1. What Protects Teenagers from Engaging in Early Unprotected Sex, Violence, Drug and Alcohol Use and Suicide? Resiliency Research Report conducted by Hope Enterprises/RFSO in collaboration with the CHANGE project funded by USAID

2. PROMOTING POSITIVE AND HEALTHY BEHAVIOUR To see all children as “at promise” rather than “at risk” is a fundamental shift that means teaching rather than fixing,pointing to health rather than dysfunction.”

3. STOP TO START STOP using drugs! STOP drinking! STOP having sex! STOP being violent! STOP feeling depressed! START DOING WHAT ?? The resilient adolescent is one who prays well, works well, plays well and expects well.

4. RESILIENCY Resilience, youth development, building social capital,developmental assets all represent the same positive approach. All variations on the developmental theme of meeting adolescents’ need for love and belonging,respect, identity, power, and meaning.

5. RESILIENCY RESEARCH Growing body of research that provides evidence of both external and internal factors that protect adolescents from engaging in health risk behaviour the precise nature of the network of relationships between risk and resilience are topics of ongoing investigation.

6. RESEARCH QUESTION The provision of environmental supports and opportunities, defined as external assets: caring relationships, high expectations and opportunities for meaningful participation will engage the adolescent’s innate resilience and promote positive outcomes in many aspects of behaviour.

7. Youth Development Conceptual Model

8. Troubles Healthy child Healthy adolescent Healthy adult RESILIENCIES CHILD Pathology CHALLENGE MODEL Challenges Rebounds Succumbs Damages

9. SURVEY DESIGN and ADMINISTRATION Instrument adapted from the CHKS, West Ed Corporation,California. Identified 13 external and 6 internal assets measured using 61 questions. Enumeration districts were randomly selected and all households within each cluster visited-1004 adolescents between 12-16 were interviewed.

10. GENDER DISTRIBUTION

11. AGE DISTRIBUTION

12. BACKGROUND DATA 52% Male 48% Female 12-16 yr olds(Sample skewed to younger age) 97% currently in school 78% living with one or both parents 5 out of 10 attending church 53% with piped water in house, 58% pit latrine 97% radio, 90% T.V, 50% phone

13. EXTERNAL ASSETS External assets measured in school, home, community and peer environments. CARING RELATIONSHIPS: supportive connections to others in the adolescents life who model and support healthy development and well-being. HIGH EXPECTATIONS: consistent communication of direct and indirect messages that the adolescent can and will succeed.

14. HIGH EXPECTATIONS Outside my home and school, in the community there is an adult…. –who expects me to follow the rules. –who always wants me to do my best. –who believes that I will be a success.

15. EXTERNAL ASSETS, CONT’D MEANINGFUL PARTICIPATION : The involvement of adolescents in relevant, engaging and interesting activities, which provide opportunities for responsibility and contribution. This fulfils the fundamental need for persons to have some amount of control and ownership over their lives.

16. CARING RELATIONSHIPS Eg In my home there is a parent…….. –who is interested in my school work. –who pays attention to me. –who talks to me about my problems. –who listens to me when I have something to say. –who I trust. –who helps me when I’m having a hard time. –who notices when I’m not there.

17. MEANINGFUL PARTICIPATION I do interesting activities at school. I help make decisions with my family. I do helpful things at school. I am involved in organised activities to help others. I am part of a club, sports team, church group, etc.

19. INTERNAL ASSETS Cooperation and Communication: –Having flexibility in relationships, the ability to work effectively with others, to effectively exchange information and ideas and to express feelings and needs to others. Self Efficacy: –The belief in one’s own competence and feeling one has the power to make a difference. Related to task mastery, the sense of doing something well, having the ability to act and exert ones will.

20. INTERNAL ASSETS cont’d Empathy: –The understanding and caring about another’s experiences and feelings, is considered essential to healthy development and the root of morality and mutual respect. Problem Solving: –Includes the ability to plan, to be resourceful, to think critically, reflectively and creatively examine multiple perspectives before making a decision or taking action. Self Awareness: –Knowing and understanding ones self. Goals and Aspirations: –Using one’s dreams,visions and plans to focus the future, to have high expectations and hope for one’s self.

