Does one size fit all: culturally appropriate teen curriculum for risk behaviors.
Abstract: As health educators continue to seek solutions for combating risk behaviors such as alcohol and drug use, sexual activity, and violence in youth, novel approaches for engagement in education are needed. The Future Leaders Outreach Network (FLON)programs were developed, implemented, and evaluated in an urban setting with predominantly African American youth. Curriculum content is tailored toward the cultural needs of African American youth and their parents or primary caregivers. Preliminary results suggest the curriculum instilled and reinforced commitment toward positive attitudes and behaviors. This article proposes a new model for health education in an urban, public school setting.
Subject: African Americans (Sexual behavior)
Teenagers (Sexual behavior)
Youth (Sexual behavior)
Education (Curricula)
Violence
Social service
Drugs and youth
Authors: Clemons, Diana E.
Wetta-Hall, Ruth
Jacobson, Lisette T.
Chesser, Amy
Moss, Ashley
Pub Date: 01/01/2011
Publication: Name: American Journal of Health Studies Publisher: American Journal of Health Studies Audience: Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 American Journal of Health Studies ISSN: 1090-0500
Issue: Date: Wntr, 2011 Source Volume: 26 Source Issue: 1
Product: Product Code: E121930 Youth; 9105130 Social Service Support Programs NAICS Code: 92313 Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
Organization: Government Agency: United States. Department of Health and Human Services; United States. Centers for Disease Control and Prevention
Accession Number: 308741538
Full Text: BACKGROUND

The literature reports numerous interventions to reduce adolescent risk behaviors (Cairns et al., 1991; Flay, Graumlich, Segawa, Burns, & Holliday, 2004; Greenwood, 1996, 2004; Jemmott, Jemmott, & Fong, 2010, 1998). In hopes of increasing their effectiveness, youth-focused programs within the past decade are designed to be more culturally oriented (Kumpfer, Alvarado, Smith, & Bellamy, 2002; Pedlow & Carey, 2003, 2004). To reach youth within their social environment, interventions are offered in schools (Kumpfer, Alvarado, Tait, & Turner, 2002) and faith-based settings (Collins, Whiters, & Braithwaite, 2007). While several studies assess the impact of paternal absence on self-esteem and youth development (Beaty, 1995; Miller, 1984), sexual role development (Stevenson & Black, 1988), and teen alcoholism (Carbonneau, Tremblay, Vitaro, Dobkin, Saucier, & Pihl, 1998; Hill, 1992), the need for youth development programs focusing on risk behavior reduction continues to exist. This article describes a community-based organization's design, implementation, and evaluation of a youth development program for African American youth focusing on both risk reduction and skill enhancement. Curriculum content encompasses culturally appropriate principles of youth development and focuses on the needs of African American youth and their parents or primary caregivers.

Adolescents (age 13-19) are identified as a vulnerable population for high risk behaviors such as violence, alcohol and drug use, and sexual activity (Bunnell, Dahlberg, Rolfs, Ransom, Gershman, & Farshy, 1999; Johnson, Stanford, Douglas, Botwinick, & Marino, 2001; Light, 1998). This is particularly true for African American inner-city youth (Bunnell et al., 1999; Busen, Marcus, & von Sternberg, 2006). These issues pose long-term health consequences. Based on the 2009 Youth Risk Behavior Surveillance System, high risk behaviors among African American youth (grades 9-12) continue to be alarming (Centers for Disease Control and Prevention [CDC], 2010). Among the 10 to 24 year old age group, homicide is the leading cause of death for African Americans; in particular, homicide rates among non-Hispanic, African American males in this age group (60.7 per 100,000) exceed those of Hispanic males (20.6 per 100,000) and non-Hispanic, White males (3.5 per 100,000) (CDC, 2010). African American students are also more likely to carry a gun, be in a physical fight, engage in dating violence, or forced to have sexual intercourse (CDC, 2010). Additionally, more African American students than White students start drinking alcohol before the age of 13 despite current alcohol use being lower for African American students than Whites (CDC, 2010). Overall, African American students show a higher prevalence of using marijuana, cocaine, ecstasy, and heroin (CDC, 2010).

