"Programs will fail unless they are linked to all the things that make young people whole." [1]
- Michael Carrera
Human behavior, including adolescent sexual behavior, is not a matter of an individual's motivations alone: we act within social contexts. As the human ecology framework describes, young people develop through interaction with many social systems -- families, peers, schools, neighborhoods, communities, workplaces, faith communities, society at large, and social media.
This essential insight is confirmed by adolescent sexual health research. Douglas Kirby describes numerous risk and protective factors that influence adolescent sexual behavior, many of which are rooted in the domains of community, school, family, and peers [2]. Pregnancy, STD, and HIV prevention programs, on the other hand, focus largely on individual, proximal factors. Although evidence-based programs are effective in changing specific behaviors (increasing condom use or delaying sexual initiation for a number of months, for example), they cannot by themselves address all the risk and protective factors that affect young people's sexual behavior and health. Kirby concludes that successful curriculum-based programs reduce one or more risky behaviors by about one-third [3].
Beyond Programs
Evidence-based programs offer an important tool to communities seeking better health outcomes for their youth. But programs can't do it alone. To have a powerful impact on health and well-being, programs must be part of a larger, community-wide effort that provides young people with the learning opportunities, life experiences, values, and supportive relationships that build protection, reduce risk behaviors, and prepare youth for adulthood.To be effective, community approaches must practice cultural competence. Cultural competence is critical for engaging all community sectors in a discussion of sexual health norms and desired outcomes. And when opportunities for youth are culturally appropriate [4] -- attuned to cultural norms, language, and practices -- young people are more likely to be engaged.
Coming together with the shared goal of nurturing strong and healthy youth, a successful coalition will:
- Engage community partners across sectors, including non-traditional partners such as businesses, faith communities, and families
- Engage youth in the coalition
- Understand the core principles of positive youth development
- Conduct a comprehensive community assessment to identify and activate community resources
- Address community collaboration with intentionality
- Plan for evidence-based programming as one component of a comprehensive strategy
- Initiate a community conversation to question local norms regarding adolescent sexual health
- Assess and enhance community readiness for change
- Address inequities in the community
References
| [1] | ACT for Youth Center of Excellence. (2009, June). Proceedings of the Adolescent Sexual Health Symposium (PDF: 346K), 29. |
| [2] | Kirby, D. (2007). Sexual Risk and Protective Factors [Summary] (PDF: 311K). Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy. |
| [3] | Kirby, D. (2007). Emerging Answers 2007. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy. |
| [4] | New York State Department of Health's Adolescent Sexual Health Work Group. Guiding Principles for Sexual Health Education for Young People (PDF: 563K), 8. |
| [5] | Santelli, J. S. (2009). What Do We Know About Trends in Adolescent Sexual Behavior in the United States? (PDF: 604K), 16. |