Key Informant Interviews

with

Youth Advocacy Coordinators

Summary Report

June 2005

Submitted to:

Partnership For A Tobacco Free Maine

Bureau of Health

Department of Health and Human Services

Healthy Maine Partnerships, Maine Department of Health and Human Services in

Collaboration with the Maine Department of Education.


Submitted by:

Market Decisions

One Park Square

85 E Street

South Portland, Maine 04106

Phone 207.767.6440

Fax 207.767.8158

THE GALLUP ORGANIZATION

283 Water Street, Third Floor

P.O. Box 2389

Augusta, Maine 04338-2389

Phone: (207) 623-3796

Fax: (207) 623-0265

Funded by Maine’s Share of the Tobacco Settlement of the Maine

Cardiovascular Health Program, CDC Cooperative Agreement

U50/CCU121347

A list of Key Statewide partners includes but not limited to the following:

Maine Department of Education

Maine Nutrition Network

American Lung Association of Maine

Maine Center for Public Health

Medical Care Development

Maine Department of Transportation

American Cancer Society, New England Division

American Heart Association, Maine Chapter

Maine Cardiovascular Health Council

Governor’s Council on Physical Fitness, Sports, Health, and Wellness

Maine Coalition on Smoking OR Health

Consumers for Affordable Health Care

Maine Network of Healthy Communities

Maine Tobacco HelpLine

Maine Youth Action Network


I. Table of Contents

II. Executive Summary 1

Evaluation Objectives 1

Methodology 2

Findings 2

Project Leadership 5

The Youth in the Youth Advocacy Programs 6

Youth Advocacy Coordinators’ Perceptions of Youth 6

Effectiveness of Messages in the Three HMP Focus Areas 7

Methods of Assessing the Impact of Youth Advocacy Programs 7

Hallmarks of a Successful Youth Advocacy Program 7

Impact of Youth Advocacy Program 8

Youth’s Sense of Inclusion in HMP Initiatives 8

Additional Comments from Youth Advocacy Coordinators 8

III. Background and Methodology 9

Youth Advocacy Coordinators and the Healthy Maine Partnerships 9

Evaluation Methods 10

Data Collection 10

Analysis and Reporting 11

IV. Appendix: Youth Advocacy Program Coordinator Interview GuidE
12

Market Decisions for the PTM -2- YAP Coordinator Interviews


II. Executive Summary

This report provides insights into the implementation and activities of the Youth Advocacy Program (YAP) sponsored by the state-level Healthy Maine Partnerships with specific leadership and funding provided by the Partnership For A Tobacco-Free Maine and guidance from the Physical Activity and Nutrition Program. These state-level programs, through the HMP collaborative initiative, work in partnership with the 31 local intervention sites, called the 31 local Healthy Maine Partnerships, to implement the YAP program. As part of their grant-funding agreement with the Bureau of Health, each of the 31 local Healthy Maine Partnerships is required to implement a YAP Program in their local region. The YAP Program is responsible for empowering youth with the skills that they need to create a healthy community (including school community) by learning how to advocate for change. The health focus of the statewide YAP initiative is to prevent tobacco use, motivate those who smoke to quit smoking, decrease public exposure to secondhand smoke, increase physical activity, and encourage healthy eating.

The recommended model for implementing the YAP in each community was to hire a YAP Coordinator to facilitate the work with the youth, participate in training and technical assistance from the MYAN (Maine Youth Action Network) and address the YAP focus areas. This evaluation explores the implementation of the YAP, including staffing, participant recruitment, decision-making and project implementation through in-depth interviews with the YAP Coordinators associated with each local Partnership. In addition, the evaluation probes on the types of youth involved experiences with training, opportunities for improvement and involvement with the work of the local and state-level Healthy Maine Partnerships.

Evaluation Objectives

· Understand the kinds of projects and activities addressed by Youth Advocacy Coordinators.

· Explore the successes and challenges of the Coordinator role, especially with regard to recruiting, coordinating, working with and impacting youth, local schools and the community.

· Understand the particular behavioral risk areas addressed by projects directed by the Youth Area Coordinators and describe the type of youth served by the Programs.

· Assess the interaction between the Youth Advocacy Coordinators and the School Health Coordinators for the Partnership

· Clarify the benefits and shortcomings of the YAP training offered in Tobacco, Physical activity, Nutrition, Working with Youth and Advocacy or Environmental Change.

Methodology

Telephone interviews were conducted with 39 Youth Advocacy Coordinators. These interviews included both close-ended (multiple choice) questions and open-ended (comments) questions to probe and clarify the reasons for responses.

