National Stakeholders Collaborative:

1. National Stakeholders Collaborative: Strengthening State Health and Education Agency Partnerships to Prevent HIV, STD and Unintended Pregnancy Among Youth This presentation is supported by CDC Cooperative Agreement Numbers U58/DP000387-04, U58/DP000410-04, 5U58DP000416-04, U62PS001782-01. Its contents are solely the responsibility of the NSC and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

2. Session Overview • National Stakeholders Collaborative (NSC) • Rationale for collaboration and program integration around HIV, STD, and unintended pregnancy prevention among school aged youth • National Stakeholders Meetings (NSM) and collaboration at the state level

3. Who we are…

4. National Stakeholders Collaborative (NSC) • Established in 2003 • Four national membership organizations with a focus on Health and Education Agencies • Operate under Memorandum of Agreement • Supported by Cooperative Agreements with the Centers for Disease Control & Prevention, Division of Adolescent and School Health (CDC/DASH)

5. NSC Mission The NSC develops state-level, inter-agency partnerships to improve adolescent reproductive and sexual health programs through shared visions and joint strategies. These dynamic partnerships, involving departments of health and education officials, create and implement effective programs and policies to prevent HIV/AIDS, other sexually transmitted diseases (STDs), and unintended pregnancies among school-aged youth.

6. Sexual Health & Youth: Facts • More new HIV infections have occurred among youth 13–29 years old than among any other age group. 1 • Nearly half of new STD infections occur in young people ages 15-24, although they represent only one-fourth of the sexually active population. 2 One in four teenage girls has an STD. 3 • In 2008, teen moms (age15-19) gave birth to 434,758 babies. 4 • Nearly 21% of 12th grade students in U.S. high schools have had four or more sex partners, and 45 percent of sexually active 12th grade students did not use a condom the last time they had sex. 5 Sources: 1 http://www.kff.org/womenshealth/upload/3040_04.pdf 2 http://www.kff.org/womenshealth/upload/3040_04.pdf 3 http://www.cdc.gov/stdconference/2008/media/release-11march2008.pdf 4 http://www.cdc.gov/nchs/fastats/teenbrth.htm 5 2009 YRBS www.cdc.gov/YouthOnline

7. Risk and Protective Factors for HIV, STD, and Teen Pregnancy Risk Factors • Unprotected sex Protective Factors • Sexual abstinence • Consistent and correct condom* use • Abstinence from AOD** • Health Education STD HIV Pregnancy * Male and female condoms ** Alcohol and other drugs

8. NSC seeks to Increase Protective Factors through Collaboration

9. What does Collaboration look like?

10. The Value of Collaboration and Integration Across HIV, STD and Teen Pregnancy Prevention • Promotes sharing of knowledge among healthand education agencies • Provides consistent messages to young people • Reduces programmatic gaps • Uses resources effectively • Increases potential effectiveness • Elevates importance of the issue • Addresses key issues around disparities

11. Barriers to SEA and SHA Collaboration Identified During NSMs • Lack of awareness across agencies • Lack of communication • Data are not shared across agencies or used for collaborative planning • Funding • Silo mentality • Different prevention approaches can be hard to reconcile (e.g., abstinence-only and comprehensive) • Collaboration is not an agency leadership priority • Turf issues

12. NSC Model For Addressing Health Disparities

13. Minority communities are disproportionately impacted across each of these areas.

14. Why integration and collaboration across health and education? …Common factors, and interrelated outcomes…

15. Whether addressing broader issues (i.e. the indirect contributing factors from the previous slide) or local issues, such as which sex education curriculum will be taught in a particular school district…

16. Education institutions are essential venues for reaching youth at risk for negative health outcomes. • Health agencies can provide important support to education institutions. • Data collection and analysis • Knowledge of effective prevention strategies • Program and policy development • Advocacy

17. National Stakeholders Meetings Participants As of March 2011 NH VT WA ME ND MT MA MN OR NY RI WI ID SD MI WY CT PA NJ IA NE OH IN DE NV IL WV UT VA CO MD KS MO KY CA NC TN DC OK AZ SC NM AR GA AL MS 2003 AK TX LA 2005 FL 2007 2008 HI 2009 Reconvene 2010 NSM 2.0

18. State Team Composition Varies based on state need and structure but often includes: • State HIV Coordinator and/or health education directors (SEA) • State HIV/AIDS directors or their staff (SHA) • State STD directors or their staff (SHA) • State adolescent health coordinators (SHA)

19. Taking NSM Teams’ Collaborative Efforts to the “Next Level” • January 2009: First-ever NSM – Reconvene • Met with teams for a “booster” session: Kansas, California, Michigan, Missouri • April 2010: NSM 2.0 • Took NSM on the Road for On-Site meetings: North Dakota, Texas

20. NSM 2.0 Agenda (2 Days) • Team building • Developing a joint vision • Environmental scan • Action planning (ToP method) • Inventory of current programming • Prioritization of ideas for collaborative • Victory circle • Commitment • Key Actions • Coordination

21. NSM Opportunities • Communication and collaboration • Networking and team building • Information and skills building support • Action planning • Capacity building that enables states to collaboratively: • secure funding • prepare and implement inter-agency strategic plans • engage youth • build, create, and share resources • revise and improve programs • develop and implement policies • integrate, assemble, and analyze data • design and deliver professional development

22. What do we Provide?…Follow-up Support • Individual Team Conference Calls • Support visits • Webinars • Mini-grants • Resource sharing • Web-based evaluation survey

23. NSC Technical Assistance • Webinars • State Strategies for Addressing the Sexual Health Needs of Youth in Foster Care Webinar 4-8-2010  • Positive Youth Development Framework: Practical Applications for State Departments of Health and Education, Webinar 9-23-10 • Strategies for Creating LGBTQ Inclusive Anti-Bullying Policies at the State Level 2-23-11

25. Evaluation Findings: 2003-2007 The NSM process was successful in… • Developing trusting relationships * • Prioritizing collaboration as a strategy to address HIV, STD, and pregnancy prevention* • Sharing data across agencies and programs* • Developing an SEA/SHA state plan to address HIV, STD, and pregnancy prevention* • Reconciling different philosophies and values across agencies and programs, such as abstinence versus comprehensive sexuality education* • Developing a unifying vision for how to address HIV, STD, and pregnancy prevention* • Improving communication patterns across agencies and programs* *statistically significant p < 0.01, two tailed test

26. Examples of State Team Activities • North Dakota: • Tell It To Me Straight Dinners (February 2011) • American Indian Health Summit (March 2011) • Texas: • Positive Youth Development – Big Tent Conference • PYD 101 Trainings with local School Health Networks • Efforts to modify the YRBS

27. The Next Phase NSC in the new funding cycle

28. Collaboration Continues • Partner organizations applied for DASH funding • Future On-Site NSM’s • Open to states that CDC has identified as target areas • Offering a “menu” of topics for states to work on • Increasing the number of NSM participants • Matching NSC leads with states according to organizational expertise

29. Suggestions… • Possible topics: • Anti-Bullying Policies • LGBTQ issues • School-based STI screenings • Positive Youth Development Frameworks • Professional Development for states • YRBS modification • Others???

30. Thank You • For more information • contact Kyle Lafferty • klafferty@thesociety.org