Evaluating the Effectiveness of a Parenting Curriculum Training of Trainers and its Utilization in Border Hispanic Communities of Texas

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  • Ref: Markham CM, Lormand D, Gloppen KM, Peskin MF, Flores B, Low B, House LD. Connectedness as a predictor of sexual and reproductive health outcomes for youth. J Adolesc Health . 2010 Mar;46(3 Suppl):S23-41. Epub 2010 Jan 22. Review. To review research examining the influence of ‘‘connectedness’’ on adolescent sexual and reproduc- tive health (ASRH). Connectedness, or bonding, refers to the emotional attachment and commitment a child makes to social relationships in the family, peer group, school, community, or culture. A systematic review of behavioral research (1985–2007) was conducted. Inclusion criteria included examination of the association between a connectedness sub-construct and an ASRH outcome, use of multivariate analyses, sample size of 􏰂100, and publication in a peer-reviewed journal. Results were coded as protective, risk, or no association, and as longitudinal, or cross sectional. Findings from at least two longitudinal studies for a given outcome with consistent associations were considered sufficient evidence for a protective or risk association. Eight connectedness sub-constructs were re- viewed: family connectedness (90 studies), parent–adolescent general communication (16 studies), parent–adolescent sexuality communication (58 studies), parental monitoring (61 studies), peer connectedness (nine studies), partner connectedness (12 studies), school connectedness (18 studies), and community connectedness (four studies). There was sufficient evidence to support a protective association with ASRH outcomes for family connectedness, general and sexuality-specific parent– adolescent communication, parental monitoring, partner connectedness, and school connectedness. Sufficient evidence of a risk association was identified for the parent over control sub-construct of parental monitoring. Connectedness can be a protective factor for ASRH outcomes, and efforts to strengthen young people’s pro-social relationships are a promising target for approaches to promote ASRH.
  • Kirby, D., Lepore, G., & Ryan, J. (2005). Sexual risk and protective factors–factors affecting teen sexual behavior, pregnancy, childbearing and sexually transmitted disease: Which are important? which can you change FIX Connectedness as a Predictor of Sexual and Reproductive Health Outcomes for Youth Christine M. Markham, Ph.D.a,*, Donna Lormand, M.P.H.a, Kari M. Gloppen, M.P.H.b, Melissa F. Peskin, Ph.D.a, Belinda Flores, M.P.H.a, Barbara Low, Dr.P.H.a, and Lawrence Duane House, M.A.c de Graaf, H., Vanwesenbeeck, I., Woertman, L., Keijsers, L., Meijer, S., & Meeus, W. (2010). Parental support and knowledge and adolescents' sexual health: Testing two mediational models in a national Dutch sample. Journal of Youth and Adolescence, 39 (2), 189-198. doi:10.1007/s10964-008-9387-3 Miller, K. S., Fasula, A. M., Dittus, P., Wiegand, R. E., Wyckoff, S. C., & McNair, L. (2009). Barriers and facilitators to maternal communication with preadolescents about age-relevant sexual topics. AIDS and Behavior, 13 (2), 365-374.
  • Centers for Disease Control and Prevention. Special focus profiles: STDs in racial and ethnic minorities. In: Sexually Transmitted Disease Surveillance, 2007. Atlanta, GA: Dept. of Health and Human Services; 2009. Available online at: http://www.cdc.gov/std/stats07/minorities.htm#a4 . Accessed: 2010 May 14. Bartholomew, L., Parcel, G., Kok, G., & Gottlieb, N. (2006).  Planning health promotion programs: An intervention mapping approach . San Francisco: CA: Jossey-Bass.
  • Is this correct? I thought we asked this question in the pre/posts and found that.