Furthermore, the prevalence of being currently sexually active is higher among African American students (47.7%) than White students (32.0%); also, having had sexual intercourse before the age of 13 is higher among African American students than Whites (CDC, 2010). More importantly, a 2009 study by the Centers for Disease Control and Prevention demonstrates that 44% of African American women aged 14-19 are infected with at least one of the most common sexually transmitted diseases including human papillomavirus (HPV), chlamydia, herpes simplex virus, and trichomoniasis, compared to 20% of young White women (Forhan et al., 2009). Overall, the birth rate for U.S. teenagers increased by 0.6% from 41.9 per 1,000 women aged 15-19 years in 2006 to 42.5 per 1,000 women in this age group in 2007 (Hamilton, Martin, & Ventura, 2009). Hamilton and colleagues (2009) further report that the overall teen birth rate for women in this age group increased 4% between 2005 and 2006 and an additional 1% between 2006 and 2007 including a 6% increase for African American teens. Preliminary data for 2008 indicates a 2% decrease for all races; however, teen birth rates continue to bear concern because of the socioeconomic burden of teen pregnancy and childbearing (Hamilton, Martin, & Ventura, 2010).

Healthy People 2020, the health objectives that guide U.S. health policy, monitors many U.S. health measures (U.S. Department of Health and Human Services [DHHS], 2010). There are two critical issues the U.S. Department of Health and Human Services (2011) identifies for this coming decade. First, the adolescent population is becoming more ethnically diverse that will require a unique, culturally oriented response to health care needs. Second, there is an increased focus on the use of positive youth development programs to prevent adolescent high-risk health behaviors. Against this background, responsible sexual behavior is promoted with a goal of increasing abstinence from sexual intercourse or the use of condoms if sexually active (DHHS, 2000). Three protective behaviors to decrease the risk of sexually transmitted infections (STIs) and unintended pregnancy include: (1) refraining from sexual activity during the teen years, (2) returning to abstinence after engaging in intercourse, and (3) using condoms correctly and consistently if regularly engaging in intercourse (DHHS, 2000). Culturally oriented educational programs such as the one outlined here aimed at preventing, delaying, or assisting teens to revert to abstinence from sexual activity are central in influencing teen choices toward healthier lives.

DEVELOPMENT OF THE CURRICULUM

THE FUTURE LEADERS OUTREACH NETWORK PROGRAM

Since 1999, Future Leaders Outreach Network (FLON) has planned, coordinated and implemented innovative youth programs. The organization teaches adolescents to pursue their dreams by setting behavioral boundaries for drugs, alcohol, violence, and sexual activity before marriage. FLON, working with predominantly at-risk, African American youth, helps to develop and sustain relationships between teens, parents, teachers, faith-based leaders, and other members within the community. Figure 1 illustrates FLON's interdisciplinary approach in working with adolescents, families, and communities. The Pursue Your Dreams (PYD) initiative assists in goal setting and personal responsibility toward health through activities specifically designed for African American youth. Recruitment strategies to engage teens and parents include school assemblies, community rallies, an annual summit, and parent education workshops. FLON emphasizes African American foundational principles and traditions. This unique cultural approach differentiates FLON from other programs that focus on high-risk adolescent behaviors. In particular, the FLON programs operate within the African American spirit of Nguzo Saba (Karenga, 2008). Nguzo Saba refers to seven social and spiritual principles that represent African American values and emphasizes the importance of family, community, culture, and tradition (Figure 2).

THEORETICAL FRAMEWORK

Against this background, the FLON youth programs operate within Bronfenbrenner's bio-ecological systems theory (Bronfenbrenner, 1986, 1993). This theory focuses on a child's development which is impacted by his/her own maturing biology, the immediate environment including family and school, and social milieu. FLON's curriculum reflects Bronfenbrenner's four systems where changes in one layer reverberate through other layers. These systems are referred to as the microsystem, mesosystem, exosystem, and macrosystem.

