Building and Sustaining Community Partnerships for Teen Pregnancy Prevention: A Working Paper. B. Minnesota

06/01/1998

Started in 1991, the Teen Pregnancy Prevention Project of Minnesota (TPPPM) developed out of an interagency team into a public-private partnership housed in Minnesota Planning, a state agency. It was governed by a steering committee of representatives of state agencies and local and private agencies. Before 1991, the state had numerous programs and task forces working to reduce teen pregnancy rates; however, there was no comprehensive, coordinated strategy at the local and state levels and no funding mechanism to support community-based programs and form a coherent and effective public policy.

TPPPM was a demonstration project with the mission of reducing teen pregnancies in Minnesota. There were four specific project goals: increasing collaboration at the community and state levels on teen pregnancy prevention issues; increasing effective and replicable teen pregnancy prevention programming; increasing leadership on the state level for the prevention of teen pregnancy and the support of teen parents; and strengthening policies in Minnesota related to adolescent pregnancy prevention and parenting.

TPPPM employed four strategies intended to develop a comprehensive system of support, resources, programming, advocacy, and public policy to reduce teen pregnancy in Minnesota:

1) Six community-based collaboratives (pilot projects): 1. Cross Cultural Pregnancy Prevention Peer Education Program in St. Paul; 2. Project SIGHT in Northfield and Fairbault; 3. the Tri County Coalition on Adolescent Pregnancy Prevention in Cook, Lake and Carlton counties; 4. the Red Lake Teen Pregnancy Prevention Coalition on the Red Lake Reservation; 5. the Youth Health Collaborative in St. Louis Park; and 6. the Youth Issues Network in Park Rapids.

2) A statewide professional membership organization: Minnesota Organization on Adolescent Pregnancy Prevention and Parenting (MOAPPP), whose membership included private, nonprofit, and public service organizations joined to strengthen polices and programming related to adolescent pregnancy prevention and parenting. Services included service provider trainings, an annual conference, a quarterly newsletter (MOAPPP Monitor) and public policy, public education, and awareness efforts.

3) Research and information activities: The Teen Pregnancy Prevention Clearinghouse collected and disseminated statistics and objective information on adolescent health and teen pregnancy. Its goals were to increase the efficacy of prevention programing and encourage the exchange of information among local programs and between state government and communities.

4) A technical assistance service: A variety of training and consultation services were provided to pilot projects, communities, and task forces over the life of the TPPPM. The TA service shared the same goals as the Clearinghouse.

Wilder Research Center evaluated TPPPM through telephone surveys, a written survey of pilot project collaborative members, in-person interviews, and analysis of data from the 1992 and 1995 rounds of the Minnesota Student Survey. The evaluators concluded that TPPPM had achieved a number of its goals:

  • Increased collaboration on teen pregnancy issues among staff at both the state and local levels occurred. Collaboration was more successful within communities than between communities.
  • Depth and coherence were added to existing adolescent pregnancy prevention programming in the pilot project sites, as evidenced in youth development measures and enhanced sexuality communication among youth. Five of the six developed new programs, strategies, and curricula, and promotional and educational materials. All of the pilot projects supplemented their TPPPM programming with funding from community-based efforts and/or other public and private funds.
  • Leadership and advocacy at the state level for teen pregnancy prevention was enhanced though MOAPPP, which had a comprehensive public awareness campaign, including interviews with the media, statewide presentations, testimony to the Legislature, and a briefing at the White House in connection with the National Strategy to Prevent Teen Pregnancy.
  • TPPPM's efforts directly contributed to the passage of two key pieces of legislation since 1991: Male Responsibility and Fathering Grants and Minnesota Education Now And Babies Later (MN ENABL).

