Evaluation of a Sexual and Reproductive Health Peer Education Curriculum for North Carolina Latino Adolescents

Latino adolescents in North Carolina face multiple sexual and reproductive health (SRH) challenges compared to their non-Latino peers, consistently reporting increased risky sexual health behaviors, higher rates of unplanned pregnancy and higher rates of sexually-transmitted infections (STIs). While evidence-based SRH interventions exist for adolescents in the United States, few are tailored for Latino adolescents and the challenges they may face. Though approaches such as peer education and advocacy skills have proven effective in SRH interventions to decrease risk of adverse SRH health outcomes, few adolescent SRH programs incorporate these tools for increasing curriculum reach beyond program participants. El Pueblo, Inc., a Latino services and advocacy organization based in Raleigh, NC, sought to fill this need by developing Nuestros Derechos sin Fronteras (DsF) in 2009. DsF is a human rights-based curriculum that addresses SRH among Latino adolescents. In 2012, El Pueblo requested the assistance of a University of North Carolina (UNC) Health Behavior (HB) Capstone team to develop and implement a formal evaluation of DsF. The evaluation of DsF had three goals: 1) improve the DsF curriculum, 2) demonstrate DsF effectiveness, and 3) enhance DsF sustainability. To this end, the Capstone team reviewed existing quantitative and qualitative evaluation tools and created new evaluation materials as needed. Next, the Capstone team created a database to manage DsF evaluation data. Once evaluation materials and the database were completed, the Capstone team implemented the evaluation in collaboration with El Pueblo staff. Finally, the results of this evaluation were analyzed and compiled into a report and used to revise a funding guide that aids El Pueblo in writing grant proposals to sustain its youth SRH programs. Through its work with El Pueblo, the 2012-2013 Capstone team gained experience with evaluating public health programs in a real-world setting. This experience included the use of quantitative and qualitative evaluation methods and increased knowledge about adolescent SRH education and program development. The Capstone team also gained exposure to the non-profit landscape in Raleigh, North Carolina, including the funding environment and resources available from supporting organizations. By collaborating with El Pueblo, the Capstone team established an effective and sustainable DsF evaluation process and identified additional funding sources to support youth SRH programs at El Pueblo. More broadly, the deliverables created by this Capstone project have the potential to establish DsF effectiveness, institutionalize DsF evaluation protocol, and facilitate dissemination of DsF throughout North Carolina.Master of Public Healt

Why Wait Until Our Community Gets Cancer?: Exploring CRC Screening Barriers and Facilitators in the Spanish-Speaking Community in North Carolina

Colorectal cancer (CRC) is a leading cause of death among Hispanics in the United States. Despite the benefits of CRC screening, many Hispanics are not being screened. Using a combined methodology of focus groups and discrete choice experiment (DCE) surveys, the objectives for this research were as follows: (1) to improve understanding of preferences regarding potential CRC screening program characteristics, and (2) to improve understanding of the barriers and facilitators around CRC screening with the Hispanic, immigrant community in North Carolina. Four gender-stratified focus groups were conducted and DCE surveys were administered to 38 Spanish-speaking individuals across four counties in North Carolina. In-depth content analysis was used to examine the focus group data; descriptive analyses and mean attribute importance scores for cost of screening and follow-up care, travel time, and test options were calculated from DCE data. Data analyses showed that this population has a strong interest in CRC screening but experience barrier such as lack of access to resources, cost uncertainty, and stigma. Some of these barriers are unique to their cultural experiences in the United States, such as an expressed lack of tailored CRC information. Based on the DCE, cost variables were more important than testing options or travel time. This study suggests that Hispanics may have a general awareness of and interest in CRC screening, but multiple barriers prevent them from getting screened. Special attention should be given to designing culturally and linguistically appropriate programs to improve access to healthcare resources, insurance, and associated costs among Hispanics