21. RISK BEHAVIOURS The prevalence of the following risk behaviours were measured: –Early, unprotected sex –Cigarette, marijuana and alcohol use –Violent and suicidal behaviour

22. SEXUAL BEHAVIOURS 44% of boys and 16% of girls age 12-16 reported having had sexual intercourse –15% reported having sex before age 10 –Three sexual partners on average –9% of girls had been pregnant –57% reported condom use, <5% used another method

23. DRUG AND ALCOHOL USE 6% reported having ever smoked ganja- 3% among 12 yr olds, 13% among 16 yr olds, M>F –2% reported binge drinking(5 or more drinks at any one time). –One in 12 smoked cigarette at least three times in the past one month.

24. VIOLENT BEHAVIOUR One in 5 adolescents (20%) carried at least one weapon –4% carried a gun, 16% carried a knife, 8% some other. –M>F likely to carry weapon (28%vs11%) 29% had been involved in a fight involving a weapon. –Recent smokers of ganja were significantly more likely to engage in violent behaviour.

25. DEPRESSIVE/SUICIDAL BEHAVIOUR 10% of adolescents felt so sad that their life was not worth living often or always –1.7% almost always thought about hurting or killing someone. –14.5% thought about committing suicide in the past 12 months. –8% had actually attempted suicide.

26. RELATIONSHIP BETWEEN RISK AND RESILIENCE The following charts show the relationship between assets and early sexual activity, condom use, violence, drug and alcohol use and suicide

27. Adolescents with opportunities for meaningful participation with parents in the home and in the community were significantly less likely to engage in sexual initiation.

28. Chart 2 Sexual Risk Behavior: Ever Had Sex By Home Environment (Parent)

29. Chart 3 Sexual Risk Behaviour: Ever Had Sex (School)

30. Chart 3 Sexual Risk Behaviour: Ever Had Sex (Community)

31. Total External assets did not show any significant relationship to condom use at last intercourse. High expectations among peers was however found to be a significant factor in terms of increasing condom use at last intercourse.

32. Chart 6 Sexual Risk Behaviour: Did Not Use Condom at Last Intercourse

33. Adolescents with high expectations and opportunities for meaningful participation in the community environment were less likely to have engaged in marijuana use.

34. All three factors: high caring relationships, high expectations and opportunities for meaningful participation were significantly related to lower cigarette use.

35. Those adolescents with high levels of external assets were found to be significantly less likely to carry a weapon. Adolescents with high expectations in the home and opportunities for meaningful participation at school and in the community were significantly less likely to have engaged in a physical fight.

36. Chart 17 Violent Behavior: Have Carried a Weapon by Home Environment (Parent)

37. Chart 18 Violent Behavior: Ever Carried a Weapon

38. Adolescents who enjoyed high expectations in the home and among peers, caring relationships at school and opportunities for meaningful participation in the community were significantly less likely to have thoughts of killing themselves (suicidal ideation).

39. CONCLUSION The Jamaica research data clearly shows an overall protective effect of caring relationships, high expectations and opportunities for meaningful participation at home, school or in the community on engaging in high risk behaviour. Both risk behaviour and their protective factors are interrelated and mutually reinforcing.

40. YOUTH DEVELOPMENT “When we speak of youth development we must be able to articulate not just what we are trying to prevent but what we are trying to promote. Being problem free is not the same as being fully prepared!”

41. NEXT STEPS To apply resiliency approach to USAID Reproductive Health Objectives, select domains that protect against early sex and unprotected sex and build into intervention programming.

42. Planned Activities Adolescent parenting program – 10 to 15 rovers. Meaningful participation (peer-to-peer mentoring). Collaboration with adolescent clinic. ? Funding for integration/evaluation. ? To scale. ? Develop appropriate indicators of protection.