California Department of Public Health, Maternal, Child and Adolescent Health
Increasing Resiliency Among Expectant and Parenting Teens in California (2014)
Adolescent Family Life Program Positive Youth Development (AFLP PYD) is an evidence-informed, standardized case management program designed to serve expectant and parenting teens that either have custody of a child or are co-parenting with a custodial parent. Youth in the program face an array of challenges including poverty, unstable home environments, domestic violence, academic struggles, substance abuse, mental health issues, and juvenile justice involvement. The program uses a positive youth development resiliency framework and life planning support with the goals of reducing repeat teen pregnancies, and increasing educational or vocational advancement, parent and child health, and linkages and supports.
Expected to reach an estimated 2,600 expectant and parenting teens across 26 counties in California, AFLP PYD empowers youth to pursue life goals that will improve the health and well being of themselves and their children. Youth in the program receive two in-person visits per month with their case manager who promotes resilience by helping youth form caring relationships, maintain high expectations, and identify opportunities for participation and contribution. Additionally, case managers help youth develop problem solving skills and a sense of purpose, as well as increase autonomy and social competence.
The California Department of Public Health, Maternal, Child and Adolescent Health (MCAH) made great strides with a formative evaluation of the AFLP PYD pilot that helped determine that the program's components, tools, and training are appropriate and effective. MCAH will expand implementation to additional sites and plans to conduct a rigorous evaluation to build the evidence base for the program.
In addition to solidifying the design of the intervention, California's AFLP PYD program has positively affected the lives of many expectant and parenting teens. One youth in the program who was recently released from a juvenile facility shared that through AFLP PYD she has learned to draw from her strengths and now feels confident in her ability to provide a better future for herself and her daughter. She remarked, "This program has taught me to be patient and to set goals. Little by little you can make things happen. It has helped me out a lot. Before this I never looked forward to meeting with a case worker, but I look forward to [her] visits. I learned to appreciate the help of others. I never thought I could do it, but here I am taking care of business. I didn't think I could go from where I was to thinking about careers."
AFLP PYD Coordinator
Partnerships Support a Life Planning Intervention for Pregnant and Parenting Teens (2013)
The California Department of Public Health’s Maternal, Child, and Adolescent Health Division (CDPH MCAH) is developing a life planning intervention for case managers to use with the Adolescent Family Life Program (AFLP) pregnant and parenting teen clients. A life planning intervention supports preconception and interconception health as a critical component of reproductive health and may improve pregnancy-related outcomes and reduce disparities in adverse pregnancy outcomes. The life planning intervention includes a life planning tool called My Life Plan (MLP) for use with case managers and a group level intervention (GLI).
CDPH MCAH partnered with Sacramento County’s Sutter Health’s AFLP to further develop a case management life planning tool called MLP that was initially created by Sutter Health using March of Dimes funding. The MLP is an interactive, client centered, strength based tool in which clients work on life planning modules with the support and guidance of their case managers. It is designed to help clients create a plan, based on their own strengths and values, and set personal goals to improve their health and well-being, and that of their child/children.
The theoretical construct of the tool is positive youth development (PYD). PYD is an affirming and prevention-based approach to working with youth that aims to develop their resiliency by strengthening developmental assets such as social competence, problem solving, autonomy, and sense of purpose. PYD is a counterpoint to deficiency models that focus on youth problems and reducing risk behaviors. The PYD focus of this life planning intervention led CDPH MCAH to designate this project AFLP PYD.
The MLP tool consists of the following modules:
- Me and My Life
- Taking Care of Me – The Skin I’m In
- Taking Care of My Baby
- Reproductive Health and Safe Sex
- Healthy Relationships
- Education, Career, and Money
Clients begin with the Me and My Life Module. This module guides clients through a process of reflection on their personal strengths, values, and their dreams and goals for the future. The tool begins with this module because it introduces clients to the importance of talking about their goals, thus preparing and empowering them for all future work on the MLP. Once the Me and My Life Module is completed, the use of, order, and duration of the remaining modules depends on the individual needs of clients and the duration of their enrollment in AFLP. As a client works through each module, a form called the My Goal Sheet is used by the client to plan their steps and timelines for reaching the specific personal goals they have set in relation to the module. In order to ensure the AFLP program goals are effectively addressed while using this client-centered tool, during every visit, regardless of which module the client is working on, the case manager briefly checks-in with the client on the four AFLP program priority areas: contraceptive use & empowerment, education, healthy relationships, and access to health care.
The eleven AFLP PYD agencies began their grant experience with a capacity building year. Grantee staff received a series of trainings including: core competencies for providers of adolescent sexual and reproductive health (for supervisors); positive youth development; case management and motivational interviewing; and life planning. The series of trainings culminated in a final “pulling it all together” training that included the theoretical constructs and skill-building on application of the MLP for 61 AFLP supervisors and case managers. Local sites are currently practicing use of the tool and will begin using the MLP with all AFLP clients in January 2013. It is projected that 975 pregnant and parenting teens will receive the intervention monthly.
In addition to developing the MLP tool for case management, CDPH MCAH also partnered with the developers of Positive Prevention Plus to explore use of a Group Level Intervention (GLI) for AFLP. Positive Prevention PLUS is specifically tailored for pregnant and parenting teens and is based on the research-validated curriculum, Positive Prevention HIV/STD Prevention Education for California Youth, the most commonly used HIV/STD prevention curriculum in California. The eight session, Positive Prevention Plus curriculum, which directly aligns with the AFLP goals, is being evaluated to assess its success in supporting MLP outcomes. Four AFLP sites are piloting the GLI.
The University of California, San Francisco will guide a formative evaluation of the MLP case management intervention and the GLI. Evaluation will include surveys, focus groups, and key informant interviews with supervisors, case managers, and pregnant and parenting teens. The goal is to synthesize the formative feedback from local partners to refine the case management tool and integrated usage of the GLI, and ultimately to develop a standardized intervention based on a full pilot evaluation for AFLP case management in California.
Title: Project Coordinator
Organization: California Department of Public health
Phone: (916) 650-0381
Content last reviewed on January 26, 2016