Integrated Approaches for Improved Adolescent Sexual Health in California
May 31, 2005
10:00 a.m. to 12:00 pm
To create a coordinated, collaborative, and integrated system among government and non-government organizations to promote and protect the sexual and reproductive health of youth in California.
Report back to Leadership Group on progress of the Adolescent Sexual Health Workgroup
Present Five Proposals to the Leadership Group and ask for input and endorsement
Outline Next Steps
Attending: Leadership Group: Michael Montgomery (OA), Susann Steinberg (MCAH), Laurie Weaver (OFP), Jan Mayer (CDE), Caroline Roberts (CDE), Gail Bolan (STD)
Working Group: Carolynn Michaels (MCAH), Chris Berry (CDE), Dorith Hertz (OA), Martha Torres-Montoya (OFP), Mari Taylan-Arcoleo (OFP), Eileen Yamada (MCAH), Sharla Smith (CDE), Paul Gibson (STD), Silvia Flores (MCAH), Susan Watson (STD), Lori Llewelyn (MCAH), Gail Sanabria (OA), Ben Bartos (California School Boards Association)
A power point presentation was conducted of the history and background of the national and state effort to forge greater collaboration/integration among those programs in DHS (MCAH, OFP, OA, STD) and CDE (School Health Connections Office) which have major programmatic interest/involvement in issues related to adolescent sexual and reproductive health. This is an ongoing national effort spearheaded by the Division of Adolescent and School Health (DASH) of CDC and several national organizations – such as the Association of Maternal and Child Health Programs (AMCHP), National Alliance of State and Territorial AIDS Directors (NASTAD), National Coalition of STD Directors (NCSD), Chief Council of State School Officers (CCSSO), National Conference of State Legislators (NCSL), and the National School Boards Association (NSBA). California – as embodied in the Adolescent Sexual Health Workgroup (ASHW) – is viewed by these national organizations as one of the most progressive and successful states in moving forward on this agenda.
The ASHW met six times between January and May 2005 and developed five proposals for improved collaboration/integration for the Leadership Group to consider. In addition, the ASHW is collaborating with the Sexuality Information and Education Counsel of the United States (SIECUS) (with fiscal support from the CDE and the STD Branch) to sponsor two trainings on Focusing on Youth in HIV and Sexuality Education in California in early June for nearly 80 key stakeholders from programs funded by OA, MCAH, OFP, STD, CDE, and DSS
Late Breaking Development:
One late-breaking development that generated considerable discussion and support by the Leadership Group is the Across the Map proposal by Norm Constantine and Carmen Nevarez of the Public Health Institute (PHI). This project involves implementing a comprehensive regional survey of public support and opinions on issues related to comprehensive sexuality education in California public schools. The California survey would largely replicate the survey questions used by the South Carolina Campaign to Prevent Teen Pregnancy in 2004 to document widespread public support in that state for most all components of comprehensive sexuality education. The California results would then be communicated to local school district and health jurisdiction officials – as well as to state level policy makers and other stakeholders about levels of support for SB-71 and comprehensive sexuality education. It was pointed out that survey results supporting comprehensive sexuality education would provide major backing for many of the school and community-based programs implemented by DHS and CDE on adolescent sexual and reproductive health. The PHI Across the Map project proposes utilizing the Adolescent Sexual Health Workgroup as an Advisory Group to guide the project.
The ASHW presented the following five proposals to the Leadership Group as priority areas for improved collaboration/integration:
Improve and expand sharing and use of HIV, STD, teen birth/pregnancy data:
collect state/local data reports on key indicators, including key risk-related behaviors;
identify strengths, gaps and deficiencies in data and make recommendations for improving consistency and comparability of data;
explore methods of sharing and disseminating integrated data for use by the public, community organizations, schools, and local health departments for improved program planning and evaluation.
Ensure that educators/counselors/case managers working in the area of adolescent sexuality can deliver effective behavioral interventions to protect the sexual and reproductive health of youth in California:
develop a guide of core competencies for providing sexual health education, and counseling consistent with the mandate of SB71;
develop a comprehensive and appropriate (gender, age, culture, sexual orientation, etc.) training program in “Adolescent Sexual Health 101” to ensure all educators, counselors, case managers working with adolescent sexuality are trained in the core competencies.
Identify, develop, and promote the use of culturally appropriate, youth-focused sexual health curricula, reflective of our priority populations (i.e., LGBTQ youth, special education youth, out-of-school youth, youth of color, etc.) for use by trained educators in school and community settings.
Identify funding, policy recommendations, and other resources to support all of the above.
Endorse continuation of the Adolescent Sexual Health Workgroup (quarterly meetings with special topic subcommittees modeled on HIV Community Planning Group structure)
Discussion, Comments, and Suggestions:
Dr. Steinberg expressed strong interest in the PHI Across the Map project – suggesting that the survey results would be extremely helpful to our collective prevention efforts and would fit in well with the data proposal (see # 1 above). Further, results showing considerable public support for comprehensive sexuality education would provide a powerful foundation for DHS/CDE collaboration as well as the proposals of the ASHW. There seemed to be general agreement among those present that the Across the Map project could prove to be an extremely important boon to our collective programs.
Dr. Steinberg also suggested that the ASHW begin to involve key non-DHS/CDE organizations and programs for input, consultation, and collaboration as the ASHW begins to move forward on the proposals. There was general consensus that this was an appropriate and needed process. She also suggested that a representative from the California Health Services Agency be invited to participate (with the Leadership Group Meetings?).
Gail Bolan suggested that we add Improved Adolescent Access to Sexual and Reproductive Health Services, which would also include Adolescent Legal Rights in regards to sexual and reproductive health services. There was general agreement to add this as a sixth proposal. Dr. Bolan suggested that Dr. Janet Shalwitz was a good point person for getting started on this issue.
Dr. Bolan also suggested that an intradepartmental data group be revived to help support work on Proposal #1. She offered to assign a senior epidemiologist from the STD Branch to spearhead this work.
Caroline Roberts pointed out that the word “standards” (see first bullet in Proposal #2 above) raises a red flag to educators, and may have different meanings in different disciplines. She suggested that the word “competencies” was sufficient and that we should strike the word “standards” from the text of this proposal. There was general agreement on this suggestion as well.
Michael Montgomery asked for clarification about the role of “other” staff that would be called upon to provide consultation to the subcommittees (see Proposal #5 above). It was agreed that usually the consultation request (for example, from epidemiologists regarding a specific data-related questions) would be for a brief period – usually only for one meeting. However it would be important for ancillary staff to understand that the consultation request is “legitimate” and supported by upper management.
The Leadership Group indicated support for all of the proposals presented by the ASHW, with the suggested changes and modifications just outlined. They agreed that an incremental approach to the proposals would be the best way to proceed – with Dr. Steinberg suggesting that the ASHW and special topic subcommittees identify more specific steps, timelines, needs, and expected outcomes for each of the proposals before proceeding any further.
The ASHW will meet soon (July?) to discuss the outcome of this meeting and to begin organizing subcommittees which will develop more specific steps, timelines, needs, and outcomes for each of the six proposals. A follow-up ASHW meeting will be set for the fall (October ?) with a Report Back Meeting to the Leadership Group to be set for early December.