In honor of National Teen Pregnancy Prevention Month, the Office of Adolescent Health on May 2 hosted a webcast on global prevention strategies. Dr. Robert W. Blum, a professor at Johns Hopkins Bloomberg School of Public Health, began the webcast by comparing U.S. teen pregnancy rates to those in other countries. Then he shared what works to prevent teen pregnancy at home and abroad.
Here are some of the highlights from Dr. Blum's hour-long presentation:
- Nearly 750,000 teens ages 15 to 19 became pregnant in the United States in 2008. Another way of saying that is that 68 teen girls in the United States out of every 1,000 became pregnant that year.
- The same year, 40 teen girls in the United States out of every 1,000 gave birth--the highest birth rate among all industrialized countries that year. Russia had the next highest birth rate among industrialized nations, with 30 teen girls out of every 1,000 giving birth.
- Developing nations such as Trinidad, Tobago and Tonga had birth rates similar to the United States.
- Countries with very low birth rates include Switzerland, where only 4 teen girls out of every 1,000 gave birth.
Dr. Blum spoke about common themes in global pregnancy prevention. Prevention strategies are more effective, for example, when agencies work to build resources in young people’s families and communities instead of just trying to change their behaviors.
The presentation also highlighted international efforts to empower women through skill-building programs and small loans. While these projects might look different in Kentucky than say, Kenya, building young people's knowledge and support systems can help them value themselves and their bodies more highly--wherever they live.
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The Administration on Children and Families’ Office of Planning, Research and Evaluation recently released a series of briefs that explore how service providers can help at-risk youth achieve well-being and self-sufficiency. One part of the formula is connecting young people to jobs with good pay and opportunities for growth and advancement. NCFY spoke to M.C. Bradley and Jiffy Lansing, two of the co-authors of "Connecting At-Risk Youth to Promising Occupations," to learn what constitutes a “promising” job, and how runaway and homeless youth workers can help their clients secure one.
NCFY: Why is youth employment important for helping youth achieve self-sufficiency?
Jiffy Lansing: First, if youth can be connected to employment, especially jobs that can lead to more responsibility and opportunity along the way, that brings in money.
And for youth who have been disconnected from school or work [because of homelessness or poverty], this is a way of connecting them to some pro-social experiences that can increase their confidence and resilience.
NCFY: How do you define a “promising” occupation for this population?
M.C. Bradley: We thought about earnings first. We asked, “What’s a reasonable threshold for what a young person needs in order to be self-sufficient?” And we wanted to identify occupations where there’s actually growth. Jobs where someone could come in at an entry level and have a career trajectory.
The earnings number we came up with was $25,000 annually. We looked at a variety of sources to arrive at this number: the national median income, the eligibility requirements for federal programs and the living wage literature. We made some assumptions that the young people would be living with another adult, there’d be a child in the household, and they would need to bring in 60 percent of the income in that household.
Lansing: Depending on where somebody lives, $25,000 might not be the appropriate threshold. But we were looking broadly across the country.
NCFY: And what jobs qualify?
Bradley: The health care and construction fields offered a lot of jobs that matched our criteria. Those may not be the right jobs for a particular program’s youth, particularly healthcare, because there are requirements about drug testing and no criminal record. So you need to think carefully about that and the population you’re serving, and where you are. Because not all communities are going to have the same growth in healthcare or construction as others.
Lansing: Most localities have workforce development boards, which can be found on the Internet, that show the projected growth occupations for their specific area. Another source that we think is a good place to look is local community colleges.
NCFY: How can runaway and homeless youth service providers use this information?
Bradley: They can use this brief to connect with local agencies that have information about the job market in their area, as well as training and education that can get youth on the track to getting those jobs.
Some of these youth need ID’s, clothes and school records to put them in a position for a job, and youth workers can help them get these. And they can help them create resumes and prepare for interviews. They can provide youth with a chance to explore and link their interests to what they might like to do.
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Teen birth rates are falling in this country, and have been, fairly consistently, for a number of years. But U.S. teens are still getting pregnant and giving birth at rates that are substantially higher than those of other western industrialized nations. And sub-groups of young people continue to get pregnant and become teen parents at rates that are even higher than the national average.
In an analysis of trends in teen births from 1981 to 2006, published in the Journal of Adolescent Health in 2011, researchers at the Centers for Disease Control and Prevention used birth certificate data to break down teen births by the age, race and ethnicity of the mother. They wanted to find out more precisely where the disparities were in order to better target the young people most at risk.
