Empowering Teens to Make Healthy Decisions

PHE trains college student volunteers to teach a skills-based health curriculum in public high schools lacking health education.


Please describe yourself.

Collaboration (partners are signed up and ready to hit the ground running!)

In one sentence, please describe your idea or project.

PHE empowers teens in low-income communities to make healthy decisions, serve as advocates and access health resources in their communities.

Does your project impact Los Angeles County?

Yes (benefits a population of LA County)

Which area(s) of LA does your project benefit?

Central LA

East LA

South LA

San Fernando Valley

South Bay

What is your idea/project in more detail?

Peer Health Exchange (PHE) recruits, selects, and trains college student volunteers to teach thirteen skills-based workshops to teens in Los Angeles on topics including Reflection, Accessing Resources, Decision-Making, and Communication & Advocacy. Our workshops build the skills of the teens we serve while engaging them in discussions and activities about sexual health, mental health, interpersonal violence, and substance use. As slightly older peers, PHE volunteers deliver our curriculum to teenagers in a language and context that is relevant to their everyday lives while modeling healthy behavior. In 2014-15, our 250 LA volunteers (from USC, CSUN and Occidental) will teach over 2,200 9th graders across nearly 20 high schools within LAUSD.

What will you do to implement this idea/project?

1. PHE partners with high schools that lack skills-based health education and in which the majority of the students come from low-income households. These students experience a disproportionate number of serious health risks including unplanned pregnancy, substance abuse, and untreated mental illness. Volunteers teach the PHE curriculum in a required, non-academic class period so that PHE does not interfere with the students’ academic requirements.

2. PHE recruits, selects, and rigorously trains college student volunteers to teach thirteen skills-based workshops on topics including Reflection, Accessing Resources, Decision-Making, and Communication & Advocacy. Our workshops build the skills of the teens we serve while engaging teens on issues related to sexual health, mental health, interpersonal violence, and substance use. PHE maintains a high level of selectivity through our rigorous volunteer recruitment process, securing a minimum of 150% applications to volunteer positions available. This standard allows us to ensure a high level of teaching quality across our cohort.

3. PHE empowers teenagers to make healthy decisions. In the classroom, PHE high school students reflect on and contextualize influences that shape their health-related attitudes and actions; articulate their values and goals; learn basic, accurate health information; practice making and communicating healthy decisions through interactive role-plays; discuss barriers to healthy behaviors and strategies to overcome them; and identify and learn how to use the health resources in their communities.

4. PHE fosters a commitment to public service in college students, many of whom go on to become leaders dedicated to addressing the needs of low-income, urban communities.

How will your idea/project help make LA the best place to LIVE today? In 2050?

PHE LA was founded to address a growing crisis: our teens are navigating difficult decisions and exhibiting risky behaviors on a daily basis, many of which threaten their bodies, well-being, and futures. According to data from the 2013 CDC Youth Risk Behavior Survey:

• 19% of LA teenagers are currently sexually active, and 37% of these teens did not use a condom the last time they had sex

• 28% of LA teenagers currently drink alcohol

• 13% of LA teenagers have seriously considered attempting suicide

These issues directly impact high school students' progress to graduation. 30% of young women who drop out of school cite pregnancy or parenthood as a key reason. Heavy alcohol use by age 16 is also strongly associated with high school dropout, particularly for young men. Finally, untreated mental illnesses affect teens’ ability to stay and excel in school. Studies of the associations between psychiatric disorders and high school dropout found a positive correlation between all disorders investigated and high school dropouts. A recent study of LAUSD middle and high school students

found 40% of adolescents within the district display symptoms of trauma at a level requiring mental health services.

In recent years, public schools’ increased focus on academic testing, budget cuts and staffing shortages have exacerbated this crisis by eliminating health courses, leaving teens unprepared to protect themselves against these serious health risks.

Peer Health Exchange directly addresses this crisis by using relatable and knowledgeable college students to give teens medically accurate, critical facts about their mental, physical and sexual health. Moreover, our volunteers engage teens in real-life role play scenarios and equip them with the skills to make decisions, communicate those choices and access health resources with confidence.

