The United States teen birth rate remains the highest of any industrialized nation. Although nationally the rate is declining, the problem remains complex and significant. Cooperative Extension staff in three San Francisco, California Bay Area counties partnered with six community-based teen pregnancy program site practitioners to adopt a new best practice to improve their programs. This article reports on the process, the implementation, and outcomes for both pregnant and parenting teen participants and programs. Male involvement, family involvement, and youth development/participation in sports and exercise were the best practices chosen for implementation

Gong, Elizabeth J

Johns, Marilyn J

Moncloa, Fe

English

Clemson University: TigerPrints

The Journal of Extension Volume 41 Number 6 Article 11 12-1-2003 Practitioners Put Research into Practice Strengthening Community-Based Pregnant and Parenting Teen Programs Elizabeth J. Gong University of California Cooperative Extension, ejgong@ucdavis.edu Marilyn J. Johns University of California Cooperative Extension, mjjohns@ucdavis.edu Fe Moncloa University of California Cooperative Extension, fxmoncloa@ucdavis.edu This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License. Recommended Citation Gong, E. J., Johns, M. J., & Moncloa, F. (2003). Practitioners Put Research into Practice Strengthening Community-Based Pregnant and Parenting Teen Programs. The Journal of Extension, 41(6), Article 11. https://tigerprints.clemson.edu/joe/vol41/iss6/11 This Research in Brief is brought to you for free and open access by the Conferences at TigerPrints. It has been accepted for inclusion in The Journal of Extension by an authorized editor of TigerPrints. For more information, please contact kokeefe@clemson.edu. 	 JOEHOME JOURNAL GUIDELINES ABOUT	JOE CONTACT NATIONAL	JOB	BANKCurrent	Issues Back	IssuesDecember	2003	//	Volume	41	//	Number	6	//	Research	in	Brief	//	6RIB3Practitioners	Put	Research	into	Practice	StrengtheningCommunity-Based	Pregnant	and	Parenting	Teen	ProgramsAbstractThe	United	States	teen	birth	rate	remains	the	highest	of	any	industrialized	nation.	Althoughnationally	the	rate	is	declining,	the	problem	remains	complex	and	significant.	CooperativeExtension	staff	in	three	San	Francisco,	California	Bay	Area	counties	partnered	with	sixcommunity-based	teen	pregnancy	program	site	practitioners	to	adopt	a	new	best	practice	toimprove	their	programs.	This	article	reports	on	the	process,	the	implementation,	and	outcomesfor	both	pregnant	and	parenting	teen	participants	and	programs.	Male	involvement,	familyinvolvement,	and	youth	development/participation	in	sports	and	exercise	were	the	bestpractices	chosen	for	implementation.	IntroductionStaff	in	three	California	counties	partnered	with	six	community-based	teen	pregnancy	programpractitioners	to	strengthen	their	capacity	to	deliver	improved	programs	by	incorporating	bestpractices	that	were	identified	in	the	Best	Practices	in	Teen	Pregnancy	Prevention:	PractitionerHandbook	(Gong	et	al.,	1999).	This	article	presents	the	challenges	and	opportunities	practitionersand	Cooperative	Extension	staff	encountered	in	the	implementation	and	incorporation	of	a	newbest	practice.BackgroundThe	United	States	teen	birth	rate	remains	the	highest	of	any	industrialized	nation.	Although	thenational	overall	rate	has	been	declining	since	its	highest	point	in	1991	(62/1000),	it	was	still	48.7births	per	1000	teen	girls	in	1999	(National	Campaign	To	Prevent	Teen	Pregnancy,	2001).	Nearlyfour	in	10	young	women	become	pregnant	at	least	once	before	they	reach	the	age	of	20.	Eight	in10	of	these	pregnancies	are	unintended,	and	79	%	are	to	unmarried	teens.	Hispanic	teens	havethe	highest	teen	birth	rates.California	continues	to	have	a	higher	teen	birth	rate	than	the	national	rate.	While	nationally,	a	13%increase	in	number	of	teens	is	expected	by	2005,	California's	population	of	13	-	19	year	olds	isexpected	to	increase	dramatically,	by	35%.	