« Previous | Contents | Next »
Listen
LEARNING TO MAKE A DIFFERENCE
HEALTHY RESPECT
HELPING YOUNG PEOPLE IN LOTHIAN DEVELOP A POSITIVE ATTITUDE TO THEIR OWN SEXUALITY AND THAT OF OTHERS, AND A HEALTHY RESPECT FOR THEIR PARTNERS WITH THE AIM OF REDUCING UNPLANNED TEENAGE PREGNANCIES AND SEXUALLY TRANSMITTED INFECTIONS.
About Healthy Respect
Healthy Respect, as its name implies, is centred around self-esteem and confidence, two of the common denominators that enable and empower young people to make informed choices about their relationships and behaviour. Healthy Respect is not about encouraging young people to have sex. It is about ensuring that young people are aware of, and accept the responsibilities which accompany sexual relationships and enabling them to take control of their lives and their futures. The Project focuses on three core areas: reducing unplanned teenage pregnancies, decreasing the level of sexually transmitted infections (STIs) and encouraging young people to develop the self-esteem that will help them form mature, enjoyable relationships as they progress through life.
Healthy Respect is a partnership initiative that has brought together key organisations involved in sexual health services and education in Lothian to achieve common goals aimed at making a difference to young people's lives. The Project is testing out new approaches to integrated working, in partnership with young people and communities, and across traditional boundaries. The key elements of education, information and accessible service provision form the basis of Healthy Respect's approach. Healthy Respect is working with young people in general, as well as key priority groups, such as young people in care, parents, young men and marginalised young people. It is combining area-wide strategies with work in areas of deprivation. It is being implemented in a variety of settings including informal youth settings, further education colleges, schools, hospitals, primary care settings and voluntary organisations.
Key achievements
Healthy Respect has undertaken considerable groundwork in its first year and has firmly established its roots in the network of partners and community organisations throughout Lothian. Inter-agency partnership working is progressing well, has raised Healthy Respect's profile and gained support for its work; an increasing number of agencies are seeking involvement in Healthy Respect. Healthy Respect has also begun to form relationships with established Churches and Christian organisations that are offering support to the Project. Healthy Respect's Young Person's Involvement Officer is ensuring that young people are consulted and involved in all aspects of the Project's work. Key components are underway in various settings and significant progress has been made.
Self-esteem and confidence
Only by creating a culture that supports young people to develop the confidence and self-esteem necessary to take responsibility for their own sexual health will Healthy Respect's targets in the areas of teenage pregnancies and sexually transmitted infections be fully achievable. Healthy Respect has launched a high profile local media campaign, encouraging young people to respect themselves and others and to take responsibility for their own sexual health, and developed an innovative on-line sexual health resource for young people and parents; the website has been well received, with over 200,000 hits during its first two months: log on at
www.healthy-respect.com .
HEALTHY RESPECT TARGETS Teenage pregnancy - to reduce the pregnancy rate among 13-15 year-olds by 20% by 2010. To reduce terminations of pregnancies by 50% by 2010 without increasing the teenage birth rate (1998 baseline). Sexually transmitted infections - to increase the reported prevalence of chlamydia among young people by 2003, followed by a 50% decrease by 2010. Self-esteem and confidence - the project will demonstrate increased self-esteem and confidence among the target group resulting in a healthy respect for themselves and their partners.
|
Healthy Respect is targeting particular groups that are often neglected in the area of young people's sexual health but have great capacity to influence young people's behaviour. Activities in Year 1 have included education programmes aimed at young men, parents and professionals and programmes aimed at bringing the issues of marginalised groups to the fore.
Healthy Respect's Parent's Project aims to encourage and support parents to be involved in the sexual health education of their children. Working in partnership with local agencies, Healthy Respect has assessed the information and support needs of a cross-section of parents and foster parents in specific areas of Lothian. The results of the survey are informing Healthy Respect's future work with parents. An Action Plan to ensure that gaps in services are identified and addressed has been formulated. Parents have been very positive about Healthy Respect as a source of information for themselves and their child.
A key priority in Year 2 is to establish stronger links between education and services in order to increase accessibility of services and provide practical help and advice on sexual health matters to young people.