As illustrated in Figure 1, an adolescent develops relationships with peers, teachers, parents, and other significant individuals. According to Bronfenbrenner, the microsystem refers to the adolescent's relationships with his/her immediate environment such as family, school, church, and peer groups. The FLON curriculum influences the adolescent and is underscored through involvement of family and school rather than either one alone. Similar logic applies to the impact of family and faith-based organizations on the adolescent. These linkages between two or more settings and how they affect the developing adolescent are reflective of the mesosystem.

[FIGURE 1 OMITTED]

Additionally, the social system--also referred to as exosystem--within which an adolescent resides, indirectly influences his/her decision making processes to abstain from high-risk behaviors. In relation to FLON, exosystems that affect the development of an adolescent include community organizations, rallies, faith-based organizations, and other community organizations. They impact youth indirectly through their influence on, for example, the family or peer group.

Finally, the macrosystem refers to the outermost layer in an adolescent's development and encompasses cultural values, norms, and laws. If values and norms advocate abstinence from high-risk behaviors, then this provides a "blue-print" for the developing adolescent. Within this theoretical framework, FLON uses an integrative, theoretical approach to combat sexual promiscuity and other high-risk behaviors.

PROGRAM COMPONENTS

As a youth development organization, FLON offers two inter-related program components: (1) the Pursue Your Dreams Educational Program and (2) the Pursue Your Dreams Career Planning Club. The Federal A-H criteria that define abstinence education were used to guide the content of both the PYD Educational Program and the PYD Career Planning Club (Title V, Section 510 (b)(2)(A-H) of the Social Security Act). In accordance with these A-H criteria, FLON set the following objectives: (1) promote abstinence until marriage, (2) address positive aspects of character development, (3) promote positive goal-setting and decision-making skills, (4) increase respect for self and others, and (5) raise awareness of the negative consequences of teen sexual activity. In summary, it is believed that abstinence-centered education and career planning enhances the overall Pursue Your Dreams curriculum.

The theoretical framework of the PYD Educational Program is based on the 40 Developmental Assets, which are grounded in extensive research in prevention, risk reduction, and resiliency among youth (Filbert & Flynn, 2010; Rose, 2006; Scales, 1999; Scales, Benson, Leffert, & Blyth, 2000; Scales, Benson, Roehlkepartain, Sesma, & van Dulmen, 2006; Scales & Leffert, 2004; Stevens & Wilkerson, 2010). Through its work with more than 500,000 students (6th-12th grade), the Search Institute--a private non-profit research organization in Minneapolis, Minnesota--identified 40 developmental assets that form the building blocks for healthy, youth development. These assets are organized into eight categories divided into two groups, external and internal assets (Scales, 1999). External assets reflect relationships and include the constructs of Support, Empowerment, Boundaries and Expectations, and Constructive Use of Time (Scales, 1999). Internal assets represent values and include Commitment to Learning, Positive Values, Social, and Positive Identity (Scales, 1999).

Together, these developmental assets represent the relationships, opportunities, and personal qualities that young people need in order to thrive and avoid engaging in risky behaviors. Furthermore, research findings consistently demonstrate that youth who experience fewer assets in their lives are more likely to engage in high-risk behaviors than youth who experience more assets (Chew, Osseck, Raygor, Eldridge-Houser, & Cox, 2010; Filbert & Flynn, 2010; Scales, 1999; Scales et al., 2006). In short, assets empower young people regardless of their gender, economic status, family, or race/ethnicity (Aspy, Oman,Vesely, McLeroy, Rodine, & Marshall, 2004; Oman, Vesely, Aspy, McLeroy, Rodine, & Marshall, 2004; Scales et al., 2006).