Unless	the	teen	birth	rate	declines	markedly,	there	willbe	a	significant	increase	in	the	number	of	pregnant	and	parenting	teens	(California	Department	ofHealth	Services,	2000).Elizabeth	J.	GongProgram	RepresentativeSan	Jose,	CaliforniaInternet	Address:	ejgong@ucdavis.eduMarilyn	J.	JohnsYouth	Development,	Nutrition,	Family	&	Consumer	Sciences	AdvisorHalf	Moon	Bay,	CaliforniaInternet	Address:	mjjohns@ucdavis.eduFe	MoncloaYouth	Development	AdvisorSan	Jose,	CaliforniaInternet	Address:	fxmoncloa@ucdavis.eduUniversity	of	California	Cooperative	ExtensionThis	complex	and	persistent	problem	of	teen	pregnancy	prompted	Cooperative	Extension	staff	inthree	California	counties	to	focus	efforts	on	linking	academic	research	with	teen	pregnancyprevention	programs	to	produce	better	outcomes	for	teens	living	in	highly	urbanized,	multi-ethniccounties.	Findings	from	surveys,	visits	to	local	teen	pregnancy	prevention	programs,	and	aliterature	review	led	to	the	team's	first	effort,	the	publication	of	Best	Practices	in	Teen	PregnancyPrevention:	Practitioner	Handbook	(1999),	which	suggested	10	best	practices	for	practitionersworking	in	teen	pregnancy	prevention	programs.The	Applied	Research	ProjectThe	goal	of	the	project	described	here	was	to	evaluate	the	process	of	best-practiceadoption/implementation--applying	research	to	practice	with	local	teen	pregnancy	preventionprograms.The	objectives	of	the	project	were	to:Document	challenges	and	opportunities	that	grassroots	organizations	face	in	incorporating	anadditional	program	component.Assess	the	role	of	Cooperative	Extension	staff	in	providing	technical	assistance	to	programs	inthe	adoption,	implementation,	and	evaluation	of	a	new	practice.Document	outcomes	for	practitioners	and	participants,	and	determine	Extension	implications.MethodologyRequests	for	proposals	for	grants	to	support	program	innovation	were	sent	to	20	agencies	andschools	with	teen	pregnancy	prevention	programs.	Many	of	the	programs	had	initially	completedsurveys	for	the	handbook	or	were	contacted	through	countywide	teen	pregnancy	preventionnetworks.	Potential	partners	were	asked	to	submit	a	proposal	to	adopt	one	of	the	10	best	practiceslisted	in	the	handbook.	Proposals	were	reviewed	by	the	Teen	Pregnancy	Prevention	Team,	whichconsisted	of	three	Youth	Development	Advisors;	one	Youth	Development	Specialist;	one	Nutrition,Family,	and	Consumer	Sciences	Advisor;	and	the	Project	Coordinator.Partnerships	were	developed	with	agencies	working	in	teen	pregnancy	prevention	in	a	variety	ofways.	Site	visits	were	made	to	25	programs	in	efforts	to	survey	staff	and	learn	more	aboutprograms	in	the	area.	Upon	completion	of	the	handbook,	over	100	books	were	distributed	tocommunity	agencies	and	schools.	The	project	coordinator	was	an	active	member	of	communitycollaboratives	and	participated	in	community	forums	and	fairs.	All	these	activities	contributed	tobuilding	relationships	with	various	schools	and	agencies.Three	schools	and	one	agency	were	selected	to	collaborate	in	the	project.	Grants	were	awarded	toeach	program	for	6	months	to	assist	in	adopting	a	"best	practice."	A	university	special	projectgrant	provided	limited	funding,	so	grants	were	set	at	$900	each.	Due	to	timing	and	fundingconstraints,	implementation	was	limited.Two	school	age	parenting	programs	at	continuation/alternative	high	schools	(Sites	A	and	B)participated	in	the	study	(Table	1).	Pregnant	and	parenting	students	participated	in	generaleducation	and	parenting	education,	focusing	on	developing	positive	parenting	skills.	Bothprograms	offered	practical,	hands-on	experiences	in	the	care	and	education	of	infants	andtoddlers.Another	school	age	parenting	program	(Site	C)	was	situated	in	an	adult	education	campus,providing	education	and	support	to	pregnant	and	parenting	teen	families.Site	D,	a	community-based	agency,	provided	home	visitation	to	pregnant	and	parenting	teenagers.Home-based	support	from	case	managers	focused	on	the	importance	of	family	involvement	inparenting	and	child	development.Table	1.	