Online Program

Context matters: Setting-level influences on active program participation and HIV risk reduction among urban youth

Monday, November 4, 2013 : 11:30 a.m. - 11:50 a.m.

Jennifer Sarah Tiffany, PhD, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY
Deinera Exner-Cortens, MPH, MA, Department of Human Development, Cornell University, Ithaca, NY
Mary Maley, MS, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY
Sara Birnel Henderson, Bronfenbrenner Center for Translational Research, Cornell University, New York, NY
John Eckenrode, PhD, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY
Background: The organizational culture of agencies that deliver adolescent sexual health programs affects the quality of both program delivery and youth participation. The Complementary Strengths Research Partnership explores how active youth program participation in an urban setting may contribute to HIV risk reduction practices. Methods: Using community-based participatory research, three waves of data were collected from youth aged 13-17 who were enrolled in New York City after-school programs. 329 youth participated in the study (62% female; 74% heterosexual; 3% white). 93% completed follow-up surveys. We later conducted in-depth follow-up interviews with youth (n=44) and staff (n=18) in the same programs. Interview data were used to create 8 dichotomous program-level variables that described characteristics that may contribute to high-quality youth program participation (e.g., active welcome, staff stability). Data were analyzed using multilevel models. Results: Findings from this study suggest that high quality youth program participation may contribute to sustained HIV risk reduction and that setting-level factors may influence quality of participation. For example, participants in programs with lower levels (-1 SD) of program-level participation reported greater declines in risk reduction practices than participants attending programs with higher levels (+1 SD) of participation (b=-0.32, p=.005). Specific empirical findings will be presented, as well as lessons learned and recommendations for setting-level practices in adolescent HIV prevention programs. Conclusions: Measurable features of organizational culture contribute to active youth participation. Active participation is associated with more sustained adolescent HIV risk reduction practices. Setting-level intervention that foster high-quality program participation may enhance sexual health promotion efforts.

Learning Areas:

Implementation of health education strategies, interventions and programs
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe potential relationships among organizational culture and climate, adolescent sexual health program delivery, youth program participation quality, and adolescent HIV risk reduction practices. Discuss next steps in exploring setting-level interventions to foster high quality youth program participation and sustained HIV risk reduction among adolescents.

Keyword(s): Adolescent Health, Sexual Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been PI, Co-PI, and/or Project Director on 15 funded research projects realted to HIV and/or adolescent health. I conducted the research reported in this abstract, in collaboration with academic and community partners. I have made numerous presentations at APHA on related topics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.