Personal Responsibility Education Program PREP

Connecticut

Personal Responsibility Education Program

(PREP)

Impact of Teen Pregnancy

Public Health Impact

Pregnant teens are at increased risk for health complications including premature birth, delivering low birth weight infants, other serious health problems, and death.

The children of teen mothers are at increased risk of either being in foster care, or being a victim of abuse and neglect when compared to children born to mothers aged 20 or older.

Educational Impact and Socioeconomic Impact

The impact and effect of teen pregnancy and high school dropout is multi-generational. Children born to teen parents who have not completed high school are more likely to drop out of high school.

64% of children born to an unmarried, teenage high-school dropout live in poverty, compared to 7% of children born to women over age 20, who are married and are high school graduates.

Disparities

Although the overall Connecticut teen birth rate has been on a steady decline since 1994, statistically significant disparities in teen birth rates have persisted in our state throughout the decade. This is evident particularly among non-Hispanic Black/African American and Hispanic teens between 15-19 years old, as compared to non-Hispanic White/Caucasian teens (Figure 1; p < 0.001). In 2008, one in every 13 Hispanic women between 15 and 19 years of age gave birth to a baby (78 per 1,000), a figure over nine times higher than that among non-Hispanic White/Caucasian women (8.5 per 1,000). The teen birth rate among non-Hispanic Black/African American women was over four times higher (41.8 per 1,000).

Within Connecticut, the town with the highest teen birth rate (ages 15-19 years old) for calendar years 2006-2008 combined was New Britain (75.6 per 1,000), three times higher than the statewide rate of 25.0 per 1,000, and nearly two times higher than the 2007 U.S. rate of 42.5 per 1,000 (Hamilton, et al, 2009; J. Morin & C. Stone, DPH, personal communication). Hartford (64.3 per 1,000), Bridgeport (63.7 per 1,000), Waterbury (58.3 per 1,000), New Haven (50.6 per 1,000), Groton (45.5 per 1,000) and Meriden (43.1 per 1,000) had teen birth rates that were at least 1.7-fold higher than the overall statewide rate, and these towns were elevated significantly compared to U.S. rate. Other towns with teen birth rates greater than the statewide average included East Hartford (37.5 per 1,000), Torrington (33.6 per 1,000), Norwich (30.1 per 1,000), New London (29.5 per 1,000), Windham (28.6 per 1,000), West Haven (27.7 per 1,000), Manchester (27.0 per 1,000), and Danbury (26.3 per 1,000).

Towns with high teen birth rates in 2008 were correlated with children living in poverty (r = 0.79), and were marginally correlated with high rates of high school dropout (r = 0.55). These data indicate that strategies to prevent teen pregnancy need to be coordinated with neighboring high schools. These data also suggest that teen pregnancy prevention strategies should include culturally-sensitive messages of appropriate literacy that reach Hispanic and non-Hispanic Black/African American teens. High teen birth rates are located predominantly in towns of high and moderate population, but elevated teen birth rates are also located in surrounding areas with less population density.

Evidence-based Prevention Strategies

In 2010, the Connecticut Department of Public Health was awarded Personal Responsibility Education Program (PREP) funding from the Department of Health and Human Services, Family and Youth Services Bureau, Administration for Children and Families to implement evidence-based teen pregnancy, HIV and STD prevention programs to youth ages 13-19. The evidence-based programs were found through rigorous research and evaluation to be effective in reducing sexual activity, increase contraceptive use in already sexually active youth and delaying unplanned pregnancy and include both abstinence and contraception.

Connecticut PREP Evidence-based Program Sites

State PREP Team Partners

In 2010, the Department of Public Health convened a PREP Advisory Team, which met weekly throughout the development of the PREP State Plan. The partners include the Department of Public Health (Lead Agency), Department of Children & Families, State Department of Education, Department of Mental Health & Addiction Services, Planned Parenthood of Southern New England, True Colors, and Partners in Social Research, LLC.

Evidence-based Programs

The Department of Public Health partnered with youth serving professionals across the state to implement evidence-based programs in their school, facility or setting. Health teachers were certified as facilitators of the respective program(s) and received facilitator kits, student workbooks and other health education supplies. The Department of Public Health provides ongoing technical assistance and support for the facilitators.

Reducing the Risk

Reducing the Risk (RTR) is a skills-based curriculum designed to help teens prevent pregnancy and the transmission of STD, including HIV. It was developed for 9^th & 10^th grade high school students. Reducing the Risk was one of the first rigorously evaluated sexuality education curricula to have a measurable impact on behavior. The program delivers and reinforces the following messages:

Abstinence is the best and safest choice.
Youth should avoid unprotected sex.
Youth should always use protection if they have sex.

