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.

Linking research to the practice of youth development

Stephen Hamilton

A special issue of the journal Applied Developmental Science explores the application of a truly translational research process to "youth development." The issue is edited by Stephen Hamilton, BCTR associate director for youth development.

From the abstract for the issue:

The articles in this special issue address some of the challenges of strengthening the links between research and the practice of youth development and identify some approaches that have worked well. Youth development emerged from practice rather than from theory or research. Research that is most useful in the practice of youth development honors that primacy both by exploring questions that are important in practice and by engaging practitioners as partners, not merely as consumers.

...

A consistent theme of this issue is that the conventional portrayal of research-practice linkage as uni-directional is both inaccurate and inadequate. Different kinds of research inform different dimensions of practice; practice can and should guide research. Efforts to aid practitioners in accessing, understanding, and using research findings should be accompanied by efforts to aid researchers in posing questions about topics that matter to practitioners, conducting research that comprehends the complexity in which those topics are embedded, honoring practitioner wisdom, and enlarging the circle of those who conduct research.

The issue includes the following articles (BCTR staff in bold):

Stephen F. Hamilton (2015) Linking Research to the Practice of Youth Development, Applied Developmental Science, 19:2, 57-59, DOI: 10.1080/10888691.2015.1030016

Stephen F. Hamilton (2015) Translational Research and Youth Development, Applied Developmental Science, 19:2, 60-73, DOI: 10.1080/10888691.2014.968279

Reed W. Larson, Kathrin C. Walker, Natalie Rusk & Lisa B. Diaz (2015) Understanding Youth Development from the Practitioner's Point of View: A Call for Research on Effective Practice, Applied Developmental Science, 19:2, 74-86, DOI: 10.1080/10888691.2014.972558

Mary Agnes Hamilton & Stephen F. Hamilton (2015) Seeking Social Inventions to Improve the Transition to Adulthood, Applied Developmental Science, 19:2, 87-107, DOI: 10.1080/10888691.2014.975227

Jane Powers, Mary Maley, Amanda Purington, Karen Schantz & Jutta Dotterweich (2015) Implementing Evidence-Based Programs: Lessons Learned From the Field, Applied Developmental Science, 19:2, 108-116, DOI: 10.1080/10888691.2015.1020155

Nicole Yohalem & Vivian Tseng (2015) Commentary: Moving From Practice to Research, and Back, Applied Developmental Science, 19:2, 117-120, DOI: 10.1080/10888691.2014.983033

Linking research to the practice of youth development - Applied Developmental Science

“30 Lessons for Loving” highlighted in the Miami Herald, includes BCTR family tie-in

Bob and Edith Levine, along with hundreds of other long-married couples, contributed their stories and advice to the recent book by BCTR director Karl Pillemer, 30 Lessons for Loving: Advice from the Wisest Americans on Love, Relationships, and Marriage. They recently told the story of how they met and married to the Miami Herald, in an article about the book. Here Edith recounts some of the difficulties of their early years together, and Bob's attitude towards the relatively small problems of domestic life:

 “It wasn’t all a bowl of roses. I remember when things were tough and I would say, ‘The kids had the measles, mumps and chicken pox, the roof was leaking, the basement was flooded, we couldn’t pay the bills,’” Edith said. “But Bob would say, ‘No one’s shooting at you, take a shower.’ That was his mantra.”

Bob, now 89, learned not to sweat the small stuff after being wounded in World War II. He took part in the Normandy invasion in 1944 as a member of the 90th Infantry Division of the U.S. Army. He was injured during the invasion, strafed by shrapnel, leaving a broken leg and a crushed right foot.

Edith also notes that Bob's upbeat attitude has been a counterbalance to her worrying,

“That has been what made my life easier. I’m a worrier and he is so positive all the time,” Edith said. “I was very blessed.”

Jane Powers

The full article contains more from the couple, including the moving story of how Bob's life was saved by a German doctor during WWII. In an additional connection to the BCTR, Bob and Edith Levine are the parents of ACT for Youth director Jane Powers.