Although funding for the overall project concluded in 1996, three of the four strategies are still in operation through MOAPPP, which is now the lead agency in Minnesota in providing both technical assistance and research and information to health professionals and agencies involved in reducing teen pregnancy in the state. Thus, MOAPPP has absorbed the roles of the clearinghouse and the technical assistance service. The only thing that has changed is that there is no state-level administrative supervision of the community-based pilot projects. MOAPPP now receives funding from public and private sources and membership dues. It currently has an active membership of 350. The MOAPPP Monitor reaches 800 to 1000, and the mailing list is close to 6,000. In fiscal year 1997-98, MOAPPP was awarded a contract to train grantees of MN ENABL. The organization is now applying for fiscal year 1998-99 funding to work with the 24 additional communities that have just received MN ENABL funding.

Although the community pilot projects are no longer funded by TPPPM, Project Sight and the Youth Health Collaborative have received funding from MN ENABL and have continued some of their adolescent pregnancy prevention efforts under that umbrella. Some community activities that were developed as a result of TPPPM continue in the other pilot project sites, but they do not function in the collaborative that was originally funded by TPPPM.

In July 1996 TPPPM released Investing in Teen Pregnancy Prevention: Lessons Learned from Minnesota, which identifies 11 key elements that contribute to the success of a teen pregnancy prevention collaborative. Of particular importance to the development and maintenance of collaboratives are two activities. First is the dual challenge of keeping members involved and of recruiting new collaborative members when turnover occurs. These are on-going processes for which new strategies are always needed.

Anticipation of conflict and the skills to work through differences were also challenges, especially at the community level. The use of consensus for collaborative decision-making may have led communities to make decisions that pleased the majority rather than fully explore the range of solutions and strategies. To avoid risking the ire of fellow community members, some sites chose intervention strategies, which, although somewhat effective, may not have been the most appropriate for their community. Conflict over the causes of and solutions to teen pregnancy produced an environment in which the communities chose methods that were not consistent with proven strategies in reducing adolescent pregnancy.

The structure of the collaborative was important to its viability. TPPPM's steering committee was composed of a diverse and committed membership who supported and monitored the project. Those involved felt that although reflective of the community and the professional organizations involved in teen pregnancy prevention and parenting in Minnesota, the board also needed to include members who had contacts with both public and private funding sources. They also noted that orientation and training for board members is vital to their effectiveness in directing policy and allocating resources. Another factor in TPPPM's effectiveness was the neutrality of Minnesota Planning and the professional commitment it had to the mission and the goals of the project. At no time did Minnesota Planning interfere in the operations and management of TPPPM.

TPPPM, through MOAPPP, has been very successful in developing and advocating for changes in Minnesota public policy related to adolescent pregnancy prevention and parenting. As a result of their efforts, $1.3 million in general funds was allocated for Adolescent Parenting Grants. These funds are available in fiscal years 1998-2000, in a competitive process, to schools interested in implementing or expanding programs in grades K-12 for adolescent parents and their children. Programs include efforts to reduce additional pregnancies among teen parents and to reduce pregnancies among their siblings. This advocacy success led to a more structured and informed advocacy group, as well as to more insight into the legislative process.

There is some frustration among those involved at the loss of focus on teen pregnancy prevention at the state level. The coordinated state policy gave importance to the issue in the public eye and provided more secure funding for various efforts. Loss of these advantages has led to more time spent raising funds and greater efforts made to develop advocacy activities.

C. New Jersey
The Network For Family Life Education
Susan Wilson, Executive Coordinator

School Based Youth Services Program
New Jersey Department of Human Services
Roberta Knowlton, Executive Coordinator

New Jersey Network on Adolescent Programs
Phillip Benson, Project Director

New Jersey does not have a single entity that oversees a comprehensive statewide strategy to prevent teen pregnancy; it has three separate organizations that combine to form an informal and successful statewide coalition. Although the three are funded and managed independently of one another, senior staff work closely in developing resources and engaging different sectors of the community to support healthy youth development. The following describes each organization and some of the challenges and successes they have had in terms of collaboration, partnership development, and the reduction of teen pregnancy.

The Network for Family Life Education (Network)
Founded in 1981 after the State Board of Education adopted a requirement for family life/sexuality education in public schools, the Network's mission is to 1) support age-appropriate, balanced family life/sexuality education in schools and communities through the delivery of training and technical assistance to New Jersey teachers, policy makers, and local governments and 2) coordinate advocacy of effective implementation of family life education in New Jersey public schools.

