Background
In 2010, the Centers for Disease Control and Prevention (CDC), in partnership with the Office of the Assistant Secretary for Health Offices of Adolescent Health (OAH) and Population Affairs (OPA), funded nine state- and community-based organizations in high need communities as part of the Teen Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives. These initiatives are tailored to the specific communities, yet all employ five common components: (1) community mobilization and sustainability, (2) implementing evidence-based programs, (3) increasing youth access to contraceptives and reproductive health services, (4) educating stakeholders, and (5) working with diverse communities.
JSI Research & Training Institute, Inc. (JSI) is one of five national organizations funded to provide training and technical assistance to the nine grantees on the five initiative components. JSI focused on the working with diverse communities (WDC) component, which aims to: raise awareness of the relationship between teen pregnancy and social determinants of health, help partners identify determinants that are feasible to change, and ultimately integrate a “social determinants” approach into all of their teen pregnancy prevention efforts.
Purpose
A “social determinants of health” approach views teen pregnancy and other adolescent health outcomes as the product of the conditions in which teens live, learn, work and play, and not simply as the result of individual behavior or biology. This toolbox provides grantees and their partners with the tools to: (1) sustain activities designed to be responsive to their community’s needs and (2) integrate a social determinants of health approach into their community-wide teen pregnancy prevention efforts.
Tools and resources included in this toolbox are organized into five content areas:
1. Communicating Effectively about the Social Determinants of Health that Impact Teen Pregnancy
2. Root Cause Analysis and Action Planning
3. Community Partnerships
4. Special Topics
5. Additional Working with Diverse Communities Component Tools and Resources
This toolbox was made possible by Cooperative Agreement Number 1U58DP002906-05 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.
Communicating Effectively about Social Determinants of Health that Impact Teen Pregnancy
Integrating a Social Determinants of Health Approach in Teen Pregnancy Prevention 
This case study was a collaboration between the WDC component and grantees to raise awareness among community partners of the relationship between teen pregnancy and social determinants of health.
OAH Podcast Series: Social Determinants of Health that Impact Teen Pregnancy
Transcript of Podcast
This podcast was created in partnership with the Office of Adolescent Health to inform the work of teen pregnancy prevention grantees. Myriam Hernandez Jennings, WDC Project Director, emphasizes the importance of understanding the impact of social determinants of health, i.e., the conditions in which teens live, learn, work and play, on the incidence of teen pregnancy and other adolescent health problems.
Root Cause Analysis and Action Planning Process
Conducting a Root Cause Analysis and Action Planning Process: Facilitator’s Guide
This tool provides an overview of root cause analysis and offers guidelines for facilitating one in your community to identify individual, interpersonal, community and social factors impacting teen pregnancy, and to recognize potential intervention points.
Engaging Community Stakeholders to Address the Social Determinants of Teen Pregnancy
These case examples illustrate how teen pregnancy prevention programs around the nation have used root cause analysis (RCA) to unearth and address the social and environmental factors impacting teen pregnancy in their specific communities. The featured programs are grantees in CDC’s Teen Pregnancy Prevention 2010-2015 project: Integrating Services, Programs and Strategies through Community-wide Initiatives.
Community Partnerships
This tool provides guidance on developing partnerships with a broad array of groups, programs and organizations, representing all sectors and stakeholders in the community, in order to strengthen and sustain communitywide teen pregnancy prevention efforts and better serve diverse youth. It includes sections on: 1) identifying potential new partners, including non-traditional partners, 2) strategies for initiating, developing, supporting and maintaining partnerships, and 3) building expanded referral networks.
Essential Elements of a Community Referral Network Planning Checklist
The purpose of this tool is to guide organizations in establishing a new referral network or enhancing an existing referral network to address the social determinants of teen pregnancy and adolescent health by connecting their program with teen clinics and other youth-serving programs. The checklist outlines four essential elements of a community referral network, and available tools and resources to support planning and continuous quality improvement.
Essential Elements of a Community Referral Network Planning Worksheet
The purpose of this worksheet is to help organizations assess readiness to pilot a new referral network or enhance an existing referral network by reviewing the four essential elements of a community referral network. Please refer to the Community Referral Network Planning Checklist for definitions of key terms and additional resources.
