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Most evidence-based teen pregnancy prevention programs focus on individual-level sexual health outcomes (e.g., STIs, pregnancy, teen births). To expand program and intervention approaches within teen pregnancy prevention (TPP), the Department of Health and Human Services funded two grantees, Innovative Teen Pregnancy Prevention Programs (iTP3) and Innovation Next (IN) to support and enable early innovation to advance adolescent health and prevent teen pregnancy. The pipeline to support and enable innovation in adolescent health is complex, resulting in barriers and challenges to research and evaluation of novel programs. This paper presents some of the barriers encountered by the grantees. Data for this paper was collected from key personnel and secondary data sources. Focus group participants included seven representatives (n = 7) across the two organizations. Focus group questions assessed barriers related to innovative intervention development and evaluation. Key findings include four barriers to evaluation when fostering innovative adolescent-focused pregnancy prevention interventions. These included (a) funding constraints on evaluation activities, (b) innovation readiness for rigorous testing, (c) evaluation knowledge and expertise on innovation-development teams, and (d) challenges with evaluation requirements. Novel and promising system- and technology-focused interventions with the potential to impact TPP require alternative tools and approaches for evaluation. This would allow research to focus on how systems-level change mechanisms (i.e., policy, access to care) impact sexual risk behaviors and better understand ecological and social determinants of health for the priority population. The advancement of approaches to impact adolescent health identifies the need to expand the focus of evidence-based interventions beyond the adolescent themselves and understand approaches that impact external contexts and environments related to reducing sexual and reproductive health (SRH) risk-taking., (© 2023. The Author(s).)

Background: The teenage birth rate in the USA has considerably decreased in recent decades; however, more innovative, collaborative approaches are needed to promote adolescent health and prevent teenage pregnancy at the community level. Despite literature on the promising results of the collective impact (CI) model for health promotion, there is limited literature on the model's ability to reduce teenage pregnancies in a community. The Central Oklahoma Teen Pregnancy Prevention Collaboration is applying the CI model to foster collaboration among multiple stakeholders with the goal of increasing community and organizational capacity to improve adolescent health outcomes. This paper reports the findings from the initiative's implementation evaluation, which sought to understand whether the CI model improved collaboration among organizations and understand barriers and facilitators that affected program delivery., Methods: Program implementers and evaluators jointly developed research questions to guide the intervention and evaluation design. The Consolidated Framework for Implementation Research (CFIR) was used to assess program components including the intervention characteristics, organization setting, community setting, facilitator characteristics, and the process of implementation. Primary sources of data included performance measures, meeting observations (n = 11), and semi-structured interviews (n = 10). The data was thematically analyzed using CFIR constructs, community capacity domains, and the five constructs of CI., Results: Key findings include the need for shortened meeting times for meaningful engagement, opportunities for organizations to take on more active roles in the Collaboration, and enhanced community context expertise (i.e., those with lived experience) in all Collaboration initiatives. We identified additional elements to the core constructs of CI that are necessary for successful implementation: distinct role identification for partner organizations and incorporation of equity and inclusivity into collaboration processes and procedures., Conclusions: Results from this implementation evaluation provide valuable insights into implementation fidelity, participant experience, and implementation reach of an innovative, systems-level program. Findings demonstrate the context and requirements needed to successfully implement this innovative program approach and CI overall. Additional core elements for CI are identified and contribute to the growing body of literature on successful CI initiatives., (© 2022. The Author(s).)