Investing in teen health today can impact the overall health of LA County by 2050 by directly decreasing teen pregnancy, STI rates, substance abuse rates, and rates of untreated mental illness, while indirectly increasing high school graduation rates. PHE teens can pass their health knowledge on to their families and friends, today and in the future. And by engaging LA college students in some of the most high-need and underserved schools and communities, we encourage volunteerism and civic participation for years to come. Many PHE teens also report they are inspired by PHE volunteers to engage in community service themselves.

Whom will your project benefit?

During the 2011-2012 program year, 92% of the PHE Los Angeles high school students qualified as low-income and received free or reduced lunch and 90% were Latino or Black.

Through our program, PHE high school students will gain:

1. The knowledge and skills they need to make healthy decisions. Teenagers who make healthy decisions now and in the future will be more likely to stay and excel in school, join and remain part of the workforce, improving opportunities for a future life of quality.

2. The knowledge and tools to access the health resources in their communities. In the Accessing Resources workshops, students identify valid services available from home, school, and in the community, learn how to locate these services, and prepare to access resources and services that are customized to their needs.

3. Role Models. Over the course of thirteen workshops, undergraduate volunteers act as slightly older peers who can respectfully address students’ questions and concerns in a language and context that is relevant to their everyday lives while modeling healthy behavior and the successful transition from high school to college.

We have 250 LA volunteers, 68 from CSUN, 90 from Occidental and 90 from USC.

They will gain:

1. Health knowledge and skills. Several studies demonstrate that peer health educators benefit from their training and teaching roles, particularly by gaining increased knowledge about the health topics they teach. In addition to increased knowledge, several studies show that peer health educators demonstrate an increased ability to communicate with friends, partners, and parents, and make positive changes in their own health behavior, attitudes and goal-setting. This growth in skills and knowledge enables PHE college students to make healthy decisions that will help them complete college, find and retain jobs, and become healthy, happy, and productive adults capable of having healthy families.

2. Public speaking, teaching, and leadership skills. In PHE training sessions, PHE Health Educators learn how to manage a classroom of high school students and communicate effectively with them, learning skills that are useful in the job market. PHE student leaders also learn to manage a group of their peers.

3. A commitment to public service. Many PHE volunteers are inspired by their experience and go on to become teachers, doctors, public interest lawyers, and policymakers, who will continue to serve their communities throughout their lives.

Please identify any partners or collaborators who will work with you on this project.

All of the following partnerships are confirmed for the 2014-15 school year:

University of Southern CA

Cal State Northridge

Occidental College

LA Alliance College-Ready Schools

Partnerships to Uplift Communities (PUC) Schools

Green Dot Schools

New Village Girls Academy

Environmental Charter HS

We have worked with each of the above partners in past years, with great success.

On the college side, each campus has demonstrated a commitment to serving our communities and a student culture invested in volunteerism. Occidental students are especially committed to social justice, as per the mission of their school. CSUN students are especially relatable to our teens, as most come from the communities we serve in the San Fernando Valley (some are even alumni of our high school partners). USC students live in South LA, one of the communities with the greatest need for our program.

We must meet a recruitment goal of 150% more applications than we have space for in our cohort to maintain a high degree of volunteer selectivity. College volunteers must also commit to attending weekly trainings led by our staff, and must teach at least 7 times each by the end of the academic year.

On the high school side, each of these schools and networks has demonstrated the willingness to provide time and space for our program during the school day, supported by host teachers who are invested in the program's success. PUC Schools and LA Alliance Schools, for the first time, are now sharing the costs of our program.

Our program must have a 40-60 minute time slot during the school day, be able to reach the entire 9th grade in the school, and have a committed and supportive host teacher in the classroom at all times in order to achieve success.

How will your project impact the LA2050 LIVE metrics?

Healthcare access

Rates of mental illnesses

Prevalence of adverse childhood experience (Dream Metric)

Percentage of LA communities that are resilient (Dream Metric)

Percentage of residents receiving coordinated healthcare services (Dream Metric)

Please elaborate on how your project will impact the above metrics.

We directly provide instruction on where and how teens can access healthcare resources in their communities, and on understanding the signs of mental illness, addressing the stigma against naming mental illness, and understanding the seriousness of mental health and the impact it can have on a young person, a family and a community. We expect to see more teens accessing mental health services thanks to our program.

