Reach for Health: A School-Sponsored Community Youth Service Intervention for Middle School Students

Investigators: Lydia O'Donnell, Alexi San Doval, Richard Duran, Deborah Haber, Rebecca Atnafou, Patricia Piessens, & Renee F. Wilson-Simmons, Ann Stueve, Joseph H. Pleck, Norma Johnson, Uda Grant, Helen Murray

The REACH FOR HEALTH COMMUNITY YOUTH SERVICES PROGRAM (RFH-CYS) targets African-American and Hispanic youth living in urban areas. REACH FOR HEALTH combines a classroom teaching component with community service work. The intervention, as implemented, provides opportunities for middle school students to participate in service activities within their communities while simultaneously reducing early and unprotected sexual activity. The intervention was initially delivered in 1994 to two large middle schools in Brooklyn, NY; one school was designated as the intervention school, the other as the control. A total of 68 classrooms participated in the initial implementation. In the control school, 33 classrooms (584 students) received the standard New York City health education program, which includes some mandated lessons on drugs and AIDS. Within the intervention school, 22 classrooms (222 students) were randomly assigned to receive core RFH curriculum (classroom component only). The remaining 13 intervention classrooms (255 students) received the enhanced RFH plus Community Youth Services program (RFH-CYS). Bi-lingual and special education classes were included from both school sites. At follow-up six months later, reports of sexual activity were higher across the sample. However, students in the control condition showed greater increases in risk behavior (ever had sex, recent sex, recent sex without condom, recent sex without birth control) than did their peers in the treatment conditions. In contrast, students in both intervention conditions showed increases in their use of STD protection and birth control. Also noteworthy are the findings that eighth graders and special education students showed the greatest improvement. Click here to view more detailed information on this program.

Reproductive Health Counseling for Young Men

Investigators: Ross Danielson, Anne Plunkett, Shirley Marcy, William Wiest, & Merwin Greenlick

Originally developed for boys between 15 and 18 years of age, this is a one-hour, single-session, clinic-based intervention. The program is designed to meet the needs of sexually active and inactive teens, and to promote abstinence as well as contraception. The session begins with a video presentation that is viewed privately by each teen. The materials address reproductive anatomy, fertility, hernia, testicular self-examination, STDs (including HIV/AIDS), contraception (including abstinence), communication skills, and access to health services. A half-hour private consultation with a health care practitioner follows the presentation. Guided by the young men's interests, the consultation may include such topics as sexuality, fertility goals, and reproductive health risks, along with rehearsal and modeling of sexual communication. A field study of the intervention was conducted with 1,195 high school-aged males visiting health maintenance organizations in two Northwestern cities. Compared to a control group of their peers, sexually active program participants were significantly more likely to use effective contraception at the one-year follow-up assessment, especially if they were not yet sexually active at the time of the intervention. Sexually active female partners of program participants were also more likely to use effective contraception at the follow-up. Click here to view more detailed information on this program.

San Francisco Teenage Pregnancy and Parenting Project, 1981-1987

Investigators: Amy Loomis & Virginia Broder

The San Francisco Teenage Pregnancy and Parenting Project (TAPP) is based in a private non-profit Family Service Agency in San Francisco, California, and receives federal funding under the Adolescent Family Life (AFL) Title XX of the 1981 Public Health Service Act. Program components include comprehensive care, continuous case management, and co-location of service providers for expectant and parenting adolescents. Data were collected by case managers at client intake, pregnancy outcome, and at six and 12 months after delivery. Data included in DAAPPP cover clients who entered the program from December 1981 through September 1987. A selection of 175 variables most useful to DAAPPP users is included. These data are presented in 2 Data Sets. DAAPPP Data Set No. C8 ("Intake") includes intake information on 1,513 clients, with a total of 70 variables. Data Set No. C9 ("Outcome") includes pregnancy outcome and follow-up information on 1,008 pregnancies, with a total of 105 variables. The same client may have as many as four separate pregnancy records in the Outcome file, Data Set No. C9. Information on the same client from these two separate files may be linked by the client's identification code.