BACKGROUND: Youth may be reluctant to seek health care from school health providers due to feeling embarrassed or stigmatized in the health office environment or worried about their confidentiality. The purpose of this project was to create a set of youth‐centered health posters that promote youth engagement with nursing staff and to standardize health messaging across high schools in Hawaii school‐based clinics. METHODS: Two community advisory boards, 1 composed of 10 youth stakeholders (mean age 17 years) and the other of 7 adult stakeholders, informed poster development utilizing web‐based discussion groups. The discussions were transcribed, and additional data was collected using field notes and anonymous digital messages. Adult advisory board members also provided feedback on suggested poster text through an online survey. RESULTS: Youth and adult advisory board participants identified 4 key health concerns facing youth: confidentiality, sexual health, relationships, and mental health. Based on input from the 2 advisory boards, 4 posters were developed, each centered on 1 key health issue. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: School‐based posters can convey important messages to help youth understand their health care rights and responsibilities, as well as identify important issues open for discussion with nurses. CONCLUSION: Posters are an underutilized tool for school health providers to create welcoming, inclusive health care environments and facilitate health‐related conversations with youth. This paper describes participant feedback about the characteristics of a memorable poster and briefly outlines current knowledge and recommendations for school health providers regarding each of the 4 health issues. [ABSTRACT FROM AUTHOR]

The Sexual Health And Peer Education (SHAPE) program implemented in middle schools in Oklahoma County utilizes a hybrid adult and peer educator model to deliver sexual health programming. While peer educators have been incorporated into school-based sexual health programs in the past, this program is unique in its approach to preparing and engaging peer educators. Researchers synthesized data from interviews with program implementers and focus group discussions with teenage peer educators and middle school students who recently participated in the program to understand the process elements that contribute to the benefit of the SHAPE program model. Interviews with program implementers described the thorough peer educator recruitment and training process. Teenage peer educators felt well-prepared to deliver lessons, and through this program, they developed leadership skills, confidence, and grew personally. Middle school students revealed that peer educators were relatable and provided a positive experience where they could engage and ask questions. The application of a hybrid adult and teenage peer educator model proved useful for delivering sexual health topics and benefited students and teenage peer educators. This study's findings highlight elements that can be utilized in future sexual health programming to prepare and engage teenage peer educators in more meaningful ways. [ABSTRACT FROM AUTHOR]

Background: Teen pregnancy prevention in the United States has traditionally focused on the development, testing, and subsequent implementation of a set of evidence-based programs (EBPs), recommended nationally. However, these existing EBPs often do not prioritize the most at-risk or vulnerable populations. Methods: The Innovative Teen Pregnancy Prevention Programs (iTP3) project was funded to facilitate the development of new, innovative programs to reach disparate populations. Through a mixed methods design, iTP3 evaluated the process and resulting innovative programs from five iterative cohorts of funded organizations, referred to as Innovators. iTP3 utilized both a traditional funding model with more traditional methods of capacity building assistance, but transitioned over time to a design-focused funding model in which organizations and individuals developed innovative programs through an intensive human centered design process. Results: Evaluation results showed that the resulting portfolio of programs had differences in the types of programs resulting from the differing funding models. Notable differences among programs from the two funding models include program length, along with personnel, time, and resources needed to develop and manage. Conclusion: Both traditional and design funding models led to innovative programs, with notable differences in the development process and resulting programs. [ABSTRACT FROM AUTHOR]

Game-based learning offers an interactive and effective way to teach health content and skills. This article discusses feasibility testing of Using the Connect (UTC), an innovative, game-based sexuality education program to evaluate its acceptability among youth. Utilizing mixed methods in a single case study design, qualitative and quantitative data was collected from youth (surveys, facilitated discussions, and observations). Qualitative data triangulated quantitative findings that youth liked the program design, felt the games and content were relatable, and learned knowledge and skills around adolescent development, accessing information, communication, and making healthy decisions through playing the games. Overall, UTC was highly acceptable to the youth; they had fun and learned information and skills. Not only would most participants recommend the program to friends, all reported they would participate in the program again and use the information they learned in the future. [ABSTRACT FROM AUTHOR]

