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Developing Partnerships to Promote Innovative Approaches

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Partnerships that Promote the Integration of HIV, STD and Teen Pregnancy Prevention was presented at Sex::Tech 2009 by Sandra Serna Smith of the National Coalition of STD Directors and Lisa Pressfield …

Partnerships that Promote the Integration of HIV, STD and Teen Pregnancy Prevention was presented at Sex::Tech 2009 by Sandra Serna Smith of the National Coalition of STD Directors and Lisa Pressfield of the Association of Maternal and Child Health Programs.

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  • An issue of culture and technology
  • Arizona – Travis LaneUTPRC – EbunOdeneye, Rocio-Maria Garza
  • Other staff/collaborators:Bureau of Indian Education – tribal schools & Boys & Girls Clubs
  • Internet-based programs have the ability to reduce health disparities by providing rural and underserved communities with access to state-of-the-art health interventions.Adapting interventions for cultural appropriateness requires the use of multiple research strategies and community based participatory research activities.Strong, multi-site partnerships can successfully build local capacity and support development of sexual health resources in underserved communities.
  • Other staff/collaborators:Arizona – Travis LaneUTPRC – Dr. Melissa Peskin, EbunOdeneye, Rocio-Maria GarzaBureau of Indian Education – tribal schools & Boys & Girls Clubs
  • CUT OUT STATS
  • CDC. Youth Risk Behavior Surveillance Survey – United States, 2009. MMWR 2010;59(SS-5):1–142. De Ravello L, Personal Communication 4-8-2010 YRBS – Youth Risk Behavior Surveillance survey – biannual survey of high school youth conducted by CDC to monitor multiple youth risk behaviors including sexA. 2008 Bureau of Indian Education YRBS 15% AI/AN middle school students ever had sex Of AI/AN youth ever having sex, 5 percent had 3 or more lifetime sexual partners25% sexually active AI/AN male teens never used contraception 37% sexually active AI/AN female teens never used contraceptionB.2009 National YRBS 46.0% of high school students ever had sex 5.9% had sex before age 13Hamilton B, et al. Births: Preliminary Data for 2009. MMWR. 2011;59:1-29.CDC, Indian Health Service. Indian health surveillance report—sexually transmitted diseases 2007. Atlanta, GA: U.S. Department of Health and Human Services.CDC. Cases of HIV infection and AIDS in the United States and dependent areas, by race/ethnicity, 2003–2007. 14th ed. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009.2008 STI rates (15-19 years): Chlamydia rates 3 times higher for AI/AN vs. White youth Gonorrhea rates 2 times higher for AI/AN vs. White youth2009 teen birth rate (15-19 years) 55.5 per 1000 among AI/AN youth 39.1 per 1000 nationally
  • Craig Rushing S. Media technology use among Native American teens and young adults: Evaluating their utility for designing culturally-appropriate sexual health interventions targeting Native American youth in the Pacific Northwest. Doctoral dissertation. 2010.Project Red Talon (2009) , 400 Native youth (age 13-21 years) living in Oregon, Washington, and Idaho.
  • Tortolero, SR, Markham, CM, Peskin, MF, Shegog, R, Addy, RC, Escobar-Chaves, SL, Baumler, ER. It's Your Game, Keep It Real: Delaying Sexual Behavior with an Effective Middle School Program. Journal of Adolescent Health. 2010; 46(2):169-179.Published online: 18 August 2009.Theory-based – in Social Cognitive theory, models of social influence, Theory of Triadic InfluenceEffective outcomes by follow-up at 9th gradeDelayed initiation of sexual intercourse Reduced frequency of sexIncreased condom usePositive impact on psychosocial variables“It’s Your Game…Keep it Real”“Game” = Life“Real” = Telling it like it is, being respectful, being responsible, doing the right thing, being yourself, being healthy and happy
  • IYG Tech is a 13-lesson, completely on-line version of IYG currently being evaluated in a randomized controlled trial in Houston, TX, funded by National Institute for Mental Health (NIMH) (Shegog & Peskin, Joint PIs).It will form the basis for the IYG version that will be adapted for AI/AN youth in the current study.
  • Internet-based programs have the ability to reduce health disparities by providing rural and underserved communities with access to state-of-the-art health interventions.Adapting interventions for cultural appropriateness requires the use of multiple research strategies and community based participatory research activities.Strong, multi-site partnerships can successfully build local capacity and support development of sexual health resources in underserved communities.
  • Year 1Build Community Relationships and SupportRecruit schools & BGCsReview existing AI/AN youth programsUsability testing of IYGYear 2Adapt IYG for AI/AN youthVideo production with AI/AN youthPilot test IYG-AI/ANTribal review & approval of adapted IYGYear 3Recruit youthRandomly assign sites to study groupsEfficacy Trial: Test new IYG for AI/AN youthAnalyze resultsYear 4Final analysis of study findingsShare results with communityEncourage widespread useExplore partnerships with websites