Transcript

  • 1. Evaluating the Effectiveness of a Parenting Curriculum Training-of-Trainers and its Utilization in Border Hispanic Communities of Texas Sheetal Malhotra , MBBS, MS Diane Santa Maria, APHN, MSN Hilda Chavarria, BS Melissa Steiner, MSA, CHES
  • 2. Background
    • The Medical Institute developed the Building Family Connections (BFC) curriculum
    • Developed from previous work in border areas
    • Information and skills training for parenting adults on parent-child connectedness
    • Goal to increase parent-child sexual health communication and connectedness
    Source: Markham,CM et al. J Adolesc Health . 2010
  • 3. Background
    • Parent-child communication and connectedness associated with
      • reduction in adolescent risk behaviors including sexual activity 1,2
    • Parents face many barriers to communicating with their children about sex
      • lack of knowledge, communication skills, and self-efficacy 3,4
    Sources: 1. Kirby, D et al Sexual risk and protective factors 2. Markham, C et al. 3. de Graaf, H et al J Youth Adolescences 4. Miller, K et al AIDS and Behavior
  • 4. Hispanic Communities
    • Disproportionately affected by sexual health outcomes 1
    • Social norms may be barrier to sexual health communication 2
    Sources: 1. CDC http://www.cdc.gov/std/stats07/minorities.htm#a4 2. Bartholomew, L et al Planning health promotion programs: An intervention mapping approach
  • 5. Exponential Program Effects
    • Community educators can be effective mediators to overcome parental barriers through education and skill building
    • Each trained educator can reach numerous parenting adults producing an exponential effect on parent-child sexual health communication
    • Training community educators across the country
  • 6. Objectives
    • Evaluate the effectiveness of BFC curriculum training for community educators
    • Assess utilization in border Hispanic communities in Texas
    • Evaluate effectiveness in transferring this information to parenting adults through trained community educators
  • 7.  
  • 8. Methods: Training & Delivery
    • 10-hour BFC curriculum
    • 2.5-day training for community educators to
      • learn and practice facilitation skills
      • plan, recruit, & market program
      • provide BFC to parents in their communities
  • 9. Methods: Training & Delivery (cont.)
    • Community courses
      • implemented based on parent feedback
      • scientific knowledge and effective parenting & communication strategies
      • interactive and skill building formats
  • 10. Methods: Evaluation
    • Training evaluation
      • usability
      • capacity building
      • logistics & delivery
    • Pre/post-surveys
      • knowledge
      • attitudes
      • intents
      • behaviors
  • 11. Results
    • May 2008: BFC Curriculum Training
      • 34 educators trained
      • pre/post surveys
      • training evaluation
    • May 2007- June 2009: BFC curriculum courses
      • 263 Hispanic parenting adults
      • border communities in TX
      • pre/post surveys
  • 12.  
  • 13. Results: Educators
    • 34 educators; 6 males, 27 females
    • Age: 25 to 65 years; median = 37 years
    • Ethnicity
      • 26% Black
      • 15% Hispanic
      • 44% White
      • 12% Asian
      • 3% Other
  • 14. Results: Educators
    • Significant increases in participant knowledge
    <0.10 25 (78) 17 (57) Decision making maturity among teens <0.10 32 (97) 23 (74) Risk of pregnancy in girls with boyfriends more than 3 years older then them <0.05 23 (70) 14 (44) Problem of dating violence <0.05 33 (100) 18 (60) Site of fertilization p Post Survey N (%) Pre-survey N (%) Item
  • 15. Results: Educators
  • 16. Results: Educators
    • Participants strongly agreed that the training
      • was useful (97%)
      • was enjoyable (94%)
      • materials were useful (91%)
      • objectives were achieved (82%)
      • prepared them to hold the BFC course (82%)
  • 17.  
  • 18.  
  • 19. Results: Parenting Adults
    • 263 parenting adults; 24 males, 238 females
    • Age: 18 to 80 years; median = 40 years
    • Ethnicity
      • 98% Hispanic
      • 1% White
      • <1% Other
  • 20. Results: Parenting Adults
    • Matched Responses:
    • 170 parenting adults; 15 males, 155 females
    • Age: 18 to 69 years; median = 40 years
    • Ethnicity
      • 98% Hispanic
      • 1% White
      • <1% Other
  • 21. Results: Knowledge <0.01 166 (99) 230 (91) Most pregnant teens are abandoned by their partners <0.01 160 (95) 167 (69) Early sexual debut and risk of multiple sexual partners <0.01 158 (94) 184 (72) Condoms make sex “safe” <0.01 151 (89) 186 (77) Risk of infertility with STIs <0.01 161 (96) 162 (69) Cause of cervical cancer p Post survey N (%) Pre-survey N (%) Item
  • 22. Results: Knowledge (cont.) p Post Survey N (%) Pre-survey N (%) Item <0.01 144 (87) 163 (69) Link between dating violence and sexual activity <0.01 143 (86) 114 (50) Abuse as a risk factor for multiple sexual partners <0.01 137 (82) 159 (64) Dating violence problem <0.01 159 (96) 62 (27) Site of fertilization <0.01 148 (88) 121 (48) Risk of pregnancy in girls who have a boyfriend more than 3 yrs older than them
  • 23. Results: Attitudes <0.01 152 (92) 195 (78) Feel comfortable talking to children about STIs and how to prevent them <0.01 158 (94) 206 (84) Its okay for my child to start having sex when they are in a committed relationship such as marriage p Post Survey N (%) Pre-survey N (%) Item
  • 24. Results: Skills & Behaviors <0.01 59 (36) 79 (32) Frequency of communication regarding sexual health <0.01 162 (96) 214 (88) Strategies to start a conversation with youth about sex p Post survey N (%) Pre-survey N (%) Item
  • 25. Results: Parenting Adults
  • 26.  
  • 27. Results: Parenting Adults
  • 28. Conclusions
    • Training is effective in increasing knowledge and skills of educators
    • Trained educators can then provide BFC curriculum to parents in their communities
    • Utilization of BFC curriculum has shown increased parent-child sexual health communication in border Hispanic areas
  • 29. Implications for Programs, Policy, and/or Research
    • Use of trained educators to reach parents is a viable and effective model
    • Such models are effective in minority populations such as Hispanics
    • Programs for minority populations should focus on increasing parental involvement in youth sexual health through trained community educators
    • Further research on utilization and impact of such models needed ie., in youth
  • 30.  
  • 31. Funding for the Study
    • This study was supported by grant # 90AE0147 from the Administration of Children and Families (ACF) and grant # 5U58DP000409 from the Centers for Disease Control (CDC) and Prevention Division of Adolescent and School Health (DASH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the ACF, CDC, the Department of Health and Human Services or the U.S. government.
  • 32. Thank You!
    • For more information contact
    • Sheetal Malhotra, MBBS, MS
    • [email_address]
    • 512-328-6268 ext 206