Program,	Population,	and	Best	Practice	Adopted	at	Four	SitesProgram Population Best	Practice	AdoptedSite	ASchool	Age	and	ParentingProgram.	Family	LearningCenter.	Continuation/Alternative	High	School.Students	14-18	years	old;35	females,	2	males;	93%Latino,	4%	African	Am.,	1%Asian.	High	number	ofstudents	on	free/reducedlunch.Male	Involvement:Collaborated	with	acommunity-based	agencywhose	target	population	isfathers.	Fathers	from	theagency	were	hired	tocontact	and	counsel	fathers,boyfriends,	or	othersignificant	men	in	teenmoms'	lives.Site	BSchool	Age	and	ParentingProgram.	Continuation/Alternative	High	School.Students	13-20	years	old(average	age	~16	years);35	females,	3	males;	86%Latino,	11%	White,	3%African	American.	Highnumber	of	students	onfree/reduced	lunch.Youth	Development/Participation	in	Sports	andExercise:	Hired	former	highschool	student	to	teach	self-defense	and	physicalfitness.	She	was	certifiedblack	belt	in	karate.Site	CSchool	Age	and	ParentingProgram.	Young	ParentsProgram.	School	DistrictAdult	Education	Program.Students	14-25	years	old(average	age	17-18	years);25	females,	3	males;	90%Latino,	5%	African	Am.,	5%White.Male	Involvement:	Focusedon	male	and	familyinvolvement,	primarilybaby's	father	or	boyfriend	ofteen	mom;	dealing	with	theimportance	of	men	inparenting	and	enrichingbaby's	life.Site	DFamily	Advocates	Program.Community	Based	Agency.Pregnant	and	parentingteens;	20	females,	3	males;80%	Latino,	10%	AfricanAm.,	10%	White.Family	Involvement:Focused	on	babies'grandmothers.	Dealing	withissues	such	as	parenting,discipline,	infantdevelopment,	and	theimportance	of	play.Technical	assistance	was	provided	in	the	adoption	and	implementation	of	one	"best	practice,"	andin	program	evaluation.	Technical	assistance	included:Providing	support	material	in	male	involvement,	assets	building,	self-esteem,	and	conflict-resolution;Providing	referrals	to	State	Liaison	for	the	Male	Involvement	Program	and	to	nutritioneducators;	andResearching	parenting	videos	appropriate	for	teens.Evaluations,	surveys,	and	interviews	with	staff	were	completed	at	the	end	of	the	project.	Interimsite	visits	were	also	made	to	observe	the	implementation	of	the	best	practice.ResultsFrom	the	inception	of	the	project	to	implementation	and	evaluation,	key	lessons	were	learned	thatinform	the	field	in	project	replication.	Our	team	was	pleased	to	see	that	our	community	partnerswere	willing	to	add	an	additional	element	to	their	current	practices	for	a	nominal	grant	amount.Each	proposal	stated	lofty	goals	and	objectives	that,	on	close	review	by	the	Teen	PregnancyPrevention	team,	seemed	unreachable	within	the	time	limit.	Partners	were	flexible	and	acceptedour	criticism	and	feedback.	Some	partners	needed	more	assistance	than	others	in	deciding	how	toimplement	the	"best	practice."Site	B,	the	alternative/continuation	high	school,	offered	a	2-week	self-defense	course	taught	by	ayouth	peer	as	a	component	of	the	youth	development	best	practice.	The	program	experienced100%	attendance	during	the	2	weeks.	The	course,	along	with	morning	refreshments,	served	as	anincentive.	The	staff	states	that	all	youth	were	motivated	to	be	at	the	school:	"The	four	mommies	inthe	group	.	.	.	were	motivated	to	come	and	they	were	motivated	to	do	their	assignments."Once	the	course	ended,	attendance	continued	to	be	high.	A	challenge	in	implementation	was	thatstaff	felt	they	were	working	"double-duty"	during	this	period.	Nevertheless,	staff	felt	that	it	wasworth	it,	and	that	they	would	do	it	again.	Next	time,	staff	felt	the	course	should	be	offered	year-round.One	alternative/continuation	high	school	and	the	Adult	Education	Program	(Sites	A	&	C)	adoptedthe	male	involvement	best	practice.	