EVIDENCE-BASED SEXUAL HEALTH PROGRAMS

Transcription

1 EVIDENCE-BASED SEXUAL HEALTH PROGRAMS Shirley Banks, BS, AASECT Certified Sexuality Counselor Emory University Heather Eastman-Mueller, PhD, CHES University of Missouri Katye Miller, MS, CHES The Ohio State University Joleen M. Nevers, MAEd, CHES University of Connecticut

2 OBJECTIVES OF RESEARCH Behavioral Objective Describe the current research published on evidence-based sexual health programming. Identify the gaps in the sexual health literature surrounding standards of practice. Content Overview of published research Overview on current evidence-based programs Discuss what areas we need research on to help with providing evidencebased programs Discuss the future of sexual health within the college student population. Work with each other to determine where the sexual health field is going on college campuses.

3 HOW WE STARTED WORKING TOGETHER During the fall 2007 New England College Health Annual Meeting, a discussion was started among the Health Educators/Promotion Staff on the topic of Evidence Based programming This conversation continued outside of the meeting especially around the topic of Sexual Health When researched further several names of people came up that were already communicating on this topic The University of Connecticut took the lead and got the parties together for monthly conference calls Conference calls turned into research interest & IRB approved study Here we are at ACHA

4 LITERATURE REVIEW A literature review was conducted during the spring semester of While some studies and findings were interesting there were gaps in the college student population. Findings that were interesting: DEBIs-CDC Science & Success-Advocates for Youth Popular Opinion Leader similar to peer educators implemented in community settings with specific populations J A Kelly The Program Archive on Sexuality, Health and Adolescence (PASHA)-NICHD The Tool to Assess the Characteristics of Effective Sex and STD/HIV Education Programs(TAC) Douglas Kirby

5 HEALTHY CAMPUS 2010 Health What Objectives Are the Leading Health Indicators? Healthy The Leading Campus Health 2010 Indicators has planning will be used guidelines to measure and the over health 200 of health the Nation objectives over the with next baselines 10 years. Each and targets of the 10 for Leading the nation's Health Indicators colleges and has one universities or more objectives to achieve from over Healthy the People 2010 associated with it. As a group, the Leading Health Indicators reflect the major next decade. The Leading Health Indicators reflect the major public health concerns health concerns in the United States at the beginning of the 21st century. The Leading in Health the United Indicators States were and selected were on chosen the basis based of their on ability their ability to motivate to motivate action, the action, availability the availability of data to measure of data progress, to measure and their importance progress, and as public their health relevance issues. as The broad Leading public health Health issues. Indicators are: The Physical Leading Activity Health Indicators are: Overweight and Obesity Tobacco 1. Use Physical Activity Substance 2. Overweight Abuse and Obesity 3. Tobacco Use Responsible Sexual Behavior 4. Substance Abuse Mental 5. Health Responsible Sexual Behavior Injury and 6. Mental Violence Health Environmental 7. Injury and Quality Violence Immunization 8. Environmental Quality Access 9. to Immunization Health Care 10. Access to Health Care

6 ACHA STANDARDS OF PRACTICE FOR HEALTH PROMOTION IN HIGHER EDUCATION Standard 1. Integration with the Learning Mission of Higher Education Effective practice of health promotion in higher education requires professionals to incorporate individual and community health promotion initiatives into the learning mission of higher education. Standard 2. Collaborative Practice Effective practice of health promotion in higher education requires professionals to support campus and community partnerships to advance health promotion initiatives. Standard 3. Cultural Competence Effective practice of health promotion in higher education requires professionals to demonstrate cultural competency and inclusiveness in advancing the health of individuals and communities. Standard 4. Theory-Based Practice Effective practice of health promotion in higher education requires professionals to understand and apply professionally recognized and tested theoretical approaches that address individual and community health. Standard 5. Evidence-Based Practice Effective practice of health promotion in higher education requires professionals to understand and apply evidence-based approaches to health promotion. Standard 6. Continuing Professional Development and Service Effective practice of health promotion in higher education requires professionals to engage in on-going professional development and service to the field.

7 CENTERS FOR DISEASE CONTROL AND PREVENTION DEBI S DIFFUSION OF EFFECTIVE BEHAVIORAL INTERVENTIONS

8 CDC S TIERS OF EVIDENCE FRAMEWORK

9 DIFFUSION OF EFFECTIVE BEHAVIORAL INTERVENTIONS PROJECT (DEBIS) FACT SHEET Introduction In 1999, the Centers for Disease Control and Prevention (CDC) published a Compendium of HIV Prevention Interventions with evidence of effectiveness, in response to prevention service providers requesting science-based interventions that work. The Division of HIV/AIDS Prevention (DHAP), Capacity Building Branch is committed to enhancing the capacity of individuals, organizations, and communities to conduct more effective and efficient HIV prevention services. Diffusion of Effective Behavioral Interventions Project Under the guidance of CDC/DHAP, the Academy for Educational Development s Center on AIDS & Community Health coordinates the Diffusion of Effective Behavioral Interventions (DEBI) project, a national-level strategy to provide training and on-going TA on selected evidence-based HIV/STD interventions to state and community HIV/STD program staff.