Directed by Susan Wilson, former Board of Education member and author of the 1981 education requirement, the Network is in the unique position of having staff who were instrumental in its own development and who have an intimate knowledge of the players and issues related to family life/sexuality education in New Jersey. The Network dominates the state with regard to this issue, and its long history of commitment and effectiveness has yet to produce a competitor. Often working in alliance with Planned Parenthood and other agencies, the Network has an informally defined territory of advocacy, resource development, and trainings related to family life/sexuality education in public schools.

The coordinator attributes most of the success of the Network to its focus: during its 16 years, it has concentrated on implementing the policy that was the impetus for its origin. The Network is a membership organization, the only state-level one of its kind in New Jersey. There are no membership dues and very few expectations of members, who include statewide youth and family planning associations, various state departments (e.g., education, health, human services), and other associations/councils that have an interest in maternal, child, and adolescent health and reproductive rights. Part of the process by which the Network stays in touch with the membership is through informal evaluations about expectations and needs and most of all by re-visiting the mission and goals of the Network every year. The Network continuously re-evaluates its effectiveness and usefulness in implementing the family life/sexuality education standards.

Members have full access to the range of services and resources that the Network provides. These include regional trainings and conferences throughout the state and statewide seminars to discuss teen pregnancy prevention across communities and disciplines. Statewide activities include four annual meetings that revolve around a variety of issues, most of which are skills-based and reflect the needs of constituents. Attendance at these meetings remains high after 16 years because members know that the information delivered will be rich in content and relevance. On the national level, the Network provides staff trainings and publishes newsletters for adolescents and teachers.

The Network's clients are the catalysts for the materials and documents it develops. SEX, etc, a newsletter developed and written by youth, is received in 85 percent of the high schools in the state, which has 600 school districts. Another publication, Family Life Matters, is sent to almost 2,000 educators and health-related staff in 49 states. The Network's membership has continued to grow over the past 10 years.

The Network is housed at Rutgers University, a publicly funded institution. There have been ongoing internal discussions about whether to remain affiliated with the University. The director believes that the Network's long history of affiliation with the University adds credibility and integrity to its work. It is seen as an objective and research-based entity dedicated to implementing the State Board of Education's policy. On the other hand, as a publicly funded body, it cannot lobby the legislature, a key strategy in insuring the allocation of funds and the adoption of policies that support the Network's goals.

The Network notes several major accomplishments: 1) establishing core curriculum standards across the New Jersey Unified Public School District; 2) creating resources and materials that support the implementation of state policy and respond directly to the needs of members; and 3) continuing to support the will of the people of New Jersey and to reflect and address the changing needs of the membership. In 1993, the Network received the Best Statewide Coalition Award from the National Organization on Adolescent Pregnancy, Parenting and Prevention, which recognized their focus and commitment to their goal.

School Based Youth Services Program (SBYSP)
SBYSP was established in 1987 to provide services to children and adolescents in New Jersey by linking education, social services, employment, and health services in or near school sites. The program was introduced by Governor Tom Kean during his 1987 State of the State speech and received the support of business, education, and parent leaders across the state. These forces were instrumental in its passage by the legislature and the appropriation of $6 million for the 1988 program year. Focus groups held with youth to determine their opinions and suggestions for program components elicited a strong message for "caring adults who would listen to them, be non-judgmental, and help them with decision making-not make decisions for them."

There is at least one SBYSP site in each of the State's 29 counties, in elementary, middle and/or high schools. The overall program is supervised by the Department of Health and Human Services, with management at the local level by public and non-profit entities and schools. The local project director works closely with all members of the school staff in order to integrate SBYSP into the school and increase its accessibility to students. All local sites have an advisory council that includes school, business, parent, and faith community representatives.

