My grant is a proposal for Alachua County high schools, UF, and Santa Fe College to have lessons about sexual health and safe-sex practices for students. The overall goal of the grant is to decrease the incidence of STIs in the Alachua county area through increased awareness, increased rates of STI testing, and increased condom usage. Adverse Childhood Experiences, or ACEs, have been proven to increase the potential for an individual to participate in risky sexual practices, namely having multiple sexual partners (Wood et al., 2022). Exposure to ACEs was also linked to an increased risk of developing life-long STI infections (Wood et al., 2022).
The proposed interventions include peer support and counseling groups, individual counseling and support, classroom messages and lessons, and increased awareness in doctors offices. Behavioral intervention methods mainly employ the use of positive peer pressure, which the targeted age group is most susceptible to (Steinberg & Monahan, 2007). Taking this into consideration, the main activities that this grant proposes are school- and community-based interventions, coupled with individual- and group-therapy interventions to help assess and improve individual’s psychological outlook on risky sexual practices. Such interventions would be done in an ACE informed way, ensuring that any prior trauma experienced by the individual is acknowledged and they are able to work through that. The age range targeted with this intervention is at increased risk of STI transmission because of the increased number of adolescents who are becoming sexually active without the proper education and information (Shannon & Klausner, 2018). While there are currently sexual education programs in place in most schools, these interventions often focus on abstinence-only interventions, and do not provide students with information on how to safely engage in sexual practices if they so choose to do so (Goldfarb, n.d.). The goal of this grant would be to change some of these educational practices in the Alachua County School district to have a more all-encompassing education for students.
The social ecological model that will best match with my grant proposal is the McLeroy model. At the individual level, the trauma-informed interventions of referral of youth and young adults to counselors or medical professionals is providing support to that specific individual (McLeroy et al, 1988). This will help them to identify any past traumas that could be contributing to their current risky sexual practices and allow them to work with a professional to acknowledge how their past experiences are contributing to their current practices. At the interpersonal level, there are peer-groups and support from teachers that help to develop a more understanding and informed community during this intervention. There would be information given to the teachers and medical professionals in the intervention, so they are more educated about taking trauma-informed approaches. The organizational level would be where the main intervention would be taking place, with the intervention classes being implemented in schools for youth and young adults (McLeroy et al, 1988). The Alachua County School District would be changing and implementing the intervention classes, creating a change within their educational policies and practices. This would also involve the addition of the new educational materials within the school districts (McLeroy et al, 1988).
The trauma informed approaches will be throughout, especially in the peer and individual support groups, by allowing individuals the time and space to share what they feel they can, as well as in the educational materials by including information about possible past ACEs and how those should also be addressed in the support groups. Peer support and mutual self help will be especially important in this intervention. Defined by SAMHSA, peer support is found through communicating with others who have lived through a similar experience to develop a sense of trust and safety (Substance Abuse and Mental Health Services Administration (SAMHSA), 2014). With the small-group meetings and individual counseling sessions, youth and young adults will be learning from each other about shared experiences, but also be able to delve deeper into their own past experiences (Feuer-Edwards et al., n.d.). Another principle of trauma-informed approaches used is that of empowerment, voice, and choice. Taking the strengths of some individuals and combining them with the strengths of others in a group or organization can allow others the encouragement to share their stories and thus benefit in the healing process as well (SAMHSA, 2014). Choice is very important within these small groups because if a person does not yet feel safe or comfortable with sharing their personal stories, they should not be pushed to divulge such information. Promoting a safe environment is another principle, meaning ensuring that all participants feel like they are safe and protected within the groups they are meeting with (Feuer-Edwards et al., n.d.). This will allow them to feel capable of healing, realizing how their past traumas may be influencing their current life, and ways to change their outlooks in the future. Empowerment, choice, and voice is important in this intervention because it can often be difficult for youth and young adults to share sexual information or histories, especially if they do not have a foundational relationship with the person (Agwu, 2020).
The framework of public health interventions incorporates not only different levels of intervention, but also the foundational principles and concepts that support the levels above them. The relation ties through all levels of public health, beginning at foundational principles such as government and education, then going up through the primary, secondary, and tertiary intervention levels (Feuer-Edwards et al., n.d.). The peer-support groups and empowerment / voice intervention aspects would be considered a secondary intervention because these would be for youth and young adults who have had an STI diagnosis and are therefore joining support and peer counseling groups to address some of the underlying causes of the risky sexual practices, but would be working to decrease the negative impacts the STI / ACE could have on their life in the future (Oral et al., 2015). The gender and culture aspects may be either primary or secondary, depending on if the person were to have a history or STI / ACE. It would be a primary, educational intervention if they had not had that experience, but a secondary, risk-mitigation intervention if they had (Oral et al., 2015).
The intervention's longevity lies in the ability for people to inform their friends and peers about what they have learned, and create a more understanding and supportive community. There is so much to be learned from people who have experienced ACEs, and they will be able to help with the development of further interventions, keeping trauma informed approaches at the forefront of public health interventions.
References:
Agwu, A. (2020, June). Sexuality, sexual health, and sexually transmitted infections in adolescents and young adults. Topics in antiviral medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482983/Links to an external site.
Feuer-Edwards, A., O’Brien, C., & O’Connor, S. (n.d.). Trauma-informed philanthropy: A Funder’s Resource Guide For Supporting Trauma-Informed Practice in the Delaware Valley Trauma-Informed Philanthropy. https://www.unitedphilforum.org/resources/trauma -informed-philanthropy-funders-resource-guide-supporting-trauma-informed-practice
Goldfarb, E. (n.d.). Lesson Selection Guide (grades 9-12). Rights, Respect, Responsibility: A K-12 SEXUALITY EDUCATION CURRICULUM. https://www.advocatesforyouth....LessonGuide_9-12.pdf
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15, 4, 351-377.
Oral, R., Ramirez, M., Coohey, C., Nakada, S., Walz, A., Kuntz, A., Benoit, J., & Peek-Asa, C. (2015). Adverse childhood experiences and trauma informed care: The Future of Health Care. Pediatric Research, 79(1–2), 227–233. https://doi.org/10.1038/pr.2015.197
Shannon, C. L., & Klausner, J. D. (2018). The growing epidemic of sexually transmitted infections in adolescents: A neglected population. Current Opinion in Pediatrics, 30(1), 137–143. https://doi.org/10.1097/mop.0000000000000578
Steinberg, L., & Monahan, K. C. (2007). Age differences in resistance to peer influence. Developmental Psychology, 43(6), 1531–1543. https://doi.org/10.1037/0012-1649.43.6.1531
Substance Abuse and Mental Health Services Administration. (2014, July). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach | SAMHSA Publications and Digital Products. https://store.samhsa.gov/produ...-Approach/SMA14-4884
Wood, S. K., Ford, K., Madden, H. C., Sharp, C. A., Hughes, K. E., & Bellis, M. A. (2022). Adverse childhood experiences and their relationship with poor sexual health outcomes: Results from four cross-sectional surveys. International Journal of Environmental Research and Public Health, 19(14), 8869. https://doi.org/10.3390/ijerph19148869
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