In an effort to incorporate age-appropriate content and medical accuracy, existing evidence-based sexual health curricula were used to develop the PYD Educational Program (Weed, 2008; Weed & Anderson, 2005; Weed, Ericksen, Lewis, Grant, & Wibberly, 2008). In particular, the PYD program is based on elements of Choosing the Best, an abstinence education program oriented toward different developmental stages of adolescents (Choosing the Best, 2010). Choosing the Best in corporates elements of social learning, cognitive learning, and inductive learning theories combined with various instructional methods such as the use of videos, discussion groups, student workbooks, activities, and homework assignments (Weed & Anderson, 2005). An independent research study funded by the U.S. Department of Health and Human Services and conducted by Dr. Stan Weed demonstrates that Choosing the Best reduces teen sexual activity by 47% (Weed & Anderson, 2005). The PYD Educational Program teaches participants that abstinence-until-marriage is the only 100% certain method of avoiding teen pregnancy and sexually transmitted infections.

CURRICULUM CONTENT

ADOLESCENT POSITIVE DEVELOPMENT ACTIVITIES PURSUE YOUR DREAMS EDUCATIONAL PROGRAM

The purpose of the PYD Educational Program is to provide curriculum-based education to adolescents about personal health and well-being by emphasizing abstinence from drugs, alcohol, violence, and sexual activity. Program slogans such as "Pursue Your Dreams, Let Your Journey Begin" and "Pursuing My Dreams--I Can Do It" point to educational activities that reinforce the abstinence message taught in schools, community centers, and faith-based organizations. This program provides middle school students with 45 minutes of instruction each day over six to eight consecutive days during the academic school year. It provides high school students with 90 minutes of instruction each day over a two-week time period during the academic school year. Booster sessions are not conducted.

Instructional Materials. The PYD Educational Program incorporates Choosing the Best's content, materials, and activities within an Afro-Centric context. It includes instructional aides such as a customized video, DVD, interactive sessions, role play, take-home activities, and discussion. These materials emphasize abstinence from high-risk behaviors as well as development of positive interpersonal relationships, self-esteem, competence, self-efficacy, and future career orientation. In particular, the PYD Educational Program uses workbooks designed to engage African American teens. Two student work-book journals, Pursue Your Dreams-Let Your Journey Begin(Grades 6-8) (Shomari, Clemons, & Benn, 2010) and Pursuing My Dreams-I Can Do It(Grades 9-12) (Clemons, Shomari, & Benn, 2010), were developed and implemented to complement Choosing the Best curricula.

Both workbooks are based on the Sankofa model The concept of Sankofa is based on the traditions of the Akan people of West Africa (Willis, 1998). The model refers to the Sankofa bird that looks back at the path she travelled while pointing her feet forward (Karenga, 2008). She understands where she comes from and where she is going. She acknowledges her past and brings experiences that served her well in the past forward into the future. The bird's heart-shaped symbol demonstrates love and respect for the path that her ancestors travelled and connects the different generations. Within the spirit of Sankofa, parents empower their teens to make healthy choices while encouraging faith so that they can do what they set out to do with their feet pointing forward on a path leading to success in life.

PURSUE YOUR DREAMS CAREER PLANNING CLUB

The Pursue Your Dreams Career Planning Club, an after-school program for middle--and high--school students, has the overall goal of educating teens about the importance of exploring career interests while focusing on future goals. It focuses on leadership development, career planning, and entrepreneurship. The program provides adolescents with a maximum of 100 hours of after-school instruction within the academic school year. Students participating in the educational program are allowed to participate in the career club if interested. Upon successful completion of the Career Planning Club, students participate in a graduation ceremony. Six months after graduation, FLON encourages students to complete a follow-up questionnaire.

An underlying premise of the PYD Career Planning Club is to teach students the importance of attaining self-sufficiency resulting in abstinence from sexual activity, drugs, alcohol, and/or violence. Community outreach activities such as volunteerism, career-oriented guest speakers, and collaborative partnerships with radio and television stations provide students with a variety of skills such as how to connect personal interests with career aspirations, job readiness, leadership, and character development. Through engagement in these activities, students begin to "unlock their potential to pursue their dreams" such as becoming a college student or a prominent figure in business or government.