Each community determines the array of programs and services that will be offered locally. These may include tutoring, mentoring, recreation, employment, educational enrichment, peer counseling, pregnancy prevention programs, and the like. Over time, sites add and enrich components or eliminate them. Because of the differences among the sites, there are in fact many models of the SBYSP. However, the preliminary findings of the analysis conducted by Academy for Educational Development indicated that the types of collaborative relationships that contributed to the programs' ability to meet SBYSP objectives were those that integrated the school and SBYSP programs and staff most completely. In well-integrated programs SBYSP staff took over school functions, played roles usually played by school staff, served on school committees, conducted workshops and classes, and provided technical assistance to school personnel. SBYSP activities that were incorporated into school procedures were most successful.

The longevity of the program is another contributing factor to its success. In many of the initial 29 sites, SBYSP has become an invaluable part of the school system, yet it remains independent and not associated with the school district bureaucracy. In addition, funding for SBYSP has been consistent (part of the Governor's line item). This contributes to staff's ability to focus on the students and program development rather than on funding issues.

Many staff have been with sites since their inception, and they are fully integrated into the daily operations of the school and extremely accessible and visible to the students. They are seen as trusted and supportive adults who provide information and guidance. They do not preach and judge, a direct result of the youth focus groups that helped shape the SBYSP.

There have been challenges along with these successes. The strong family life education and comprehensive sexuality education component of the program was often contrary to messages supported by the local faith community. In one site, Pinelands High School, a rural, predominantly Anglo community, opposition from the faith community was strong. In a compromise "agreement to disagree," for the last 10 years a guest speaker has discussed abstinence before the family life education curriculum is introduced to classes.

There have also been turf issues between school staff and SBYSP staff concerning access to students and the "rewards" of the job. School staff have often tried to have SBYSP become more involved in crisis management, substance abuse counseling, and suicide and abuse intervention, functions that actually fell under the purview of school administration. At times maintaining confidentiality was an issue between school staff, SBYSP staff, and students at some of the sites, particularly around mental health, parental consent, and health related issues.

Evaluation of SBYSP is on-going. Six of the 29 sites have been selected for intensive study, including quantitative and qualitative measures, such as grades, employment, school retention, suspension, and absence rates. The baseline evaluation report will be available in mid-1998. However, evaluators and staff note that small daily changes are the most rewarding and long lasting and the hardest to capture as hard data.

With regard to reductions in teen pregnancy, Pinelands, New Jersey, has seen a dramatic decrease from an estimated 20 full term adolescent pregnancies per year for a population of 1500, to an average of two per year. The project director attributes the drop to SBYSP's provision of in-school comprehensive sexuality education, a broad spectrum of recreational and employment programs, and staff that is fully integrated into the school. Its efforts are being replicated at sites in Camden, Phillipsburg, Planfield, and Longbridge. Informal findings at the Camden site have revealed a large drop in teen pregnancies since the inception of its teen pregnancy prevention program a year ago. Formal results of an evaluation of the Pinelands High School program and its replication at Plainfield will be available in early 1999.

New Jersey Network on Adolescent Programs (NJNAP)
Founded in 1979, the NJNAP is based at the Center for Social and Community Development at Rutgers University's School of Social Work. It targets adolescents who are at risk for engaging in behaviors that are detrimental to their health and well-being. NJNAP's goal is to increase the capacity of community-based and local organizations to develop programs, policies, and services that impact youth in a variety of areas, including teen pregnancy. Its objectives are:

  • To insure youth input and involvement;
  • To establish linkages between public and voluntary agencies;
  • To identify funding sources and pertinent current legislation regarding potential funding;
  • To identify existing resources, programs, and partnerships in New Jersey and to establish new programs where gaps exist in the system;
  • To develop an understanding of the political implications of youth development;
  • To establish a system for information-sharing on a state and regional level in order to maximize information dissemination; and
  • To educate youth-serving professionals and other interested adults in the implications (i.e., health, education, psychosocial and socioeconomic) of high risk adolescent behaviors.

In order to meet its objectives, NJNAP uses various techniques/resources: 1) technical assistance and counseling; 2) a quarterly newsletter, EXCHANGES; 3) seminars, conference and trainings; 4) a resource center including print and audio-visual materials; and 5) statewide clearinghouse services on adolescent health issues, including teen pregnancy prevention. By providing linkages among existing organizations, often through county networks that implement local policy and activities, NJNAP seeks to create an environment in which youth-serving organizations can share information and resources that pertain to healthy youth development.

