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Center for Adolescent Health

Center Projects

Teen Pregnancy Prevention Initiative (TPPI) Evaluation

The Center is working with the Baltimore City Health Department to evaluate the City’s TeenPregnancy Prevention Initiative (TPPI).TPPI is a component of the B’More for Healthy Babiesand works to reduce teen births by improving young people’s access to age-appropriate and evidence-based health education, medically appropriate clinical services, and opportunities to engage their communities and grow as civic leaders.TPPI activities include the Know What You Want campaign, the Youth Advisory Council (YAC), and a multi-agency effort to increase access to Long Acting Reversible Contraceptives (LARCs).The Center has long served as a member of the TPPI coalition and is now evaluating TPPI’s activities as well as the coalition functioning.

Center Researchers:
Beth Marshall: bmarsha2@jhu.edu
Terri Powell: terri.powell@jhu.edu

UChoose Teen Pregnancy Prevention Program

Baltimore City’s UChoose Coalition, led by the Baltimore City Health Department (BCHD), intends to decrease the overall teen birth rate of 43.3 per 1,000 teen girls by 30 percent by the end of the five-year project through reductions in disparities among African American and Hispanic teens, and to ensure sustainable delivery of evidence-based teen pregnancy prevention (TPP) programs in Baltimore City. Through this project, BCHD in partnership with the Baltimore City Schools and a network of seven Title X clinics, plans to reach 15,890 adolescents aged 12-19 each year with evidence-based TPP programs implemented in middle schools, high schools, and Title X clinics in Baltimore City. UChoose will implement It’s Your Game in middle schools, Be Proud! Be Responsible! in high schools and Seventeen Days in the clinics. The Center is conducting the implementation evaluation of all project activities.

Center Researchers:
Beth Marshall: bmarsha2@jhu.edu
Terri Powell: terri.powell@jhu.edu
Kristin Mmari: kmmari1@jhu.edu

Integrating Age Appropriate Reproductive Health into Schools

Through school-based trials and a citywide monitoring system, The Center’s Core research project will:

The research project will aim to examine both the impact of age appropriate sexual health education on health risk behaviors as well as school attendance and academic performance among adolescents. Additionally, we will be examining the school and community level factors on fidelity. The study information will be used to improve efforts to increase positive adolescent health, health behaviors and well-being.

Center Researchers:
Beth Marshall: bmarsha2@jhu.edu
Terri Powell: terri.powell@jhu.edu
Phil Leaf: pleaf@jhu.edu

Rales Center for the Integration of Health and Education

The Ruth and Norman Rales Center for the Integration of Health and Education is redesigning school-based health programs to improve the health and thus the academic achievements and lifelong prospects for youth from low-income communities.The first fully integrated school-based health model in the United States, called “READY” (Rales Educational and Health Advancement of Youth) breaks down historical silos between educational and health-related activities. Weaving comprehensive health services and wellness programming into the school environment helps children thrive and achieve academic success.

READY offers a fundamentally new way of viewing primary care, wherein health (including mental health and oral health) services, wellness programming and prevention, and health education are delivered in the school setting, in partnership with teachers, administrators and parents. More information is available at The Rales Center website.

Center Researchers:
Beth Marshall: bmarsha2@jhu.edu

Children of Incarcerated Parents

This is an exploratory study that will guide future research efforts as well as the development of public policies and practices concerning children with or who have had an incarcerated parent.  The research questions center around the challenges families and children face when a parent is incarcerated, the responses of public systems, and how young people with an incarcerated parent can be more fully supported.  The first objective of the proposed project is to conduct a qualitative inquiry into ecosystems of children of incarcerated parents.  The ecosystems to be explored include parents, secondary caregivers, peers and other informal supports, judges, parents’ parole/probation officers, police officers, case managers, and other formal supports.  