Instructional Materials. FLON's instructors facilitate sessions on entrepreneurship and career management utilizing three workbooks: (1) New Youth Entrepreneur (Education, Training and Enterprise Center, 2010), (2) Unlocking Your Potential (Edge Learning Institute, 1984), and (3) COIN Career Targets (Durgin & Michael, 2008). The New Youth Entrepreneur curriculum educates adolescents interested in business and entrepreneurship. The Unlocking Your Potential curriculum is for students who plan to attend college, vocational school, or seek employment after high school graduation. All students are required to work through the COIN Career Target workbook, a career exploration assessment that assists them with exploring career opportunities.

PURSUE YOUR DREAMS TEEN SCHOOL ASSEMBLIES

The purpose of the assemblies is to emphasize the message about setting boundaries and saying "no" to drugs, alcohol, violence, and sex. School assemblies are developed to share the abstinence message with students who are not offered the in-class abstinence curriculum. During these assemblies, FLON uses a variety of strategies to communicate its message including the use of speakers, musical performances from the Pursue Your Dreams CD/DVD, and a fifteen minute skit entitled "Abstinence, Boundaries, Choices and Dreams."

PARENT/FAMILY PROGRAM ACTIVITIES

FLON engages parents and other primary caregivers (e.g., extended family members) in its educational programs to support continuity of its message. Within the context of African American values, FLON has incorporated and customized the Seven Principles of Kwanzaa (Nguzo Saba) into its educational programs for parents (Figure 3). Parents and family members are trained on how each of the seven principles applies to the FLON effort in terms of ensuring their children's health and success in life. Additionally, FLON's slogan, "It's All About The F.A.M.I.L.Y. (Fathers, all Adults, and Mothers Individually Leading Youth)--It Takes An Entire F.A.M.I.L.Y. To Raise A Child," reflects involvement of family members.

PARENT NETWORK SOCIAL

FLON employs different strategies to engage parents in the PYD Educational Program and PYD Career Planning Club. Parents are required to sign a letter of commitment in which they pledge program engagement and attend a monthly meeting, the Parent Network Social. One of its main objectives is to bring parents and other caregivers together in a setting that allows them to share experiences when talking with their children about abstaining from sexual activity. It is a three-hour session including networking, a parent abstinence education workshop, and a question and answer opportunity. Each activity is approximately 60 minutes long. Events are specifically designed to educate, support, and reinforce parental values while enhancing the bond between parent and teen. Activities usually take place in the evenings. FLON's encouragement of consistent and unconditional parental support assists teens in becoming self-sufficient, responsible adults.

PARENT EDUCATION WORKSHOPS

The primary goal of a parent workshop is to assist parents in their communication and expectation of behavioral values to their children. Activities focus on one central theme: to support youth in their development to become self-sufficient adults. The workshops use the Parents Abstinence and Family Values manual (Shomari, 2006) based on the principles of Eban and Sankofa (Willis, 1998). As described earlier, the concepts of Eban and Sankofa are based on the traditions of the Akan people of West Africa (Willis, 1998).

Eban, translated as "the fence," is meant to offer protection from the outside world and incorporates positive aspects about the family: love, protection, safety, and security (Willis, 1998). Sankofa teaches parents that they must go back to their roots in order to move forward. Parents should reach back into their past and collect the best of what the past offered them so that parent and child can reach their full potential in the future. If there is anxiety regarding sexual activity, then parents should resolve these feelings first rather than projecting them onto the relationship with their children. Other workshop activities include the review of Afro-Centric, recorded presentations including the Parents Speak Up National Campaign Talk To Me public service announcement and Choosing The Best Parent Prep DVD. At the end of each workshop, participants receive a canvas tote with educational materials.

Altogether, overarching goals and objectives for parent workshops include:

1) To enhance parental skills in establishing specific and culturally supported family values;

2) To assist parents in promoting family values to their children regarding sex, alcohol, tobacco and drug use, age-appropriate relationships, and cultural knowledge;

3) To enhance parental ability to communicate effectively within the family;

4) To provide parents with information, resources and community services that support their values; and,

5) To provide parents with information how to continue to support their teen's future dream career choices.

