Engaging Cornell students to study adolescent sexual health in the digital age

Janis Whitlock and Jane Powers

BCTR researchers Janis Whitlock (director, Cornell Research Program on Self-Injury and Recovery) and Jane Powers (director, ACT for Youth) have joined forces to study how technology impacts teen sexual behavior. Their project Adolescent Sexual Health in the Digital Age explores youth and “technology-mediated sexual activity” (TMSA): how young people engage in sexually explicit activities through digital technologies, such as online pornography, sexting, and hook up apps. The work is supported by a recently-awarded Hatch grant.

As a starting point, Whitlock and Powers surveyed youth service providers, sex educators, and parents to assess their overall level of awareness and concern about TMSA, and to capture what these individuals have been observing among the youth with whom they interact.

To learn directly from young people themselves, the researchers enlisted the help of undergraduates. In collaboration with Professor Kelly Musick and students in her Research Design, Practice and Policy class (PAM 3120) Whitlock and Powers launched a semester-long project to develop a survey that could be used to explore TMSA among college students. Class members first participated in focus groups led by members of the ACT for Youth evaluation team, research assistants in the Cornell Research Program on Self-Injury and Recovery lab, and Callie Silver (HD ’16), a Cooperative Extension intern and core research assistant for the project. The focus groups prompted students to discuss how they think their peers navigate sex in this new digital landscape. The students then learned how to code the focus group transcripts and generate themes to develop a college survey. Once the survey was developed, students conducted a pilot study, generating approximately 400 responses. Finally, the class presented their findings as well as their recommendations for revisions to the survey.

In this mutually rewarding project, students learned about research methods through a real- world project, and in turn their work provided BCTR researchers with essential information that will be incorporated into an NIH proposal to further examine this understudied, but important, topic.

Supporting Young Families: The Role of Social Network Analysis

Young parents, especially teen parents, must depend on a network of support and multiple services to raise their children, achieve educational and financial goals, and keep their families healthy. Resources for expectant and parenting teens and young adults may come from many directions: supportive housing, child care, and employment services, to name a few – but often there is no clearly identifiable system that coordinates these efforts.

Pathways to Success, an initiative of the New York State Department of Health, aims to better connect parenting teens and young adults to key resources in Buffalo, Rochester, and the Bronx. The initiative funds one community college and one public school district in each community, with technical assistance provided by the BCTR’s ACT for Youth Center of Excellence. Specifically, ACT staff members Amanda Purington, Dora Welker, Divine Sebuharara, Mary Maley, Christy Heib, Jane Powers, and Heather Wynkoop-Beach have all played important roles on various parts of this initiative.

While Pathways grantees had a good sense of available services, coordinating these services to best serve youth in need was a daunting challenge. ACT staff recognized that social network analysis could be used in these communities to both create a distinct picture of existing networks and identify ways to strengthen collaborations.

Social network analysis is a set of methods for examining social structures and relationships within a network. Using the PARTNER social network analysis tool (created at the University of Colorado Denver), ACT staff worked with grantees to build customized online surveys and analyzed results in order to better understand collaborative activity within grantee networks and possibilities for new connections.

To define their networks, all the Pathways grantees were asked to compile a list of organizations with whom they already have relationships, or would like to be connected. ACT staff then developed PARTNER-based surveys tailored to each community. Next grantees distributed the surveys to their network lists, encouraging participation. Finally, ACT staff quantified the results, creating a visual representation of how the different organizations are -- or are not – connected.

These example maps show a city's grantees' (yellow dots) network with all collaborations (top) and then those at the "networking" and "coalition" levels of engagement.

Using the survey results, ACT staff created two types of network maps for the Pathways to Success initiative. The first map illustrates the level of collaboration. “Networking” is the most basic level: members of the network are aware of one another and may have informal relationships, but do not make any major decisions together. Networking is followed on the continuum by cooperation, coordination, and coalition, with collaboration at the highest level – when all major decisions are made collectively. The second map depicts frequency of contact among organizations. “Higher” and “more frequent” are not always ideal or feasible. The maps help spur discussion of what level of collaboration and frequency of contact would best serve young families in each community.

