Washington D.C., USA, 22-27 July 2012www.aids2012.org

Active program participation and HIV risk reduction among urban youth:

Findings from the Complementary Strengths Research Partnership

Jennifer Sarah Tiffany, John Eckenrode, Deinera Exner-Cortens, Sara Birnel-Henderson

July 25, 2012 - Session WEAE04: Young People, HIV and Sexual and Reproductive

Health Services

Washington D.C., USA, 22-27 July 2012www.aids2012.org

This project was supported in part by award #R21NR009764 from the NIH/National Institute of

Nursing Research and by USDA grant #NYC-323442-0219950. The content of this report is solely the

responsibility of the authors and does not necessarily represent the official views of the

National Institute of Nursing Research, the National Institutes of Health, or the USDA.

We have no conflicts of interest to disclose.

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Overview of today’s talkComplementary Strengths Research Partnership

Background and historyMethodsResultsImplicationsLimitationsNext steps

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Background and historyWe started with a question: Does active participation boost HIV risk reduction among youth?

Partnership included Cornell University, New York State Department of Health, community programs, and New York City Department of Youth and Community Development

Steering committee launched pilot study (98 youth in 2006) and exploratory observational study (329 youth ages 13 to 18 in 2008-2009)

Aim: To develop measures, assess links between youth participation and sexual health promotion

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Pilot project 2005-2006

Exploratory study2007-2010

Developed new measures for

participation and HIV risk reduction

Interviews : What helps/hinders participation?

Intervention to boost the quality of youth engagement

in ASH EBPs

Designing N

ow

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MethodsMixed-method Community-Based Participatory Research project; mostly statistical analyses

Youth and program staff worked with university to develop and refine surveys, sustain participation

329 ethnically diverse participants from 18 after-school programs in New York City; 62% female, 37% male, 1% transgender; 74% heterosexual, 26% LGBTQ; 91% retention at waves 2 and 3

Youth-Adult “data dialogues” to translate results

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Results OverviewExploratory and confirmatory factor analysis validated our 20 item youth program participation scale (the “TEPPS”)Candidate measure for sexual health/risk reduction Significant positive associations: program participation, social connectedness, and HIV risk reduction scoresYouth in programs with participation scores that were average or high were more likely to sustain risk reduction practices (setting impact on individuals)Longer program involvement increased the impact of participation on risk reduction practices

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Result #1Validated 20 item youth program participation scale5-point scale (1=not at all true for me, 5=very true for me) Scores are created by summing across the 20 items; higher scores indicate greater program participation Cronbach’s alpha at baseline was 0.87Example items include “I help decide things like program activities or rules” and “I think that participating in the program will help me to get a job.”4 subscales: Personal Development, Voice/Influence, Safety/Support, Community Engagement

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Result #2

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Significant relationships among program participation, risk reduction & social connectedness

Result #3

Risk Reduction

Participation Family Connectedness

School Connectedness

Age Ethnic Identity (MEIM)

Hours per week

Duration of involvement

Risk reduction 1.00

Program Participation

.257** 1.00

Family connectedness

.140* .294** 1.00

School connectedness

.171** .163** .335** 1.00

Age .020 .061 -.172** -.036 1.00

Ethnic Identity .232** .349** .231** .149** .044 1.00

Hours per week .020 .198** .004 -.046 -.089 .060 1.00

Duration of involvement

.104^ .047 -.003 -.047 .127* .121* .149* 1.00

**p<.01 *p<.05 ^p<.10 Two tailed significance tests. Effective sample size ranged from 302 to 329

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Youth in programs with participation scores that were average or high were more likely to sustain risk

reduction practices (setting impact on individuals)

Result #4

b=-0.32, p=.005

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Longer program involvement increased the impact of participation on risk reduction practices

Result #5

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ImplicationsConsider contexts as well as individual behaviors

Setting-level factors influence risk reduction among adolescents

Highly engaged program participation may help sustain adolescent risk reduction practices over time

Quality of youth program participation experiences can be reliably and easily measured using new 20-item scale

Design and test interventions that increase program-level engagement (intervene with settings, not just individuals)

After-school/out of school time programs one key setting

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LimitationsObservational study Only 3 waves of survey data Program variability and few sites (18)

Next StepsIntervention study with larger number of sites and more data wavesSetting-level intervention

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Thanks to Complementary Strengths research partners and participants:

Hetrick Martin InstituteLutheran Family Health Care/Project Reach YouthCitizens Advice Bureau/BronxWorksBronx AIDS ServicesMosholu Montefiore Community CenterThe Educational Alliance/EdgiesThe Children’s Aid Society/Frederick Douglass Community CenterLegal Outreach Inc.NYS Department of Health AIDS Institute Adolescent HIV Prevention Services UnitNYC Department of Youth and Community Development

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For more information:Jennifer Tiffany

jst5@cornell.edu

Bronfenbrenner Center for Translational Researchwww.bctr.cornell.edu

Tiffany, J., Exner, D., and Eckenrode, J. (2012). A new measure for youth program participation. Journal of Community Psychology. 40(3), pp. 277-291. doi: 10.1002/jcop20508

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