CHARMAINE, AGED 34, SINGLE PARENT, WITH ONE DAUGHTER (AGED 12) 'I think it's really important to be involved in the sex education of my kids - not just leave the school to do it. It was ok talking to my daughter about starting her periods, but when it comes to sex I get really embarrassed, and I don't know the right things to say. I just want to tell her to stay away from the boys - but I know that won't keep her safe. I think if I knew more about the facts myself it would feel easier. Parents need support - I'm so glad Healthy Respect is doing this.' |
HEALTHY RESPECT IN THE SCHOOL SETTING Healthy Respect's work in schools involves a partnership approach to sexual health and relationships education which includes the voluntary sector, the NHS and the four local authority education departments in Lothian. It seeks to link effective sexual health education and information within the classroom with appropriate health service provision, targeted at key groups. This includes making Sexual Health and Relationships Education (SHARE) training (previously for education professionals) available to a wider team of professionals, including youth workers, school nurses and voluntary organisations. SHARE emphasises the development of skills and competencies and the importance of good self-esteem. In Healthy Respect's work with young people, SHARE is also referred to as SAFE, HAPPY and RESPONSIBLE, reinforcing the Healthy Respect message of increasing young people's self-esteem and confidence. Issues such as homophobic bullying have been incorporated into the programme. Healthy Respect's multi-disciplinary approach is ensuring that young people are receiving consistent information throughout the project. Healthy Respect has provided SHARE training sessions in 11 Lothian schools and is offering ongoing support to those delivering SHARE in the classroom. Healthy Respect is developing a framework for sexual health and relationships education that will guide sexual health work in Lothian schools in the future. |
Teenage Pregnancy
By laying strong foundations in the form of education programmes, accessible service provision and public awareness campaigns, Healthy Respect aims to ensure that young people are equipped with the skills and knowledge they require to protect themselves from unplanned pregnancy. Securing the support and confidence of parents and educators is fundamental to Healthy Respect's success in this area.
As well as Lothian-wide work, Healthy Respect is also focusing specifically on young people who, through adverse life circumstances, are particularly at risk from pregnancy and abortion. The Project has developed initiatives targeted at young people in residential care and young women who may be at risk of repeat abortions.
In Year 2, Healthy Respect will raise awareness of the risks of pregnancy and the need to use protection, as part of education sessions throughout Lothian; and will undertake a study of 600 women using abortion services in order to improve post-abortion counselling services. In partnership with local education authorities and voluntary agencies in Lothian, Healthy Respect is establishing health 'drop-in' centres in, or near, Healthy Respect schools that both meet the needs of young people and add value to the taught curriculum. An advertising campaign focusing on the issues surrounding pregnancy and contraception will be launched.
Sexually transmitted infections
A radical change in the attitudes of young people and how they view their sexual health is needed to address the issue of STIs. Healthy Respect's approach sets the concept of good sexual health within a framework of total bodily health and encourages young people to accept and take responsibility for their, and their partner's, sexual health. As with its other targets, Healthy Respect's approach combines education, service provision and awareness raising activities. In its first year, Healthy Respect:
launched a media campaign to address taboos that prevent young people from acknowledging the potential risks of contracting STIs and the need to take action to protect themselves
encouraged condom use through several initiatives, including the establishment of condom outlets in specific settings and focused media campaigns
provided chlamydia testing in four Further Education colleges and free condom outlets in three colleges (over 30,000 students attend the colleges).
Healthy Respect is focusing on chlamydia, the most rapidly increasing, but least known, STI affecting young people. In its first year, Healthy Respect has pioneered chlamydia testing in a range of non-medical settings and developed a ground-breaking postal testing kit to further increase young people's access to chlamydia testing opportunities.
Year 2 will see the launch of Healthy Respect's innovative postal testing kit for chlamydia in a variety of non-medical settings (up to 5,000 postal tests will be carried out in Year 2); and further expansion of the community-based testing programme. The next phase of Healthy Respect's advertising campaign will use eye-catching images and messages to create acceptance and awareness of STIs and encourage young people to act to prevent their spread.