D. Austin, Texas
East Austin Youth Charter
Dennis Campa, formerly Director of the Community Services Division of Austin/Travis County Health & Human Services Dept., currently Neighborhood and Community Initiatives Officer of the City of Austin
Robert Penn, Vanguard Management
Kit Abney, Program Coordinator

East Austin Youth Charter began when Public/Private Ventures, a national nonprofit organization, approached the city about participating in a new initiative. This initiative, Community Change for Youth Development (CCYD) involves five "core concepts" of positive youth development-supportive relationships with adults, constructive work experiences, activities for non-school periods, involvement in decision making, and support through transitions-and a process for implementing them. CCYD leaves the specific program model to be developed by the community. Further, the CCYD approach is based on the hypothesis that community mobilization is necessary for lasting community change.

The Community Services Division of Austin/Travis County Health and Human Services Department (CSD) had been working with others in the community to develop a proposal for an Empowerment Zone grant for a group of three adjacent neighborhoods in the East Austin area. Over 80 percent of the residents of this area are Latino, and 37 percent are poor. Although the group did not receive the grant, the process generated enthusiasm and a commitment to working together to benefit the community. Recognizing the limits of their ability, as a government agency, to involve community residents, CSD joined with Austin Interfaith (AI) as co-lead agency. AI is a part of the Industrial Areas Foundation, a nonprofit membership organization whose mission is to organize community institutions and residents for political action. AI had been working for 12 years in the community.

Between March and October 1995, the two agencies' staffs and residents worked to develop a plan. Several elements were important to their success: for the most part, the partners knew each other from their previous work on the EZ grant; they had a shared interest in seeing their earlier work take strategic shape; and they had a shared commitment to the process of creating a community that supports healthy youth development. It was important that they were "not chasing money." Early in the planning, one of the partners questioned whether the group even needed P/PV. CSD committed half of the small amount P/PV offered for planning, if partners would commit to the process. The group was prepared to work with or without P/PV funding.

Much of the planning time was spent mobilizing the community, informing them about CCYD, and determining the concerns and priorities of adult and youth residents. AI used neighborhood walks, house meetings, and community meetings in different locations around the neighborhoods to involve residents. They formed "action teams" led by residents to plan programs related to each of the core concepts. A leadership team of three CSD staff, two AI staff and two or three residents had overall responsibility for planning strategies and developing ideas for the plan; thus leadership was shared among the city, AI and the community. Service providers were organized into a separate group to prevent the loss of community control. Community churches and schools were involved through their association with AI. An outside expert conducted a household survey that provided information on risk factors and community attitudes. This information helped to mobilize all sectors of the community, including churches. CSD drafted the formal implementation plan based on the ideas developed and agreed on by the community.

Obstacles to planning included maneuvering for position and power, especially by some of the neighborhood associations, which tended to be negative about partnership activities that were not part of their agenda. When others did not adopt their agenda and they did not gain the power and resources they had hoped for, they left the group. The formation of a permanent Neighborhood Steering Committee (NSC) to direct the implementation of the CCYD plan has been a source of continuing controversy, and the group has had several configurations. The NSC has recently been restructured and now includes one youth and one adult community member nominated from each of three local churches, one high school teacher and a student, two community parents who are active in their children's elementary schools, a school district representative, a representative from Communities in Schools and one from Capital 4-H, the director of the local recreation center, a member of the UT Urban Issues Program, and the head of prevention programs of the Texas Youth Commission. The NSC has pushed the schools to be more active partners. The relationship of the NSC to the Service and Support Partnership of 24 local service providers and neighborhood associations is still being worked out.