San Jose, California Study of Adolescent Perinatal Risk Reduction Behavior, 1982

Investigators: Paul Hensleigh and Nancy Moss

The purpose of this study was to develop a model of adolescent perinatal risk behavior and examine the relationship between at- risk pregnancy behavior of adolescents and perinatal outcomes. The file contains data collected from 93 women under age 18 who had just given birth in one of five San Jose area hospitals in July and August of 1982. The data were collected by means of a structured, close-ended survey instrument. The file includes information on substance use and abuse, pregnancy and labor outcomes, social support, the use of services, contraceptive use, previous pregnancies, education, respondents' orientation toward the future, and relationship to the father of the child.Note for users of DAAPPP Data Sets #01-B1DAAPPP data sets 01 through B1 are comprised of a User's Guide, SPSS syntax files (*.SPS or *.SPX) and raw data files only. Most of these datasets contain SPSS syntax files that use Job Control Language (JCL) from 1980s versions of SPSS-X. Because the syntax is old, the syntax files require editing to conform to the current syntax standards used by SPSS/Windows or SPSS/Unix. If you require technical assistance in using or editing these syntax files, please contact Sociometrics' Data Support Group at 800.846.3475 or socio@socio.com.

Santa Cruz County Male Involvement Program

Investigators: Lynn McKibbin, Lisa Cederblom, & Belinda Carter

The Santa Cruz County Male Involvement Program (hereafter, Male Involvement Program) is a collaborative school-, community-, and clinic-based intervention, which was originally implemented as part of a statewide, male-focused pregnancy prevention effort funded by the California Department of Health Services. The overall goals of the Male Involvement Program are: to increase knowledge, skills, and motivation of at-risk adolescent boys and young adult men in order to actively promote their role in reducing teen pregnancies; to increase community and individual awareness regarding the importance of the roles and responsibilities of young males in the prevention of teen pregnancies and to reinforce community values that support these roles; and to increase males' access to reproductive health information and contraceptive supplies. To foster community support surrounding male involvement in the prevention of unintended pregnancies, the Information Campaign focuses on four activities: (1) the design and distribution throughout the county of posters regarding the importance of male involvement in teen pregnancy prevention; (2) pamphlets about the program and fathers' rights and responsibilities; (3) male involvement events; and (4) media purchases, including radio spots and signs on public buses with male involvement messages. In Santa Cruz County, program participants were instrumental in designing media slogans and images. The Male Involvement Program was chosen for the Archive of Male-Oriented Pregnancy Prevention Programs because it has clear goals and objectives; it has been sustainable for a number of years; and both staff and participants expressed satisfaction with the program. In addition, the program has received both local and international honors.

School-Linked Reproductive Health Services (The Self Center)

Investigators: Laurie Schwab-Zabin, Janet B. Hardy, & Rosalie Streett

Originally launched as a partnership between junior and senior high schools and a neighborhood clinic, this program combines education, counseling, and reproductive services into a comprehensive intervention for youth. Services are provided by a team of nurses and social workers who divide their time between the schools and clinic. School-based components include: (1) at least one presentation to each homeroom class per semester to introduce the program and begin discussing values clarification, decision making, and reproductive health; ( 2) informal discussion groups that arise as students seek advice and information from staff on such themes as pubertal development, drug use, and parenting; and (3) individual counseling sessions, available as needed, with a social worker. At the clinic, reproductive and extended counseling services are provided, and referrals are given for teens requiring medical care. Staff encourage students waiting for appointments to participate in discussion groups and examine educational videos and pamphlets. A three-year field test of the intervention was conducted in a low-income neighborhood in Baltimore, Maryland, where elevated rates of sexual activity and teen pregnancy had been recorded. Compared to their peers attending comparable schools, students in the target schools showed reduced levels of sexual activity and (among the sexually active) more effective use of contraception. These effects were greatest among the younger, sexually active girls and boys whose use of contraception was minimal at the start of the program. A delay in the onset of sexual activity was also recorded among abstinent youth. Click here to view more detailed information on this program.

School/Community Program for Sexual Risk Reduction among Teens

Investigators: Murray Vincent

This program is a community-wide public outreach campaign. It incorporates multiple forms of outreach and public education to engage the entire community in preventing pregnancy among unmarried adolescents. Public schools, universities, church groups and civic organizations are all targeted as sites for training and workshops concerning human physiology, sexual development, self-concept and sexual awareness, values clarification and communication skills. Abstinence is promoted as the preferred sexual health decision in all activities; contraceptive information is provided for teens who do choose to become sexually active. The intervention was developed and field tested in a rural, low-income and predominantly African-American community. A significant drop in the pregnancy rate was recorded during the full implementation period of the program. Click here to view more detailed information on this program.