Three network indicators are also included in the analysis: 1) density -- the number of network ties relative to the total number of possible ties – which demonstrates the overall cohesiveness of the collaborative, 2) degree centralization, which refers to how well connected the members of the network are collectively, and 3) the level of trust among the members as a whole. For example, one community network had an overall trust score of 78%, indicating that a majority of responding organizations reported high levels of mutual trust. In addition to these whole network indicators, many other metrics can also be examined for each of the organizations in the network.

To discuss the findings, ACT for Youth held “data dialogue” sessions with grantees in each community. The network maps clarified where communication and collaboration are strong, and where there are opportunities to help the community better serve expectant and parenting young people. Some grantees were surprised that while their community was rich in resources, those resources were not being evenly accessed. Grantees also recognized a lack of coordination among certain organizations, resulting in some members of the network “doing the same job many times over.” Other grantees realized the need to focus on strengthening and building community systems to include organizations that may not have completed the survey, but should be at the table. For example, one group was surprised when they noticed that their county health department and a home visiting program had not responded to the survey, prompting the grantees to think about strengthening connections to include these valuable resources in future conversations.

Following these initial sessions, the grantees are holding meetings with their networks of community organizations. These meetings mirror the first data dialogue session, but allow an opening for the larger community to discuss how they can strengthen relationships in the entire network, bring others to the table, decrease duplication of services, and take steps to bridge gaps.

For the Pathways to Success initiative, this first implementation of the survey will serve as a baseline for the communities. ACT for Youth will help grantees administer the survey annually, documenting change over time, including stronger relationships among the vital organizations within each community.

Collaboration with CCE on new youth development curriculum

A new training curriculum for youth work professionals, Positive Youth Development 101, has just been released by the ACT for Youth Center of Excellence. Authored by Jutta Dotterweich, the curriculum was developed in collaboration with New York State (NYS) 4-H, the NYS 4-H Educator Association, the Risk and Thriving in Adolescence Program Work Team, and several youth development consultants and former trainers of the NYS Advancing Youth Development (AYD) Partnership.

This curriculum is designed for professionals who work directly with youth in late childhood and adolescence in a wide range of educational, recreational, or residential programs. It is especially appropriate for newly hired 4-H or community educators within the Cornell Cooperative Extension (CCE) network.

The first phase of curriculum development consisted of a literature review and series of meetings to reflect on lessons learned from past youth development training initiatives such as the AYD Partnership. This led to a draft curriculum structured as a 10-hour training. The draft curriculum was pilot-tested in three upstate locations and in New York City. Participants included CCE 4-H educators and other CCE community educators working with youth, as well as community-based youth work professionals outside the CCE network. During each pilot training, participants provided extensive feedback on activities and materials.

Positive Youth Development 101 and all related materials are available without charge from the ACT for Youth site. This curriculum development and training project is supported by the USDA National Institute of Food and Agriculture, Smith Lever project 2012-13-272.

ACT for Youth at American Evaluation Association conference

Powers, Purington, and Maley

This October, staff from the ACT for Youth Center of Excellence participated in the annual conference for the American Evaluation Association held in Denver, CO. For the conference, Jane Powers, Mandy Purington, and Mary Maley organized a panel on the theme of building capacity to strengthen youth programming through the use of evaluation findings. The ACT team described how the Center of Excellence has been supporting the implementation of evidence-based teen pregnancy prevention programs. Through case examples, they illustrated how implementation data are summarized and made accessible to program staff, and how these data help staff reflect on evaluation findings and identify ways to improve fidelity and quality. Colleagues from the University of Wisconsin joined the panel to present on their work in Madison with community program staff, educators, and youth.

In a demonstration session, the ACT team described the three-phase needs and resources assessment process they developed to identify gaps in local supports for expectant and parenting young people. Their approach includes a community partner brainstorm phase, a key informant interview process, and youth focus groups with expectant and parenting young people. They described how the information gained from this process led to action planning for each of the participating communities.

Finally, Jane Powers served as a discussant on a panel organized by Abe Wandersman addressing the issue of organizational readiness for implementing innovations. The three papers in this session focused on how to assess, build, and evaluate organizational readiness.

ACT for Youth supports sex education and positive youth development at Provider Day

Attendees at Provider Day
Photo by Brian Maley

This September, the ACT for Youth Center of Excellence (COE) sponsored Provider Day 2014, a professional development conference for 224 teen pregnancy prevention program staff from communities across New York State. The COE provides technical assistance, training, and evaluation for three pregnancy prevention initiatives funded by the New York State Department of Health. Sex educators and youth service professionals from each initiative came together in Albany to share and gain new insights, strategies, and tools to promote healthy development among youth.