At	Site	A,	the	program	was	designed	in	response	to	anexpressed	need	by	young	mothers.	They	wanted	"the	boyfriends	or	the	fathers	of	their	babies	towork	with	them	as	a	team	in	raising	their	child."Two	female	students	volunteered	to	serve	as	"liaison"	between	male	facilitators	(staff	from	apartnering	community-based	agency)	and	the	males.	The	liaison	spoke	with	them	on	the	phone,mailed	them	announcements,	and	called	them	the	same	day	to	confirm	their	participation.	Maleswere	invited	to	two	social	gatherings,	yet	the	only	people	who	showed	up	were	the	femalestudents.An	unexpected	outcome	of	this	intervention	was:	"with	the	reality	of	the	mother	seeing	that	therewasn't	always	willingness	for	the	male	to	participate	in	what	she	thought	was	important,	and	so	.	..	I've	got	to	go	on	and	do	the	best	I	can."	Yet	at	the	same	time,	the	female	students'	interactionwith	the	male	facilitators	and	with	other	members	of	the	community	gave	them	a	chance	to	"seethat	there	were	some	men	that	were	really	interested	and	involved	in	parenting	relationships."At	Site	C,	male	participation	was	low,	yet	it	was	the	process	of	involving	the	males	thatstrengthened	the	group	of	young	women.	As	the	staff	person	states:	"we	didn't	get	the	dads	wewanted,	but	we	built	a	nice	network	among	the	girls,	that	was	nice	and	unexpected."	A	staffmember	observed	that,	although	the	intervention	did	not	work	as	expected,	she	did	learn	how	toassess	what	works	and	what	doesn't	work.	"I	was	very,	very	pleased	that	we	were	given	thechance	to	see	if	something	would	work	and	a	chance	to	test	our	creativity,	a	chance	to	followthrough	on	the	suggestions	from	our	students."At	Site	D,	the	agency	adopted	the	family	and	other	caring	adult's	involvement	best	practice	intotheir	home	visitation	program.	Staff	procured	parenting	videos	and	age-appropriate	toys	andorganized	a	family	picnic	with	the	grant.	Staff	took	the	toys	to	young	women's	homes	and	usedthem	to	interact	with	the	child,	the	teen	parent,	and	the	babies'	grandmothers.The	adoption	of	the	best	practice	made	staff	aware	of	the	importance	of	serving	as	parenting	rolemodels	for	the	young	mothers.	Staff	felt	that	they	needed	more	time	to	serve	as	parenting	rolemodels	and	work	at	involving	the	families.	One	staff	member	stated	that	"my	impression	is	themore	involved	we	get	the	entire	family,	I	believe	the	more	you	move	this	parent	forward."Implementation	ChallengesImplementation	of	this	project	was	challenging	for	our	collaborating	partners	due	to	the	following.Scheduling:	Once	the	grant	process	was	finalized	through	the	university,	our	partners	hadonly	6	months	to	design,	implement,	and	evaluate	this	project.	The	school	calendar	year	wasa	limiting	factor.	Overworked	staff	had	difficulty	in	scheduling	planning	meetings.	Programsthat	targeted	increased	involvement	of	families	and	males	had	difficulty	scheduling	meetingsbecause	many	men	worked	during	afternoon	and	evening	hours.Teacher/staff	workload:	In	one	school,	the	teacher	was	in	her	first	year	at	that	particularschool.	Balancing	the	workload	of	regular	teaching	with	this	"extra"	project	was	difficult.Change	in	location:	An	additional	alternative	high	school,	with	its	own	funding	source,	wasready	to	adopt	the	family	involvement	best	practice.	A	facilitator	was	hired,	and	childcare	wasprovided.	The	project	had	one	meeting,	and	then	it	was	postponed	until	the	following	year,because	the	entire	school	moved	to	a	new	location.Implementation	challenges	experienced	by	Cooperative	Extension	included	the	following.Communication	with	site	staff:	From	inception	to	completion	of	the	project,	making	contactwith	program	coordinators	and	direct	service	staff	was	difficult.	Many	staff	did	not	return	ourphone	calls--probably	due	to	the	work	overload	that	they	were	experiencing.	Our	repeatedphone	calls,	followed	by	e-mails	and	faxes,	resulted	in	off-and-on	communication.Completing	site	visits:	Site	visits	were	conducted	as	part	of	the	evaluation	effort.	