Evaluating the Effectiveness of a Parenting Curriculum Training of Trainers and its Utilization in Border Hispanic Communities of Texas

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

smalhotra@medinstitute.org

512-328-6268 ext 206