Conclusions

  • Conclusions

Preliminary data from all 17 YEP grantees provide early evidence that points to the conclusion that the Youth Empowerment Program is working.

Summary of Reproductive Health

Collectively, the low rates observed across the YEP for both teen live births and STDs suggest a positive effect of the YEP to decrease risky sexual behaviors in at-risk minority youth, and demonstrate a significant return on investment. For Youth Empowerment Programs, and especially Latinas Adelante, these impressive outcomes are due to the comprehensive nature of the programs. Certainly, direct educational programming in reproductive health is one factor. An additional explanation is that the YEP develops positive resiliency, protective, and developmental factors, which facilitate healthy behaviors. Indeed, at the University of Utah statistically significant asset improvements in problem solving, cultural pride, self-efficacy, family communication, school bonding, personal development, wellness, nutrition, injury prevention, and self-perception profile have been reported. The development of personal assets has been shown to correlate with a reduction of risky behaviors and an increase in positive, healthy behaviors, including those that address reproductive health.

Summary of Anti-Violence

Using preliminary measures of school suspensions, school disciplinary incidents, and arrests, the YEP positively affects behavior and reduces violent tendencies. Three factors are hypothesized as effecting that change. First, minority students engage in positive after-school activities at times when other youth are prone to being involved in more negative behaviors. Second, the YEP provides curricula that addresses impulse control and conflict resolution allowing YEP students to have healthier interactions with peers. Third, increased resiliency assets, protective factors, and educational outcomes likely have a strong effect on reducing risky behavior. Cumulatively, these three factors appear to decrease negative behaviors and reduce violence.

Summary of Drug, Alcohol, and Tobacco Abuse

Collectively, the preliminary data suggest a positive effect of YEP programming to reduce substance abuse and risky behaviors. Both of these successful YEP models – at Swarthmore College and Stone Child College – utilize a youth asset development model to address substance abuse. In addition, Stone Child College’s PEAK Project provides a comprehensive ATOD prevention curriculum. Accordingly, both approaches appear to be effective in reducing risky substance abuse behaviors.

Summary of Youth Resiliency & Protective Factors

All YEP grantees build youth assets, resiliency, and protective factors. The data indicates that YEP programming stabilizes and, in many cases, reverses the normal decline in youth assets seen in adolescence. Role models, advising, academic support, mentorship, and individualized developmental plans are important elements in YEP activities that develop youth assets. Improved academic outcomes, such as graduation rates, grade promotion, and performance indicators, suggest better futures for YEP students. Moreover, the outstanding health outcomes in YEP in the areas of reproductive health, alcohol, tobacco and other drug use, and anti-violence programming imply that the development of assets is one factor that may contribute to altering these important youth behaviors.

Summary of Fitness and Wellness

The EYES fitness and wellness model at CUNY–Medgar Evers demonstrates convincingly that a targeted program of exercise and nutrition results in substantial weight loss and reduced BMIs in minority youth. The intensity, frequency and duration of the program distinguishes the Medgar Evers’ program. All programs that showed marked success utilized group exercise sessions led by trained motivational exercise group leaders who used group dynamics to support a positive lifestyle change. The YES! program at CSU Long Beach showed that BMI percentile and body composition could be altered to a more lean body mass and that part of that effect was likely due to improved youth assets. The YES program at Marquette University showed positive effects on a variety of fitness measures, leading to a significant reduction in obese and overweight youth. Moreover, Marquette showed that a focused trial intervention to improve nutrition by controlling school lunch calories has a significant effect to reduce body weight.

Limitations

The preliminary data from the YEP shows a strong positive effect in promoting healthy lifestyles and life choices in minority youth. However, the program must be evaluated within the context of the YEP’s size and scope as a relatively modest demonstration project of 17 programs with an average sample size of 48 minority youth each. Where possible, group data across multiple YEP grantees were used to increase the sample size for outcome measures in reproductive health, anti-violence, and GPA. Comparison of various measures pre-YEP and after two years of YEP programming were used to assess youth assets, GPA, body weight, BMI, and fitness. In contrast, pre-post comparisons were not available for markers that assessed violence, reproductive health, and substance abuse. In these cases, a control or comparison group was used to evaluate YEP data. Still, a pre-post comparison in all outcome measures would have strengthened the data by adding statistical power.

In addition, some of the measurement tools used to assess attitudinal or behavioral shifts in health required self-reporting which injected subjectivity into the measurements. The use of self-reported data is unavoidable in some areas of health, but regardless, self-reporting may not be as valid, or reliable, as health outcomes assessed by external objective measures. Finally, each YEP grantee works with a disadvantaged population of minority students. However, to participate in the YEP, each student had a parent or guardian that was sufficiently engaged in the student’s development to consent for his or her participation. Hence, students whose parents were not engaged, or not willing to consent, could not be included in YEP programming. Accordingly, in spite of the economic or educational disadvantage, some self-selection bias may exist in YEP cohorts based on the required parental support to enroll in YEP. With these limitations in mind, several conclusions, opportunities, and recommendations about the YEP result from the intriguing preliminary data from the program’s first two years.