COMMUNITY-BASED PROGRAM ACTIVITIES

In 1999, the Pursue Your Dreams programs were initiated through a teen leadership development summit. During the following year, a second bi-state summit was held at multiple sites. Between year one and year two, attendance grew from 800 teens to 5,200 teens. More than 30 key partnerships contribute to the success of the FLON programs. Partners contribute in-kind donations, schedule school assemblies, provide venues to conduct the annual summit, and coordinate volunteers who could serve as C.A.R.E. (Committed Accountable Responsible and Enthusiastic) workers. The target audience for all FLON activities includes at-risk youth 12 to 21 years of age residing in three Midwestern urban counties.

The Pursue Your Dreams Rally/Summit activities focus on promoting healthy behaviors and support adolescents in abstaining from sexual activity and other high-risk behaviors. The rallies, held twice a year, precede the annual summit and are conducted in a safe, drug-free environment. Their purpose is to support FLON's mission and engage families throughout the metropolitan area. During the rallies and summit, speakers and performing artists share nmessages about abstaining from sex until marriage, drugs, alcohol, and violence.

Altogether, the rallies and annual summit provide:

1) A gathering place for adolescents, parents, and other adults to hear messages about abstinence until marriage and to abstain from drugs, alcohol, and violence through motivational talks and performing arts;

2) Encouragement for participants to remain in the program or for others to get involved in the program; and

3) Recognition for youth participants.

CURRICULUM EVALUATION

Table 1 displays demographic characteristics of participants during the 2008-2009 program year. Participation to complete the survey before and after the intervention was voluntary. The age of participants ranged from 11 to 19 (6th through 12th grade). The majority of participants were within the 13 to 14 years age range, male, and African American. More than half of respondents reported living with both or one biological parent. In both pre-intervention and post-intervention survey, more than two thirds of respondents indicated they received free or reduced lunches at school--a federal indicator of poverty.

From pre--to post--survey administration, independent sample t-test results indicated change in a positive direction in abstinent attitudes and intentions. Table 2 shows the absolute values for the t-statistic and the difference in means between both groups expressed in percent change. As Levene's test was significant (p < 0.05), equal variance among the two samples was not assumed. Cohen's d for item 1 (saying "no" to sexual activity until marriage) was small to medium, d = 0.32, while Cohen's d for items 2, 3, and 4 were small with d = 0.17, d = 0.17, and d = 0.16 respectively. Overall, participants' responses to these four commitment questions indicate more positive beliefs after participation in the FLON curriculum. Responses were based on a 5-point Likert scale (1 = Strongly Disagree, 2 = Disagree,3 = Not Sure, 4 = Agree, or 5 = Strongly Agree). Responses in self-reported sexual abstinence varied (Table 3).

DISCUSSION

The focus of this article points to a community-based organization's design and implementation of a youth development program targeting high-risk behaviors including violence, alcohol and drug use, and sexual activity. Future Leaders Outreach Network (FLON) developed its innovative youth programs within the framework of Bronfenbrenner's (1986, 1993) bioecological systems theory and Scales' (1999) developmental assets. FLON's unique approach lies in its reliance on the African American foundational principles of Nguzo Saba (Karenga, 2008).

Preliminary findings suggest positive program impact. Additional research into evaluation of the curriculum's overall outcome is ongoing and will be the topic of a subsequent article. Demographics indicate that the majority of program participants were male, 13 to 14 years old, and African American. It is interesting to note that the initial data from this study shows an increase in positive attitudes toward abstinence among other races (more than one third of participants were not African American). This could indicate that the integration of family, school, and community in youth development programs to prevent engaging in high-risk behaviors is beneficial for Whites, Hispanics, and others as well. A collaborative, culturally oriented approach such as the one outlined here warrants further investigation into additional benefits for other high-risk populations.

Another interesting observation points to more than half of program participants residing with both or one biological parent(s). The survey did not ask about the extent of parental involvement in teens' lives and this could point to another area of future inquiry. Does the degree of parental involvement make a difference in a teen's decision to engage in sexual behaviors and intentions? In their meta-analysis, Buhi and Goodson (2007) stated that though increased parental monitoring has a protective effect on sexual activity initiation, most studies report no statistically significant effects. They further reason that this may be the result of using different instruments or scales to measure parental monitoring and/ or failure to ensure validity and reliability issues on the researcher's part (Buhi & Goodson, 2007). Hence, parental involvement in relation to adolescent sexual activity is an area worth exploring.