What they found, among other things, was that Hispanic teens have significantly higher birth rates than non-Hispanics in all three of the age ranges they studied – 10-14 year olds, 15-17 year olds and 18-19 year olds. Though the most recent data used for this study is 7 years old, they say that the overall trend clearly points to the need for services that better target Hispanic young people.
Making Services More Relevant to Latinos
But what do effective services for Latinos look like? The Family and Youth Services Bureau, the Office of Adolescent Health and the CDC have funded a number of projects to build that evidence base. But so far, the research is still pretty thin. Social scientists in New York and London recently conducted a review of the existing literature in an effort to pinpoint strategies youth-serving agencies might use to reduce sexual risk behavior in Latino youth.
Their paper, published in the Journal of Clinical Social Work, highlighted three factors that research shows can make a difference for Latinos:
- High quality communication between parents and adolescents
- Relationships between parents and adolescents that are based on mutual warmth, closeness and trust
- Parental supervision and monitoring that sets high expectations for behavior, monitors behavior, and provides inducements or disciplinary action to encourage behavior
The authors recommend that practitioners help parents incorporate these "protective factors" into their relationships with their children.
Building Interventions for Latino Youth
Some researchers believe that interventions that are built with Latinos in mind from the get-go and with input from Latino families may be more effective. To test that theory, a team of researchers from the University of Arkansas, Fayetteville, worked with Latino families in their rural, southern community to design a teen pregnancy prevention intervention called the Family-Festival Prevention Model. In a paper published in the Journal of Family Social Work, they lay out the theories behind the model and discuss its first implementation.
While using the evidence-based curriculum Choosing the Best, the intervention is built around an all-day festival that includes the families of each of the participants as well as the greater community. The design responded to the community's need for:
- Strategies to engage fathers, who don't typically communicate with children around sexual health
- Involvement of community members, particularly faith leaders and employers at the plants that employ the fathers
- Fun, free activities that families can do in their limited relaxation time
- Ways to express their cultural and immigrant experiences
The event was held in fall 2010, with more than 400 Latino youth and families participating. Results of the study will be published in a subsequent paper.
Read the Articles
“Recent Changes in the Trends of Teen Birth Rates, 1981-2006” (abstract). Journal of Adolescent Health, Vol. 48, No. 3 (March 2011).
“Latino Adolescent Reproductive and Sexual Health Behaviors and Outcomes: Research Informed Guidance for Agency-Based Practitioners” (abstract). Clinical Social Work Journal, Vol. 40, No. 2 (June 2012).
“A Participant-Informed Model for Preventing Teen Pregnancy in a Rural Latino Community” (abstract). Journal of Family Social Work, Vol. 16, No. 1 (2013).
Q&A: 'One Word Can Make a Difference' and Other Insights Into Addressing Teen Pregnancy in Latino Communities
According to the latest statistics, Latinas have a higher overall all teen birth rate than the nation at large. To gain insight into how teen pregnancy prevention professionals can tailor their efforts to Latino communities, we spoke with Ann Marie Benitez, senior manager of the Latino Initiative at The National Campaign to Prevent Teen and Unplanned Pregnancy.
NCFY: People often think of teen pregnancy among Latinas as a cultural issue. How do you respond to that?
Benitez: While disparities exist and 4 out of 10 Latinas get pregnant before the age of 20, teen pregnancy is a challenge for the whole nation. Because it’s still a fact that 3 out of 10 teens get pregnant before the age of 20.
NCFY: How do parents figure into teen pregnancy prevention among Latino teens?
Regardless of race and ethnicity, all parents don’t know what to say about sex or when to start the conversation about sex. We do a public opinion survey every other year, and 88 percent of the general population agrees that parents in general just don’t know what to say and when to start.
When we compared them to other groups, Hispanic teens were more likely to strongly agree that their parents don’t know what to say about sex and when to start the conversation. And the pattern holds true for adults, where 70 percent of Hispanic adults are more likely to strongly agree that parents need help when it comes to talking to their kids about sex.
Parents are the ones who influence teens the most in terms of their decisions about sex. More than peers, more than popular culture, more than teachers. In fact, 91 percent of Latino teens agree that it’s much easier for them to postpone sexual activity and avoid teen pregnancy if they were able to have more of an open honest conversation with their parents.
NCFY: Do Latino teens and parents talk about teen pregnancy differently than teens and parents from other groups?
We conducted a study called “Toward a Common Future” and we found that there were more commonalities than differences regardless of whether [parents] are Hispanic or not. All parents have high aspirations for their teens. All parents want to see their kids succeed, finish high school and hopefully attend college. They believe it is important to talk to their kids about sex. They also believe it’s important to talk about both abstinence and contraception.