10 THEORETICAL FRAMEWORK: DEFINING SEX AND SEXUALITY For the purposes of our survey and for Health Education and Promotion, what do we mean by sex and sexuality? Sexuality Information and Education Council of the United States (SIECUS) publishes Guidelines for Comprehensive Sexuality Education, Kindergarten through 12 th Grade, 3 rd Edition (aka the Guidelines )

11 NATIONAL GUIDELINES TASK FORCE American Medical Association* American School Health Association* Center for Health Training + Centers for Disease Control and Prevention* Independent consultants + Indiana University* March of Dimes Birth Defects Foundation* Montclair State University + National Education Association* National School Boards Association* New Jersey Medical School New York University* Planned Parenthood Federation and affiliates* + Public school systems in various locations* Rutgers University + SIECUS* + *1991 Original Review Panel Member Third Edition Review Panel Member

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14 GUIDELINES - ORGANIZATION

15 GUIDELINES - ORGANIZATION

16 GUIDELINES - ORGANIZATION

17 METHODOLOGY Requested 1 person per institution complete the survey Survey took approximately 15 minutes to complete IRB approval from UConn Letter of request to complete the survey was sent the week of 2 March 2009 to the following: SHS list serve (n=3405 subscribers) hlthprom@lists.wisc.edu (n=658 members) College-Health-LGBT@WUVMD.WUSTL.EDU HEDIR CCHA NEHEN (n=56) ACTWELL (n=31) NYSCHA BACCHUS (n=300)

18 METHODOLOGY (CONTINUED) Reminder letter was sent the week of 16 March to: SHS list serve CCHA NECHA ACTWELL BACCHUS sent the week of 23 March: California directors (n=39); 1 was returned as undeliverable sent on 3 April: Partners in Prevention list serve sent to all members, n=100; Network (Network Addressing Collegiate Alcohol and other Drug Issues), n=80 members on the listserv but overall membership to organization n=1500

19 RESEARCH QUESTION 1 What demographic factors were the most frequently reported by the participants?

20 INSTITUTIONAL TYPE N=157 Types of Institution Public 97 Private 58 Religious 16 Certificate Program 9 Associate Degree 16 Total Baccalaureate Degree 100 Masters Degree 91 Doctorate Degree 58 Research (very high) 19 Research (high) 16 Doctoral/Research Universities 21 Special Focus Institution 5 Serve Specific Demographics 5

21 LOCATION BY REGION

22 INSTITUTIONAL SIZE

23 DEPARTMENT REPORT TO STUDENT AFFAIRS N=133

24 STAFF ALLOCATION TO SEXUAL HEALTH PROGRAM

25 TOP 5 MOST FREQUENTLY REPORTED TYPES SEXUAL HEALTH PROGRAMS IMPLEMENTED

26 DISTRIBUTION OF ELECTRONIC COMMUNICATION

27 SIECUS GUIDELINES - TOPIC AREAS Topic Most Covered Least Covered Sexual Health STD Pregnancy Skills Communication Assertiveness Relationships Romantic Kids Behavior Abstinence Dysfunction Human Development Reproduction Puberty Society & Culture Sexuality & Society Arts

28 TOP 5 THEORETICAL FRAMEWORKS USED IN STRATEGIC PLANNING/PROGRAMMING

29 TOP 5 TYPES OF EVALUATIONS CONDUCTED

30 TOP 5 DEBIS USED IN SEXUAL HEALTH STRATEGIC PLANNING/PROGRAMMING

31 EVALUATION AND REASONS Types of Evaluations 1 st 2 nd 3 rd 4 th 5 th Satisfaction Surveys Program Refinement (77.27%) Use New Strategy (63.64%) Annual Reporting (54.55%) Current (41%) Department Justification (37.5%) Outcome Evaluations Program Refinement (83.87%) Annual Reporting (70.97%) Use New Strategy (70.96%) Program Justification (61.3%) Stakeholders (48.39%) Process Evaluations Program Refinement (89.19%) Program Justification (83.78%) Annual Reporting (70.27%) Current (54.05%) Department Justification (48.65%) Impact Evaluations Program Refinement (91.43%) Use New Strategy (71.43%) Program Justification (68.57%) Stakeholders (57.14%) Department Justification (51.43%) Judicial Recidivism Use New Strategy (71.43%) Stakeholders (64.29%) Current (57.14%) Department Justification (50%) Grant (35.71%) Behavioral Trends Annual Reporting (84.09%) Current (59.1%) Stakeholders (50%) Research (13.64%) Newsletter (13.64%)

