Project Connect: Implementing multi-level interventions to prevent teen pregnancy and STDs

Purpose: This report discusses implementation of intervention programs to prevent teen pregnancy and STDs among middle and high school students in an urban, Southern California public school district. Recognizing the influence of environmental and social contexts on adolescents' sexual risk behavior, Project Connect intervenes at structural levels to reduce risk and promote protective behavior. Success in structural interventions depends on building upon institutions' and agencies' existing strengths and creating two-way discourse between stakeholders and study staff.

Methodology: Intervention activities were developed targeting school-based health services (e.g., school nurses, school-based health care clinics, Condom Availability Programs), health teachers, and other school staff. The goal of these activities is to increase utilization of health care services, fidelity of health education, and after-school supervision. Structural and ecological changes made at these contextual levels are expected to positively influence youth to make healthier decisions regarding their sexual health. Development, implementation and maintenance of these intervention activities occurred following extensive input from school and health care personnel. Study staff collaborated with stakeholders within the unique reality of each institution and agency to implement appropriate interventions.

Lessons Learned: Project Connect has worked with various intervention targets to understand intervention needs and identify structural solutions to adolescent sexual risk behavior. Schools have integrated the project into school culture and utilized intervention materials. Structural interventions come with challenges, including shaping interventions based on each school's environment, building and sustaining relationships. This project demonstrates the utility of ecological models in a school-based study to reduce risky adolescent sexual behavior.