Another roadblock was the need to overcome the usual way of doing things, that is, the City making decisions about programs and services rather than building communities by sharing power with residents. On the other hand, residents have had to learn to trust agencies and to fully participate in the development and implementation of the plan. These are continuing challenges. Building residents' capacity has been and continues to be a primary concern of P/PV, which has conducted workshops and retreats on defining roles and responsibilities, consensus building, decision making, conflict resolution, team and trust building, budgeting and the like. Residents were trained to make quarterly presentations to the funders. As residents have assumed new responsibilities, for example, for fiscal oversight and leadership, new capacities have to be developed. Redefining roles and responsibilities is an ongoing process. P/PV reviews the partnership's operation monthly, asking questions and pushing the group to evaluate and solve problems.

Youth Charter now operates with three separate grants: one from P/PV, one federal Title V juvenile delinquency prevention grant through the governor's office, and one Strategic Intervention for High Risk Youth grant. Additional city and county money comes from CSD. The effort is staffed by one adult organizer, one youth organizer, and, until very recently, one coordinator for each of the grants. The coordinators for the first two grants have now been merged. The NSC makes policy and planning decisions for the P/PV programs, and a Prevention Policy Board performs these roles for the Title V grant. These groups meet regularly. Coordinating these efforts is a work in progress and led to the appointment of the Texas Youth Commission representative, who serves on the Prevention Policy Board, to the NSC. The boards have standing and ad hoc committees, organized by sectors, that meet regularly and report back to the larger group. Residents lead the committees and boards.

Those involved in Youth Charter consider the partnership a success in a number of ways. It has established a conversation in the community among key institutions, residents, and youth. It has raised the level of awareness of the issues facing youth and the strengths of the community and outside institutions and has increased accountability. At the end of its second year Youth Charter has begun to change the system of supports for children and families in an enduring way: involving adults in several programs, linking youth to existing enrichment activities, creating new programs for non-school times, providing job training, career awareness opportunities and jobs, developing programs for youth moving into middle and high school. More youth are involved, and preliminary results indicate that more youth are remaining in school. P/PV collected baseline data on various behavioral measures, including arrests, sexual experience, gang membership, alcohol and marijuana use, carrying of weapons, use of force, and participation in protective activities, such as sports, recreation, religious activities, and job training. They have been tracking participation in Youth Charter programs and will survey youth behaviors again at the end of the third year. Until then, impact remains conjecture. Youth Charter staff have begun tracking participation themselves in order to have more immediate feedback.

While rates of teen pregnancy are high in the East Austin area and the community is concerned about the issue, Youth Charter has not done direct prevention programming for two reasons. First, the youth development philosophy supports programs that emphasize assets and provide opportunities for youth rather than those that provide specific intervthe PRECEDE model. Comm perhaps, is the fact that two large Catholic churches in the area are very involved in Youth Charter efforts and only support teen pregnancy prevention activities within very limited parameters. The city's Family Health Unit operates a multi-component teen pregnancy prevention effort in the area, loosely patterned after the South Carolina school-community program. It includes education of parents and other youth leaders on how to talk to youth about sexuality and a family life education program that reaches all seventh grade students in the local middle school. Youth Charter staff maintain close relations with these programs; both are housed in the same city department, and staff communicate regularly and cooperate whenever possible without any formal, written relationship. Youth Charter participants are referred to these programs. Youth Charter also plans to develop Family Learning Centers, which will provide various educational activities, including pregnancy and drug and alcohol prevention, in the near future.

E. Roanoke, Virginia
Teen Outreach Program
Cheri Hartman, Ph.D., TOP Director

The Teen Outreach Program (TOP) began as a project of the Association of Junior Leagues International (AJLI), sponsored and operated by local Junior Leagues (JL) in cities across the country. In 1990, TOP was in place in one school in Salem, Virginia, where a lack of support from the principal and staff was creating roadblocks to every activity. When the principal of a Roanoke high school heard TOP described at a JL board meeting and advocated for the program, the TOP coordinator began a pilot program in one class of 20 students at the Roanoke school.