Center Researchers:
Phil Leaf: pleaf@jhu.edu

Faith Leaders Involved in Prevention (FLIP)

The goal of the FLIP Project is to identity the health-related assets available in local congregations. Faith leaders in Baltimore, Maryland are invited to complete a congregational health survey that asks about their congregation, important health issues to their congregants and communities, as well as the resources they offer to meet these needs. Participant response will be used to help develop synergistic approaches to health promotion and prevention among youth and adults. Research finding will aid in the tailoring of health-related programs and sharing of resources across congregations.

Center Researchers:
Terri Powell: terri.powell@jhu.edu
Courtney Turner: cturne35@jhmi.edu

Strategic Plan to Reduce Teen Births in Baltimore City: Five Years Later

The Center for Adolescent Health is partnering with Healthy Teen Network and the Baltimore City Health Department to develop a new Strategic Plan to Reduce Teen Births in Baltimore City.  With partners, the Center is retrospectively examining data that documents the local efforts over the past five years to support the three recommendations outlined in the original report including:  Increased collaboration to provide evidence-based sexuality education and confidential contraceptive services; Increase youth outreach and connection, especially among certain high risk sub- populations of Baltimore youth; and the creation of a city-wide coalition to manage this comprehensive plan, collect data, and advocate at the City and State levels.  In addition to examining retrospective data, new quantitative and qualitative data collection will replicate the original data collection to both lay a foundation for the next five years of planning and allow for comparisons of context between the current landscape of programming and youth concerns and those from five years ago.

Center Researchers:
Beth Marshall: bmarsha2@jhu.edu
Terri Powell: terri.powell@jhu.edu

theConnect/Baltimore City Opportunity Youth Collaborative

The Center for Adolescent Health is serving as part of Baltimore City’s Backbone for theCONNECT/ Baltimore City Opportunity Youth Collaborative.  The mission of theCONNECT is to create integrated, sustainable pathways for youth ages 16-25 leading to post-secondary education, employment, and entrepreneurship opportunities with family sustaining-wages. The vision of this initiative is for all youth who are disconnected from school or employment to have access to the resources and supports needed to maximize their potential and be provided opportunities for sustainable employment. TheCONNECT is a broad-based, collective impact collaborative including youth and key leaders from the government, education, business, community, and not-for-profit sectors. Through the development of an integrated network of stakeholders, linked through site-based Pathway and System Navigators, and supported through technological innovations, the network will bridge the silos and mend the gaps in services and supports for these youth. One project under discussion with the Governor’s Office of Children is the placement of GED and workforce training programs in existing Early Childhood Centers and linking with non-site based early childcare initiatives. 

Center Researchers:
Philip Leaf:  pleaf@jhu.edu

East Baltimore Trauma Response

Following the city’s uprising, Johns Hopkins President Ronald Daniels has asked Dr. Leaf to create the East Baltimore Community Trauma Response Program.  The goal of the East Baltimore Trauma Response is to improve the health and well-being of the local East Baltimore community especially youth by systematically addressing the traumas experienced. In partnership with local residents, community leaders, clergy, educators, and health and human service professionals, we will work towards this goal by promoting safer communities, breaking the cycle of violence, identifying and helping those that have pathological stress responses, fostering resilience, and building a trauma-informed culture for those who provide services to affected individuals so that our community and city can begin the process of healing.

  1. To achieve this goals, we are in the process of creating a Trauma Response Team that will support the following activities: Training first responders (health professionals, police, and community) for incidents of violence involving children, youth, and families
  2. Developing trauma-informed community responses for mental health first aid, community supports, and clinical outreach
  3. Expanding trauma-informed clinical services and procedures at the Johns Hopkins Hospital Emergency Department, Trauma Surgery, and Psychiatry.
  4. Creating more trauma-informed institutions, including training of human resources personnel, supervisory staff, and others working with Baltimore’s children, youth, families, and those working with Baltimore’s children, youth, and families.