There’s this myth that Latinos don’t like talking about [sex] or don’t like talking about both [contraception and abstinence]. But the fact of the matter is they do think it’s important, they do think talking about contraception and abstinence is really important.
NCFY: Given those similarities, what does it mean for folks who are working in teen pregnancy prevention to be culturally competent with Latino families?
When I talk in Spanish about teen pregnancy prevention, I use more the word of delaying pregnancy for when you’re ready to have a baby and start a future with your family, versus using the word prevention. Because prevention can come across in some circles as something that’s anti-family. And we’re very pro-family. We’re very pro- trying to support families starting in the most successful way so that they can reach their goals and succeed in life for themselves and their children.
NCFY: And it’s such an easy tweak. It’s one word.
Yes, but at the end of the day, it’s still the same. All families want the best for their kids. Just how they respond to one word can make a difference.
Learn more about the campaign's Latino Initiative, including an effort that trains community health workers to use an evidence-based curriculum to prevent teen pregnancy in Latino communities.
Public Comments Requested for Federal Strategic Action Plan on Services for Victims of Human Trafficking
The White House has released for public comment the new federal strategic action plan on services for victims of human trafficking in the United States.
The framework of the 5-year plan was developed in a collaborative federal effort led by co-chairs from the U.S. Departments of Justice, Health and Human Services, and Homeland Security. It will ensure that all victims of human trafficking in the United States have access to the tools and services they need to escape exploitation and rebuild their lives.
The comment period provides an opportunity for stakeholders and experts within the anti-trafficking field, and civil society at large, to
- review the plan;
- make recommendations to strengthen the plan; and
- suggest additional items that can be accomplished through collaboration with states, tribes, and local communities or partners.
Go to the comments page to read the plan and submit your idea. Comments are due by 11 p.m. Eastern, May 24, 2013.
“Evidence-based Programs in Children's Services: A Critical Appraisal.” Children and Youth Services Review Vol. 35, No. 2. (February 2013).
What it’s about: Proponents of “evidence-based programs” in social services for children and youth and their families take on the debate about the use of such programs.
Why read it: Momentum is growing behind efforts to promote more widespread use of programs that have been studied by researchers and found to result in better outcomes for families and youth. Many private and public funders, including the Family and Youth Services Bureau, are encouraging or requiring their grantees to take evidence into account when planning and implementing programs for youth and families. While many practitioners have embraced evidence-based programs, others are skeptical. By looking at both sides and responding to arguments that have been made against emphasizing evidence-based programs, this article makes a compelling case for their use.
Biggest takeaways for youth workers: The authors look at five different types of critiques of evidence-based programs: scientific, ideological, cultural, organizational and professional.
Among the scientific critiques are those that question the validity of and methods behind the research that has been done to determine whether programs are effective or not, and the idea that programs can be declared to work or not. The authors argue that though some studies may be flawed and the answer may not be cut and dry, scientific study does enable us to have a better understanding of what works. They write that “the most promising innovations should be strengthened and tested with a level of rigor appropriate to their stage of gestation as part of a logical process of program development.”
Among the many arguments the authors take on are contentions that evidence-based programs:
- Only treat symptoms of larger problems and ignore bigger-picture issues like poverty and racism. To the contrary, the authors say, evidence-based programs can contribute to greater social justice.
- Do not translate across cultures. If designed with enough flexibility, the authors write, evidence-based programs can be used with families and youth of different cultures.
- Are too expensive and time-consuming to set up. Not all are expensive, but even so, their ultimate cost savings may justify their upfront cost.
- Hamper innovation and creativity on the part of practitioners. Evidence-based practices are the product of innovation, often by practitioners.
The article ends with concrete suggestions that could bridge the gap between proponents of evidence-based programs and those with reservations about their use. The authors write:
Researchers need to learn more about what makes programs transportable and understand cultural variation in impact. Methods for adapting [evidence-based programs] need to be developed and tested. When introducing programs to systems it is imperative to stress the importance of the practitioner, demonstrating how professional knowledge and experience contribute to outcomes. The place for innovation should be highlighted, as should the radical nature of programs that reach the most needy and reduce inequality, and the significant amount of ‘face time’ with users. Program training should be seen as an opportunity to master new skills and be certified as such. These are all things that practitioners are reported to find motivating.
Additional references: A new NCFY report looks at FYSB’s position on the importance of evidence-based practice, one grantee’s experience implementing an evidence-based program, and how some programs are partnering with researchers to show the effectiveness of their work.
