DIY is an innovative intervention based on positive youth development and youth-centered design. This presentation will describe how to involve youth in the program design, share strategies on how to engage vulnerable populations, and highlight preliminary findings.

2. Successes and Lessons Learned From An
Innovative Youth-Centered Initiative
the youth + tech + health conference (May 6-7, 2018)
yth live
Ythlive.org
Melisa Price (UCSF), Mariela Uribe (YTH), and Emma Schalmm

3. The views expressed in written training materials,
publications, or presentations by speakers and
moderators do not necessarily reflect the official policies
of the Department of Health and Human Services; nor
does mention of trade names, commercial practices, or
organizations imply endorsement by the U.S.
Government.
Funded by Department of Health and Human Services,
Family and Youth Services Bureau, under grant
#90AP2688
2

4. • 5-year randomized-control trial in
Fresno, California
• In-person, group-based,
comprehensive sexual health
education + phone app
• Homeless and unstably housed youth,
youth of color, LGBTQ youth, and
Native American youth
• Ages 13-19
What is In the Know?
4

5. WH
6
BACKGROUND

6. Adolescent Birth Rates: US, California
70.9
46.7
31.6
17.6
61.8
47.7
22.3
0
10
20
30
40
50
60
70
80
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
CA
US
34.2
BirthRate(per1,000femalesage15-19)
Sources: California Department of Public Health and Office of Adolescent Health (2017)
7

7. Fresno County
Sources: (Map) California Adolescent Sexual Health Needs Index. California Department of
Public Health, Maternal, Child and Adolescent Health Program; 2016. 2016 STD
Surveillance Report. STD Control Branch.
Adolescent birth rate
• Fresno: 32.6
• CA: 17.6
• Chlamydia rate (females 15-24)
• Fresno: 3637 (#1)
• CA: 2747
• Gonorrhea rate (females 15-24)
• Fresno: 605 (#3)
• CA: 355
8

8. Lessons learned
• SRH education often limited
• Lacking connections to local services
• Curricula out-of-date, not designed by youth
• Often missing youth who most need the information
10

9. WH
WHAT TO
DO?
11

10. Objectives
1. Increase use of condoms and contraceptives among those who are
sexually active.
2. Improve awareness about healthy relationships and decrease the
incidence of sexual, physical, and emotional violence among youth.
3. Improve educational and career skill development and attainment.
4. Develop healthy life skills including goal setting and stress
management.
5. Increase access to healthcare and other services through referrals
and information.
12

11. positive youth development
positive youth
development
human-centered
design
We involve & engage youth as
partners & respect their knowledge,
strength, & leadership.
We design, iterate, & share
solutions that meet the needs of
youth & reflect their experiences.
13

12. Youth-Centered Health Design
Inspiration
During this phase, we conduct
interviews, research, and learn as
much about the issue as possible.
15

13. Youth Centered Health Design in Fresno
Photo: Decker, 2017
16

14. Youth-Centered Health Design
Ideation
During this phase, we brainstorm
solutions to make prototypes.
18

15. Youth-Centered Health Design: Ideation
19
Photo: YTH, 2017

16. Youth-Centered Health Design
Rapid Prototyping
Before implementation…
We start to rapid prototype. This means we are bringing
one of the ideas to life, using creative materials.
20

17. 22

18. Youth-Centered Health Design: Prototyping
Photo: Decker, 2017
23

19. Youth-Centered Health Design
Inspiration
Ideation
Implementation
25

20. 27

21. 29

22. 30

23. 32
WHAT DOES IT
LOOK LIKE IN
PRACTICE?

24. Setting
• Alternative schools
• Foster care
• Reservations
• Genders & Sexualities Alliance
• Boys and Girls Clubs
• Fresno Housing Authority
34

25. What Has Worked Well
• Implementation after school or evening
• Referring to “In the Know” as an adolescent development
program
• Incentives for completing all the modules
• Food and drinks
• Flexibility with schedule
• Success with other implementation sites
40

26. Challenges
• Intervention vs control group
• Difficult to schedule with site
• In school implementation because of comprehensive
sex education
• Not all youth have cell phones
• Data, space, battery, share with siblings
• Retention of youth
• Too many days? Length? Priorities?
41

27. 43
DOES IT MAKE A
DIFFERENCE?

28. Sample and Research Question
• Groups of 10-20 students (cohorts)
• Estimated 136 cohorts/1360 participants
• Enrolled over 2 years
• To what extent does In the Know impact short
term and long term outcomes?
• What sociodemographic variables moderate the
impact of In the Know?
46

29. Sexual and reproductive health (n=133)
48.1
11.0
59.4
0
10
20
30
40
50
60
70
80
90
100
Ever had vaginal sex Ever pregnancy Know of SRH clinic
Source: Preliminary PREIS baseline results March, 2018
%
51

30. Baseline use of tech for health (n=133)
To look for sexual
health info: 21%
To find or schedule
health services: 23%
53Source: Preliminary PREIS baseline results March, 2018

31. Focus group quotes
It explained a
lot…things like you
actually need.
I thought it was
going to be boring.
It was good
actually.
56

32. Favorite parts
Budgets
Healthy relationships
and communicating
without fighting
The first day
– it was funny
Interviewing
The jobs because
it’s going to
prepare us for
our future
57

33. Least favorite parts
The time
seemed short
[Youth] would rather
just go home and
sleep. Go smoke and
drink.
They didn’t go
over other
jobs
I was tired
58

34. Acknowledgements
• Mara Decker, our PI
• The talented teams at
YTH, Fresno EOC, and
IHPS/UCSF
• All the youth who helped
to develop In the Know
and continue to offer their
insights
60
Photo: Sullivan, 2017

35. References Resources
• YTH.org – Youth-centered tech solutions
• Healthpolicy.ucsf.edu – Evaluation resources
• Kahoot.com – Game-based learning
• Amaze.org – Sexual and reproductive health
educational videos
61
• California Department of Public Health. 2017.
Adolescent Births in California 2000-2015.
Sacramento, CA: California Department of Public
Health.
• (Map) California Adolescent Sexual Health Needs
Index. 2016.California Department of Public
Health, Maternal, Child and Adolescent Health
Program.
• 2016 STD Surveillance Report. 2016. STD
Control Branch.

36. Melisa Price
University of California, San Francisco
melisa.price@ucsf.edu
Mariela Uribe
YTH
mariela.uribe21@gmail.com
Emma Schlamm
YTH
emmas@gmail.com