By Lizanne Reynolds, JD | January 30, 2017
I am excited to be working on a new dfusion program called Live Your Best Life AHORA! This is an innovative teen pregnancy prevention and sexual risk reduction program for rural Hispanic youth and their parents in California’s Central Valley. Our program partner is the California Health Collaborative (CHC), which has worked closely with the community for many years to promote healthy practices.
Live Your Best Life AHORA! is an evolution of a project called Rural ImPACT (Informing Parents and Children Together). We have created a cultural adaptation of this existing successful evidence-based intervention. The population we’re working with experiences high rates of teen pregnancy and sexually transmitted infections (STIs). Health outcomes in the community are further complicated by the region’s economic challenges. Youth here face a range of financial and geographic hurdles in accessing prevention education, contraceptives and reproductive health services.
Note: This post comes from dfusion, one of ETR's strategic partners. They develop unique applications of cutting edge and classic technologies to support healthier lives.
The primary goal of the Live Your Best Life AHORA! program is to increase (both in quality and quantity) parent-youth communication about relationships, sex and protection. Enhancing these communications is, by itself, a powerful strategy for reducing teen pregnancy and other risky behaviors.
We believe the intervention will be particularly successful with this population, where discussion of these issues, especially between parents and their children, is often seen as culturally taboo. Most of the parents were born in Mexico or are first-generation Mexican-Americans, while their children have either grown up in or adapted to U.S. culture. Our project aims to build on the community’s strengths while responding to the parents’ thirst for information, programs and support for talking with their teens.
Live Your Best Life AHORA! is innovative in several ways. We are actively engaging parents and youth from the community in the development of the intervention. We are producing a culturally-tailored video (in English and Spanish) featuring parents, youth and community stakeholders. The video will be incorporated into the family session that facilitates parent and teen conversations about relationships, sex and protection.
In contrast to the original intervention—in which a community health worker would conduct home visits with individual families—the family sessions will occur in a casual and festive group setting. Refreshments will be served, and the facilitators will set a fun and energetic tone.
And, unlike traditional interventions which teach parents how to talk to their youth later, the parents will actually start the conversations with their youth during the intervention. This allows the parents and teens to receive immediate guidance and support from the facilitators as well as other participants. The parents will also receive ongoing, step-by-step (paso-a-paso) support through a customized website, personalized booster phone calls and other reminders, including conversation-starter tools that will foster ongoing discussions with their youth.
So far, we have surveyed parents and community stakeholders to identify their need for and interest in the project. We have also convened several focus groups for both parents and teens.
The top factor parents identified as leading to teen pregnancy was that “parents do not talk with their children.” This was particularly interesting because most of these parents also indicated they did not talk with their youth about sexuality or protection. The same percentage (74%) was “very supportive” of this project. The parents want to talk to their teens, but feel they need more information and support about how to do it.
We surveyed a wide range of community stakeholders, including educators, healthcare providers, faith-based organizations, youth service organizations, social service providers and law enforcement. These stakeholders also overwhelmingly (89%) identified “less than ideal parent-teen communication” as the top factor contributing to teen pregnancy, followed by limited sex education in schools (68%), lack of recreational opportunities (68%), and family stress (63%).
We gained several insights from the focus groups. For example, there was a strong disconnect between parents and youth when it came to LGBTQ issues—many parents felt uncomfortable including this content in the program materials, but the youth welcomed it. Although both parents and youth expressed discomfort at the idea of talking to each other about these issues, they agreed that the conversations need to take place. Both parents and youth articulated strong cultural values that teens should “live their age”—that is, enjoy the energy and excitement of being young while keeping a strong focus on educational and career achievement.
When Live Your Best Life AHORA! is implemented throughout the community, we are hoping to see broad effects on the community’s social fabric, with discussions about relationships, sex and protection becoming more common and acceptable. The program materials we are developing will also draw the connection between preventing teen pregnancy and STIs and the strong cultural values of helping youth achieve their educational and career goals. By reducing teen pregnancy and STI rates in these communities, youth will be more likely to finish their education and achieve career and economic success. As more youth succeed economically, the poverty rates in these communities will decline.
Our overall goal? For these efforts to contribute to the eventual breakdown of the teen pregnancy-poverty cycle.
Later this year, all of the program materials will be completed and ready for pilot-testing (contingent upon receiving Phase 2 funding) in California’s Fresno, Kings and Tulare Counties. We are enthusiastic about this project’s ability to benefit families in California’s rural Central Valley and look forward to sharing the pilot test results with other communities.
dfusion’s Regina Firpo-Triplett is leading the development effort for the Rural ImPACT project and the Live Your Best Life AHORA! program. dfusion’s project partners are the California Health Collaborative (CHC) and Dr. Bonita Stanton. CHC is a nonprofit headquartered in California’s Central Valley whose mission is to enhance the health and quality of life of Californians, especially the underserved and unrepresented. Dr. Stanton is the founding Dean of the School of Medicine, Seton Hall University and a leading researcher and developer of interventions that have demonstrably reduced sexual risk-taking by youth, including Focus on Youth (FOY) and Informed Parents and Children Together (ImPACT). The Rural ImPACT project is being funded through a federal grant from the HHS Office of Adolescent Health, which is administered by the Center for Community Health Development in the Texas A&M Health Science Center School of Public Health.
Lizanne Reynolds, JD, is an attorney who is interested in the world of public health, especially health promotion and socio-behavioral health issues. She is currently serving as an intern with dfusion.