As mentioned earlier, initial results to four commitment questions indicate positive program impact. The commitment to stay abstinent from all sexual activities until marriage is stronger than the commitment to refrain from alcohol, drugs, and violence. According to Cohen (1988, 1992), effect sizes can be defined as small, medium, and large with d = .2, d = .5, and d = .8 respectively. Effect sizes found in this study are small to medium. The question arises as to how meaningful these findings are in comparison to other studies. To date, there is a paucity of studies in the teen sexual health literature that discuss the significance of small to moderate effect sizes. Without moving into a discussion about the importance of small effect sizes, future research should focus on whether small effect sizes matter. In particular, is there a cumulative effect of small effect sizes over time?

Last, initial findings show that responses toward abstinence from sexual activities are somewhat varied. After completion of the FLON educational program, the majority of respondents (58%) report that they are always committed to abstinence as opposed to 53% before completion. This finding shows that the program was able to reinforce positive beliefs toward abstinence from sexual activity. However, about one fifth of respondents were not sure about abstinence from sexual activities before completion. After completion of the program, this number only dropped by less than 2%. This needs further examination as one would expect the not sure number to increase by larger increments after program completion.

CONCLUSION

As interventions focusing on reduction of adolescent high-risk behaviors proliferate, the need for culturally appropriate curricula regarding youth development continues to exist. In fact, this is one of the emerging issues that the U.S. Department of Health and Human Services has drawn attention to when it released Healthy People 2020. The Future Leaders Outreach Network provides a community-based model to examine and discuss the physical, emotional, and social benefits of youth development within a safe atmosphere. This model is designed within the African American foundational principles of Nguzo Saba, which sets the FLON program apart from other programs that focus on adolescent high-risk behaviors. In particular, Nguzo Saba emphasizes the importance of family, community, culture, and tradition akin to Bronfenbrenner's bio-ecological systems theory. Against this background, FLON operates programs incorporating youth, parents, and community. This ecological and cultural approach makes the delivery of this curriculum particularly powerful. While this article provides a platform for culturally oriented youth development programs, objective measures and results from program evaluation are needed. Altogether, lessons learned from the FLON program should be noted. A supportive environment and presentations by role models allow teens to witness live examples of goal-setting and positive choices. Consequently, this empowers teens to make good decisions regarding sexuality and high risk behaviors resulting in more productive lives for the future.

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Diana E. Clemons

Ruth Wetta-Hall, RN, PhD, MPH, MSN

Lisette T. Jacobson, MPA, MA

Amy Chesser, PhD

Ashley Moss, MS

Diana E. Clemons, is a Chief Executive Officer, Future Leaders Outreach Network, Ruth Wetta-Hall, RN, PhD, MPH, MSN, is an Assistant Professor, Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Lisette T. Jacobson, MPA, MA, is an Intern/Research Associate, Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Amy Chesser, PhD, is a Research Assistant Professor, Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, Ashley Moss, MS, Research Assistant, Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, Please address all correspondence to Ruth Wetta-Hall, University of Kansas School of Medicine--Wichita, 1010 North Kansas, Wichita, KS 67214-3199, Phone: 316-293-2627, Fax: 316-293-2695, E-mail:@ Rwettaha@kumc. Edu
Table 1. Demographics 2008-2009 Program Year

Characteristic             Pre        Post
                       Responses    Responses
                      (n = 1538)   (n = 1545)
                           %            %

Sex

  Male                   59.0         54.7
  Female                 41.0         45.3

Age in Years

  11                      9.6          8.7
  12                     16.6         18.8
  13                     30.6         22.3
  14                     23.7         22.8
  15                     13.5         17.4
  16                      3.1          5.9
  17                      1.9          3.0
  18                      0.9          0.9
  19                      0.1          0.2

