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Center for Adolescent Health

Center for Adolescent Health Blog

Wide Angle Youth Media offers media production training for Baltimore youth. Wide Angle students (over 4,000!) have made 200 films about their neighborhoods and experiences. 

Violence in Baltimore: A Community in Chaos from Wide Angle Youth Media on Vimeo.


CAH's director, Dr. Philip Leaf, was featured in Violence in Baltimore: A Community in Chaos, which was made by Wide Angle's Spring 2017 Mentoring Video Project students. 


Making Connections Matter from Wide Angle Productions on Vimeo.


Wide Angle Youth Media produced this film for the Bloomberg American Health Initiative's Making Connections Matter Conference. Some of the young people featured are members of the Youth Leadership and Advocacy Network. 

Rashad Staton is youth engagement specialist for Baltimore City Public Schools, co-chair of YLAN, and a valued partner of the Center for Adolescent Health.Rashad Staton is the youth engagement specialist for Baltimore City Public Schools, co-chair of YLAN, and a valued partner of the Center for Adolescent Health.

Rashad Staton heard about the U.S. Congressional Page Program on the morning announcements at Paul Laurence Dunbar High School in Baltimore City.

“I ran down to the guidance counselor's office and I applied. I received a nomination to be one of the U.S. Congressional pages for the U.S. House of Representatives to represent the state of Maryland. That was at [age] 16 and it changed my life. I no longer wanted to be an athlete,” he explained.

The page program exposes young people to the legislative process as they serve as messengers and prepare the congressional chambers for session.

The summer Rashad spent working on Capitol Hill in Washington, D.C. exposed him to new opportunities and experiences. “I knew that politics and advocacy work could change the trajectory of my life, my community, and my family,” Staton said. “I went from dribbling a basketball to using my brain and analytical skills to change my space and my environment,” he added.  

Staton’s experience as a page introduced him to the impact one can make as a public servant. He decided to major in political science and attended Morgan State University--a stepping stone to his dreams. While in college, Staton held executive positions in the Student Government Association and National Pan-Hellenic Council. Leading large student groups gave him practical experience in community organizing while learning political theory in class.

Staton also served as vice chair for the Baltimore City Youth Commission, which at the time was a mix of young people ages 13-24 representing city council districts. “We had to be very keen and receptive to perspectives on our own team,” he said, “I had to still be able to understand the needs and the wants of a middle schooler.”

Staton said one highlight of his time as a commissioner was when he led and organized family dinners with resource fairs for residents of Perkins Homes, an East Baltimore public housing community, called BeMore Dinners, with the support of his friends and fellow commissioners.

Staton began collaborating with the Center for Adolescent Health as a youth commissioner. The Youth Commission partners with CAH’s Youth Leadership and Advocacy Network (YLAN) to connect youth leaders across the city and ensure youth are represented in policy decisions that directly impact their well-being and healthy transition to adulthood.

“It allows young people to learn early to not fall victim to working in silos, but to work collaboratively. It's a shared space of young people learning what other young people are doing,” Staton said.

Programs and initiatives created with youth are more effective than ones simply made for youth.

He’s continued to chair YLAN along with Katrina Brooks, CAH’s community relations director. “Rashad is remarkable. His personality and his work ethic helps people be comfortable around him,” Brooks said.

Staton formerly worked as a program assistant for Family League of Baltimore and recently started a new job--youth engagement specialist for Baltimore City Public Schools. In this position, his work focuses on promoting the district’s Blueprint Initiative, which is centered on literacy, student wholeness, and leadership.

He works on multiple projects at the City Schools Family and Community Engagement Office and plans programming focused on empowering youth to raise their voice and make positive change. In February, Staton coordinated a youth information session on the school budgeting process with small group activities and discussions. “I wake up every day trying to figure out how to engage and promote youth voice and I love it,” he said.

Staton’s dedication impresses Brooks, “He’s such a great role model for young people. It’s so good to work with someone who really means what they say.”