WORKING WITH YOUNG PEOPLE IN RESIDENTIAL CARE Studies of young people in local authority care, or leaving care, consistently document very poor outcomes in all aspects of health. Problems of poor self-esteem and risk-taking activities contribute to high levels of unsafe sexual practice. In partnership with the Residential Care Health Project, Healthy Respect is integrating sexual health promotion work into residential care units and has developed innovative ways to help and support this group of young people to protect and improve their sexual health, working both individually and through carers. As part of this work, each young person is offered a health assessment by the project paediatrician. This includes a discussion about sexual health issues and sexual health promotion, where appropriate. Any issues are addressed, with recommendations for referrals, investigations and treatment as indicated. Project nurses are helping carers to provide support to young people; and are using their links with service provision in the area to facilitate visits for young people, if necessary, to local sexual health services or GPs. By late 2001, 60 young people had been supported through this project. |
'Helen', aged 18, accessed Healthy Respect's chlamydia testing service in her local college after her friends told her how easy and convenient it was. She had had one sexual partner (her current boyfriend of 6 weeks). They didn't use condoms as she was on the "jag". Helen was shocked when her result came back positive. She agreed to tell her boyfriend herself about the infection and advise him to get tested and treated. She was worried about this but knew that neither of them was to blame as they had both agreed to have sex without using a condom. Three weeks later Helen came back for follow up. She had had no problems with the medication; and confirmed that her boyfriend had been to his GP and had been treated. She felt happier knowing that she had taken responsibility for her sexual health and was thinking about going to GUM for a full sexual health screen. |
HEALTHY RESPECT IN FE COLLEGES Healthy Respect is working in partnership with four Further Education (FE) Colleges to promote positive sexual health to students. Healthy Respect's FE work encompasses four elements - sexual health promotion, training for FE staff and students, provision of services for students and development of sexual health policies and frameworks to enable sexual health promotion in Further Education settings. Healthy Respect launched its FE work in August 2001 to coincide with the new term. In its first year, Healthy Respect launched a convenience advertising campaign (promoting safer sex and the concept of sexual health check-ups); established condom (C-Card) outlets, providing students with free access to condoms; piloted a chlamydia testing programme; and delivered training to FE College staff and students. |
Challenges faced
The complexity of Healthy Respect, with its 13 partner organisations and 12 component projects looking at very different, but overlapping, areas of young people's sexual health, has proved demanding but fruitful. Obstacles and challenges faced in Year 1 have included:
integrating Healthy Respect's objectives into partner organisations at strategic management level
negative perceptions of Healthy Respect as a result of pressure groups and sensationalist press coverage of young people's sexual health issues
teething problems with partners involved, e.g. working with some schools on their role and curriculum development
practical barriers to consultation with young people in schools/community education due to timetabling and pressures on young people's time and involvement
managing the high expectations for the Project and securing time to establish it whilst developing the work
difficulties in setting up school 'drop-ins' involving numerous partners concerned about accountability to parents
delays caused by the time needed to develop and approve Patient Group Directions and to secure Ethics Committee approval for some aspects of the Project's work.
CHLAMYDIA TESTING IN NON-MEDICAL SETTINGS Healthy Respect's chlamydia testing project has 3 main aims: firstly to raise awareness of chlamydia; secondly, to promote and facilitate testing for the infection; and thirdly to identify young people's preferred settings for testing. The project is making testing more accessible to young people by introducing the new urine testing methods into targeted non-medical settings where large numbers of young people congregate. In its first year, Healthy Respect carried out successful pilot testing at Caledonia Youth (formerly Brook), at local army barracks and in Further Education Colleges. In collaboration with the Royal Mail, Healthy Respect has also designed an attractive and user-friendly postal testing kit for chlamydia, for distribution in a variety of non-medical settings throughout Lothian, including pharmacies, retail outlets and pubs. This innovative approach is intended to overcome the stigma that often prevents young people getting tested for STIs. Young people are able to receive their results by email, mobile or post. |
Informing policy and practice
Fundamentally, Healthy Respect aims to demonstrate that an integrated, inter-agency, strategic approach that combines education, information and accessible service provision can make a real difference to the sexual health of young people. The Project will offer important lessons regarding:
effective strategies and interventions to improve young people's sexual health
how to work in partnership with other agencies and disciplines and with young people and parents to make a real step-change in the sexual health of young people
organisational development issues
how to facilitate change (at professional and organisational levels).
Early lessons
Healthy Respect's various partners have identified a number of early lessons:
Partnership working: it is important to keep agencies informed, consider their views and support them; each of the four Local Authorities has different understandings, needs and concerns and this needs to be built into plans as a Lothian-wide project.
Consultation and involvement: young people and parents need to be involved and informed at all stages of the Project's work and it is important to build in sufficient time to allow this; getting headteachers, parents and other influencers on board early and spending time with them in consultation is essential.
Competing pressures: most guidance staff and schools value Healthy Respect and what it wishes to achieve, but accessing schools can be difficult due to timetabling and competing curricular pressures.
Practical guidance: school staff would benefit from policy guidelines to support their work when dealing with sex education and sexual health issues in schools.
Getting the message across: successful development of the Healthy Respect image and appeal among young people is essential if the Project is to have its desired impact.
Learning about projects: Healthy Respect is a complex and challenging project with its success strongly dependent on the perseverance and motivation of the team; a strong team and good communication are vital.
Looking to the future
Much of the Healthy Respect project aims to fundamentally change the attitudes and behaviour of young people. The Project's impact will not be felt by all young people in 3 years. However, it is hoped that a project as diverse and involving as many partners as Healthy Respect will have an impact on the lives of a large number of young people in Lothian and demonstrate lessons for the rest of Scotland. Healthy Respect's first year has been challenging but good foundations have been laid. Years 2 and 3 look equally promising.
« Previous | Contents | Next »