OVERVIEWS

Teen sexual activity, teen pregnancy and incidence of sexually transmitted diseases among youth are a significant problem in Colorado, particularly within sub-sets of the population including Latino and African American youth, and rural teens. These high-risk behaviors lead to increases in depression among adolescents, poor academic performance and school drop-out, and can lead to future poverty. Abstinence until marriage education programs empower teens and their parents by teaching relationship and boundary setting skills, providing tools to help them abstain from sexual activity and other high risk behaviors. The goal of WAIT Training’s Community Based Abstinence Education Grant is BAE work through WAIT training is Healthy Futures, Healthy Families for the State of Colorado.

WAIT Training is excited to present our "Healthy Futures, Healthy Families" initiative for Colorado, for consideration of 2006-2011 Community Based Abstinence Education program funding. Healthy Futures, Healthy Families is a complete and sustainable community saturation plan for implementation of highly effective abstinence until, and in preparation for, marriage programming throughout key geographic and demographic communities in the state.

There is a clear need for abstinence programming in our service area based upon the current state trends in teen sex, teen fertility, STD infections and divorce. Compelling data from the Youth Risk Behavior Surveillance System (YRBSS) survey demonstrates that youth in our proposed service area exhibit consistently high levels of sexual risk behaviors relative to national averages. Summary data from YRBSS surveys conducted in Colorado in 2003 indicate that an average of 46% of high school students reported having engaged in sexual intercourse; the same survey indicated that Hispanic high school students are particularly at risk with 49.6% engaging in sexual intercourse as compared to 33% of their white counterparts. Other findings are equally troubling, including significant risk factors for African American students; and a progressively earlier onset of sexual activity as evidenced by tracking responses by student age groups. In the service area, students in 9th and 10th grade during the survey period were nearly twice as likely to have initiated sexual intercourse before the age of thirteen, when compared to 11th and 12th graders responding to the same question during that time period. Youth are initiating sexual activity at a younger age, giving further evidence of need for additional prevention efforts. Occurrences of STDs have also risen at an alarming rate. According to two recent reports - the Sexually Transmitted Diseases in Colorado Surveillance Report: 2000, and CDPHE Colorado Youth Risk Behavior Study 2003 – the increase in Chlamydia cases from 1999 to 2000 was 13.6% while the increase in Gonorrhea cases for the same period was 33.6%. Furthermore, STD cases are dramatically higher in teens, including 44.2% of the cases in African Americans.

While the overall teen fertility rate in Colorado has been declining since 1992, the fertility rate for Hispanic teens, ages 15–17, increased by 11 percent during the same time period. In 2003, the fertility rate for Hispanic teens was more than six times higher than Caucasian teens and twice the rate of African American teens, ages 15–17. Colorado’s very young teens, ages 13 to 14, experienced similar trends during the 1990s. The 2003 fertility rate of 13- to 14-year-old Hispanic teens was 10 times higher than the rate of Caucasian teens, and five times higher than the rate of African American teens. Most adolescent childbearing occurs outside of marriage, a trend that has increased remarkably over the last several decades. According to latest US census data 80 percent of births to adolescent females under the age of 20 were out-of-wedlock compared to 44 percent in 1970. The Heritage Foundation has found that teenage mothers are less likely to complete school, and more likely to be single parents and remain in poverty. Their children experience poorer health, reduced cognitive development, more behavioral problems, often becoming teen parents as well.

Finally, with regard to healthy marriage formation, statistics from the U.S. Census place Colorado 33rd on the list for marriage stability among the United States. Data from the Colorado Department of Public Health and Environment for 2001 shows that the state has a marriage rate of 8.5 per 1000 population, slightly above the U.S. rate of 8.4/1000. However, in 2001 Colorado’s divorce rate was 4.7 per 1000 population, as opposed to the US average of 4.0/1000. The risks associated with marriage dissolution, according to a 2002 Heritage Foundation compilation entitled “The Positive Effects of Marriage: A Book of Charts” include increased child poverty, welfare dependence, domestic violence, incarceration and suicide.

