United States Programs

Project Activities and Highlights

• The Central Coast Adolescent Sexual Risk Reduction Project was launched in 2000. The project is being implemented in California's agricultural Central Coast region and includes a special focus on Latino youth. Using a youth development model, the program helps teens develop valuable career and life skills while producing hip, trendy health education messages via innovative media campaigns. The initiative has received special recognition for its media developed 'by and for youth', including the ShoutOut newspaper and website (www.shoutoutnews.org), "Amor y Deseo at Heartville High," an award-winning 12-part radio novela, and YouthTopia Radio, a talk show produced by teens on issues that they find important. The project offers Habla Conmigo parent skills-building workshops to help adults talk with their kids about sex, the "Teen Advocates" peer education program, as well as the "Safer Sex Machine" condom initiative which places condom vending machines sporting a graffiti art logo in youth-friendly businesses and hangouts.

• PSI and members of the Harvard Tobacco Control Working Group have developed the X-Pack, a self-help smoking cessation kit for young smokers. Cigarette companies spend $11.2 billion a year on packaging to make sure smokers enjoy opening each and every pack. That's the trouble. It's not just the nicotine that's addictive, it's the ritual. The X-Pack has been designed to grab the attention of the young adult smoker and help them break the habit and find new rituals to get them through the day.
Development of the X-Pack kit was based on best practices in smoking cessation and in-depth research with the young smokers and is full of strategies and tools to help young smokers quit. X-Pack is being sold at college campus bookstores, at www.x-pack.org, and to organizations promoting smoking cessation throughout the U.S. Currently, a National Institute of Health funded two-arm randomized trial to determine the efficacy of an X-PackTM based intervention is in the field. Key Findings are expected by September 2005.

• Obesity/overweight among teens has become a major epidemic. Recent reporting of U.S. data from 2000 showed that 15% of teens were overweight and another 15% were at risk of being overweight. Physical inactivity and unhealthy eating contribute to obesity, cancer, cardiovascular disease, and diabetes, and are responsible for at least 400,000 deaths each year in the general population. Promoting regular physical activity and healthy eating, as well as creating an environment that supports these behaviors, are essential to reducing this epidemic of obesity.

PSI's USP program aims to increase physical activity and healthy eating among teens ages 12-18 by developing a communication tool kit for teen peer educators that schools and community programs can use to implement a youth run campaign. Over the course of three years, PSI will develop, evaluate, and disseminate the communication tool kit. The tool kit will include fun activities, posters, print ads, a pedometer challenge, T-shirts and other items. PSI will work with teens, schools, and community members in Portland, Oregon and the Central Coast of California to develop and test the tool kit. The toolkit is being funded by Estee Lauder and promoted by Ashley Judd nationwide as part of PSI's cause related marketing NutritionAID program.

• PSI is partnering with the State of Oregon to implement the Family Planning Project. The project's aim is to expand use to Oregon's publicly funded family planning services among low-income people. PSI promotes full utilization of these services and the use of more effective contraceptives (i.e., hormonal methods and the IUD) among women at risk for unintended pregnancy. In addition, PSI has worked to encourage male involvement in reproductive health issues by coordinating training to strengthen clinic capacity to address male sexual health needs and by developing Los Chidos, a comic book that educates Spanish-speaking men about reproductive health and encourages them to take a more active role in family planning. Based on extensive quantitative and qualitative research conducted with reproductive health service consumers and providers, PSI has developed and implemented strategies to improve quality of care and customer satisfaction.

• PSI piloted the Emergency Contraception Promotion Project in Sacramento (California) and Portland (Oregon) between 2000 and 2002. PSI and partners (The Pacific Institute for Women's Health and the Program for Appropriate Technology in Health) combined strategic community mobilization, health worker training (1,500 clinical and non-clinical health service providers trained) and a media campaign to increase awareness of EC as a means of reducing unintended pregnancies and abortions among young women.

The project resulted in significant improvements in provider practices regarding EC among training participants. In Portland, at post-test, nearly three fourths (73%) of the training participants reported having EC information available to all of the women they serve, compared to only a little over one-fourth (29%) at baseline. Also, there was an increase in the number of providers giving advance prescriptions or supplies of EC to their patients after attending PSI EC trainings. In Sacramento this increased from 15.6% at base-line to 45.5% at follow-up.

The EC media campaign, Accidents Happen, Pregnancy Doesn't Have To, was effective in generating increased awareness of and knowledge about EC. During weeks in which the EC radio advertisements aired, calls to the 888-NOT-2-LATE EC hotline (which was promoted in all EC messages) tripled in the Portland and quadrupled in the Sacramento area. Calls to the hotline still remain well above baseline in these cities.

Furthermore, PSI staff in California coordinated a team of over 20 trained EC advocates who promoted improved teen knowledge and access to 2,400 key local and state health policy makers. Advocates encouraged and supported local health service providers to adopt appropriate policies, protocols, and trainings regarding EC. To support the advocates, PSI has developed an EC advocacy tool kit (including video) and created a provider EC Resource Guide (including client education materials and sample clinic EC protocols). Advocacy efforts were launched in February 2003.

• Project ACTION was the first teen-focused condom social marketing project in the U.S (Portland, 1992) and has since gained recognition as a cutting edge sexual risk reduction project. To date, Project ACTION vending machines have sold 300,000 affordable condoms in Portland, Oregon alone. Project ACTION has been successfully replicated in Seattle, WA and San Jose, CA and components of the project are being implemented by PSI on the Central Coast of California. Other communities including Manchester, England and La Paz, Bolivia, are integrating elements of the project into their own sexual risk reduction programs.
Project Action works to decrease the incidence of sexually-transmitted infections (including HIV) and unintended pregnancy among sexually active teens. It uses direct communications to address the sexual behavior of teens and it addresses broader social systems and communities to build support for safer sexual teen behavior. Key findings drawn from the project evaluation demonstrated a positive effect on behavior change coinciding with project implementation. For example: