1. EVALUATION OF A COMMUNITY- BASED DATING RELATIONSHIP PROGRAM FOR TEENAGERS IN RESIDENTIAL CARE AEA ORLANDO—11.12.2009 GRANT FUNDED BY HHS CBAE AWARD #90AE0226 K. Duppong Hurley, L. Buddenberg, K. McGee, & M. Dinger

2. Teen Risks  According to the 2007 CDC’s YBRS  48% of teens reported having sexual intercourse  15% reported having 4 or more sexual partners  35% reported being sexually active in past 3 months 38% reported not using a condom last time had intercourse 23% using alcohol or drugs before last time had intercourse  Approx 14% of people diagnosed with HIV/AIDS were between 13-24 years old (2006 CDC Surveillance Reports)  Nearly half of the 19million new STD infections each year are youth between 15-24 years old (Weinstock, Berman & Cates, 2004)

3. Youth in Out-of-Home Care  Special risks and concerns for youth in out of home care  High rates of emotional and behavioral needs  Many with histories of physical, emotional, and sexual abuse and neglect  Many have issues setting physical and emotional boundaries for self and others

4. Intervention Approach Combination of WAIT Training and Sexual Con Games Interventions  Peer refusal skills  Emotional and physical boundaries  Learning about self and others  Handling conflict effectively  Consequences of teen sex  Cultural influences  Recognizing and avoiding sexual manipulation and coercion

5. Intervention Format  House Parents deliver information in small group discussions with same gender youth  HP trained by reviewing program guide and watching 5 minute web video clips  Conduct 3-4 45 minutes sessions a month  Mix of discussion with activities for youth

6. Evaluation Goals  Determine if program acceptable and feasible for direct care staff to implement  Examine if program acceptable to youth (buy-in, interest in content)  See if content is delivered to youth by staff  Examine if youth retain content of program, any shifts in attitudes and behaviors  Collect preliminary information to help with program development/refinement  Prepare for future comparison study

7. Process Evaluation Plan  A multiple baseline design to allow for ongoing program improvements  Create 8 small groups of homes  Collect brief surveys from youth and staff at pre-test and every 3 months to monitor change over time  Train two groups of homes (1 boy, 1 girl) every 3-4 months  Conduct interviews and focus groups with staff and youth to determine acceptability and satisfaction with program  Evaluation plan nixed as too few youth served

8. Revised Process Evaluation Plan  Conduct two waves of staff interviews (3 months after training, end of first year)  Online survey following end of first year  Examine lesson logs to look at participation/satisfaction with individual lessons  Youth surveys in August, January, and April to newer youth in program  Half of homes trained in September, other half in Feb.  Anonymous surveys (cannot track responses)  Eval budget cut in half, program likely losing funding

9. Preliminary Results

10. Staff Interviews  Two waves (6 in winter, 11 in summer)  Believed the program was important and useful  Youth looked forward to program  Liked the sessions that were more activity-based  Used the manual primarily and on-line for presentation ideas  Had difficulty scheduling program with busy kids  Some difficulty knowing how to handle youth that miss meetings  Worked well with boys and girls, variety of ages

11. Staff Online Survey Results

12. Percent of family Teachers who agree with the statement (n=31)

13. Youth Survey: Demographics  Sample size  August 111 youth  January 100 youth  April 89 youth  Treatment condition  56% treatment  44% waitlist  Gender  64% boys  36% girls Percent Hispanic21% White Caucasian 60% African American 28% American Indian/Alaskan 12% Other5% Percent 8 th or younger 8.1% 9 th grade18.9% 10 th grade30.6% 11 th grade27.9% 12 th grade14.4% Race/Ethnicity Grade in School

14. Program Content Covered August Treatment n=56 August Waitlist n=49 January Treatment n=53 January Waitlist n=45 April Treatment n=48 April Waitlist n=39 Ways to refuse peer pressure 26%27%19%20%13%21% Setting boundaries 32%27%10%23%12%21% STD’s 59%58%35%52%25%41% Consequences of sexual activity 40%44%25%33%17%15% Advantages of waiting until marriage 63%57%21%46%23%21% Different types of intimacy 48%58%27%46%13%31% Percentage of youth that reported “never” discussing topic with Family Teacher in past month

15. Dating, Sex, and Marriage  Over time more agreement that abstinence only certain way to avoid pregnancy and STD’s  Treatment group shows more support at post that teens are not ready to have sex  Many items showed no significant change over time, but did seem to be an effect by gender  Girls more likely to agree with items supporting abstinence and that teens should not have sex  Boys more likely to endorse idea that it is OK for teens dating for a long time to have sex, that condoms are as effective as abstinence, and that it is difficult for teen parents to attain their financial dreams.  Need to examine gender patterns more in-depth. (Boys make up majority of respondents in this study.)

16. Attitudes Toward Abstinence  Until end of high school  43-48% indicate support across time  68-70% of girls and 27-36% of boys  Until marriage  21-24% indicate support across time  34-40% of girls and 12-17% of boys  Need to examine with larger sample, so can examine more by sub-groups (gender, age)

17. Implications  Staff in a group-home setting expressed buy-in to teaching youth content related to dating and sexual activity  Delivery method of on-line training and manuals at least modestly effective for staff to feel prepared  Possibility of replicating in foster care homes  Or with community groups (church, afterschool…)  An in-home version for parents to use with their kids?  Need outcome data to determine effectiveness of program in changing youth behaviors (comparison group; pre-post-follow-up design)

18. Next Steps  Youth & staff focus groups  See what like and dislike about program  Content they would like to see in program  Prepare for program sustainability  Refined lesson logs  Gather youth survey data in Fall 2009 and Spring 2010 (pre-post)  Larger n  Individual generated tracking number  Examine differences by youth characteristics (age, gender…)  Compare to national rates  Prepare for rigorous outcome study

19. Contact Information  Laura.Buddenberg@boystown.org Laura.Buddenberg@boystown.org  Kdupponghurley2@unl.edu Kdupponghurley2@unl.edu