HORIZON INTERNATIONAL SOLUTIONS SITE

Problem Overview:

Unwanted pregnancies and sexually transmissible infections among youth.

Helping youth avoid unwanted pregnancies and sexually transmissible infections is a challenge that faces communities around the world. Children having children is a problem with dire consequences for both the young people themselves and for society as a whole. Young people with children have sharply reduced education and employment opportunities and a poorer quality of life. Meeting their needs places a severe burden on both families and public resources. Moreover, sexually active teens are at great risk of contracting AIDS and other sexually transmitted diseases.

Background:

Launched in 1993, the Plain Talk initiative is aimed at helping communities develop and implement locally acceptable plans to protect sexually active youth from unwanted pregnancy and sexually transmissible infections. It is based on three critical, underlying principles:

1) Community residents are the primary stakeholders in changing community behavior and, as such, must play a critical role in the decision-making process.

2) There must be strong consensus among the residents about what changes are necessary.

3) Communities must have access to, or the means to obtain, reliable information about the problems and practices they are trying to address.

The Foundation believes that adults play the most important role in shaping messages and motivation for reducing sexual risk-taking by adolescents. Therefore, the distinguishing characteristics of the Plain Talk strategy are its focus on adult acknowledgement of teen sexuality and adult reinforcement of appropriate contraceptive use. In addition to encouraging straightforward communication about sexual behavior and contraception, Plain Talk assists communities in improving adolescents' access to preventive health care. It requires all sites to complete a community mapping process to identify existing reproductive health resources and services as well as potential barriers to adolescent use.

The Plain Talk initiative is being implemented at five sites across the United States -- Atlanta, Hartford, New Orleans, San Diego and Seattle. Site selection was based on rates of teen pregnancy, a demonstrated readiness within the community to confront these problems, and the presence of a neighborhood organization with existing youth programs and established credibility in the community. At each site, a lead agency was selected to oversee the program. The chosen communities were charged with three missions: to encourage parents and other adults to engage youth in frank and open discussions regarding sexuality and contraceptive use, to improve communication between residents and neighborhoods about the needs and concerns of adolescents, and to improve the contraceptive services youth receive from local health care providers.

One of the sites where the Plain Talk initiative is being implemented is the Logan Heights neighborhood (Barrio Logan) of San Diego, California. This is a primarily Mexican-American community in the southeastern section of the city where 44 percent of its 13,488 residents live below the poverty level (according the the 1990 census). The Logan Heights Family Health Center serves as the lead agency for the project.

The lead agency in each site was asked to convene a core group of community residents and agency representatives in order to conduct an extensive data collection effort ("community mapping"), disseminate the results and engage the community in a dialog, formulate goals and develop a message, and prepare a three-year implementation plan. The San Diego Plain Talk core group includes representatives of four segments of the local community: adults, teens, professionals from local health, religious and educational institutions, and public figures. Some local institutions and community residents receive a stipend as an incentive for maintaining their involvement. In return, they provide space for Plain Talk activities, disseminate information, and help to recruit participants.

The community mapping process and the information it provided resulted in the creation of community education forums and the Vecino-a-Vecino (Neighbor-to-Neighbor) program to address the perceived needs of the community adults. A concerted effort was made to build community leadership and involvement and to strengthen parental roles as the most viable mechanism for ensuring the protection of sexually active youth.

The Vecino-a-Vecino program is a community strategy for engaging adults in understanding adolescent sexuality and protecting sexually active youth. Community residents are trained as "promotoras" (adult peer educators) and recruit other community residents to participate in a four-session, eight-hour training program in the privacy of a resident's home. The in-home education sessions are designed to build communication skills and increase knowledge about human sexuality and reproduction. This outreach and education effort has been instrumental in creating a cadre of "askable adults". It has increased the confidence, knowledge, and comfort level of parents and other adults, and has furthered the acceptance of open dialog as an important means of preventing unwanted teen pregnancies and sexually transmissible infections. Combined with the community education forums, the Vecino-a-Vecino program has been very effective in encouraging parents and adults to take a more active role in the lives of their children in this bicultural, bilingual environment.

Status:

Achieving a consensus and a commitment to the Plain Talk program has been very difficult in this predominantly Latino community. Until the community mapping survey broke through their denial, residents were reluctant to accept the fact that many of the youth in their community were sexually active.

Marta Flores, the project manager, describes her work as an "ongoing educational process" for both Plain Talk team members and the community at large. To facilitate commitment to the program, she expresses Plain Talk goals in values that this Latino culture embraces -- strong family ties and the responsibility of parents to nurture and protect their young. These values are reflected in the logo developed for the project -- two parental figures surrounding a youth with a slogan that reads "Plain Talk: With Love and Respect."

Step by step, she and her staff have succeeded in moving team members from their initial reluctance to a gradual acceptance of Plain Talk and a commitment to being its messengers in the community. Many are now willing to put aside their personal beliefs for the sake of protecting their children from early pregnancy and exposure to HIV and other sexually transmissible infections. The San Diego Plain Talk community core group remains strong and active. Its members meet twice a month and now include 54 community residents and 20 community agencies. To date, 460 community residents have participated in its educational forums, and 717 in the Vecino-a-Vecino program.

Documentation:

An evaluation of the Plain Talk program and additional dissemination products are anticipated by November of 1998.

Weblinks:

Contacts and Submitted by:

Debra Delgado
Annie E. Casey Foundation
Tel: 410-547-6600
Fax: 410-547-6624
701 St. Paul Street
Baltimore, MD 21202
United States of America
debra@aecf.org