Second U.S. National Health and Nutrition Examination Survey: Selected Variables, 1976-1980

Investigators: National Center for Health Statistics

The second National Health and Nutrition Examination Survey (NHANES II) is one of a series of related programs carried out over the past 20 years by the U. S. National Center for Health Statistics. The first National Health and Nutrition Examination Survey (NHANES I, DAAPPP data set 19) was designed as a national probability study involving approximately 30,000 individuals and was carried out between 1971 and 1975. Even before the completion of NHANES I, plans were underway for the second survey. A major consideration in the design of the NHANES II was that content and procedures should permit comparison with NHANES I data. The experience gained in the NHANES I program, however, made possible certain modifications in NHANES II in order to make the data obtained more useful. For example, NHANES I revealed anemia to be a significant health problem in the U.S., and anemia was investigated in more detail in NHANES II. Additional variables were also included in the study after extensive consultation with numerous other Federal agencies and departments. The survey included two main components: (1) household and medical history questionnaires, and (2) medical examinations. The questionnaires were designed to obtain basic demographic data, information on participation in food programs, and data on each individual's general medical history. The medical examination included dental, dermatological, and ophthalmological examinations; body measurements; biochemical tests; a supplementary medical history questionnaire; and dietary interviews. Like the NHANES I file, the NHANES II DAAPPP file contains information on demographic background characteristics; participation in school lunch, milk, and breakfast programs; birth weight and condition; medical history; and medical examination results, including indices of nutritional status, body build, and bone structure. The DAAPPP HANES II file contains data only for children aged 6 months to 11 years. Because data on the age of the child's mother is included, this is an excellent data set for examining the health consequences for children of teen-aged mothers.

Short-term Consequences of the Decision to Parent or Relinquish among Adolescent Mothers, 1993

Investigators: Linda D. Winges, Diane L. Manninen, and D. H. Klepinger

This study examines the consequences for adolescent birthmothers of their decision to either parent their child or to place their child for adoption. The consequences examined are their subsequent household composition and income, marriage and fertility rates, educational attainment, employment status, and social/psychological well-being. The adolescent birthmothers, 134 who chose to relinquish and 253 who chose to parent, are clients from a pregnancy counseling agency in Washington State. Background information about the clients was collected by the counselor at the time of pregnancy counseling. The clients were then surveyed by mail questionnaires at 6, 14, and 26 months after the birth of their first child.

SiHLE: Health Workshops for Young Black Women

Investigators: Ralph DiClemente, Gina Wingood, Kathy Harrington, Delia Lang, Susan Davies, Edward Hook III, M. Kim Oh, Richard Crosby, Vicki Stover Hertzberg, Angelita Gordon, James Hardin, Shan Parker, & Alyssa Robillard

SiHLE (Sistas, Informing, Healing, Living, Empowering) was developed to address the STI/HIV/AIDS prevention needs of African-American adolescent girls. Research has shown that this subgroup of the general population is at higher risk than their White or Hispanic peers. SiHLE was originally implemented in the South, where adolescent HIV prevalence was higher than any other geographic region in the U.S. Participants were girls seeking health services at community health agencies. Eliglible participants were African American between the ages of 14 and 18 who had engaged in vaginal intercourse within the previous six months. At baseline, 522 girls, aged 14-18, completed the baseline survey and were randomized into either the HIV-prevention intervention (n=251) or the general health control group (n=271). The HIV-prevention intervention was grounded in social cognitive theory and the theory of gender and power. Participants explored issues related to ethnic and gender pride, risk reduction strategies (including correct and consistent condom use), negotiating safer sex, and healthy relationships as they relate to practicing safer sex. At the six-month follow-up, intervention girls reported using condoms more consistently in the previous 30 days than did their control group counterparts (intervention, 75.3% vs. control, 58.2%). At the 12-month follow-up, intervention girls reported more consistent condom use both in the previous 30 days (intervention, 73.3% vs. control, 56.5%) and during the entire 12-month review period (adjusted odds ratio, 2.30; 95% CI, 1.51-3.5; Phere to view more detailed information on this program.