Respecting the Circle of Life youth Respecting the Circle of Life combines basketball with lessons about healthy communication, anatomy, and STI prevention. 

Baltimore City Schools teachers at a U Choose Teen Pregnancy Prevention training

Baltimore City Schools educators at an U Choose Teen Pregnancy Prevention curriculum training. 

Over the summer, Baltimore City Health Department (BCHD) officials expected their year three grant award letter for U Choose from the Department of Health and Human Services’ Office of Adolescent Health (OAH). This grant funds the City’s teen pregnancy prevention program. But this year, the award letter contained a surprise: the letter noted that the project period would end in June 2018, two years early.

Baltimore was one of over 80 projects awarded funding through OAH’s Teen Pregnancy Prevention Program in 2015. The grant funded the health department and its U Choose Coalition partners to implement evidence-based teen pregnancy prevention (TPP) interventions in Baltimore City middle schools, high schools, and Title X clinics.

The Johns Hopkins Center for Adolescent Health has been a member of the U Choose Coalition since its inception. CAH acts as the evaluation lead and serves as a member of the core implementation team of the citywide TPP program.

“This is something that our Center has wanted for a very long time--to have systemic sexual health education in the city school system,” said Beth Marshall, CAH’s associate director.

In 2015, Baltimore’s teen birth rate was 36.2 per 1000 women, which represents a 44 percent decrease since 2009. However, this rate is double the state average, according to the Maryland Vital Statistics Annual Report. Teen pregnancy has negative social and economic consequences for teen parents and their children. Teen parents have lower levels of educational attainment compared to young adults who do not have children. The CDC reports that children of adolescent mothers are more likely to dropout of high school, experience more health problems, and become a teen parent themselves.

This is why evidence-based teen pregnancy prevention programs (TPP) are important. Evidence-based TPP programs help prevent teen pregnancy as well as reduce sexually transmitted infections (STIs) and sexual risk behaviors.

Locally, BCHD and its partners are working hard to make sure adolescents continue to receive this programming after the grant’s end. “We have been focused on sustainability in terms of the way we've implemented this program from day one,” Marshall said. To further sustainability, the group chose to train City Schools staff, typically health and physical education teachers, to deliver the school programming instead of contracting health educators through outside agencies.

We wanted to build the infrastructure within City Schools so that they can continue to offer systemic comprehensive sexual health education,” Marshall said. The training has shifted from two days to one day to make it easier for the teachers implementing the TPP programming.

“Having City Schools as a partner helps with sustainability,” said Meghan, CAH’s senior research program coordinator. “We’re training as many people as we can,” she added.

The coalition selected three different TPP programs to implement: It’s Your Game in middle schools, Making Proud Choices in high schools, and Seventeen Days in clinics. The evidence-based programs used in the schools meet the state health education standards for human sexuality and have shown to have positive results. The grant covered the curriculum purchasing costs and training costs.

CAH staff conduct observations in all of the program settings; monitor the young people who participate in the programs; and evaluate and help organize the teacher trainings. The project is required by OAH to reach 10,000 young people and annually report that data online.

Teachers complete logs to note how their lessons went, and the comments are particularly positive. One educator said, “The students seemed engaged and participated in the activities throughout the class. The students understood the lesson and were receptive to the information.” Another teacher mentioned that students “have a million questions.”

As teachers and clinic staff implement the interventions, CAH staff sit in and observe to make sure everything is going smoothly. “We're there to ensure that they get the support they need to be able to offer the curriculum with fidelity,” Marshall said.

The observations put the complex project into perspective. While some people may think young people are not mature enough for the material, Marshall said she sees students having thoughtful discussions about sexual activity and risk.

BCHD and its U Choose Coalition partners are working together to ensure the TPP program continues by identifying its critical components and looking for additional funding sources.