Center Researchers:
Philip Leaf:  pleaf@jhu.edu
Terri Powell: terri.powell@jhu.edu

Health And Well-being Of Baltimore’s Youth

The Baltimore City Health Department and a coalition of City and State agencies, youth-led networks, academic institutions, and community members are collaborating together to develop and evaluate the implementation and outcomes of Baltimore City’s Youth Health and Wellness (YHW) strategy, www.baltimoreyouthhealthandwellness.com . This is a five-year plan with the goal of ensuring that all young people in Baltimore ages 6-19 have equal opportunities to connect with the people and services they need to be healthy and successful. The Initiative has three different but related foci: Healthy Minds, Healthy Bodies and Healthy Connections, all important to health and each one affecting the other. Center researchers are in the process of developing a number of reports concerning trends in health and wellbeing, geographic and other variations in Baltimore, and the outcomes or lack of outcomes from current and future initiatives.

Center Researchers:
Philip Leaf: pleaf@jhu.edu
Beth Marshall: bmarsha2@jhu.edu
Terri Powell:  terri.powell@jhu.edu
Carlos Castillo-Salgado: ccastil3@jhu.edu

Maryland State Department Of Education (MSDE) Multi-Tiered System Of Services (MTSS)

The goals of the Multi-Tiered System of Services (MTSS) in Maryland are to sustain current successes of supporting the installation of universal schoolwide behavior intervention systems, align Maryland State Department of Education (MSDE) departmental intitiatives and programs, and accelerate the expansion of supports to tier II and tier II resources to support students and families in Maryland schools through preventative and proactive disciplinary practices.  This initiative builds on more than 15 years of work by Dr. Leaf and others in Maryland, including the training of approximately 80% of all public schools in Maryland on Positive Behavioral Interventions and Supports (PBIS).  The evolution to the MTSS is in recognition of the significant role that additional efforts need to be targeted at the health, mental health, substance use, and trauma-related challenges facing Maryland’s students, teachers, school staff, and communities. Philip Leaf participates in the MTSS Executive Committee that includes the Assistant Superintendents for four MSDE divisions along with partners from other academic institutions and helath care providers.  The Initiaive builds upon the Mangement Team consisting of MSDE, Johns Hopkins, Sheppard Pratt, and University of Maryland personnel, a Leadership Team consisting of representatives from all of Maryland’s Local School Systems, and a statewide system of coaching and regional training collaboratives.  The collaboration has fostered a number of federally funded research projects.  After the MTSS is approved by the State School Board, the Center will be collaborate on research identifying health related school/student needs and outcomes accruing from different intervention strategies.

Center Researchers:
Philip Leaf: pleaf@jhu.edu

Maryland Early Childhood Initiative

In response to a 2010 investment in the scale up of evidence-based early childhood home visiting (HV), Maryland focuses expansion on at-risk communities determined where current services fall short of projected need.  Johns Hopkins researchers lead Maryland's evaluation of these efforts to build infrastructure.  Evaluation is grounded in implementation science and the Theory of Planned Behavior as applied both to HV recipients as well as staff, including both home visitors and their supervisors.  Evaluation methods include:  a) an analytic study of multi-level drivers of family recruitment, HV coordination with health services, and visitor communication style; and b) randomized trial of the impact of MD's workforce development strategy -- a Communications Certificate Course targeted to home visitors and supervisors and based on the stages of change model and reflective practice. 

Center Researchers:
Philip Leaf: pleaf@jhu.edu

Summer Youth Leadership Institute

The Summer Youth Leadership Institute focuses on youth voice and authentic communication between youth and caring adults within a Restorative Practices framework, in order to spur positive, lasting change in an atmosphere that is purposefully designed to create equity, a mutual dedication and understanding of collective responsibility to actively protect and promote school pride and ownership. Each School-based Summer Institute member will serve as an ambassador of a healthy school climate and will directly address climate issues using skills that promote team work, organization, strong verbal and written communication, and innovative presentation skills. The 5-week Summer Youth Leadership Institute is designed to support City Schools in its examination of the social issues students confront in Baltimore City and explore how students creatively respond through organizing, political education, and identity development when part of a support system that values positive youth participation. 

Center Researchers:
Katrina Brooks: kbrook23@jhu.edu