Authors: Laura Avellaneda-Cruz, LMSW & Jaclynne Oyoumick, BA of the Alaska Native Tribal Health Consortium (ANTHC), Alaska Native Epidemiology Center, in Anchorage, Alaska
What are the goals of the card?
The wallet-sized, fold-out safety card is an evidence-based tool developed by health and domestic violence professionals for use in health care to promote safety and support for patients experiencing intimate partner violence, sexual violence, and/or reproductive coercion. The safety card can facilitate education, screening, and response in a health care setting, and it also allows the patient to walk away with positive messages and resources, whether she or he discloses to a provider or not. National organization Futures Without Violence, which is hosting the National Conference on Health and Domestic Violence March 19th – 21st this year in DC, has created a number of national safety cards, including a gender-neutral card for teens called “Hanging Out or Hooking Up?”
The goal of our Alaskan gender-neutral teen card, “Getting Together,” was to design something specifically for Alaskan youth, addressing the forms of victimization that most affect them using the language and approach that speaks most powerfully to them.
The “Getting Together” card is a tool of universal primary prevention, educating youth on healthy and unhealthy relationships, what consent is, what their sexual rights are, what exploitation/trafficking is and how to look out for it, and pointing them towards helpful websites. It is also an intervention for youth who have experienced abuse and for youth who are abusing others. The card speaks to a general youth audience, including potential victims, potential perpetrators, and friends and bystanders. The “Getting Together” card, just like the national safety cards, aims to reduce isolation and to provide resources for safety and support. It also aims to provide a tool to facilitate conversations between adults and teens, and between teens.
Why was this needed?
Though interpersonal violence is prevalent globally and throughout the US, Alaska’s rates of intimate partner and sexual violence are typically among the highest in the nation. According to data from the 2013 Alaska Youth Risk Behavior Survey (YRBS), 9.1% of teens in traditional high schools reported experiencing physical dating violence in the past 12 months and 11.4% reported experiencing sexual dating violence in the past 12 months. Information about adverse childhood events (ACEs) from the 2013 Alaska Behavior Risk Factors Surveillance System indicate that adolescents in Alaska experience abuse outside of dating; 23.1% of Alaskan women and 7.2% of Alaskan men reported that they were sexually abused before age 18 by someone 5 or more years older than they were. Many more reported enduring physical and verbal abuse in their homes while growing up.
There are multiple societal factors that might conspire to keep young victims silent – whether they were sexually abused within a family, controlled by a dating partner, or assaulted at a party – and the aim of this card is to play a role in breaking that silence and supporting people to talk, listen, and step in to help others.
How did this teen safety card project come about?
Before the gender-neutral teen safety card called “Getting Together” was created, staff at the Alaska Native Tribal Health Consortium (ANTHC’s) Alaska Native Epidemiology Center (EpiCenter) had already created community-informed health materials on the issues of domestic and sexual violence and wellness. In 2013, the EpiCenter partnered with the State of Alaska Family Violence Prevention Project and the national organization Futures Without Violence to create a safety card for Alaskan teen girls and women. The cover of this wallet-sized card shows a young Saint Lawrence Island Yupik woman, her face rimmed by a fur ruff and parka and the empowered words “We are Worthy” matching her expression. This Alaska-specific card was created with feedback from over 110 teen girls and women, the majority of whom were Alaska Native, from villages and towns across the state.
The “We are Worthy” card, which addresses healthy and unhealthy relationships, pregnancy pressure/reproductive coercion, effects of stress on health and health behaviors, the importance of getting help to stop drinking before and during pregnancy, and how to get help, has been popular among health care providers, social workers, and others around the state. It was adopted by the State of Alaska Public Health Nurses, and several regional tribal health care organizations have requested and received training in using the card. It is also used by law enforcement and DV/SV agencies. The card is considered helpful because, in a small amount of space, it offers highly relevant information and resources in a dignified, non-judgmental, and culturally-appropriate way.
While there was significant demand for the “We are Worthy” card, particularly by health care providers, there was also demand for a similar, Alaska-specific resource for primary prevention and outreach forteens of any gender. To create this resource, a partnership was built with the State of Alaska’s Adolescent Health Program and Family Violence Prevention Project with additional support from ANTHC’s STD Prevention Program, to identify the major issues affecting Alaskan youth and how to address them.
How did teens participate in developing its content?
Because we wanted to create a card relevant to all Alaskan teens, we hosted focus groups in villages and towns across the state as well as in a juvenile justice facility and a teen shelter to gather feedback. The 113 youth who offered feedback represented dozens of different communities and every major racial group, although approximately 75% were Alaska Native. Participants were evenly split by gender; unfortunately, we did not hear from any transgender youth during the feedback process. Teens shared their reactions to the content, the issues addressed by the card, thoughts on common language used by youth, what appealed to them in graphic design and color, and more. Teens were also asked about barriers to seeking help through hotlines, websites, trusted adults, etc. and how best to address those barriers on the panel dedicated to resources. Their guidance and feedback was invaluable in shaping the content and feel of the card at every phase in the process of its creation.
How are we distributing the teen card to teens?
The primary dissemination strategy adopted by ANTHC and its partners is to encourage organizations and institutions to adopt the card and share it with teens. We are also doing some direct distribution to youth at sports events, youth conferences, etc., with a focus on rural and Alaska Native youth. We have worked to disseminate the card to social service agencies, medical and behavioral health care providers, DV/SV agencies, child protection workers, court personnel, law enforcement including Village Public Safety Officers, and schools. Since 84% of teens in Alaska reported in the 2013 YRBS that they have a trusted adult they could speak with about difficult issues they are facing in life, we suggest that adults build on these relationships and use the teen card as a tool to discuss relationships with youth. We also encourage youth to share the card with each other, particularly within existing peer education and youth leader programs, of which there are a number in Alaska.
We also provide training on the concept of the teen safety card and ways to have effective conversations with youth about topics such as healthy and unhealthy relationships and consent. We recently held a workshop at the 2014 Elders and Youth Conference, a gathering of primarily Alaska Native elder and adolescent community members from rural and urban communities throughout Alaska. In this workshop, we engaged the elders and youth in critical analysis of popular media on the topics addressed by the card and created an opportunity for elders and youth to brainstorm different ways of creating safe conversations and of using the card. Based on feedback from workshop participants about desiring similar workshops for their home communities, we are now creating tools that we can make available online, such as role-plays on YouTube and comics to illustrate concepts such as how to create a safe environment for conversation. We will also offer sets of slides with talking points and national and Alaskan teen friendly resources, such as www.loveisrespect.org and www.iknowmine.org.
Both the “We are Worthy” and “Getting Together” cards are available for free download or order on our website www.anthctoday.org/epicenter/healthyfamilies. You can also find user-friendly, visual DV/SV resource guides for each region of Alaska, a user-friendly data book on DV/SV, an executive summary of 2013 ACEs data for Alaska Native people, and more. If you have questions about the card or other resources, or would be interested in modifying the card for your population and/or translating it, please contact our Community Outreach Specialist, Jaclynne Oyoumick at (907) 729-2971 or jkoyoumick@anthc.org. If you have questions regarding training and implementation, particularly in health care, please contact Program Manager Laura Avellaneda-Cruz, LMSW, at (907) 729-2489 or ldavellanedacruz@anthc.org. Both Jaclynne and Laura can also be found on ACEs Connection.
References
- State of Alaska. Division of Health and Social Services. Youth Risk Behavior Survey, 2013.
- State of Alaska. Division of Health and Social Services. Behavioral Risk Factor Surveillance System, 2013.
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