Tailoring Family Planning Services to the Special Needs of Adolescents: New Adolescent Approach Protocols

Investigators: Lynn Cooper Breckenmaker & Laraine Winter

This family planning clinic-based intervention was originally developed for teens less than 18 years of age. It is based on the premise that regular contraceptive use by teens can be increased by offering information, social support, and counseling, in addition to health and medical services. Accordingly, the program aims to provide family planning services in a manner that will increase teens' sense of comfort, increase their self-confidence, and reduce any fears that may discourage regular and effective contraception. A key component of the intervention is the Personal Information Form, a one-page questionnaire designed to aid staff in understanding teens' concerns, providing counsel and identifying patients who may be at greatest risk for early pregnancy. To ease teens' anxiety, the first appointment is divided into two visits, with education and counseling provided in the first session and the medical examination (and contraceptive prescription) deferred until the second. The intervention also includes: (1) education in a one-on-one rather than a group setting; (2) use of visual aids; (3) a follow-up visit scheduled six weeks after the initial appointment; and (4) encouragement of participation by family members, partners, and friends, while respecting the patient's right to confidential services. A field study was conducted with 1,261 teens attending six family planning clinics. Compared to their peers receiving standard services, program participants showed significantly greater gains in knowledge, contraceptive usage and significantly fewer pregnancies at the 6- and 12-month follow-up assessments. Click here to view more detailed information on this program.

Teen Health Project (THP): Community-Level HIV Prevention Intervention for Adolescents in Low Income Housing Development

Investigators: Kathleen J. Sikkema, Jeffrey A. Kelly & the Teen Health Project Team

TEEN HEALTH PROJECT was developed for adolescents ages 12 to 17 living in low-income housing developments. The purpose of the evaluation study was to determine whether the effects of a community-level HIV risk reduction intervention would be stronger when the intervention targeted change in individual-level risk reduction as well as change in the social and peer normative environment. Participants (n = 1,172) were recruited from 15 housing developments. Developments were randomly assigned to the community-level intervention (5 developments), workshop-only (5 developments), or a control condition (5 developments). Assessments were conducted at baseline, approximately 3 months after completion of the educational sessions, and again approximately 18 months after baseline. At long-term follow-up, adolescents living in the community-level developments were more likely to have remained abstinent than their control group peers (t(1, 10) = 2.22, Phere to view more detailed information on this program.

Teen Talk

Investigators: Marvin Eisen, Alfred L. McAlister, & Gail L. Zellman

This is a collaborative school- and community health centers-based sex and contraception education intervention for teens between the ages of 13 and 19 years. The 12- to 15-hour pregnancy prevention program begins with two large-group, lecture format presentations covering reproductive physiology, contraception methods, and contraceptive effectiveness. During the remaining four sessions, students participate in small group discussions that are designed to help teens: (1) understand and personalize the risks and consequences of teenage pregnancy; (2) develop and practice the skills that will make abstinence an easier decision to implement; and (3) become more knowledgeable regarding contraception. The sessions include games, role plays, and trigger films that encourage group discussion. A field study of the intervention was conducted in both rural and urban communities in Texas and California. Teens of diverse ethnicities recruited from different agencies and schools participated. Participation in the program was especially beneficial to males, leading to a delay in the onset of sexual activity among male virgins, and to the use of more effective contraception among male non-virgins. Click here to view more detailed information on this program.

Testing an Intervention Model for Teen Fertility Control, 1986-1988

Investigators: Marvin B. Eisen

Data were collected in Texas and California over a three-year period in a design which closely approximated a randomized field trial. Six family planning services agencies and one independent school district compared their ``usual care'' outreach or regular classroom curriculum with an experimental Health Belief Model-Social Learning Theory (HBM-SLT)-based intervention program. Each agency recruited its sample by its usual methods and the school district used its eighth and ninth grade population. Within an agency's targeted age range (13-21 overall), participants were unselected with respect to sex, race or ethnicity, and previous coital experience. Participants were randomly assigned individually or by classroom unit to either the agency's usual program (Comparison groups) or to the HBM-SLT program (Experimental groups). Study data were collected at three points: before exposure to the intervention; immediately following the intervention; and twelve months after the scheduled program completion date.