Our skills-based instruction also builds the confidence and strengthens the agency of young people, factors directly connected to increasing their resilience. As young people become more resilient, so do LA's communities, now and in the future.

We also have a secondary impact on teens' progress to high school graduation, and on college students' level of civic engagement in low-income communities throughout LA County.

Please explain how you will evaluate your project.

1. Pre- and Post-Test (High School Students): A survey administered to PHE high school students before and after the program to assess their knowledge of the health topics we address. In 2012-13, PHE Los Angeles students made statistically significant increases in their health knowledge, with a 19 percentage point growth from Pre-Test to Post-Test.

2. Program Evaluation (High School Students and Partners): A questionnaire completed by PHE high school students, teachers, and principals. In 2012-2013, 92% of PHE Los Angeles high school students said they will use something they learned from PHE workshops to make a healthy decision in the future, and 71% said they had already used something they learned to make a healthy decision. Moreover, 97% of partner high school principals would recommend PHE to other schools.

3. Program Evaluation (Volunteers): A questionnaire completed by PHE college student volunteers to assess whether their experience in the program has affected their future plans. In 2012-2013, 90% of Los Angeles volunteers reported that their experience with PHE influenced their career plans and 85% of volunteers reported that they were likely to seek opportunities related to PHE’s mission after college. Specifically, 66% of our volunteers are considering a teaching career thanks to their experience with PHE.

We have also recently invested in a national evaluation of our impact regarding teen behavior change, with an external evaluation firm leading a control group-based analysis over two years at our Chicago and New York City sites. We are proud to be a learning organization, and will incorporate changes to our curriculum and program structure implied by our evaluation results to achieve the deepest impact possible on the teens we serve.

What two lessons have informed your solution or project?

1. We have seen great results from our Cal State Northridge volunteers in terms of "relatability," given the shared demographics in terms of socioeconomic status and race of a majority of our CSUN students to the teens we serve. In volunteer surveys this past year, 85% of CSUN volunteers reported a strong sense of community with their PHE workshop cohort, in contrast to 53% at Occidental and 42% at USC. Out of all 25 PHE colleges across the country, CSUN volunteers reported the strongest “sense of community” with both their campus chapter and their city chapter of PHE, a significant achievement considering CSUN is one of our newest college partners. Given these results, we are seeking to strengthen and expand our work with Cal State volunteers.

2. We did not have an Executive Director or more than 1-2 LA Board members for the entirety of our 3rd year of LA operations (FY12). With an LA Executive Director now moving into her third year and an LA Board of 6 (soon to be 7) in place, we can see the path to local financial sustainability, and are focusing our Executive Director and national external affairs staff in service of achieving this goal. We have also committed to recruiting 1-2 National Board members based in LA in the coming year.

Explain how implementing your project within the next twelve months is an achievable goal.

We have refined our core program model over the past decade nationwide and over the past five years in Los Angeles. We are confident that we can reach at least 2,200 teens in LA County in the 2014-15 school year with a volunteer corps of 250 college students, and have a proven track record of achieving impact through this model.

Please list at least two major barriers/challenges you anticipate. What is your strategy for ensuring a successful implementation?

1. Need for increased visibility in the LA community to build our network of support

We are launching a new communications plan, in conjunction with our national office, and are poised to hire a National Communications Director for the first time in PHE history. As we plan to celebrate our 10th anniversary nationally and our 5th anniversary in LA, we are poised to increase our visibility through new media strategies such as online videos, Giving Tuesday, and a series of celebratory events in LA and beyond. We will also send a quarterly newsletter to our LA donors to stay in close touch with our new and expanding network of supporters in between in-person touchpoints.

2. Need for strengthened volunteer training as we roll out a brand new curriculum

We have key supports in place as we launch our new skills-based curriculum, including an LA Program Director and Program Manager entering their second year, and funding for our national program team members to travel to LA quarterly to provide technical assistance. We have also revised our volunteer training model, including our annual health educator retreat, to focus less on content memorization and more on advanced teaching and facilitation skills, with the goal of a more interactive and engaging curriculum and PHE experience in mind for our teens.