Findings

Profile of the Youth Advocacy Coordinator Position

ü Almost half of the Youth Advocacy Coordinators interviewed held part-time positions. Just over one-third (36%) were full-time and the remaining 26% were stipended. Over half (60%) had been in their position over one year.

ü Half of the YAP Coordinators (51%) held other positions that are not funded by the Healthy Maine Partnerships.

ü Having too much to do and too little time in which to do it was cited by half (51%) of the Youth Advocacy Coordinators as the major challenge of their work. Recruiting (28%), school policies, politics or collaboration issues (23%), scheduling (21%) and transportation (18%) were also concerns for many coordinators.

ü The majority of Youth Advocacy Coordinators (59%) described their work with the school health coordinator for their Partnership as being characterized by an excellent, supportive relationship.

Training for the Youth Advocacy Coordinator Position

ü Almost half of the Youth Advocacy Program Coordinators interviewed (46%) cited prior experience working with youth as the most helpful training they received prior to taking the YAP job. Several also mentioned life experience (18%), health training (18%) or group facilitation training (15%).

ü Two-thirds of the coordinators interviewed (67%) received training from the Healthy Maine Partnerships during their tenure as YAP Coordinators. MYAN conferences (33%) and YAP coordinator conferences (15%) were also mentioned by several coordinators.

ü The vast majority of Youth Advocacy Coordinators (95%) have had training working with youth at some point in their career. Many were trained in advocacy or environmental change (87%), tobacco (78%) or nutrition (65%). About half (55%) have had training in physical activity.

ü All but one coordinator found their training to be helpful. Most (71%) said the opportunity to obtain new skills, information or resources was what made the training helpful. Others mentioned sharing insights with other coordinators (29%), and helping them to think outside the box or see the big picture (18%).

ü Professional development (21%) and nutrition, physical activity or body image (18%) were areas where coordinators would like to receive more training.

Types of Projects Managed by Youth Advocacy Program Coordinators

Topic Areas

ü Although most coordinators’ efforts spanned the three HMP areas, tobacco-intervention was a major focus. Two-thirds (64%) said the youth were involved in tobacco-intervention programs, and 41% mentioned nutrition and/or physical activity programs. Many also mentioned projects working with elementary school students and health fairs.

ü Many coordinators described projects that extended beyond their local schools to the community and even beyond their local community to impact state-wide policy and legislative issues.

ü All but one Youth Advocacy Coordinator reported youth being involved with awareness building or role-modeling projects. The majority said the youth had also been involved with events (92%), policy and environmental change (92%), peer to peer education (90%) or training for youth (87%). Half of the Coordinators interviewed said the youth were involved with social justice issues (49%).

ü With regard to the risk areas addressed, the vast majority of coordinators (92%) said that they address tobacco cessation, followed by nutrition (69%) and physical activity (69%). Several also mentioned alcohol abuse (15%), health decisions (15%), drug abuse (15%), advocacy/life skills (13%), eating disorders (10%) and other social and behavioral issues (10%).

Specific Projects Within the Three HMP Focus Areas

ü The Great American Smokeout was the tobacco-related project conducted most frequently (31%), followed by various community-based programs (28%), Kick Butts (23%), awareness activities (21%) and Samantha Skunk (18%).

ü Walking programs such as walk-a-thons, pedometer programs or walk to school programs were the most commonly offered physical activity-related projects, mentioned by 38% of the YAP Coordinators. Activities such as ski clubs or dances (28%), creating trails for walking, hiking or biking (21%) and either reserving special gym times or informational presentations (15% each) were also mentioned frequently.

ü A sizeable percentage of the projects related to nutrition (41%) consisted of changing vending machine or concession stand offerings to healthy snacks or otherwise ensuring that healthy snacks are offered at schools or special events. Peer nutrition awareness programs (21%), development of community or school gardens (21%), activities to make school lunch menus healthier (18%) and working with younger students to promote healthier nutrition (15%) were also frequently mentioned.

Developing Projects and Initiatives

ü The majority of Coordinators (75%) said that when they are developing ideas for projects and initiatives, the kids themselves decide what their focus will be. A few said that they work with school advisors, staff, coalition partners, or others to determine the focus of projects and initiatives.

ü All the Coordinators used brainstorming to generate new ideas and learned from other organizations, and the majority also used the other specified techniques included in the questionnaire, including working with the local HMP School Health Coordinator, working with HMP funded schools, open houses and participant referrals. Somewhat fewer used non-funded schools in the HMP service area to recruit youth.