32 RESEARCH QUESTION 2 Of those who used DEBIs, what type of evaluation was conducted?

33 DEBIS AND TYPES OF EVALUATION 77% evaluated satisfaction X 2 =16.70, df=1, p< % used outcome evaluations X 2 =61.62, p< % used impact evaluations X 2 =28.46, p< % used process evaluations X 2 =4.89, p< % used judicial recidivism X 2 =5.30, p<.05

34 RESEARCH QUESTION 3 Are there any differences in mean level of feelings between those who are concerned with job-related issues as opposed to those who are unconcerned?

35 FEELINGS AND CONCERNS ABOUT EBS Variables Lack of Training Concerned Not Concerned M SD M SD t Feel Unprepared ** Worried * Pressure Outside HP * Pressure Inside HP ** No Encouragement Outside HP * No Encouragement Other Health ** Anxious ** *p<.05. **p<.01.

36 FEELINGS AND CONCERNS ABOUT EBS Variables Concerned Not Concerned M SD M SD t Overwhelmed Staff Time ** Worried Job Security * Types of Evaluations Pressure Outside HP ** Pressure Inside HP ** Pressure Other Health ** Anxious * *p<.05. **p<.01.

37 SEE THE FOREST FOR THE TREES AND STUDY LIMITATIONS Themes and Significance What stands out for us Why is this important Communication Shared resources Study Limitations Psychometrics (check all that apply-coding/reliability) Cannot generalize (response rate unclear)

38 DISCUSSION QUESTIONS: As discussed, evidence-based strategies are available, but their effectiveness on college campuses is not fully understood. How can we increase impact and outcome evaluations of evidence-based strategies in college sexual health programs? What are ways to effectively implement EB sexual health strategies on college campuses?

39 WHAT UCONN IS IMPLEMENTING:

40 WHAT EMORY IS IMPLEMENTING:

41 WHAT MU IS IMPLEMENTING: Health Issue 1: The majority of sexually active MU students do not use any type of barrier protection. Seventy-five percent (n=663) of MU students sampled described themselves as sexually active (defined as had sex in the last 30 days). Sixty percent of MU students had engaged in sexual activity prior to entering the University of Missouri. However, 42.4% (n=270) of these sexually active individuals did not use a condom. Of all the students who had engaged in sexual activity (n=639), 77% (n=494) had occurred in the last 30 days. Thirty-six percent (n=180) of MU sexually active respondents, did not use a barrier method in the last 30 days. The last time they engaged in sexual activity, 48% (n=304) of students living in the res halls did not use any barrier method. Data Sources: 2005 Sexual Health Survey, Spring 2008 ACHA Survey, Residence Hall Sexual Health and Safety Products Survey, Goal 1: To increase the proportion of sexually active students at MU who use barrier protection consistently. Objective Action Steps Evaluation Measures 1. Increase student knowledge of the benefits of consistently using barrier protection. 2. Improve access to barrier protection to students. 3. Create a fiscal sustainability plan that supports the SHSP Initiative 4. Conduct a longitudinal study of SHSP annually 1. Provide CA, HC, PAs information about online program requests/training opportunities for their residents 1.2 Create safety products demonstration videos and place on the SHAPE website (FC, OD, MC) 1.3 Continue to explore innovative ways to educate students on how to use barrier protection (facebook, texting, itunes U) 1.4 Normalize safety products use through social norms marketing plan 1.5 Develop quarter sheet handouts re: online program requests/barrier use 2.1 Assign two SHAPE peer educators per residence hall (that houses a machine) to meet with each HC at least once a month i.e, improve access/shsp program 2.2/3.1 Meet at least once a month with Res Life professionals staff to discuss the SHSP program (SHSP Task Force) 3.2 Research a variety of methods for funding potential for sustainability of the SHSP program 4.1 Continue to report to IRB findings/gain approval 4.2 Inform stakeholders of research findings 4.3 Refine survey methodology with research team Qualitative data from S. Affairs professionals/ staff Longitudinal SHSP Assessment NCHA Master inventory of SHSP utilized Number of Safety Products programs requested Responsible Staff Heather, GA, peer educators Timeframe Ongoing

42 WHAT OSU IS IMPLEMENTING:

43 QUESTIONS? CONTACTS: Shirley Banks, BS, AASECT Certified Sexuality Counselor Emory University Heather Eastman-Mueller, PhD, CHES University of Missouri Katye Miller, MS, CHES The Ohio State University Joleen M. Nevers, MAEd, CHES University of Connecticut