The attached presentation is Jenny Byelick’s UIC School of Public Health Capstone project for her Master of Public Health degree, relating the introductory public health course at Pedro Albizu Campos High School as part of a comprehensive public health curriculum. Public health curricula at the high school level may be a vehicle for addressing health disparities and improving health outcomes among adolescents, particularly in socially marginalized communities. Public health curricula may address health disparities and contribute to the composition of the future health professions workforce; this is especially relevant when high school education programs are linked to career pipelines. This presentation addresses how a school course encompassed aspects of population wellness utilizing social constructionist methods of education. The course was developed adhering to a theoretical framework influenced by principles of positive youth development, critical race theory and school connectedness. This presentation also discusses lessons learned and future directions of the public health curriculum in Humboldt Park. Next steps include improving and evaluating the public health curriculum and career-linked pipeline and connecting this program with other area schools.

1. Career Pipeline-Linked Public Health Curricula in Secondary Education Lessons Learned from the First Year in a Chicago Latino Community Jenny Byelick, MPH Candidate University of Illinois at Chicago School of Public Health April 22, 2011 1

2. Public Health Significance Adolescence = critical time in development to address health- related behaviors Latino youth exhibit elevated rates of: Asthma Lack of adequate sleep Suicide ideation or attempts Sexual behaviors that contribute to unintended pregnancies or sexually transmitted infections (HIV) Higher risk for diabetes 2 Centers for Diseases Control YRBSS (2009);Healthy People 2010 and 2020

3. Future Implications of Adolescent Health Issues Unhealthy youth today chronic conditions Healthy youth learn better! Improved education, improved communities Issues that impact entire community (i.e. violence) Financial burden of chronic diseases due to behaviors started during adolescence Annual adult health-related costs from cigarette smoking - $193 billion 3 U.S. Department of Health and Human Services. Healthy People 2010.

4. Comprehensive Public Health Curricula Public health education in the classroom Enhanced personal and public health literacy Community-based youth activism Connect students to local community health efforts and to college-level public health programs Opportunities for mentorship Exposure to health professions 4 Nutbeam, D. (2006), Freedman, D., Bess, K., Tucker, H., Boyd, D., Tuchman, A., Wallston, and K. (2009)

5. Logic Model – Introduction to Public Health

6. Objectives of Curricula 1. Address adolescent health disparities 2. Promote an understanding of root causes of health disparities among youth and in communities 3. Raise awareness of some solutions at individual, community and policy levels 4. Interest youth in future health careers, enhancing cultural competence 5. Connect students to career-linked pipeline programs 6

7. Classroom Delivery Remember DARE? Evaluations of DARE program ineffective Less overall influence on substance use behaviors when compared to interactive programs Traditional lecture style approach on intrapersonal factors, "Just say no” vs. developing strong drug-specific social skills (interpersonal) 7 Ennet, S.,Tobler,N., Ringwalt, C. & Flewelling, R. (1994)

8. Theoretical Framework Positive Youth Development Social Constructivism/ Youth Organizing Theory School Connectedness Empowerment Education – Paulo Freire Youth as agents of change Opposes a “banking education” Critical race theory – culture as capital 8 Freudenberg, N., Eng, E., Flay, B., Parcel, G., Rogers, T. & Wallerstein, N. (1995), Link, B and Phelen, J. (2007), Yosso, T. (2005), Watts, R. & Flanagan, C. (2007), Oyserman, D., Bybee, D. & Terry, K. (2006)

9. Anticipated Outcomes Involve youth with local health initiatives Enhance personal and public health literacy skills Interest youth in public health careers Create positive possible selves Improve adolescent health outcomes Inspire youth public health leadership Change community norms to support healthy behaviors 9

11. 1 in 4 Puerto Rican children in the community have asthma

12. 14% of residents are afflicted with diabetes (compared to 8% of the total U.S. population with diabetes)10

13. Puerto Rican Cultural Center Founded in 1972 Community building and business development Cultural and arts center Vida/SIDA – HIV Outreach Muevete – Physical fitness Project CURA – Asthma prevention and child care CDC-funded diabetes program – Block by Block Healthy foods cooperative/urban agriculture Award winning alternative charter high school – Dr. Pedro Albizu Campos Alternative High School (PACHS) 11

14. PACHS Public Health Curriculum Introductory public health course Science-based urban agriculture program Opening of the school greenhouse Underage youth drinking campaign Youth engagement with local community health campaigns 12

15. Introduction to Public Health elective Unit 1 – Intro to Community Health and Disease Unit 2 – Health Issues Unit 3 – Personal and Relationship Well-being Unit 4 – Transformation/Social Change *Based on Illinois State Standards in health and physical education 13

16. PACHS Pipelines to Health Careers Funded by Advocate Bethany Community Fund Selected students from the introductory public health course to apply 1.) Academic - develop skills necessary for college/ACT 2.) Community - interactive activities on health disparities and public health interventions within the Humboldt Park community 3.) Health Careers Exploration - summer internships 14

17. 15 Educating their community

18. Opening an urban greenhouse

19. 17

20. Advocating for healthy choices

21. Limitations/Challenges Preparation and staff time Resource availability/funding Fluctuations in the student body and attendance issues Variations in student cognitive abilities Strong student emotional responses 19

