Planning, Implementing, and Evaluating Your Health Promotion Programs

1. Planning, Implementing, and Evaluating Your Health Promotion Programs A 6-Week Public Health Course Week 2: Assessing Our Population, Part 1

2. Today: • Discuss behavior change theory application homework • PRECEDE-PROCEED introduction • Assessing our Population Part 1: epidemiological assessment and behavioral and environmental assessment • Applying Social Cognitive Theory

3. Homework • What did you learn? • Which theory did you think was best for STI prevention? • Share components of the best fit theory

4. Health Belief Model

5. Health Belief Model

6. Health Belief Model

7. In Sexuality Education • Works with: • Primary prevention—prevent pregnancy, STIs, etc. by increasing condom use • Secondary prevention—increase early detection of STIs or HIV to reduce spread/early treatment • Does not work well with: • Comprehensive sexuality education programs that are not action oriented • Not a good fit for abstinence only (threat logic) Source: Resource Center for Adolescent Pregnancy Prevention. http://www.etr.org/recapp/index.cfm?fuseaction=pages.TopicsInBriefDetail&PageID=51

9. JC’s No Sex Policy • What is the effect on STI rates? When would it be helpful and when harmful? • What is the effect of abstinence-only education? • Lowest STI rate in 15-24 y/o from states with no mandates for abstinence education • States with mandates emphasizing abstinence had the highest rates • States with mandates to cover (not emphasize) abstinence fell in the middle Source: Hogben, M. et al. (2010). Sexuality education policies and sexually transmitted disease rates in the USA. International Journal of STD and AIDS. 21; 293-297.

10. In Sexuality Education • Works with: • Programs designed for long term behavior change • Overall effective • Couples and individuals • Does not work well without: • Integration with the other theories El-Bassel, N, et al. (2003). The efficacy of a relationship-based HIV/STD prevention program for heterosexual couples. 93(6), 963-969. DiClemente, R.J., et al. (2007). A review of STD/HIV prevention interventions for adolescents: sustaining effects using an ecological approach. Journal of Pediatric Psychology. 32(3), 888-906.

12. In Sexuality Education • Works with: • Working 1:1 with teens • Troubleshooting risky behaviors • Interventions that take place in the HW center • Does not work well with: • Comprehensive sexuality education programs that are not action oriented/cognitive learning-based programs • Groups Source: Resource Center for Adolescent Pregnancy Prevention. http://www.etr.org/recapp/index.cfm?fuseaction=pages.TopicsInBriefDetail&PageID=51

14. In Sexuality Education • Works with: • Prevention-based programs (prevent sexual involvement or increase condom use) • Particularly good for pregnancy prevention, STI prevention and HIV prevention • Influenced by knowledge/skills/attitudes/relationships/environment, few positive role models for teens, behavioral skills practice • Does not work well with: • Comprehensive sexuality education programs that are not action oriented/cognitive learning-based programs Source: Resource Center for Adolescent Pregnancy Prevention. http://www.etr.org/recapp/index.cfm?fuseaction=pages.TopicsInBriefDetail&PageID=51

17. Cool Things That Came Up • Age-specific interventions • A lot of partnerships • Myths: “One male student told me that if he put his finger in his partner’s vagina then touched his finger behind his ear and it did not burn, then she didn’t have an STI.” • Strategic placement of condoms • Role play situations • Peer education/groups • Cultural/gender-specific interventions • Know the policy to advocate for change

19. Social Assessment • What health issues affect students’ quality of life? • Involving the student in planning • Key informant interviews • Focus groups • Observation • Surveys

20. Epidemiological Assessment • Documents which health problemsare most important • Data collection • Data analysis • Do you want to focus on a specific group? • How about a specific disease?

21. Behavioral and Environmental Assessment “The Behavioral and Environmental Assessmentidentifies factors, both internal and external to the individual, that affect the health problem.”

22. Questions to Ask • Behavioral factors • What are the behaviors linked to this issue? • Which of these behaviors are most important? • Which of these behaviors are most changeable? • Environmental factors • What parts of the environment (social and built) hinder healthy choices? • Which of these factors are most important? • Which of these factors are most changeable?

23. Finding Information • Interviews, survey, focus group • Literature • PubMed (http://www.ncbi.nlm.nih.gov/pubmed) • Google scholar (http://scholar.google.com) • Hint: American Academy of Pediatrics: Condom Use by Adolescents: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;107/6/1463 (check out the PubMed and Google Scholar links on the side too)

24. Organize Your Thoughts

25. Example

26. Social Cognitive Theory

27. Closing • Homework #2 due by COB on Friday • Questions?