Description of Target Communities

Colorado’s population, by virtue of geography and topography, is arranged primarily along major interstate highway corridors; and secondarily in more remote concentrations centered on the larger mountain communities. WAIT Training, based in the Denver metro area, has established partnering relationships within five target areas in Colorado, with an understanding that risk behaviors are interconnected, and influenced by other environmental and economic factors. School district, health, census and marriage data, along with feedback from focus groups and widely accepted research findings were used to determine which eligible communities would most benefit from our services and in what ways those communities could best be served. In assessing areas for partnership, the following criteria were observed: ethnicity, with emphasis in identification of communities with a large Hispanic population; school drop-out rates and percentage of free-and-reduced lunch participation; incidence of child poverty; teen fertility rates and percentage of births to unmarried mothers; numbers of single-parent households; divorce rates and relative cultural resistance to abstinence education efforts.

WAIT Training has targeted services based on the understanding that urban, suburban and rural areas have differing needs and require differences in approach. Finally, identified areas of highest need and priority within the state were then assessed relative to the presence of well-developed networks of community partners and identified community leaders willing to commit to our efforts, and the communities targeted are as follows: A. Metro Denver – sub-divided for purposes of project implementation, into 1) the urban City & County of Denver; and 2) the heavily populated south-eastern suburb areas of Arapahoe and Douglas counties, including the cities of Littleton, Englewood, Greenwood Village, Parker and Highlands Ranch. WAIT Training will work directly with the Denver Public Schools, Cherry Creek Public Schools; the Black Ministerial Alliance, the African American Healthy Marriage Initiative, health providers, and youth serving non-profit agencies to implement programming. B. Mountain Communities – This service area is sub-divided into 1) Summit/Eagle Counties and 2) Routt/Moffat Counties. These communities will be served through collaboration with the Visiting Nurses Association of Steamboat Springs, providing linkage to schools and county health departments as our primary mountain community partner. Although perceived as wealthy and low risk, ski resort towns like Vail, Beaver Creek, Avon, and Steamboat Springs are economically dependent upon high numbers of support employees who live primarily in the immediate outlying areas. Communities such as Craig, Edwards, Glenwood Springs, Frisco, Dillon and Eagle are home to thousands of service workers; ethnically diverse populations which are often at or below the poverty line, and susceptible to a myriad of high risk behaviors. C. Mesa County and Montrose Counties – Mesa County is home to more than 100,000 people in 15 communities, the largest of which is Grand Junction. Montrose County and the city of Montrose are located due south of Grand Junction, in a primarily agricultural valley setting. These cities are the primary population centers of what is referred to as the “western slope”, and serve as the major crossroads communities for the area, providing easy access to the communities of Glenwood Springs, Delta, Gunnison, Paonia and Ridgeway. The FACT Foundation of Grand Junction is WAIT Training’s primary partner in the area, through which we will bring training, curriculum and community mobilization, technical assistance and capacity building services to expand abstinence education throughout area school districts, the healthcare community and other youth service providers. D. La Plata County: LaPlata County will serve as the hub for services to Southwestern Colorado, including the cities of Cortez, Durango and the underserved Hispanic and Native American Indian population of the San Luis Valley. WAIT Training will provide services in conjunction with the Durango Life Foundation, which has been providing crisis pregnancy and teen counseling services in the area since 1978, and is well positioned for implementation.

The Approach

The WAIT Training Healthy Futures, Healthy Families project is a community saturation model, utilizing multiple program strategies to introduce effective abstinence programming to the communities served. All aspects of the program initiative are thematically consistent, and all are in complete alignment and compliance with the themes and requirements of the CBAE program.