Transcript

  • 1. Developing partnerships to promote innovative approaches to prevent teen pregnancy among American Indian & Alaska Native youth
    Alaska Native Tribal Health ConsortiumInter Tribal Council Of Arizona, Inc.Northwest Portland Area Indian Health BoardUniversity Of Texas Prevention Research Center
    Funded by the Centers for Disease Control & Prevention (SIP10-033)
    Sex::Tech Conference 2011
    Saturday April.02.2011
  • 2. Emerging Partnerships
    Official partnership pending regional review board approvals
    Cornelia Jessen
    Stephanie Craig-Rushing
    Jessica Leston
    Gwenda Gorman
    John Lewis
    Ross Shegog
    Christine Markham
    Melissa Peskin
    Susan Tortolero
    Inter Tribal Council of Arizona, Inc.
  • 3. CDC
    Heather Tevendale
    Indian Health Service
    Lori de Ravello
    Scott Tulloch
    Consultants
    William Lambert, Oregon Health & Sciences University PRC
    Carol Kaufman, University of Colorado
    Other Partners & Consultants
  • 4. GOAL:
    To adapt and evaluate the effectiveness of an Internet-based HIV/STI & pregnancy prevention program for middle school-aged youth (12-14 years old) in three geographically dispersed AI/AN communities in Alaska, Arizona & Pacific Northwest (Idaho, Oregon, Washington State)
  • 5. Overview
    Background
    Youth Perspective
    It’s Your Game…Keep It Real (IYG)
    IYG-AIAN: Building the partnership
  • 6. Background
  • 7. AI/AN Youth: Sexual Health
    Compared to Non-AI/AN Peers AI/AN youth have:
    Higher birth rates
    Higher rates of Chlamydia and gonorrhea
    Earlier sexual debut (which is associated
    with increased risk of STI’s and pregnancy)
    Lower condom and contraceptive use
    19% of AI/AN HIV/AIDS cases are among youth (<25)
    The need or effective sexual health is indicated
    CDC 2009; CDC, Indian Health Service, 2007; Hamilton B. MMWR. 2011;59:1-29
  • 8. Youth Technology Use
    AI/AN youth use media technology at higher rates than national average
    75% use internet/iPods on daily or weekly basis6
    87% have a social networking page (i.e. Facebook)1
    Use to: create social networks, & share culture within and beyond local community 2
    Rezkast(www.rezkast.com)
    RezLifeYouthwww.rezlifeyouth.ning.com)
    NativeTube(www.nativetube.com)
    The potential for a technology based channel for sexual health education is indicated
    1 Craig Rushing, Doctoral dissertation. 2010; 2 Project Red Talon (2009) .
  • 9. Youth PerspectiveLeonard Edmo Jr.
  • 10. It’s Your Game…Keep It Real: An Evidence-based Approach
  • 11. It’s Your Game…Keep It Real
    Theory-based, multimedia program
    Designed for 7th & 8th grade students
    Two randomized controlled trials (NIH, CDC funded)
    Effective outcomes by follow-up at 9th grade 1
    OAH effective program
    Theme: “How do you keep your game real?”
    Respect yourself and respecting others
    Play by your rules
    © 2004, Tortolero, Markham, Shegog & Peskin. All Rights Reserved.
    1Tortolero, SR et. al. Journal of Adolescent Health. 2010
  • 12. IYG Decision-Making Paradigm
    © 2004, Tortolero, Markham, Shegog & Peskin. All Rights Reserved.
  • 13. IYG Tech: Lessons & Topics
    © 2011Peskin, Shegog, Markham & Tortolero. All Rights Reserved.
    Funding: NIH NIMH R01
  • 14. Lesson Sequence
    Lesson Objectives
    Recap of Previous Lesson
    Serial: Peer Modeling
    Interactive Activities (IA): Peer Video
    IA: Information Transfer
    IA: Skills Training
    Serial Conclusion
    Lesson Recap
    Serial Questions
    © 2011Peskin, Shegog, Markham & Tortolero. All Rights Reserved.
  • 15. Cast of Characters
    © 2011Peskin, Shegog, Markham & Tortolero. All Rights Reserved.
  • 16. Activities
    Information Transfer
    Modeling
    Teen Talk:
    Peers
    Reel Life
    Serial
    Skill-building
    & Practice
    © 2011Peskin, Shegog, Markham & Tortolero. All Rights Reserved.
  • 17. IYG-AIAN: Building the partnership