22. Semester 1: Student Survey Positive Feedback: Enjoyed class discussions and appreciated a forum for asking questions Felt instructors were supportive, knowledgeable and attentive Indicated the course covered a comprehensive span of relevant health topics Areas for Improvement: Frustrations with course management, behavioral issues More reading and writing activities in class Field trips outside the community 20

23. Course Evaluation Student journals and reflections, in class feedback End of course survey Pre and Post testing Pretest designed for current semester Assess student knowledge across domains (personal health behaviors, disease specific content, environmental influences to health, public health literacy) 21

24. Lessons Learned Engaging students and improving attendance Improved general math and literacy skills Consistency Effectively reaching students Self-reflection on becoming an organic intellectual Relationship building and critical engagement with personal and social issues 22 Tickle, L.( 2001)

25. Future Directions Evaluate and improve introductory public health course Plans to have linked pipeline and curricula across 8 elementary and 4 high schools in the greater Humboldt Park area Plans to have a life skills course incorporated into curricula to enhance prevention 23

26. From the students My father’s 5 brothers and 1 sister all have diabetes. My doctor says my brother and I have a 70% chance of getting diabetes. Since then, we changed our ways of eating and hopefully lowered our chance of getting this illness. Diabetes has a major effect on my community. I feel we need to take action and help prevent future generations from being diagnosed; some ways could be holding community exercise events to keep our children fit, more super markets and less fast food restaurants so we can eat healthy and finally, monthly check ups to make sure we keep our blood sugar levels balanced. 24

27. From the students In my old school, I didn’t care because my teachers didn’t care. They taught and everything, but didn’t seem like they wanted to be there and were just going through the motions. Here, I can tell teachers care about me and it makes me want to do well for myself. 25

28. From the students We learn about how the whole community influences health, not just what you can do to keep healthy. This class is the bomb! I never had a health class that covered so much. 26

29. Selected References Centers for Disease Control and Prevention. (2009) School Connectedness: Strategies for Increasing Protective Factors Among Youth. Atlanta, GA: U.S. Department of Health and Human Services. Bocksay, K., Harper-Jemison, D., Gibbs, K., Weaver, K., Thomas, S. (2007) Freire, P. (1970). Pedagogy of the Oppressed. New York: Continuum. Birkhead, G., Riser, M., Mesler, K., Tallon, T. & Klein, S. (2006) Youth Development Is a Public Health Approach. J Public Health Management Practice, S1–S3. International Union for Health Promotion and Education- IUHPE (2010) Achieving Health Promotion in Schools: Guidelines for Promoting Health in Schools. Accessed from http://www.iuhpe.org/. Carline, J & Patterson, D. ( 2003) Characteristics of Health Professions Schools, Public School Systems, and Community-based Organizations in Successful Partnerships to Increase the Numbers of Underrepresented Minority Students Entering Health Professions Education. Acad. Med; 78:467–482. U.S. Department of Health and Human Services. Healthy People 2010. Volumes 1 and 2. Washington, DC: U.S. Government Printing Office, November 2000. This information can also be accessed at http://wonder.cdc.gov/data2010/. Youth Risk Behavior Survey (YRBS) (2009) Center for Disease Control. Accessed from http://www.cdc.gov/HealthyYouth/yrbs/pdf/us_overview_yrbs.pdf Towey, K. & Fleming, M. (2003) Healthy People 2010: Supporting the 21 Critical Adolescent Objectives. American Medical Association. Paul, T., Park, M., Nelson, C., Adams, S., E. Irwin, C. & Brindis, C. (2009) Trends in Adolescent and Young Adult Health in the United States. Journal of Adolescent Health; 45:8-24. Bocksay, K., Harper-Jemison, D., Gibbs, K., Weaver, K., Thomas, S. (2007). Community Area Health Inventory Part One: Demographic and health profiles. Health Status Index Series Vol. XVI No. V. Chicago, Ill: Chicago Department of Public Health, Office of Epidemiology. Retrieved April 30, 2010 via Frieden, T. (2010) A Framework for Public Health Action: The Health Impact Pyramid. American Journal of Public Health; 100(4); 590-595. Yosso, T. (2005) Whose culture has capital? A critical race theory discussion of community cultural wealth. Race Ethnicity and Education; 8(1): 69-91. Ennet, S.,Tobler,N., Ringwalt, C. & Flewelling, R. (1994) How Effective Is Drug Abuse Resistance Education? A Meta-Analysis of Project DARES Outcome Evaluations. American Journal of Public Health; 84(9): 1394-1401. Tickle, L.( 2001) The Organic Intellectual Educator. Cambridge Journal of Education; 31(2): 159-172. 27

30. Acknowledgements Thank you for your ongoing support and dedication in making the public health curriculum in Humboldt Park possible! Dr. Michele Kelley Dr. Michael Fagen Jose Lopez Zenaida Lopez Juana Ballesteros Vanessa Santiago Matthew Rodriguez, Judith Diaz and all faculty/staff at PACHS UIC and Humboldt Park community partners 28