Lifetime of loving - what long-married couples can teach us about relationships - Miami Herald

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!

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 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.

BCTR at the American Public Health Association annual meeting

Jennifer Tiffany and Mary Maley

Jennifer Tiffany and Mary Maley presented papers at the American Public Health Association (APHA) annual meeting, held in Boston, November 2-6, 2013 and attended by approximately 13,000 public health professionals and stakeholders.

Jennifer Tiffany's paper, Context matters: Setting-level influences on active program participation and HIV risk reduction among urban youth (co-authored by Deinera Exner-Cortens, Mary Maley, Sara Birnel Henderson, and John Eckenrode) was part of a panel on Social-Ecological Supports for Reproductive Health Among Diverse Populations of Adolescents and Young Adults sponsored by APHA's Maternal and Child Health section.

Mary Maley's paper, 'It's just a piece of paper': Teen perceptions of orders of protection for dating violence was part of a panel on Issues in Family Violence: Policy, Prevention, and Intervention, also sponsored by the Maternal and Child Health section. It was co-authored by Jane Powers, Deinera Exner-Cortens, Sara Birnel Henderson, and Jennifer Tiffany.

Work from two BCTR projects were also presented:  Evaluating the implementation of evidence-based programs that promote adolescent sexual health: Lessons learned from New York State (Jane Powers, Christine Heib, Amanda Purington, and Mary Maley) and the poster Partnering with homeless youth to study the scope and nature of youth homelessness (Jane Powers, Christine Heib, and Amanda Purington).

The theme of this year's annual meeting was "Think global, act local: Best practices around the world" and included a rollout of the APHA's media campaign "We can do better" (video) aimed at building health equity as well as confronting and eliminating health disparities. This was the 141st annual meeting of the APHA, whose mission is to "improve the health of the public and achieve equity in health status" and whose new tag line is "For science. For action. For health."

ACT for Youth sponsors “Provider Day”

Across New York State, communities want to promote the health and well-being of their young people more effectively. The ACT for Youth Center of Excellence offers key support to these efforts among 76 community projects, building their capacity to offer positive youth development and adolescent sexual health programming. On September 23rd, close to 200 program providers from these New York State projects came together in Albany for “Provider Day,” a professional development opportunity sponsored by ACT for Youth.

The three provider groups represented are all funded by the New York State Department of Health (NYSDOH), as is the ACT for Youth Center of Excellence. Comprehensive Adolescent Pregnancy Prevention (CAPP) and Personal Responsibility Education Program (PREP) projects aim to reduce adolescent pregnancy and STDs/HIV by providing evidence-based sex education and expanding opportunities for teens in their communities. Successfully Transitioning Youth to Adolescence (STYA) providers focus on pre-teens. Their charge is to prevent teen pregnancy and STDs through positive youth development approaches such as expanding developmental opportunities and promoting long-term, positive relationships with adults.

Jane Powers

Provider Day participants were welcomed by John Eckenrode, BCTR director; Jane Powers, director of the ACT for Youth Center of Excellence; Dr. Guthrie S. Birkhead, Deputy Commissioner of the Office of Public Health, NYSDOH; and Kristine Mesler, Director of the Bureau of Maternal and Child Health, NYSDOH. Glynis Shea from the Konopka Institute at University of Minnesota delivered a dynamic keynote challenging the audience on how to communicate more effectively to build public support. A wide range of workshops were offered on topics from reaching immigrant parents to making better use of agency Facebook pages. Facilitated networking sessions provided project staff the opportunity to share their challenges and expertise on topics of mutual interest, such as roles for youth, and effective community outreach.

In evaluations, participants commented “Great job! I learned a lot that I can immediately apply,” and “Let’s do more of this!” Powers commented, “We were thrilled to offer this professional development day to our many youth-serving providers to build connections among those who are working to support adolescents across New York State.”