The evening before Provider Day, the BCTR hosted a reception that set a warm and collegial tone. Jane Powers and John Eckenrode opened the day’s events, and BCTR staff offered workshops on a range of topics, including Self-Care and Youth Work (Heather Wynkoop Beach and Michele Luc), Youth with Mental Health Concerns (Jutta Dotterweich), Using Evaluation Data (Mary Maley and Amanda Purington), and Life Purpose and Teens (Janis Whitlock), among others.

One participant wrote,

I found the day valuable and validating. I believe we need all the validation we can get when working in this field. It's not easy, and when we can recharge and gain new knowledge and tools, I know that I come back to the office looking for ways to use the information I have gotten. Thank you!

Visiting fellow Ravhee Bholah joins the center this semester

Ravhee Bholah, an associate professor at the Mauritius Institute of Education, received a Fulbright Scholarship to study policy and community partnerships that promote adolescent sexual health, with a particular focus on school-based programs. He plays leading roles in curriculum development on sexual health, HIV prevention, and education for sustainable development in the Republic of Mauritius. Ravhee works closely with the United Nations Development Programme, UNESCO, the Swedish International Centre of Education for Sustainable Development, and the Southern African Development Community Regional Environmental Education Programme on regional programs addressing these issues. He has been a member of various committees at national and regional levels. For instance, he has been the chairperson of Network of African Science Academies Expert Group Committee since 2012 and a member of the South African Development Community Education for Sustainable Development Research Network since 2008. At national level in Mauritius, he is a member of steering committees at the Ministry of Education and Human Resources for the following: (1) Sexuality Education, (2) Health and (3) Climate Change Adaptation. He is a board member of the National Ramsar Committee in Mauritius. He has also done considerable work on climate change education. Ravhee will be working in the BCTR as a visiting fellow through the end of December.

He will be mentored by Jennifer Tiffany during his time at Cornell, and he will be working very closely with the ACT for Youth Center of Excellence.

Ravhee is joined his wife Rouma and their three sons, Divyesh, Sudhakar, and Prabhakar, ages 10, 12, and 15, respectively.

ACT Youth Network presents to New York State agencies

NYC ACT Youth Network at Youth Development Team Meeting in Albany

Since 1998, the New York State Youth Development Team (YD Team), a public-private partnership of 30 leading statewide agencies and youth-serving organizations, has been dedicated to promoting the health and well being of adolescents in our state. The YD Team has provided leadership that integrates positive youth development practices and principles into New York State services and supports intended for youth, families, schools, and communities.

The ACT for Youth Center of Excellence (COE) provides ongoing support to the YD Team, who hold meetings three times a year in Albany. Partners share cutting edge research findings, best practice information, and resources to help coordinate state and community youth development efforts.

For the past three years, the team has held an annual Youth Meeting, inviting diverse groups of young people from across the state to make presentations on issues that impact their lives. Led by COE staff Sara Birnel Henderson and Michele Luc, five members of the ACT Youth Network travelled from New York City to Albany and presented to the YD Team at their July 17th meeting. Youth Network members, who act as consultants to the COE and the NYS Department of Health (among others), reported on the projects in which they have been involved, including

• reviewing website content to assure its youth friendliness;
• developing and testing focus group questions on health topics;
• and observing educators implementing evidence-based teen pregnancy prevention programs to provide feedback for quality improvement.

The ACT Youth Network is available to consult on noncommercial services, products, media campaigns, and research designed for youth. Contact Sara Birnel Henderson to discuss your project.

ACT teams with communities to better support young parents

Erin Graupman, District Coordinator of Student Health Services, Rochester City School District

This July Pathways to Success community teams from Buffalo, the Bronx, and Rochester met for the first time on campus. They reviewed the results from needs and resources assessments of services and support available for young parents in their respective cities. Funded by the New York State Department of Health, and administered through the BCTR's ACT for Youth Center of Excellence, the Pathways to Success Initiative pairs one public school district with one community college (in Buffalo, the Bronx, and Rochester). The aim of this initiative is to create community infrastructure that will help expectant and parenting teens and young adults improve their health, education, and self-sufficiency, as well as strengthen their families.

