evaluating the effectiveness of a parenting curriculum training of trainers and its utilization in...
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Evaluating the Effectiveness of a Parenting Curriculum Training-of-
Trainers and its Utilization in Border Hispanic Communities of Texas
Sheetal Malhotra , MBBS, MSDiane Santa Maria, APHN, MSN
Hilda Chavarria, BSMelissa Steiner, MSA, CHES
Background
• The Medical Institute developed the Building Family Connections (BFC) curriculum
• Developed from previous work in border areas
• Information and skills training for parenting adults on parent-child connectedness
• Goal to increase parent-child sexual health communication and connectedness
Source:Markham,CM et al. J Adolesc Health. 2010
Background
• Parent-child communication and connectedness associated with
- reduction in adolescent risk behaviors including sexual activity1,2
• Parents face many barriers to communicating with their children about sex
- lack of knowledge, communication skills, and self-efficacy3,4
Sources:1. Kirby, D et al Sexual risk and protective factors2. Markham, C et al. 3. de Graaf, H et al J Youth Adolescences4. Miller, K et al AIDS and Behavior
Hispanic Communities
• Disproportionately affected by sexual health outcomes1
• Social norms may be barrier to sexual health communication2
Sources:1. CDC http://www.cdc.gov/std/stats07/minorities.htm#a42. Bartholomew, L et al Planning health promotion programs: An intervention mapping approach
Exponential Program Effects
• Community educators can be effective mediators to overcome parental barriers through education and skill building
• Each trained educator can reach numerous parenting adults producing an exponential effect on parent-child sexual health communication
• Training community educators across the country
Objectives
1) Evaluate the effectiveness of BFC curriculum training for community educators
2) Assess utilization in border Hispanic communities in Texas
3) Evaluate effectiveness in transferring this information to parenting adults through trained community educators
Methods: Training & Delivery
• 10-hour BFC curriculum
• 2.5-day training for community educators to
- learn and practice facilitation skills
- plan, recruit, & market program
- provide BFC to parents in their communities
Methods: Training & Delivery (cont.)
• Community courses
- implemented based on parent feedback
- scientific knowledge and effective parenting & communication strategies
- interactive and skill building formats
Methods: Evaluation
• Training evaluation
- usability
- capacity building
- logistics & delivery
• Pre/post-surveys
- knowledge
- attitudes
- intents
- behaviors
Results
• May 2008: BFC Curriculum Training
- 34 educators trained
- pre/post surveys
- training evaluation
• May 2007- June 2009: BFC curriculum courses
- 263 Hispanic parenting adults
- border communities in TX
- pre/post surveys
Results: Educators
• 34 educators; 6 males, 27 females
• Age: 25 to 65 years; median = 37 years
• Ethnicity
- 26% Black
- 15% Hispanic
- 44% White
- 12% Asian
- 3% Other
Results: Educators
• Significant increases in participant knowledge
ItemPre-survey
N (%)
Post Survey
N (%)p
Site of fertilization 18 (60) 33 (100) <0.05
Problem of dating violence
14 (44) 23 (70) <0.05
Risk of pregnancy in girls with boyfriends more than 3 years older then them
23 (74) 32 (97) <0.10
Decision making maturity among teens
17 (57) 25 (78) <0.10
Results: Educators
Results: Educators
• Participants strongly agreed that the training
- was useful (97%)
- was enjoyable (94%)
- materials were useful (91%)
- objectives were achieved (82%)
- prepared them to hold the BFC course (82%)
Results: Parenting Adults
• 263 parenting adults; 24 males, 238 females
• Age: 18 to 80 years; median = 40 years
• Ethnicity
- 98% Hispanic
- 1% White
- <1% Other
Results: Parenting Adults
Matched Responses:
• 170 parenting adults; 15 males, 155 females
• Age: 18 to 69 years; median = 40 years
• Ethnicity
- 98% Hispanic
- 1% White
- <1% Other
Results: Knowledge
ItemPre-survey
N (%)Post survey
N (%)p
Cause of cervical cancer 162 (69) 161 (96) <0.01
Risk of infertility with STIs 186 (77) 151 (89) <0.01
Condoms make sex “safe”
184 (72) 158 (94) <0.01
Early sexual debut and risk of multiple sexual partners
167 (69) 160 (95) <0.01
Most pregnant teens are abandoned by their partners
230 (91) 166 (99) <0.01
Results: Knowledge (cont.)
ItemPre-survey
N (%)
Post Survey
N (%)p
Risk of pregnancy in girls who have a boyfriend more than 3 yrs older than them
121 (48) 148 (88) <0.01
Site of fertilization 62 (27) 159 (96) <0.01
Dating violence problem 159 (64) 137 (82) <0.01
Link between dating violence and sexual activity
163 (69) 144 (87) <0.01
Abuse as a risk factor for multiple sexual partners
114 (50) 143 (86) <0.01
Results: Attitudes
ItemPre-survey
N (%)
Post Survey
N (%)p
Its okay for my child to start having sex when they are in a committed relationship such as marriage
206 (84) 158 (94) <0.01
Feel comfortable talking to children about STIs and how to prevent them
195 (78) 152 (92) <0.01
Results: Skills & Behaviors
ItemPre-survey
N (%)
Post survey
N (%) p
Strategies to start a conversation with youth about sex
214 (88) 162 (96) <0.01
Frequency of communication regarding sexual health
79 (32) 59 (36) <0.01
Where does fertilization pccur?
0%
20%
40%
60%
80%
100%
Fallopian tubes Ovaries Uterus
Re
sp
on
se
%
Pre-Survey
Post-Survey
Results: Parenting Adults
Results: Parenting Adults
Shared class information with
0%
20%
40%
60%
80%
Adult familymember
Neighbor/friend Children Other youth
Resp
on
se (
%)
Conclusions
• Training is effective in increasing knowledge and skills of educators
• Trained educators can then provide BFC curriculum to parents in their communities
• Utilization of BFC curriculum has shown increased parent-child sexual health communication in border Hispanic areas
Implications for Programs, Policy, and/or Research
• Use of trained educators to reach parents is a viable and effective model
• Such models are effective in minority populations such as Hispanics
• Programs for minority populations should focus on increasing parental involvement in youth sexual health through trained community educators
• Further research on utilization and impact of such models needed ie., in youth
Funding for the Study
This study was supported by grant # 90AE0147 from the Administration of Children and Families (ACF) and grant # 5U58DP000409 from the Centers for Disease Control (CDC) and Prevention Division of Adolescent and School Health (DASH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the ACF, CDC, the Department of Health and Human Services or the U.S. government.
Thank You!
For more information contact
Sheetal Malhotra, MBBS, MS
512-328-6268 ext 206