With	regardto	one	site,	the	project	coordinator	made	multiple	phone	calls	to	schedule	a	visit,	but	by	thetime	site	staff	returned	phone	calls,	the	sessions	had	ended.For	our	community	partners	and	our	team,	this	was	the	first	time	we	engaged	in	a	reciprocalcollaboration	to	adopt	a	new	practice.	All	of	our	partners	concluded	that	the	new	best	practicemade	a	positive	impact	on	participating	youth.	Our	partners	and	the	Teen	Pregnancy	Preventionteam	concur	that	if	we	were	to	do	this	again,	we	would	like	a	longer	time	frame,	such	as	3	years,and	substantially	more	funds	to	support	the	effort.	Our	community	partners	have	used	theadoption	of	a	best	practice	along	with	the	handbook	as	a	way	to	leverage	additional	funds.ConclusionOur	study	examined	the	process	that	teen	pregnancy	prevention	programs	undergo	in	theadoption	and	implementation	of	a	new	best	practice.	Conversations	with	our	partners	and	the	siteobservations	helped	us	understand	the	reality	that	schools	and	non-profit	organizations	face	on	adaily	basis	and	the	challenges	and	opportunities	that	this	approach	presents	for	CooperativeExtension.	Results	suggest	that	community	partners	welcome	the	opportunity	to	improve	theirpractice	and	need	support	in	implementation	and	evaluation.	Findings	also	highlight	theimportance	of	community	partners'	and	Cooperative	Extension's	flexibility,	persistence,	andpatience	to	maintain	ongoing	and	open	communication.It	is	important	to	note	that	the	results	of	this	applied	research	study	should	be	viewed	in	thecontext	of	a	relatively	small	sample	with	limited	implementation	time.	Our	focus	was	on	California,specifically	the	San	Francisco	Bay	Area.	Our	goal	was	to	document	the	process	of	implementationof	a	new	practice,	not	to	document	the	impact	of	a	best	practice	on	participating	pregnant	and/orparenting	teens.	Impact	on	youth	is	an	important	aspect	to	consider,	but	it	would	need	to	bemeasured	on	a	project	that	is	long-term	(minimum	of	3	years)	and	with	a	source	of	greaterfunding.ReferencesCalifornia	Department	of	Health	Services,	Primary	Care	and	Family	Health,	Office	of	FamilyPlanning	and	Office	of	Community	Challenge	Grants.	(2000).	Adolescent	pregnancy	prevention,Leadership	2000	Conference.	April	11-13.Gong,	E.,	Johns,	M.,	Lee,	F.,	Moncloa,	F.,	Russell,	S.,	&	West,	E.	(1999).	Best	Practices	in	TeenPregnancy	Prevention:	Practitioner	Handbook.	San	Jose,	California:	University	of	CaliforniaCooperative	Extension.Johns,	M.J.,	Moncloa,	F.,	Gong,	E.G.	(2000).	Teen	pregnancy	prevention	programs:	Linking	researchand	practice.	Journal	of	Extension	[On-line],	38(4).	Available	at:http://www.joe.org/joe/2000august/a1.htmlKirby,	D.	(2001).	Emerging	answers:	Research	findings	on	programs	to	reduce	teen	pregnancy.Washington,	DC:	National	Campaign	to	Prevent	Teen	Pregnancy.National	Campaign	to	Prevent	Teen	Pregnancy.	(2001).	Facts	and	stats.	Washington,	DC.	Availableat:	http://www.teenpregnancy.org/Copyright	©	by	Extension	Journal,	Inc.	ISSN	1077-5315.	Articles	appearing	in	the	Journal	become	the	property	of	theJournal.	 Single	 copies	 of	 articles	may	 be	 reproduced	 in	 electronic	 or	 print	 form	 for	 use	 in	 educational	 or	 trainingactivities.	Inclusion	of	articles	in	other	publications,	electronic	sources,	or	systematic	large-scale	distribution	may	bedone	only	with	prior	electronic	or	written	permission	of	the	Journal	Editorial	Office,	joe-ed@joe.org.If	you	have	difficulties	viewing	or	printing	this	page,	please	contact	JOE	Technical	Support©	Copyright	by	Extension	Journal,	Inc.	ISSN	1077-5315.	Copyright	Policy

Practitioners Put Research into Practice Strengthening Community-Based Pregnant and Parenting Teen Programs

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Practitioners Put Research into Practice Strengthening Community-Based Pregnant and Parenting Teen Programs

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