Research Roundup: Developing Culturally-based Teen Pregnancy Prevention Programs for Minority Youth

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Photograph of two Native American girls smiling.

When it comes to choosing evidence-based, culturally-relevant teen pregnancy prevention programs, organizations often don’t have a large selection, but this is changing. Taken together, three recent studies provide a blueprint of how strong, culturally-based teen pregnancy prevention programs can be developed.

Read on for a summary of each of the studies, followed by some tips based on our reading of them.

Multimedia Circle of Life: Carol Kaufman and her colleagues, from the Centers for American Indian and Alaska Native Health and the Center for Public Health Practice at the University of Colorado-Anschutz Medical Campus received a grant to take Circle of Life--a curriculum for older youth that combines Native American philosophy, such as the Medicine Wheel, with Western behavior change theories--and modify it for 10- to 12-year-olds. Preteens are considered by some the most appropriate target group for a prevention program, because most of them have not yet had sex.

The curriculum the researchers came up with, Multimedia Circle of Life, or mCOL, uses an online format to address not only teen pregnancy prevention, but also prevention of Hepatitis B and C, two sexually transmitted infections that are prevalent in Native American communities of rural North and South Dakota.

Pono Choices: The research team of Holly Manaseri, Denise Uehara and Kelly Roberts, from the University of Hawai’i at Manoa-Center on Disability Studies, created the Pono Choices curriculum and program, based on Native Hawaiian cultural beliefs and values. Pono Choices aims to prevent teen pregnancy and sexually transmitted infections among Hawaiian middle school students.

The program teaches ‘pono,’ or right, choices that lead to a balanced life, and it includes ‘ohana' (family) activities. As with mCOL, feedback from community members was an integral part of the curriculum development process.

Family Festival Prevention Model: Previously featured in May 2013’s Research Roundup about programs tailored to the Latino community, the Family Festival Prevention Model, or FFPM was developed after an adolescent pregnancy prevention program in a rural, Latino community had difficulty recruiting participants. Yvette Murphy-Erby, Kimberly Stauss and Edwar Estupinian, from the School of Social Work at the University of Arkansas in Fayetteville, held focus groups with community members to see how they could better attract youth and families.

The feedback they collected informed FFPM. The model incorporates the cultural beliefs and values central to rural Latino families, and takes into account everyday realities, such as fathers’ work schedules and their limited time availability.

What are the takeaways for youth and family service professionals?

All three programs demonstrate that culturally-based teen pregnancy prevention programs can be designed in unique communities, with community buy-in, community involvement and cultural humility on the part of researchers and program planners. Here's what we gleaned about how you can use the lessons learned by these projects to design culturally relevant teen pregnancy prevention in your community:

  • Community involvement is the key to program success. Including community members in the design and development of a program is essential for making a program culturally-relevant and for establishing community buy-in. For the Native American communities that participated in the mCOL program, it was important that all residents, not just parents, had a say in every concept covered in the curriculum. For example, many elders could not agree on the right age for a person to have their first child. This range of cultural viewpoints required extensive discussion between the researchers and community members before the curriculum could be finalized.
  • Allow time for program planning and learning about the population. The more time invested in planning, the better a program will be. Manaseri, Uehara and Roberts recommend using planning time to learn about the sociocultural norms and unique programmatic needs of the target community. The planning stage is also the time to design an evaluation plan, they write. In the Pono Choices curriculum, program planners made sure to build time into their program for data collection (surveys, in this case) and data evaluation.
  • Flexibility and adaptability make programs resilient. Programs are often implemented in the context of an ever-changing community. Expect that there will be ups and downs, as well as unexpected events, Manaseri and her colleagues write. During the implementation of the mCOL curriculum, community crises interrupted planned program activities, but the well-trained staff members were skilled improvisers who restructured activities around the community’s need for grieving and healing. In the Pono Choices curriculum, it helped to create flexible lesson plans that could be adjusted to varying class schedules, as is common in Hawaiian middle schools.
  • Respect participants’ needs for privacy. Involve community members in discussions about how privacy and confidentiality can be protected in the program, especially in rural, close-knit communities. Yvette Murphy-Erbya, Kimberly Staussa and Edwar F. Estupinian found that Latino families in Mena, AR, were worried about being identified with a sexual health education program, especially since the community was highly involved with the local Catholic Church. Having agreed-upon confidentiality standards alleviated these concerns and fostered trust.

Read the Articles

 “Planning For a Group-Randomized Trial with American Indian Youth.” Kaufman, C. E., Black, K., Keane, E. M., Big Crow, C. K., Shangreau, C., Arthur-Asmah, R., Tuitt, N. Journal of Adolescent Health, Vol. 54, No. 3 (2014).

 “Making Pono Choices: A Collaborative Approach to Developing a Culturally Responsive Teen Pregnancy and Sexually Transmitted Infections Prevention Curriculum in Hawai’i.” Manaseri, H., Uehara, D. & Roberts, K. Maternal and Child Health Journal, Electronically published ahead of print (December 2013).

A Participant-Informed Model for Preventing Teen Pregnancy in a Rural Latino Community.” Murphy-Erby, Y., Stauss, K. & Estupinian, E. F.  Journal of Family Social Work, Vol. 16, No. 1 (2013).

(Publications discussed here do not necessarily reflect the views of NCFY, FYSB or the Administration for Children and Families. Go to the NCFY literature database for abstracts of this and other publications.)

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