1. Positive Choices, Positive Futures Helping Parents Help Teens Washoe County District Health Department Kelli Seals, MPH Health Educator II

2. County Demographics Washoe County Includes Reno, Sparks, and rural northwestern Nevada Only 6,600 square miles, but second most populated county and city in state Population of 396,844, with dramatic growth expected by 2026 14% of population is adolescents; and 13% is Spanish-speaking Community influences include gaming, recreation/tourism, and poor health

3. Responding to the Problem Adolescent Sexual Risk-Taking 48% of high schoolers in Washoe County are sexually active 35% did not use a condom; and 12% used no contraceptive method Teen pregnancy rate is 76 per 1,000 females; teen birth rate is 42 per 1,000 Chlamydia rate is 7 times higher in adolescents; gonorrhea in teens increased 70%, and HIV increased 400% Latino youth disproportionately represented in both teen pregnancy and STD rates

4. Responding to the Problem Parent-Child Communication Teens say parents are the strongest influences on decisions about sex 87% of teens say communicating with parents makes it easier to postpone sexual activity 37% of teens say they’ve never had a conversation about sex with a parent Interventions to enhance parent-child communication can help teens reduce risk Few interventions exist in Washoe County; and none are in Spanish

5. Responding to the Problem A Proven Intervention Positive Choices, Positive Futures (PCPF) Goal: increase parental knowledge of and attitudes about adolescent children Inspire parents to have conversations about sexual activity with their teens Covers adolescent development, sexuality, safer sexual practices, and family morals and values Provides factual information and strategies for conversations Outcome: Parental communication leads to lessened adolescent sexual risk-taking

6. Collaboration Planning and Preparation Nevada State Health Division & Nevada Department of Education –Financial support of program in Southern NV –Interest in supporting program in Northern NV Area Health Education Center of Southern Nevada –Sharing of materials and expertise –Training

7. Collaboration Identifying stakeholders Established partnerships with youth service organizations Collaborations within Health Department programs Identified agencies & organizations that expressed interest in collaboration Special outreach to organizations reaching the Hispanic community

8. Implementation Contacted organizations that could reach parents through current infrastructure Provided PCPF training and solicited agencies to participate in program implementation

9. Implementation Partners Allocated $1000 per partner agency to cover costs to implement Subcontracted with 4 agencies to provide program –Hispanic service agency –Planned Parenthood –Community service agency –Parent and child agency

10. Health Department provided: Training Materials for classes –incentives –parent folders/brochures –presentation supplies Technical Assistance –flyers for recruiting parents –assistance with classes –additional training Evaluation materials Agencies agreed to: Use funds to facilitate implementation of at least 2 PCPF classes –staff costs –food for participants –additional materials and incentives –childcare Participate in reporting and evaluation requests Implementation

11. Phases of Implementation Phase One Agencies (4) were trained and implemented program with no designated method of recruiting parents –Two agencies struggled with recruitment of parents Phase Two Two agencies (one from phase one) implemented program with designated method of recruiting parents –Captured Audience –Tupperware Approach

12. Sustainability Engaging state level health and education departments to provide resources Encouraging partners to apply for funding by providing, materials, evaluation results and technical assistance for future proposals Continued buy-in and action of internal HD staff (HIV, STD, & Family Planning)

13. Sustainability Excitement about program extended to new community partners including faith- based organizations Sharing program with other stakeholders in Nevada including school nurses, counselors, and other participants in annual Adolescent Sexual Health Summit Keeping awareness of the program alive internally and externally Ability to provide program within existing services and leveraging resources

14. Outcomes 94 parents participated in the PCPF classes 45% of these were Spanish speaking Majority of parents attending were mothers Program coordinators reported early evening being best time to schedule class Parents reported that the class content and a family member or friend motivated them most to attend the class

15. Outcomes Survey results 91% reported learning “a lot more” about the way teens develop and mature 91% reported learning “a lot more” about communicating with teens 84% reported an intent to change the interactions they have with their children based on what they learned 100% of parents reported that they would participate in another class like PCPF if given the opportunity Note: Small survey size – only those in Phase Two of program completed survey

16. Challenges & Lessons Learned Communication Agency contracts Timeframe for gathering materials Evaluation –Type of evaluator –Process vs. outcome evaluation

17. Successes & Lessons Learned Partnerships formed with the community agencies were very positive Cross-program coordination within the Health Dept Experience with outside evaluator was positive Interest in program is significant among both parents and community organizations

18. Contact Information Kelli Seals Washoe County District Health Department (775) 325-8244 kseals@washoecounty.us