Local Implementing Sites

The Department of Public Health partnered with the Capitol Regional Education Council (CREC) to implement the Reducing the Risk program as part of the School Health Education curriculum in the following high schools:

High School Name	Street Address	City
Academy of Aerospace & Engineering High School	1289 Blue Hills Avenue	Bloomfield
Metropolitan Learning Center	1551 Blue Hills Avenue	Bloomfield
Polaris	474 School Street	East Hartford
Public Safety Academy	1617 King Street	Bloomfield
Two Rivers Magnet High School	15 Van Dyke Street	Hartford

Be Proud! Be Responsible!

Be Proud! Be Responsible! is a six part curriculum designed for high school students and delivered over six, one-hour sessions. The program is delivered through group discussions and exercises, videos, games, and role- play.

Be Proud! Be Responsible! is geared toward behavior modification and building knowledge, understanding, and a sense of responsibility regarding STD/HIV risk in vulnerable youth. It was designed to affect knowledge, beliefs, and intentions related to condom use and sexual behaviors, such as initiation and frequency of intercourse.

The core content of Be Proud! Be Responsible! includes:

Teaching youth correct information about HIV, STDs and pregnancy and prevention strategies
Behavioral attitudes/outcome expectancies
Builds negotiation skills and problem-solving skills
Builds self-efficacy in adolescents and a desire to practice abstinences
Builds participants’ confidence in their skills by incorporating positive reinforcement, support and constructive feedback

Rigorous research and evaluation has proven that Be Proud! Be Responsible! has a miserable impact on behaviors.

Local Implementing Be Proud! Be Responsible! Sites

The Department of Public Health partnered with the Connecticut Technical High School System (CTHSS) to implement Be Proud! Be Responsible! as part of the School Health Education curriculum in the following high schools:

School Name	Street Address	City
Abbott THS	21 Hayestown Road	Danbury
Wolcott THS	75 Oliver Street	Torrington
Bullard-Havens THS	500 Palisade Avenue	Bridgeport
Cheney THS	791 W. Middle Tpke.	Manchester
Ellis THS	613 Upper Maple Street	Danielson
Goodwin THS	735 Slater Road	New Britain
Grasso THS	189 Fort Hill Road	Groton
Kaynor THS	43 Tompkins Street	Waterbury
Norwich THS	7 Mahan Drive	Norwich
O'Brien THS	141 Prindle Avenue	Ansonia
Platt THS	600 Orange Avenue	Milford
Prince THS	401 Flatbush Avenue	Hartford
Vinal THS	60 Daniels Street	Middletown
Whitney THS	100 Fairfield Avenue	Hamden
Wilcox THS	298 Oregon Road	Meriden
Windham THS	210 Birch Street	Willimantic
Wright THS	120 Bridge Street	Stamford

The Department of Public Health partnered with the following sites to deliver the Be Proud! Be Responsible! program to high school youth:

Community/School	Street Address	City
Branford High School	185 East Main Street	Branford
Bulkeley High School	300 Wethersfield Avenue	Hartford
East Hartford High School	869 Forbes Street	East Hartford
High School, Inc.	275 Asylum Street	Hartford
Journalism and Media Academy	150 Tower Avenue	Hartford
Klingberg Family Centers	37 Linwood Street	New Britain
Weaver High Culinary and Arts Academy	415 Granby Street	Hartford
Windham High School	355 High Street	Willimantic

The Department of Public Health partnered with the Department of Children & Families to deliver the Be Proud! Be Responsible! program as part of the High School Health Curriculum in the following residential facilities:

Facility	Street Address	City
Solnit South (Riverview)	915 River Road	Middletown
CT Juvenile Training School	1225 Silver Street	Middletown
Solnit North	36 Gardner Street	East Windsor

Making Proud Choices! (2011 version)

Making Proud Choices! A Safer Sex Approach to STDs, Teen Pregnancy, and HIV Prevention is an eight-module curriculum that provides young adolescents with the knowledge, confidence, and skills necessary to reduce their risk of sexually transmitted diseases (STDs), HIV, and pregnancy by abstaining from sex, or using protection correctly and consistently. It is based on cognitive behavioral theories, focus groups, and the researchers' extensive experience working with youth. Making Proud Choices! is an adaptation and extension of the original Be Proud! Be Responsible! curriculum in that it integrates STD, HIV and pregnancy prevention. To reduce risk for STD/HIV and pregnancy risk-related behaviors, young adolescents need not only knowledge and perception of personal vulnerability, but also positive attitudes towards condom use, skills, and confidence in their ability to use condoms. The Making Proud Choices! curriculum is designed to meet those needs. The goal of Making Proud Choices! is to empower young adolescents to change their behavior in ways that will reduce their risk of becoming infected with HIV and other STDs, and their risk for pregnancy.