“We as a Center desperately want for all our young people to have access to this information so whatever we can do to further this and ensure that this grant proceeds in a way that has the best chance of success--success being that when these funds are gone this still happens,” Marshall said.

The grant’s early end came as a shock to recipients nationwide. Our Johns Hopkins School of Public Health colleagues at the Center for American Indian Health  were also recipients of TPP funding from OAH. I spoke with Dr. Lauren Tingey about their TPP program designed for native youth, Respecting the Circle of Life. Read more here:

By: Lauren Burns

teachers at the fall LST training

LifeSkills Training is a substance abuse prevention program proven effective by over 30 research studies. The curriculum was created by Dr. Gilbert Botvin, a health behavior and prevention expert. Teachers follow the LST curriculum to provide teens the skills and knowledge needed on to handle changing situations.

The Johns Hopkins Center for Adolescent Health (CAH) is taking big strides to build on the efforts of the already effective LifeSkills Training program by expanding the middle school curriculum to include new modules on sexual risk reduction. The Center began implementing LST and the new modules (LST+) at six Baltimore City public schools in 2014.

“We thought a good way to reach an awful lot of young people in the city would be to work in Baltimore City Schools. One way you can do that is by finding or creating evidence-based programs that fit within a normal school day, while meeting the state and city standards for health education,” said Meghan, the Center for Adolescent Health’s senior research program coordinator.

CAH was awarded funding from the Centers for Disease Control and Prevention for 2014-2019 to implement LST as its core research project. This project was designed to build on City Schools’ and Behavioral Health Systems Baltimore’s Sixth-Grade Expanded School Behavioral Health Initiative, which targets sixth graders at risk of dropping out. The initiative supports implementation of LST in small groups of sixth graders at 35 Baltimore City schools. However, CAH’s strategy focuses on universal implementation. In the project’s third year, all students in 6th-8th grades at the five schools participate in LST and at 3 of the schools, students participate in additional modules focused on sexual and reproductive health.

The additional modules on sexual and reproductive health students receive in 7th and 8th grade follow the same pedagogy and decision making model that is the core of LST. Meghan said what often happens is that there are several health programs, each on a specific risk behavior like smoking or alcohol misuse, in one school. “So young people may be learning three different ways to say ‘no’ to something rather than learning one technique and framework to apply [in] a lot of different health situations,” she said.

LST and the Center’s new modules (LST+) equip young people with skills on how to handle difficult situations related to drugs, alcohol, smoking, violence, and sexual activity. “The school administration itself decides whether it's going to be taught and how, like during the PE class or some schools do it as a part of their science curriculum,” said Courtney, a research assistant at CAH.

Asari trained new teachers who will implement the modified curriculum earlier in the fall. Asari, now a doctoral student at Johns Hopkins Bloomberg School of Public Health, previously implemented LST in schools and community centers in New York City as a Children’s Aid Society prevention specialist. While working for Children’s Aid Society, Asari attended the LifeSkills Training-of-Trainers workshop through National Health Promotion Associates, a research and development firm founded by Botvin.

As an evidence-based program, LST was meant to be taught exactly how the curriculum was written. When taught with fidelity, it has positive results for young people. “We don't really know what happens if a lot of changes start happening. We don’t know if it would be more effective or if it would actually detrimental to young people so the safest bet is to implement as closely as we can to how it was tested,” Meghan said.

To ensure LST is implemented with fidelity, teachers complete fidelity logs after each lesson to track how much material they covered, changes they made and why. Teachers are also observed at least once by CAH staff.

“As our funding cycle winds down, we'll be thinking more about sustainability and being able to continue with the schools,” Meghan said. By the end of the research project, CAH hopes to provide information about feasibility, implementation quality, and feedback from teachers and administrators to staff at other schools who are considering implementing the program. “Part of the way it's set up right now is to look for just feasibility of implementing LifeSkills at a universal level and feasibility and acceptance of the new modules. So the next steps will be to look more into impact,” she said.