New Holistic Pregnancy Prevention Program Shows Promise, Study Shows
The Wahine Talk program, a holistic sexual health and pregnancy prevention program developed by Waikiki Health’s Youth Outreach (YO!) Program, has the potential to help reduce pregnancy rates and improve sexual health for young women experiencing homelessness, according to a new study.
Wahine Talk, delivered at YO!’s homeless youth drop-in center, has four components: basic needs provision, peer mentorship, sexual health education groups, and sexual healthcare. “Wahine means ‘girl’ or ‘woman’ in Hawaiian and comes from the central goal of the program — working with women in a community-engaged, holistic, trauma-informed manner to address their sexual health needs,” said Dr. Elizabeth Aparicio, the study’s lead author and an assistant professor of behavioral and community health. She was assisted by other researchers in the Community THRIVES Lab.
“When you're homeless, sexual health is typically not at the top of the list of concerns to address because of the magnitude of effort required every day to meet your basic needs.”
Half of homeless youth experience pregnancy at some point during their adolescence. They have higher sexually transmitted infection rates, and are more likely than their stably housed peers to engage in survival sex — exchanging sex for basic needs like shelter, food, and money.
The Wahine Talk program gets teens talking about and directly addresses sexual health in the context of larger needs, like housing, food, education, connection, belonging, and healthcare.
The program engages youth through respecting their autonomy and providing for basic needs, and aims to enhance youths' social connectedness through relationships with staff and with other girls in the program. The program also integrates technology in new ways by providing youths with cell phones upon entry, data boosts for attending weekly sexual health education groups, and an upgraded cell phone if they decide to select a highly effective, longer-acting form of birth control. The phones are used for 24/7 communication with one another and with the on-staff peer mentor through social media, texting, and (much less frequently) phone calls.
“Wahine Talk meets clients where they are, providing attuned, trauma-informed care across intervention levels,” Dr. Aparicio said. “Youth are welcome to engage in as little or as much of each of the four program components as they desire, which is part of a trauma-informed approach that centers youth voice and choice.”
The study, an initial test of Wahine Talk, found the program was feasible to provide to homeless youth, appropriate for homeless youth, and acceptable as delivered to both homeless youth participants and to interdisciplinary program providers (including public health, social work, and medical providers). The study also found the use of incentivized programming was helpful in improving engagement in sexual and reproductive health services to homeless youth, including sexual healthcare, as it is in other areas of healthcare delivery. Researchers plan in future studies to test program efficacy and expand to additional implementation sites. Future studies could include examination of how male partners may impact intimate relationships, personal health, and pregnancy prevention, the researchers state.
The paper, “Youth and Provider Perspectives of Wahine Talk: A Holistic Sexual Health and Pregnancy Prevention Program Developed with and for Homeless Youth,” was published in the October edition of the journal Children and Youth Services Review. Co-authors include Elizabeth M. Aparicio and Danielle R. Phillips of the University of Maryland; Trisha Okimoto and Megan Kaleipumehana Cabral of the University of Hawai'i at Mānoa; and Carla Houser and Kent Anderson of Waikiki Health.
Wahine Talk was developed and tested through a research-practice partnership between Waikiki Health, University of Maryland, and University of Hawai‘i at Mānoa. Funding (PI: Kent Anderson) was provided by the U.S. HHS Office of Adolescent Health via the iTP3 Program of Texas A&M University.
Read more about the Wahine Talk project and other Community THRIVES Lab projects on their website and follow them on Twitter @commTHRIVESlab.