Objective: LinkedUp is a multi-sector partnership focused on linking older teens (ages 17-19) to sexual and reproductive health (SRH) services at school-based health centers (SBHCs) in Mississippi. The purpose of this study was to examine key partnerships in LinkedUp development, focusing on community needs that initiated the formation of the partnership, and patterns of collaboration among these partners. Methods: In 2018, researchers conducted interviews (N = 3) and focus groups (N = 9) with Mississippi school administrators and high school and college students. In 2019, evaluators examined collaboration between these community partners (N = 6) using an interorganizational network analysis survey. Results: Thematic analyses of qualitative data indicated a need to commit to linking older teens to SRH services by increasing communication/ planning among community stakeholders. Network analysis scores included an average network density of 1, strength of tie of 3.04, and degree centrality of 4.6 (SD = 1.4) for partners. Conclusions: Our findings illustrate how community stakeholders inform the development of a public health program as critical partners during both needs assessment and program development phases. This information can be used by practitioners and policymakers interested in addressing complex, community-level health issues. [ABSTRACT FROM AUTHOR]

Over the past 20 years, teenage birth rates in the United States have declined substantially but continue to persist among certain populations. During this time period, a series of rigorously tested teen pregnancy prevention (TPP) programs were developed, and a number of evidence-based interventions (EBIs) emerged. In April 2017, researchers reviewed EBIs in TPP and examined each program's socioecological levels of intervention, measurements approaches, and other ecological aspects. Findings indicate that the majority of TPP EBIs are aimed at the individual and/or interpersonal level of intervention. Furthermore, the programs were evaluated using the individual as the unit of analysis, regardless of what level the EBI targets. These findings represent serious gaps, specifically a lack of system-, environmental-, and policy-level EBIs. Future TP approaches should target multiple levels of social ecology, ensure measurements appropriately capture changes within these levels, and shift to a focus on a longer term population health improvement. [ABSTRACT FROM AUTHOR]

At-risk adolescents may experience Social Determinants of Health (SDoH) that lead to higher rates of risky sexual behavior, including increased risk of pregnancy and sexually transmitted infections. These SDoH may include components such as unstable family structures, incomplete education, and poverty. Targeting at-risk youth for sexuality education is one way to work toward decreasing sexual health disparities. However, preferences for sexuality education approaches may differ among at-risk youth by additional factors including sex and sexual orientation. The purpose of this study was to describe sexuality education preferences among at-risk youth and how sexuality education preferences differ based on sex and sexual orientation in an at-risk sample of high school-aged youth in Texas. Results indicate sexuality education preferences differ based on sex and sexual orientation when examined by sexual health topics and methods of delivery. Implications of this study indicate including at-risk youth in sexual health programs may be a way to target those at-risk of adverse SDoH, but these groups also have specific preferences for sexuality education. [ABSTRACT FROM AUTHOR]

Adolescents are influenced by the type, length and quality of the connections shared with different people throughout their lifespan. Relationships with peers, friends, and adults help to shape knowledge, attitudes, and beliefs related to health. Recognizing healthy or unhealthy characteristics allow youth to strengthen relationships and interactions with others. In this interactive teaching strategy, students identify and rank characteristics of friend and romantic relationships. Students are challenged to generate authentic stories about relationships incorporating these traits. National Health Education Standards and National Sexuality Education Standards provide the base of the teaching strategy. [ABSTRACT FROM AUTHOR]

This study evaluates whether a randomized school-based intervention for adolescent teenage mothers successfully helped participants achieve better financial independence and economic prospects. Project Mothers and Schools (PMAS) is an initiative intended to modify attitudes and beliefs related to self-sufficiency, parenting, educational goals and achievement, career goals, health behaviors, and interpersonal relationships with family members. PMAS participants were surveyed at baseline and 12months after intervention enrollment to evaluate the receipt of financial support from 11 sources. The 48 "core group" participants received a basic level of services, whereas the 43 "core-plus group" participants received the same basic services and additional enhanced services. Wilcoxon signed-rank tests were used to identify statistically significant changes in participant responses from baseline to 12months post-intervention. Both groups reported higher levels of employment 12months post-intervention compared to baseline. The core-plus group used more Food Stamps 2.673, p=0.008) and reported receiving more child support (z=2.236, p=0.025) 12months post-intervention versus baseline. PMAS benefited all participants by promoting employment 12months post-intervention versus baseline. The enhanced services offered to the core-plus group appeared to also increase participant access to Food Stamps and child support, sources which assist participants down the path toward eventual financial independence. [ABSTRACT FROM AUTHOR]