
Hamilton, B., & Ventrua, S. (2012, April). Birth Rates for U.S. Teenagers Reach
Historic Lows for All Age and Ethnic Groups. National Center for Health Statistics (89).
Hoffman, S. (2006). By the numers: The Public Costs of Teen Chidbearing. The
National Campaign to Prevent Teen Pregnancy , pp. 1-50.
SARC. (2011). School Accountability Report Card: Richmond High School.
Ryan, S., Franzetta, K., & Manlove, J. (2005, February). Hispanic Teen Pregnancy and Birth Rates: Looking Behind the Numbers. Child Trends , 1-8.
Villarruel, A., Jemmott, J., & Jemmott, L. (2006). A randomized controlled trial testing
HIV prevention intervention for Latino Youth. Archives of Pediatrics and Adolescent Medicine , 8 (160), 772-777.
Waddell, E., Orr, M., Sackoff, J., & Santelli, J. (2010). Pregnancy Risk among, Black,
White, and Hispanic Teen Girls in New York City Public Schools. Journal of Urban Health , 87 (3), 426-439.