Whole Teen Assessment Question Bank
JSI Research & Training Institute (JSI), 2015—This question bank offers a variety of ways for teen pregnancy prevention programs, teen clinics, and other youth-serving programs to incorporate into their client assessments, questions about social determinants that may affect a teen’s health, well-being, and risk behaviors.The purpose of asking these questions is to gain a more comprehensive understanding of teen clients’ life circumstances, and to connect them to needed social services, as the foundation for promoting their physical and emotional health, as well as their healthy decision-making.
Special Topics
Benefits of a Reproductive Justice Approach When Promoting Contraceptive Use in Diverse Communities
This webinar highlights the importance of utilizing a reproductive justice approach in our efforts to increase access to effective forms of contraception, including long acting reversible contraception (LARC), in disadvantaged and vulnerable communities.
Handling Disclosures of Trauma: Guidelines for EBI Facilitators
JSI Research & Training Institute (JSI) — EBI sessions provide a “safe space” to discuss sensitive and personal issues, which for some youths may trigger disclosures of trauma, such as sexual abuse or dating violence. This job aid/guide sheet helps EBI facilitators to be prepared to handle such disclosures by teens participating in EBI sessions.
Mobilizing a Community Health Worker to Reach Teens and their Families
JSI Research & Training Institute (JSI) — This case study illustrates how a teen pregnancy prevention program is using the Community Health Worker model to reach and serve the needs of teens and their families who reside in public housing developments in Spartanburg, SC. The featured programs are grantees in CDC’s Teen Pregnancy Prevention 2010-2015 project: Integrating Services, Programs and Strategies through Community-wide Initiatives.
Engaging Youth in Teen Pregnancy Prevention
Place Matters: Youth Perspectives on Teen Pregnancy & Their Environment
The purpose of this video is to educate diverse audiences about the influence community factors may have on teen pregnancy. While this video can be used with diverse stakeholders (e.g., youth, parents, school staff, youth service providers, healthcare providers, and community members), two guides were developed for use with specific audiences – youth and youth-serving providers.
Place Matters: Youth Perspectives on Teen Pregnancy & Their Environment- Youth Video Discussion Guide
Place Matters: Youth Perspectives on Teen Pregnancy & Their Environment- Youth Service Providers Video Discussion Guide
In addition, we have developed two discussions guides, one specifically for youth and the other tool for youth service providers. Questions in each section of the guide correspond with the main themes addressed by YLT members in the video, including:
• What their community and family mean to them,
• Challenges they face,
• Recommendations as to how their communities can better support them, and
• Their hopes and dreams.
Additional Working with Diverse Communities Component Tools and Resources
Working with Diverse Communities: Strategies Guided by Best Practice
To help grantees effectively address disparities and inequities in teen births, this document provides a list of recommended strategies. These strategies provide guidance as to what grantees can do specific to working with diverse communities organized by the other key components of the teen pregnancy prevention community-wide initiative: community mobilization, educating and engaging stakeholders, evidence-based and evidence-informed prevention program.
The assessment tools listed below were designed as optional tools for CDC Teen Pregnancy Prevention: Integrating Services, Programs, and Strategies through Community-Wide Initiatives Part A grantees to select Strategies Guided by Best Practice that are relevant to their work in engaging diverse communities in their efforts. The information gathered informed the WDC strategies to be included in their Work and Evaluation plans and in the Performance Measure Reporting Tool (PMRT).
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Strategies for Clinic Partners
This tool refers to strategies #27-37 and indicates where in the “process” each clinic partner is in implementation of the “clinic specific” WDC strategies. -
Strategies for Implementation Partners
This tool refers to strategies #19-26 and indicates where in the “process” each implementation partner is in the implementation of “evidence-based program specific” WDC strategies. -
Strategies for Part A Grantees
This tool uses the information gathered by the clinic and implementation partner assessment tools to inform selection of the WDC strategies to be included in your Work and Evaluation plans, and in the PMRT to be submitted to the CDC -
Planning Questions for Implementation of Strategies
This handout demonstrates how to use the Who-What-How-Where-When approach to help plan specific action steps to implement selected WDC ‘strategies guided by best practice’. -
Grouping Strategies for Implementation
This handout helps to simplify the 37 WDC ‘strategies guided by best practice’ by showing how they reflect just a few key underlying themes, and by indicating which strategies overlap with others, so that programs implementing one of them are well on their way to implementing others. -
Process Measures to Assess WDC Strategies
These measures provide guidance on how to document the implementation of a selected WDC strategy. -
Quality Indicators to Assess the implementation of WDC Strategies
These indicators provide guidance on how to assess whether a selected WDC strategy has been implemented with “high quality”.