ü The Youth Advocacy Coordinators make the decisions regarding project or initiative content far less frequently than the youth themselves. Although about three-fourths of the coordinators interviewed (77%) said the youth “always” decide which projects to work on just 31% reported that the coordinator “always” decides.

ü The majority of the Youth Advocacy Coordinators (80%) acknowledged that the decisions regarding project or initiative content are made through an interactive process involving both themselves and the youth they work with. Six coordinators (15%) reported that the decisions are “sometimes” made in combination, and two additional coordinators (5%) were unsure.

Recruiting Methods

Recruiting Practices

ü Most coordinators use a combination of several methods to recruit youth for the Youth Advocacy Programs. About a third included recruiting youth through school announcements and presentations, by using current YAP members or a youth advisor, or through posters (33% each). Word of mouth (28%), referrals from teachers, guidance counselors or parents (21%), open houses (15%) or recruiting through other youth groups (10%) were also mentioned.

ü When describing what recruiting approaches work best, and what doesn’t work for them, coordinators most often cited using youth to recruit other youth (33%) and word of mouth (21%) as the most successful recruiting tools. About a third (33%) reported that posters, fliers or announcements did not work well.

Use of Specific Recruiting Methods

ü The most widely used and most effective of the recruiting methods was using participant referrals or having participants bring friends. The vast majority (85% of coordinators) found it to be “very” effective.

ü Although about two-thirds (64%) said local HMP-funded schools were “somewhat” or “very” effective in recruiting youth for Youth Advocacy Programs, a fourth of the coordinators interviewed had not used them.

ü About half of the coordinators interviewed had not used existing youth groups in their recruitment efforts. Most of those Coordinators who had worked with existing youth groups, however, found them to be “somewhat” effective (36% of coordinators overall).

ü All but two coordinators who had used open houses or other event places to recruit youth and found them to be “very” or “somewhat” effective. One in three coordinators interviewed (33%) had never used them.

ü Coordinators offered mixed opinions of the effectiveness of working with the local HMP School Health Coordinator to recruit youth for the Youth Advocacy Programs. About half of the coordinators reported that the local HMP School Health Coordinator was at least “somewhat” effective. About one-third (31%) had not used the School Health Coordinator in recruitment.

ü Just one coordinator (3%) found non-funded schools to be “very” effective in recruiting youth for Youth Advocacy Programs. Most of those who had used non-funded schools to fulfill recruiting needs found them to be “somewhat” effective (41% of coordinators overall), however almost half of the coordinators interviewed had not used non-funded schools in recruiting.

Project Leadership

ü Most projects are led by the youth themselves. The majority of coordinators said that more than 75% of the projects are lead by youth.

ü Most coordinators (72%) said that less than a quarter of their projects are led by a coordinator. Just 6% said that more than half of their projects are lead by a YAP Coordinator.

The Youth in the Youth Advocacy Programs

ü Each Youth Advocacy Program involves an average of 41 youth over the course of a school year. Most Youth Advocacy Coordinators (74%) reported that the most of the youth working on their projects are middle school students. About one-fourth (26%) said high school students work on their projects, and none reported having elementary school children involved in working on projects.

ü About two-thirds (67%) of the coordinators interviewed said that the same kids tend to work on all the projects. In general, projects involving more kids tended to involve different youth in the projects, whereas the smaller projects were more likely to rely on a core group of participants.

Youth Advocacy Coordinators’ Perceptions of the Youth They Work With

ü About a third (33%) specifically said that the youth, as a group, contained a wide variety of personalities and styles, and this opinion also pervaded many other comments that did not specifically address the issue.

ü Most of the Youth Advocacy Coordinators interviewed described a wide variety of characteristics when describing the kids they work with. The most commonly used adjectives included “driven”, “motivated”, “achievement-oriented”, “energetic”, “involved” and “outgoing”.

ü About one in four (23%) indicated that at least some of the kids they work with are at risk for behavioral issues.

ü Over half of the Youth Advocacy Coordinators interviewed thought that the adjectives warm-hearted, promising, considerate and good student applied “a lot” to the average youth they work with. Clean-cut, natural leader, healthy challenging, at-risk for unhealthy nutrition and involved in the community were also thought to describe youth “a lot” by half to a third (49-33%) of coordinators.

ü The greatest barriers to reaching at-risk or edgier youth were problems with home life and lack of family support or a negative school environment (31% each). Lack of transportation and lack of interest were also mentioned by several Coordinators (18% each), as well as not being perceived as “cool”.

ü The most powerful opportunities for promoting behavior change with at-risk, edgier youth included empowering them and making them feel useful (18%), teaching coping skills (13%), providing a safe place and a good relationship (10%) and getting youth involved in something positive (10%).