From that beginning, the program has gradually developed and evolved in Roanoke under the constant leadership of the TOP coordinator. In 1994 TOP began a transition from JL sponsorship to a community-based project. The coordinator assembled a community advisory committee that included the local General Assembly representative, the principal of the high school, representatives of agencies with similar missions, health care providers, and others who might be partners in the program. The coordinator and board undertook a process of determining TOP goals and objectives, establishing criteria for a new sponsoring agency, identifying possible matches, and interviewing agency directors and boards. TOP eventually found a home within Family Service of the Roanoke Valley, a private, nonprofit human services organization that wanted to expand its prevention services to youth. The JL TOP coordinator became the TOP director.

Technical assistance from AJLI helped the local TOP staff make effective presentations to the community. In addition, the availability of data from the national evaluation of TOP, which documented its impact, added to the program's appeal. Strong advocates in the school, who knew the program in operation, increased the case for TOP. With funding from United Way, TOP made a first step toward self-sufficiency. A series of powerful articles in the Roanoke Times on the impact of teen pregnancy on the community and a subsequent editorial were also important in attracting support. TOP now receives funding from the State Departments of Health and Education, the city through Community Development Block Grant funds, United Way, the March of Dimes, several foundations, and service organizations.

Relationships with service learning sites, which include a program for handicapped preschoolers, nursing homes, and businesses, are developed by mini planning teams. The teams work out mutual commitments and expectations, as well as logistics. There are no written contracts. Coordination, supervision, and problem solving are managed through planning meetings, personal contact, and open and frequent communication. According to the director, if lines of communication are not open frustration mounts and service learning sites may leave the program.

Other partners include the City of Roanoke school system, which works with TOP in many ways-providing teachers to help implement the curriculum and coordinate service learning, monitoring grading, integrating TOP into English classes, managing school administrative requirements, providing referrals to TOP through the counselors, and planning and staging special events. Prevention Plus, a division of the local mental health department, provides two prevention specialists who help implement the curriculum. Roanoke Adolescent Health Partnership provides Teen Health Clinics and two health educators who help implement the curriculum. The Voluntary Action Center helps identify new volunteers for TOP's tutoring and mentoring programs and provides information on summer youth volunteer opportunities.

These partnership relationships are conducted without written contracts. Personal relationships and open communication are key. However, the full commitment of partners, particularly the schools, from the district administration down, is essential. TOP's director suggests that her long personal history with the program facilitates the trusting nature of these arrangements. However, each of the partners is committed to the program because each gains from its involvement. The program gains credibility from evaluation, and the organizational goals the partners attain through TOP cement these relationships without formal agreements.

The TOP director makes day-to-day decisions in compliance with the policies of Family Service of the Roanoke Valley and of the schools, which host the programs. The Board of Directors of Family Service and a committee of a local youth development coalition provide input on goals, objectives, and the evaluation process. The advisory committee continues to guide strategic planning. Student participants and their families are surveyed at the end of each year for input on TOP content and activities; however, these groups have not been attracted to service on the board.

The TOP director attributes TOP's success in part to networking that she does in two coalitions committed to youth development. Networking has made her aware of grants and funding opportunities and has connected TOP with new partners for the service learning component. Through these coalitions, as well, she hopes to develop a comprehensive plan for coordinating local youth development activities and to remove barriers to partnering with other organizations that share TOP's turf.

TOP in Roanoke has grown from a single class to sites in a school for students with court connections, a school for pregnant and parenting teens, a special education program, a program for educable mentally retarded students, and a church-based project, as well as two high schools. These programs reach about 120 active participants each month. Each year for the period between 1993 to 1997 TOP has shown consistently positive impact, reducing rates of absenteeism, suspension, school drop out, and class failure by substantial amounts. Teen pregnancy rates have also been reduced, but the numbers are so small that significance cannot be assessed. A survey that measured sexual knowledge and resiliency showed significant improvement among TOP students after their TOP experience. All students rated their TOP experience favorably.

Sustaining TOP over the long term has depended on evidence of positive outcomes from the local evaluation, as well as national data. In addition, technical assistance has given the program self-sufficiency in training facilitators, the most costly and uncertain element of program operation. The director is now working to integrate TOP into the English curriculum, which will strengthen the partnership with the school system and make TOP more than an add-on program that can be easily eliminated. She is also working with the Virginia Department of Health, which is TOP's major funder, and a local foundation to spur replication and expansion in other communities through partnerships at the state level.