    It’s Your Game…Keep It Real for American Indian/Alaska Native Youth
    Funded by the Centers for Disease Control & Prevention (SIP10-033)
  • 18. Project Premise
    Internet-based programs have the ability to reduce health disparities by providing rural and underserved communities with access to state-of-the-art health interventions.
    Adapting interventions for cultural appropriateness requires the use of multiple research strategies and community based participatory research activities.
    Strong, multi-site partnerships can successfully build local capacity and support development of sexual health resources in underserved communities.
  • 19. Study Activities
    PHASE1
    PHASE2
    Year 1
    Gain Community Support
    Review Existing Resources for AI/AN youth
    Usability Testing of IYG-Tech
    Year 2
    Adaptation
    Usability Testing of IYG-AIAN
    Year 3
    Efficacy Trial – RCT (5 month F/U)
    1200 AI/AN youth (12-14 yo)
    Year 4
    Complete efficacy trial (16 month F/U)
    Dissemination of Results
    Form partnerships with youth-popular websites
  • 20. Regional PerspectiveGwenda Gorman, ITCA
  • 21. Collaborative Agreements
    Certificate of Confidentiality
    (pending acceptance)
    A Certificate of Confidentiality from the CDC prevents the research team from being forced to share data about the community and its individuals, including if by legal order. This protection is permanent, even if a participant leaves the study or dies.
    Data Sharing Agreement & Publication Protocol
    Protocol for use and reporting of data – decision-making partnership.
    IRB approval (tribal health council and health research review committees)
    Human Subjects Review ensuring ethical conduct of research.
  • 22. Potential Benefits
    AI/AN Youth
    Delay initiation of any kind of sex
    Reduce:
    Sexual activity
    Drug and alcohol use
    Increase/improve:
    Use of protection during sex
    Overall emotional well-being
    Long-term benefits:
    • Reduce the number of AI/AN teen pregnancies
    • 23. Reduce AI/AN youth’s rates of HIV and other STIs
    AI/AN Community
    • A community-centered online sexual health curriculum for AI/AN youth.
    • 24. Increased universal awareness for AI/AN issues
    • 25. Multi-region participation ensures a diversified voice to represent each group
    • 26. Build Relationships & significant support from research investigators and collaborative partners for the future
  • Dissemination of Results
    Results sharing:
    Tribal communities
    Research community
    If intervention is effective, encourage widespread adoption across tribal communities
    Investigate partnerships with websites popular with AI/AN youth
  • 27. Questions?
  • 28. CDC. Youth Risk Behavior Surveillance Survey – United States, 2009. MMWR 2010;59(SS-5):1–142.
    De Ravello L, Personal Communication 4-8-2010
    Hamilton B, et al. Births: Preliminary Data for 2009. MMWR. 2011;59:1-29.
    CDC, Indian Health Service. Indian health surveillance report—sexually transmitted diseases 2007. Atlanta, GA: U.S. Department of Health and Human Services.
    CDC. Cases of HIV infection and AIDS in the United States and dependent areas, by race/ethnicity, 2003–2007. 14th ed. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009.
    Craig Rushing S. Media technology use among Native American teens and young adults: Evaluating their utility for designing culturally-appropriate sexual health interventions targeting Native American youth in the Pacific Northwest. Doctoral dissertation. 2010.
    Project Red Talon (2009) , 400 Native youth (age 13-21 years) living in Oregon, Washington, and Idaho.
    Tortolero, SR, Markham, CM, Peskin, MF, Shegog, R, Addy, RC, Escobar-Chaves, SL, Baumler, ER. It's Your Game, Keep It Real: Delaying Sexual Behavior with an Effective Middle School Program. Journal of Adolescent Health. 2010; 46(2):169-179. Published online: 18 August 2009.
    Saturday April.02.2011
    Sex::Tech Conference 2011
    References