1. Plain Talk Lorelei Walters Program Officer Plain Talk Replication Public/Private Ventures Replication and Expansion Services

2. The Plain Talk Vision “All vulnerable youth will have a knowledgeable, caring adult they can turn to for support, information and helpful communication in order to make informed, responsible decisions about sexual behaviors and consequently increase options for connecting to educational and economic opportunities.”

3. Plain Talk Overview  At its core, Plain Talk is about:  Messages;  Messengers; and  Skills, tools and information that messengers want and need to deliver clear, consistent and accurate messages about protection from too- early pregnancy, STDs and HIV/AIDS.

4. Theory of Change Create Consensus Educate Community Adults Effective Communication Use of Contraception and STD/HIV protection Adolescent Knowledge and Attitudes Pregnancy and STD/HIV rates Reproductive Health Services

5. Plain Talk Demonstration Phase Phase: 1994 – 1998  $5 million, 4-year neighborhood-based, family- centered initiative designed by The Annie E. Casey Foundation, to improve ARH outcomes in 5 racially & ethnically diverse, low-income communities.  Atlanta, Ga.  Hartford, Ct.  New Orleans, La.  San Diego, Ca.  Seattle, Wa.

6. Plain Talk Evaluation  cross-site and multi-method  outcomes study was planned for 3 of the 5 communities  Were the sites able to create a community consensus?  How effective were the community education strategies in educating a large number of adults?  Did the sites improve access to quality, age appropriate reproductive health services?  Did Plain Talk have an effect on adolescents ’ behavior and teen pregnancy rates?

7. Evaluation Design  Multiple methods:  Surveys of community adolescents in 1994 and 1998  Implementation research  Ethnographic research  Birth records data

8. Interim Outcomes  Increased levels of talk between adults and sexually active youth  61% in 1994  70% in 1998  “ Talkers ” showed increased knowledge about sexuality and birth control  1.4 times more likely to know where to get birth control in 1994  2.1 times more likely to know where to get birth control in 1998.

9. Key Long-Term Outcomes  The effects of residents as community volunteers and workshop facilitators  Informal outreach in the community  Teens  Males  Changing Institutions- Working with healthcare providers to increase and improve reproductive health services for community adolescents

10. Key Long-Term Outcomes  Proportion of sexually experienced youth who spoke with adults about topics related to sexuality were half as likely to:  have an STD,  have had or created a pregnancy  have a child  Compared to youth who did not talk with adults

11. Linking Evaluation Results With Program Components  The two sites that used Peer-Educators (Walkers & Talkers) in conjunction with Home Health Parties had a higher degree of success in educating a larger number of adult residents:  800 in New Orleans  1,350 in San Diego  Sites that equally focused on both increasing adults sexual knowledge and increasing adults ability to communicate with teens about sexual issues had better success.

12. Making the Case for Replication: The Power of Evidence  1998 – 2000 Conducted final household survey & outcome report  1999 – 2000 Documented growing demand from communities  2000 – 2001 Conducted replication assessment  2001 – 2003 Piloted 3 replication projects to test:  Potential for streamlining costs;  Potential for streamlining the model;  Tools and materials for transferring knowledge; and  Potential for achieving RESULTS.  2004 Established P/PV as national intermediary for replication

13.  Assessed program implementation in Atlanta, New Orleans and San Diego  Examined elements of each program that were successful  Paid close attention to similarities across sites Replication Assessment of Plain Talk Program

14. 1) Community Mapping 2) Walkers & Talkers (Peer Educators) 3) Home Health Parties The More Successful Sites had 3 Common Program Components:

15. Services to Sites  P/PV staff provides technical assistance to all replication sites in the areas of:  Funding and Health policy  Training and Technical assistance  Data collection and Analysis

16. Plain Talk Website http://www.plaintalk.org