The Abecedarian Approach

Investigators: Craig T. Ramey, Joseph J. Sparling, & Sharon L. Ramey

The Abecedarian Approach is a combination of teaching and learning enrichment strategies for use in early childhood education settings that is comprised of four key elements: 1) learning games, 2) conversational reading, 3) language priority, and 4) enriched care giving. These strategies were developed for and validated in a longitudinal research study known as the Abecedarian Project. By using the Abecedarian Approach, early childhood professionals can enhance their abilities to provide stable and stimulating interactions with children by engaging them in many rich and varied adult-child interaction activities on a daily basis. The ultimate goal of this educational approach is to facilitate positive child outcomes in areas such as cognitive, social-emotional, communication, and school readiness skills. The evaluation results of the Abecedarian Project demonstrate that early education for at-risk children within a safe, responsive, and stimulating environment can produce positive and long-lasting effects on the course of development. The Abecedarian Project is the only early childhood education program that has demonstrated statistically significant cognitive benefits into young adulthood. The four key elements of the Abecedarian Approach constitute a powerful tool for early childhood professionals to improve the competence and quality of life, particularly for children from low resource environments.

The Abstinence and Contraception Education Storehouse (ACES)

Investigators: Josefina J. Card, Shobana Raghupathy & Charles Klein

ACES is an online library of multimedia activities and exercises that can be used to enhance behavioral skills training in teen sexual risk reduction interventions. The goal is to enable teachers and practitioners to improve program delivery by using these activities to supplement existing interventions, and consequently promote active youth engagement and involvement. ACES has two components: (1) The Youth Activities Library (YAL) (2) The Teacher Training Library (TTL) The activities in the Youth Activities Library are aimed at youth and include multimedia audio-visual presentations, role-play demonstrations, group discussion activities, video clips, quizzes and polls, as well as traditional classroom exercises, handouts, and homework assignments. The library also includes classroom presentation materials that provide factual information on HIV/AIDS and STD awareness (incidence, prevalence, modes of STI transmission etc.). These activities in the YAL are arranged into 40 separate modules, with each module focusing on the following themes in the area of teen HIV/AIDS/STDS and pregnancy prevention: Refusal skills and resistance to peer pressure Assessing risks/using safety skills Stress management/ conflict resolution Dating and relationship decisions Negotiation skills/contraception use HIV/AIDS/STD awareness Safe sex practices Abstinence/delaying sexual activity Sexual orientation Buying contraception Condom demonstration Parent-child communication To help teachers use these modules, ACES also includes tutorials for teacher training. The ACES Teacher Training Library (TTL) is aimed at teachers and will train teachers and practitioners by offering video demonstrations in conducting role plays, group discussions and general classroom management strategies.

The Brookline Early Education Project (BEEP): A Comprehensive Birth-to-Kindergarten Program for Children and Their Parents

Investigators: Donald E. Pierson, PhD, Robert I. Sperber, Martha B. Bronson, EdD & Mary-Jane Yurchak, EdD

The Brookline Early Education Project (BEEP) is a comprehensive birth-to-kindergarten program that combines child education and health monitoring services with parent education and support. BEEP utilizes a family-oriented approach designed to reduce learning and adjustment difficulties in school. BEEP consists of three components: 1) Parent Education and Support Program, 2) Child Education Program, and 3) Health and Development Monitoring. The Parent Education and Support Program provides home visits to families, parent discussion groups, a book and toy lending library, and social events. The Child Education Program consists of weekly playgroup sessions and daily prekindergarten classes. Finally, the Health and Development Monitoring program provides nine health and developmental screening exams for children beginning from two weeks of age through age 5. Evaluations of the BEEP program demonstrated higher school functioning in kindergarten and the second grade compared to age-matched peers. At early adulthood, benefits for BEEP participants compared to peers included higher educational attainment, higher income, and more positive health indicators. Click here to view more detailed information on this program.