F. Seattle, Washington
Partners in Action for Teen Health
Sharon Brew, Program Coordinator
Steve Daschle, Director, Southwest Youth and Family Services
Cynthia Goodwin, Associate Director for Community Based Services,
Ruth Dykeman Children's Center

Seattle Partners in Action for Teen Health (PATH) began in 1993, when new statistics revealed that the White Center neighborhood had the second highest rate of teen pregnancy in the State. The White Center community is diverse and includes 40 percent Southeast Asians, who are themselves a very diverse group. Many teens in the area live at or below the poverty level and have four or five risk factors for negative outcomes. The Southwest Teen Pregnancy Prevention Alliance, part of a larger coalition of social service providers who met (and still meet) monthly to share information and support, wanted to do something about the problem. They did not want to create new programs but wanted to coordinate services and identify gaps.

This group spent much of the early years learning "how to be a collaboration." For some time, program development was neglected as the partnership was created. They hired a facilitator to help identify issues and define the collaboration partners' roles. They worked on crossing professional and jurisdictional boundaries. And they worked on creating a flat, non-hierarchical structure. At first, two of the partners assumed fiscal responsibility and managed the hiring and supervision of staff. However, without coordination at the partnership level, staff worked at cross purposes, and there was a great deal of frustration and dissatisfaction.

Eventually, the collaboration hired a program coordinator. Although technically staff are still hired through the two agencies that have fiscal responsibility, the program coordinator is intimately involved in hiring and supervises the staff, which includes one community organizer, one health educator, and one employment/mentorship development specialist, one intern, and a group of regular translators. The coordinator makes day-to-day decisions. The 12 collaborative partners, who include agency representatives and individuals, provide guidance on policy, programming, fundraising, and community awareness issues. There is no lead agency; the partnership calls itself "nonhierarchical." Decisions are made by consensus and cooperation. Responsibility is shared. Possible new members are interviewed to determine their philosophical fit with the group.

Partners in PATH attribute their successful organizing effort to the members' genuine sense of goodwill, commitment to the collaboration, and willingness to set aside personal and organizational biases to achieve their common goals. They spoke openly about their competing agendas and their concerns. They worked around different personal and communication skills. They agreed not to micro-manage the daily operation of the program.

Early in the program's development, PATH struggled to involve parents and other residents. Now, after five years, the program has become a fixture in the community, a long-term endeavor that residents view as committed to the area. Community adults and teens value PATH's presence, and youth especially seek to be involved. At the end of 1997, when members of the Christian Coalition attacked PATH, the community rallied to its defense. Part of PATH's acceptance is due to the staff, who share the philosophy of the program and reflect the community ethnically.

In addition to community acceptance, other measures of PATH's success include the remarkable stability of the group, which retains all except one of its original members. The staff has grown from one to five. This past year PATH received a grant from the Children's Aid Society and is a replication site for the Carrera model. In conjunction with this grant, participants have increased from 30 to 100. PATH's program has changed somewhat as a result of the grant; it will soon be a six-part, comprehensive program that includes academic assessment and tutoring, life time sports, self-expression/arts, employment and career awareness and training, family life/sexuality education, comprehensive health services, and mental health care. Parents of participants are involved in Plain Talk for Parents, in family meetings, and in assisting in programs in various ways.

A state evaluation that ended in July 1997 called PATH a "promising approach," although problems with the control communities prevented clear comparisons. The Children's Aid Society program is being evaluated using an experimental design. Students are surveyed every six months on behavior and risk indicators. First year results will be available in late 1998. Participants report a great deal of satisfaction with the program, attend activities regularly, have helped recruit new participants, and have stayed connected to the program through the changes.

The partners see the Children's Aid Society grant as an opportunity to gain credibility from the name and the national reputation of the Carrera model. The evaluation of their program, funded by the grant, should assist PATH in securing the resources for long-term sustainability.