The centerpiece of the Healthy Futures, Healthy Families initiative is the nationally acclaimed WAIT Training curriculum – a Title V, A-H compliant collection of materials designed to serve middle and high school students with inspiration, motivation, reasons, skills and support to choose abstinence from sexual behaviors until marriage. Originally developed in 1996 by Joneen Mackenzie, RN, BSN, the curriculum was updated and enhanced for a 2nd edition early in 2004, and has also been adapted into several culturally specific versions for Latino Youth, use in faith-based settings, Medical Cessation for health care professionals and has been translated into Spanish. . WAIT stands for Why Am I Tempted? and has a strong focus on the benefits of healthy relationships, boundaries and behaviors, the curriculum provides medically accurate, culturally sensitive information and activities to youth aged 12-18, at a critical time in their development. The provided curriculum description for WAIT Training provides details of the thematic alignment with CBAE requirements.

The Healthy Futures, Healthy Families initiative incorporates multiple program strategies and activities for community engagement and development of effective and sustainable programming implementation. Programming is arranged around three primary strategies: Community Capacity Building and Mobilization, Targeted Specialized Provider Training (Parent, Teacher, Healthcare Professional, Spanish-speaking, etc.) and Support Services for delivery to targeted youth. Throughout these strategies, the initiative complies with CBAE requirements, adhering to both the intent and spirit of all thematic elements…because these themes have been at the center of WAIT Training programs since the beginning (before Title V or CBAE Funding). In all program communications and activities, the WAIT Training Healthy Futures, Healthy Families project provides a clear definition of sexual abstinence as voluntarily choosing not to engage in sexual activity until marriage, with sexual activity defined as any type of genital contact or sexual stimulation between two persons including, but not limited to, sexual intercourse. Healthy Futures, Healthy Families programming provides a clear message regarding the importance of student abstinence from sexual activity until marriage and emphasizes that the best life outcomes are more likely obtained if an individual abstains from sexual activity until marriage. Throughout the entire program, the term "marriage" is defined solely as a legal union between one man and one woman as a husband and wife, and the word 'spouse' refers solely to a person of the opposite sex who is a husband or a wife. Healthy Futures, Healthy Families programming teaches the psychological and physical benefits of sexual abstinence-until-marriage for youth; along with the importance of marriage, commitment, responsible parenthood, especially fatherhood, and the potential harm of out-of-wedlock childbearing to all racial, socioeconomic, geographic, age, gender and ethnic groups. Healthy Futures, Healthy Families programming does not promote or endorse, distribute or demonstrate the use of contraception or instruct students in contraceptive usage. All materials and references regarding STDs are consistent with the National Institute of Allergies and Infectious Diseases definition for STDs.

WAIT Training will be using a Community Saturation Model, which provides engaging all the community stakeholders and building capacity. Our goal is to train and educate all individuals directly and indirectly involved in the lives of our youth to help in communicating the optimal health message. We will providing 2 day certification training for individuals that will work directly with the youth. We will education parents on the issues their kids are facing as well as opportunities for them to have healthy conversations with their children and how WAIT training provides specific skill training that practically gives their children the ability to move from the negative toward the positive. We will implement community mobilizations that empower businesses, local stores, supermarkets, gas stations, restaurants and any other establishment that has a chance to post a positive message to encourage our kids to make the best decisions for the future. As well as work with the medical professional and those working with youth that are currently sexual active to teach a way to gradually move them toward an abstinence lifestyle that promotes the future goals and dreams.

Project objectives will be met through implementation of our Community Saturation Model, which provides Community Mobilization and Capacity Building; Teacher and Community Leader Training & Materials, and Youth Delivery Support Services. Community Mobilization Services include “Why Abstinence, Why Marriage?” mobilization events for community stakeholders, Parent Workshops and school assemblies. Teacher and Community Leader Training includes implementation of WAIT Training and culturally specific adaptations, Parent Programs, Healthcare Provider Training in the Medical Cessation Model for Sexually Active Youth; and training for Pregnant and Parenting Teens. Delivery Support Services include technical assistance, project management and oversight, a speakers bureau, a quarterly newsletter for all constituents, youth advisory boards, event marketing and project evaluation.

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