(Publications discussed here do not necessarily reflect the views of NCFY, FYSB, or the Administration for Children & Families. Go to the NCFY literature database for abstracts of this and other publications.)
We're excited to unveil a new NCFY report that looks at youth engagement strategies that challenge young people to take charge of their wellbeing.
First we talk to a youth worker who wants to make sure that youth self-advocacy is always trauma-informed. Next we speak to two university professors who have employed transition-age young people as research assistants. And last, we hear from a Michigan drop-in center that asks their participants to shape every facet of programming, from the courses on offer to hiring new staff.
In our recent article about how to get donations of food for your family and youth services program, we shared tips on working with grocers and restaurants. Then we learned that Janus Youth Programs in Portland, OR, also gets free meals for its youth from faith-based organizations and service groups, like the Lions Club.
“Our dollars just aren’t going to stretch day in and day out to cover meals,” says Advancement Director Rosalie Karp.
The volunteers, who mainly hear about Janus by word of mouth, prepare the home-cooked meals offsite and deliver them to Janus’s two shelters. Karps says the shelters serve two meals a day, breakfast and a late dinner.
Janus asks volunteers to put the food in large disposable plastic, paper or aluminum trays or containers, which work well for transporting food. Two to three large disposable aluminum trays of food feeds one shelter of 30 youth, and five to six trays feed 60 youth in both shelters.
Here’s what breakfast might look like:
- Fruit (canned or fresh)
Dinner might feature:
- Lasagna or other pasta
- Meatloaf or roasted meats
- Goulash, stroganoff
- Macaroni and cheese
- Sloppy Joes
- Nachos or tacos
- Hearty soups or chili
- Hot dogs
- Fruit (canned or fresh)
- Vegetables (ready to serve)
Food variety tends to work itself out. When asked if Janus ever gets lasagnas donated three nights in a row, Karp says, “That’s never been a problem.”
The Family and Youth Services Bureau last month released its Report to Congress on the Runaway and Homeless Youth Program for fiscal years 2010 and 2011. The biannual Congressional report summarizes FYSB’s efforts to combat youth homelessness with its Basic Center, Transitional Living and Street Outreach Programs.
The report includes statistics about the youth served by the three programs and the services they received. It also discusses the four key outcomes FYSB is promoting in its Runaway and Homeless Youth Programs: safety, permanent connections, well-being and self-sufficiency. FYSB, in consultation with the field, chose the outcomes based on research into what young people need to succeed.
Here are a few of the achievements highlighted in the report.
- A total of 84,187 youth received services from a basic center program, and more than 90 percent of those leaving the center returned to their families or another stable living situation.
- Street outreach workers helped more than 49,000 youth move off the street and into a shelter for at least one night.
- About 87 percent of youth who left a transitional living program made a “safe exit” into a private residence or residential program.
- The National Runaway Switchboard (now called the National Runaway Safeline), which operates as FYSB's national communications system to help youth in crisis, handled about 300 calls a day from youth and concerned adults.
Read "Report to Congress on the Runaway and Homeless Youth Program, 2010-2011" on the FYSB website.
Q: What is rapid re-housing and how can it help runaway and homeless youth?
A: “Essentially rapid re-housing is exactly what it sounds like,” says Tiana Brown, rural housing coordinator for The Salvation Army Ohio in Delaware, OH. “It’s moving folks directly from homelessness quickly into their own homes.”
In addition to quick access to a stable home in which clients can stay even after they stop receiving social services, programs following this model offer case management, life-skills training and financial assistance. Some research has shown this approach can be effective at ending the cycle of homelessness for many people.
Rapid re-housing is a lot like the Family and Youth Services Bureau’s Transitional Living Program for Older Homeless Youth. The main difference is that the housing offered by many transitional living programs is just that—transitional—and youth and their case managers must find other housing options once the young person “graduates” from the program.
Brown’s rapid re-housing program for youth in four Central Ohio counties, which started in 2009, remains one of a handful in the country. One obstacle to promoting the model more widely as a solution to youth homelessness is the reluctance of some landlords to rent to young people, Brown says.
"Landlords are less willing to take a chance,” she says. “It is a ton of advocacy, a lot of selling up your program, selling why your program works well.”
Despite the challenges, Brown thinks rapid re-housing can really work for homeless youth. She says, “We’ve had really great success and find that when [youth] have something that is their own, eventually they learn--whether it’s at the beginning or the end [of the program]. They respect their own space and they want to keep it."
The National Alliance to End Homelessness has a wealth of resources on rapid re-housing.
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