Jane Powers, director of ACT for Youth, explains the importance of this initiative,

This project tries to improve outcomes for this population, who are prone to fall through the cracks of our service delivery systems. Often they don’t finish school and don’t get prenatal care, which can compromise their future health, occupational and economic outcomes.

To inform the initiative, ACT for Youth developed a process that engaged each community in the assessments. The community partners gathered data through a series of key informant interviews with local agencies. Then ACT for Youth staff consulted expectant and parenting youth by conducting focus groups in each community. Data from the interviews and focus groups were coded here at Cornell. ACT for Youth staff then travelled to each community to discuss findings in “data dialogue” sessions that allowed for rich and locally-based reflection and planning.

Reginald L. Cox

As the final step in this process, staff from each community project came together in Ithaca on July 14-15, 2014. The first day was dedicated to connecting across the communities, followed by workshops given by Jutta Dotterweich (ACT for Youth director of training and technical assistance) on collaboration, systems-level change, and sustainability. On the second day, groups focused on finding common themes, defining and prioritizing actionable steps, and a hearing a closing talk on engaging fathers from a regionally known expert, Reginald L. Cox, director of the Fatherhood Connection.

 New York communities join to help teen parents - Cornell Chronicle

ACT for Youth introduces PhotoVoice to Career Explorations participants

As part of the 4-H Career Explorations program, the ACT for Youth Center of Excellence hosted a three-day “Focus for Teens” workshop to introduce youth to a qualitative, participatory action research method called PhotoVoice. Thirteen youth participants explored the question, “How youth-friendly is Ithaca?” from the perspective of potential college students. The project was led by Mary Maley and the ACT for Youth research and evaluation team, including Amanda Breese, Christine Heib, Brian Maley, Jennifer True Parise, Amanda Purington, and Divine Sebuharara.

In an interactive, small group format, participants were introduced to social science research methods, and how research can be used to mobilize community action. They learned how to tell a story with photographs, including the elements of photography they could use to highlight their perspectives as they gathered data.

The group identified and discussed the qualities of youth-friendliness that they would look for in a college town. Then, in a hands-on field trip with digital cameras, they visited three locations in the city of Ithaca to take pictures.

Participants evaluating photos

Over 100 photos were selected by the youth for analysis, which was conducted using an iterative grounded theory approach. Three themes were identified: mobility (including accessibility and transportation), aesthetics (including both the natural and built environment), and amenities (including services for youth, jobs, entertainment, and food).

Results highlighted the presence of youth-friendly qualities in the city, including the use of color, art, and greenery in public spaces, along with available bus service and a variety of shops and restaurants. Some unfriendly qualities the youth identified included buildings, streets, and sidewalks in need of repair, and the amount of advertising for alcohol and smoking products. At the conclusion of the program, youth participants presented their results in a poster session for BCTR faculty, staff, and invited guests.

ACT for Youth at HHS Conference

Jane Powers, Jutta Dotterweich, and Amanda Purington

Jane Powers, Jutta Dotterweich, and Amanda Purington of the ACT for Youth Center of Excellence were presenters at the 2014 U.S. Health and Human Services Teen Pregnancy Prevention Grantee Conference in Washington, DC this June. The conference brought together federally funded prevention programs to enhance understanding of best practices, programs, and strategies, particularly on the theme of “Bridging the Gaps: Eliminating Disparities in Teen Pregnancy and Sexual Health.”

Conference participants offer evidence-based programs in their communities in order to support youth in improving sexual health (e.g., delaying sexual activity and using condoms and effective contraception when they do become sexually active). These programs are not new, but to ensure positive results funders are now strongly emphasizing fidelity to program design as well as implementation quality. Recognizing that many participants struggle to collect and use data effectively, Powers and Purington offered tools to track attendance, monitor fidelity, and assess quality, as well as strategies to help facilitators use data to improve program implementation. They also shared lessons learned in New York State’s efforts to scale up evidence-based programs.

Dotterweich and Powers focused on building organizational capacity for evidence-based programming. They introduced participants to resources intended to enhance facilitator competencies, as well as an online training on implementing evidence-based programs in adolescent sexual health that was recently developed by ACT for Youth.

Jane Powers is project director for the ACT for Youth Center of Excellence, where Jutta Dotterweich is director of Training and Technical Assistance and Amanda Purington is director of Evaluation and Research. The Center of Excellence supports the New York State Department of Health in its efforts to promote adolescent sexual health.