Race/Ethnicity

  African American       59.0         59.1
  American Indian or      5.4          1.4
    Alaskan Native
  Asian                   0.7          1.3
  Native Hawaiian         0.3          0.2
    or Other Pacific
    Islander
  White                  10.1         11.3
  Hispanic or Latino     16.5         17.9
  Multi-Racial            0.2          0.1
  Other                   7.8          8.8

Live w/Now

  Both biological        43.8         38.6
    parents
  One biological         23.8         18.8
    parent
  Relative other         24.5         34.8
    than parent
  Legal guardian          3.1          2.6
  Foster parent           3.1          3.2
  Adoptive parent         1.1          1.0
  Not applicable          0.6          1.0

Table 2. Mean Scores and Independent t-test Results
for Commitment Questions

Question          Pre      Post    % Change     t      df      p
                 Survey   Survey   Pre/Post
                  Mean     Mean

1. I commit by    3.43     3.84     11.95     8.645   2997   < .001
  saying "NO"
  to all
  sexual
  activities
  until
  marriage
2. I commit by    3.79     4.00      5.54     4.609   3032   < .001
  saying "NO"
  to alcohol
3. I commit by    3.98     4.19      5.28     4.787   3019   < .001
  saying "NO"
  to illegal
  drugs
4. I commit by    3.74     3.95      5.61     4.458   3023   < .001
  saying "NO"
  to violence

Table 3. Student Responses to Abstaining Question

Frequency of Responses      Pre          Post
toward Abstinence from   Responses    Responses
Sexual Activities        (n = 1538)   (n = 1545)
                             %            %

Always                      52.6         58.2
3 years or more              2.8          3.2
Between 2 and 3 years        1.5          1.6
Between 1 and 2 years        3.3          2.3
Between 7 months and         4.1          1.9
  1 year
Between 2 and 7 months       2.6          3.0
Between 1 and 2 months       2.5          3.2
Less than 1 month            8.4          6.2
Not sure                    22.2         20.5

Figure 2: Nguzo Saba--The Seven Principles of Kwanzaa

Umoja          Unity            To strive for and maintain unity
                                in the family, community, nation,
                                and race

Kujichagulia   Self-            To define ourselves, name ourselves,
               Determination    create for ourselves, and speak for
                                ourselves

Ujima          Collective       To build and maintain our community
               Work and         together and make our brothers' and
               Responsibility   sisters' problems our problems and
                                to solve them together

Ujamaa         Cooperative      To build and maintain our own
               Economics        stores, shops, and other businesses
                                and to profit from them together

Nia            Purpose          To make our collective vocation
                                the building and developing of our
                                community in order to restore our
                                people to their traditional greatness

Kuumba         Creativity       To do always as much as we can, in
                                the way we can, in order to leave
                                our community more beautiful and
                                beneficial than we inherited it

Imani          Faith            To believe with all our heart
                                in our people, our parents, our
                                teachers, our leaders, and the
                                righteousness and victory and our
                                struggle

Source: Karenga, M. (2008). Kwanzaa: A Celebration of Family,
Community and Culture. Los Angeles, CA: University of Sankore Press.

Figure 3: Nguzo Saba--The Seven Principles of Kwanzaa Applied to
High-Risk Behaviors

Umoja          Unity            The belief that working together as
                                parents ensures children's success

Kujichagulia   Self-            The belief that speaking up
               Determination    for yourself as a parent is more
                                effective than leaving conversation
                                to chance

Ujima          Collective       The belief that collective work
               Work and         helps to overcome barriers and fears
               Responsibility   about talking to one's children
                                about high-risk behaviors

Ujamaa         Cooperative      The belief that cooperation provides
               Economics        children with reasons to succeed in
                                life

Nia            Purpose          The belief that purpose clarifies
                                the roles for adults when leading
                                youth

Kuumba         Creativity       The belief that creativity lifts
                                parents' voices when there is an
                                opportunity to speak up

Imani          Faith            The belief that faith sustains hope
                                that children will wait to engage
                                in sexual activity until marriage
                                through communication of values

Source: Karenga, M. (2008). Kwanzaa: A Celebration of Family,
Community and Culture. Los Angeles, CA: University of Sankore Press.
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