Making Proud Choices! was designed to be used with small groups ranging from six to 12 participants, but it can be implemented with larger numbers of youth. The curriculum can be implemented in various community settings, including schools or youth-serving agencies. The curriculum has eight hours of content divided into eight one-hour modules. It also can be implemented in eight sessions of 60 minutes each, or in four two-module sessions.

Implementing Making Proud Choices Sites

The Department of Public Health partnered with the New Britain YWCA to deliver the Making Proud Choices program to youth in the following tow middle schools.

Middle School	Street Name	City
Slade Middle School	183 Steele Street	New Britain
Pulaski Middle School	757 Farmington Avenue	New Britain

Teen Talk (A Promising Program)

Teen Talk is an intervention program developed by Planned Parenthood of Southern New England (PPSNE) with a goal to decrease rates of teen pregnancy and STD, HIV among teens aged 13-19. It is a co-ed, comprehensive PREP program designed to provide reproductive health education, and facilitate access to reproductive health care in order to delay sexual activity, prevent unplanned pregnancy, and prevent sexually transmitted diseases (STDs) and infections (STIs). Teen Talk is a ten-hour program comprised of four 2.5-hour sessions. Core design uses the Health Belief Model (HBM) behavior change theory.

The Teen Talk program was delivered to youth in child welfare congregate care group home settings. The program was rigorously evaluated by the Partners in Social Research, LLC after receiving Institutional Review Board approvals from the Department of Public Health and Department of Children & Families.

PREP Teen Talk Participant Homes 2013

Streetwise to Sex-wise

Streetwise to Sex-wise Sexuality Education for High-Risk Youth (2nd Edition) was developed by Steve Brown and Bill Taverner. It provides a comprehensive model for a basic series on human sexuality for high-risk teens in non-traditional settings who often have limited academic skills and are resistant to classroom-based learning. Lessons are divided into a series for older teens (ages 14-19) and a series for pre-teens and young teens (ages 9-13).

Local Streetwise to Sexwise Implementing Sites

This program was delivered to youth in the Department of Children and Families Short term Assessment and Respite programs (STAR homes). In 2014-2015 the program will be expanded to programs serving youth with developmental disabilities and other youth in non-traditional settings.

Real Life. Real Talk. Sex Ed for Parents

Real Life. Real Talk. Sex Ed for Parents is a 90 minute program designed by Planned Parenthood of Southern New England (PPSNE) health educators with objectives to:

identify the importance of the parental role and the level of their influence as sexuality educators;
identify messages that parents give their children about sexuality and the impact of those messages on their sexual health;
identify age-appropriate responses and information to give their children regarding sexuality; and provide resources that provide positive and accurate sexuality information for tweens and teens.

Program Delivery

The Real Life. Real Talk. Sex Ed for Parents education has been delivered to foster and other parents across the state.

Human Sexuality and Adolescent Development

Human Sexuality and Adolescent Development was developed by Erin Livensparger, Regional Director, Education & Training for Planned Parenthood of Southern New England in 2011. To goal of the program is to increase participants’ regarding human sexuality. Participants are asked to explore their beliefs and values around human sexuality and discuss how those beliefs may or may not impact their behavior. Participants are taught the variety of influences that shape sexual identity, as well as ways to increase their comfort discussing issues related to human sexuality.

Human Sexuality and Adolescent Development Program Delivery

This program has been delivered to health education teachers as part of the orientation process for facilitator certification of evidence-based programs. Human Sexuality and Adolescent Development was delivered to State employees that oversee programs working with youth, including the Department of Public Health, Department of Children & Families, Department of Mental Health & Addiction Services and the State Department of Education.

Data Reports

2015 Personal Responsibility Education Program Performance Measures Report

2014 Personal Responsibility Education Program Performance Measures Report

CT Youth Risk Behavior Survey 2013

Forms

Entry Survey

Entry Survey Video for Facilitators

Exit Survey

Exit Survey Video for Students

Instructions for Completing Entry and Exit Questionnaires

Links & Other Information

Adolescent Sexual Health, Confidentiality and Teen Legal Rights: A Basic Primer