Conclusions

The programming across the Youth Empowerment Program is built on an “asset model,” which reversed the normal decline of youth assets during adolescence as all YEP grantees who measured youth assets reported stabilization of asset levels, and each showed one or more assets which improved significantly over baseline levels. Based on preliminary data, the stabilization of, or actual increase in, minority youth assets in YEP grantee programs correlates with more positive health outcomes, like reduced levels of teen pregnancy, STD’s, violence, and substance abuse, along with better academic and wellness outcomes. These improved assets and health outcomes have been reported across the country by multiple YEP grantees, contributing to cumulative YEP data sets. Better youth asset profiles in YEP participants is an underlying foundation for better health choices. The use of an asset model supplements and enhances direct disease prevention and health promotion curricula for specific health issues. Asset models appeared highly effective in changing drug, alcohol, and tobacco use in minority youth. Swarthmore’s Blueprints Program tested the effects of an asset model alone. While providing no direct prevention programming in substance abuse, Swarthmore YEP students reduced these risky behaviors through asset-building alone.

Academic achievement among YEP students is a major youth asset, which can lead to success, college, jobs, better life choices, and therefore, improved health outcomes. While the GPA change with YEP over one to two years of programming is modest, one hypothesis is that a modest GPA change could be magnified and grow over an entire academic career. Clearly, the YEP’s positive effect on promotion and graduation rates, two major benchmarks of academic success, suggests that a YEP intervention can magnify the short-term effect of a modest increase in GPA An individualized case management approach has a positive effect on youth assets. Many of the YEP grantees use this type of one-on-one interaction, such as the University of Utah and CUNY–Hunter College, where social work models addresses teen pregnancy and trauma in minority youth, respectively.

Family involvement and student compliance are difficult and important issues that were generally reported as “challenges” across the YEP grantees. Towson University has shown that an individualized model, that enlists a local community organizer, can provide a key link to parents by regularly going into homes to build a strong relationship between the YEP staff and the parents. This novel intervention strategy fosters student compliance and parental support through a true understanding of the goals for their children. In addition to an individualized approach for some health issues, group activity templates led by motivational role models appear to be vital approaches for difficult behavior changes like healthy eating, fitness, and impulse control. Central State University, CSU-Long Beach, Marquette University, Medgar Evers College, and Stone Child College all had success in these areas by using group work and inspirational role models as group leaders to effectively address violence and fitness behaviors.

Dramatic changes in body weight can be made by combining a dedicated nutrition curriculum and a commitment to physical activity. A comprehensive fitness and wellness program of improved nutrition education, combined with exercise of sufficient intensity, duration, and frequency, can lead to impressive weight loss, decreased BMI, and body fat reduction in minority youth. The EYES program at Medgar Evers College sets the standard for all youth empowerment programs with a 20-pound average weight loss over two years. Testing the effect of a pilot school lunch program on body weight, Marquette University has shown that controlling caloric intake in school lunches can have a dramatic affect on weight, while maintaining nutritional quality. Cumulatively, these YEP programs provide models of success to fight the rising rate of obesity in minority youth.

Opportunities and Future Directions

While this document reports on only the first two years of YEP programming, the conclusions from the YEP demonstration project suggest that further investment in youth empowerment is both warranted and needed to alter the life course of minority youth. Specifically, YEP data suggest that even short programmatic interventions can have positive effects on youth assets, academic achievement, and health outcomes. The data imply that longer YEP interventions built on this strong foundation, might magnify the results over time. Accordingly, longitudinal studies of YEP programming, designed with repeated measures analysis, are needed to assess the possible long term impact of the YEP on health outcomes.

Several YEP grantees featured in the preceding data sections have tested innovative and creative models in specific minority populations to address difficult adolescent behaviors that negatively affect health. The early positive results in areas like reproductive health, obesity, youth assets, and anti-violence programming suggest that these new approaches be studied by, and expanded into, other YEP programs as model practices in minority youth empowerment.

These innovative approaches need to be studied across all racial and ethnic cohorts. In other words, the YEP should utilize the lessons learned herein in future grant cycles. From such studies, the ideal dosage and frequency of YEP interventions would better define best practices in youth empowerment. Furthermore, any conclusions about the YEP will be strengthened by expanding the entire YEP program to include larger sample sizes and more grantee programs. An expansion of YEP would allow OMH to study the capacity of the YEP to make changes in health in larger cohorts. Finally, within each program, the power of the YEP data analysis would be enhanced by the use of an age-, race- and ethnicity-matched control group, and by the collection of pre-post comparison measurements for all available health markers.

Potential Ripple Effect of the YEP

Clearly, the early data suggest that YEP has had a positive effect on the lives of minority youth and their parents all across the country. Anecdotally, the impact extends beyond those directly affected or touched by programming. The decrease in violence in the center of Dayton makes the city a safer place for all residents. The coming together of two distinct high schools has brought together American Indian students, parents, and the Chippewa Cree community on the Rocky Boy’s Indian Reservation — where arrests have decreased and academic achievement has increased — where families are uniting as one to make the reservation a stronger and more positive place for youth to grow.

Improved high school graduation rates across YEP grantees translate into increased opportunities for employment and college, therefore decreasing the financial burden on ever-tightening federal and state budgets. The reduction in YEP teen pregnancy in Salt Lake City, and across the grantees that reported live birth data, changes the course, not just of these young women, but also their families, providing the opportunity for them to transition from just surviving to thriving. Truly, the ripple effect of the YEP in altering the paths of adolescents can be transformational to a family, community, city, and ultimately to the country. This initial return on investment for adolescent intervention and empowerment programs is just the beginning, and it shows the potential to impact the health and well-being of the nation in the long term.