The Coping Bear: Group and Individual Cognitive-Behavioral Therapy for Children with Anxiety Disorders and their Parents

Investigators: Katharina Manassis, MD & Sandra L. Mendlowitz, PhD

The Coping Bear is an intervention with parental involvement for children with: social phobia, depression, simple phobia, panic disorder, generalized anxiety disorder, and/or separation anxiety disorder. The treatment program utilizes a group process problem-solving approach with the overall goals of: 1) teaching children to recognize their emotional distress, and to learn and practice new coping skills; and 2) facilitating the generalization of these coping skills by involving parents in the treatment process. The program can be implemented in both individual and group settings and includes systematic desensitization techniques, reinforcement principles, approaches to resistant behavior, aids to exposure to anxiety-provoking situations, and relaxation techniques. Two separate randomized clinical trials evaluated the therapeutic efficacy of this program. In the 1999 study, participants were randomly assigned to a child only therapy group (no parental involvement), parent only group (no child involvement), or child and parent group (separate groups of children and parents run concurrently), or a wait list control condition. Less anxiety and depression were reported post-treatment by all children. Children who were treated with their parents used more active coping strategies than children in the other treatment groups. In the 2002 study, participants were randomly assigned to either separate individual therapy sessions for child and for parent, or concurrent child-only and parent-only groups. Assessments pre- and post-treatment showed that regardless of treatment setting, children and mothers reported decreased anxiety and improved global functioning post treatment. In addition, children with high social anxiety had more improvement in an individual treatment setting than in a group setting. Click here to view more detailed information on this program.

The Coping Course for Juvenile Corrections

Investigators: Paul Rohde, PhD, Jenel Jorgensen, MA, John Seeley, PhD, David Mace, ED

THE COPING COURSE utilizes cognitive-behavioral therapy to treat incarcerated youth in closed-custody juvenile facilities. The aims of this intervention are: improving behavior within the facility; reducing negative emotions, including depression, anger, frustration, boredom, sadness, and fear; and enhancing general coping and problem solving skills. THE COPING COURSE consists of 16 group treatment sessions occurring twice a week over 8 weeks. The program uses handouts, structured learning tasks, short quizzes, and homework assignments to teach the following skills in a group treatment setting: social skills, relaxation techniques, identifying and increasing fun activities, changing negative thinking, communication and problem-solving skills, and developing a Life Plan and long term goals. Click here to view more detailed information on this program.

The Future is Ours (FIO)

Investigators: Anke A. Ehrhardt, Heidi Arner, Pam Farquhar, Laura Frye, Jeff Natt, Inez Sieben, Imelda Walavalkar, Susie Hoffman, Jessica Adams-Skinner, & Teresa Exner

The Future Is Ours (FIO) is an eight-session HIV prevention intervention delivered to high-risk heterosexual women in a group setting. FIO is guided by three major theories, Modified AIDS Risk Reduction Model (MARRM), Social Learning Theory, and Gender Theory. The goal of FIO is to empower women to reduce unsafe sexual encounters by increasing the use of male and female condoms and alternate protection strategies including sex without penetration, getting tested for HIV jointly with a partner along with mutual monogamy and a safety agreement, deciding to be celibate, and refusing unsafe sex or deciding to not get involved with a partner who will not use condoms. FIO is a gender-specific HIV/STD risk reduction intervention designed for heterosexually active, at-risk women of diverse ethnicities (African-American/Black, Caribbean, Latina, White), ages 18 to 30, who are not injection drug users, are HIV-negative or of unknown status, are not pregnant or trying to become pregnant, and who live in communities where rates of HIV and other STDs are high.