The Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program (CAS-Carrera)

Students and their families from disadvantaged urban, rural and suburban neighborhoods; youth may come from single-parent homes and reside in neighborhoods characterized by higher than national rates of poverty, teen pregnancy, and crime, unemployment, and high school dropouts

For children/adolescents ages: 10 - 19

CAS-Carrera is designed to develop young people's capacity and desire to avoid parenthood and other risky behaviors during adolescence, and help them break the cycle of poverty and despair affecting their full development. CAS-Carrera uses a holistic, above-the-waist approach to help young people develop ambitious personal goals, improve their sexual literacy, and cultivate aspirations for a productive future. Guided by a philosophy that sees youth as at-promise not at-risk, CAS-Carrera begins working with boys and girls in middle school - at age 10 or 11, and follows them through high school graduation and college admission. The program's logic model centers on the understanding young people prevent teen pregnancy when their future is filled with promise and exciting possibilities.

The CAS-Carrera program model can be implemented in two ways:

• Offered as a traditional after-school, youth development approach each day (and Saturdays), including a summer program
• Integrated within a public or charter school day, working with succeeding grades each year until the entire school is receiving the model

Shelia Reich, MSW

• Title: Deputy Director, National Implementation
• Agency/Affiliation: The Children's Aid Society Carrera Program
• Website: https://www.childrensaidnyc.org/programs/carrera-adolescent-pregnancy-prevention
• Email: sheliar@childrensaidsociety.org
• Phone: (718) 208-5939

The goals of The Children's Aid Society Carrera Adolescent Pregnancy Prevention Program (CAS-Carrera) are:

• Reduce teen pregnancies by developing young people's capacity and desire to avoid early parenthood and other risky behaviors, and to help them break the cycle of poverty and despair affecting their full development

The primary desired outcomes include:

• Greater knowledge of sexuality and reproductive health
• Lower rates of pregnancy
• Higher rates of abstinence
• Higher rates of contraceptive use
• Improved access and receipt of medical care/reproductive health services
• Increased exposure to the world of work/employment opportunities
• Increased exposure to college and careers
• Higher high school graduation and college admission rates than contrast groups

The essential components of The Children's Aid Society Carrera Adolescent Pregnancy Prevention Program (CAS-Carrera) include:

• Seven integrated and age-appropriate components:
• Education: Daily homework help, remediation, and enrichment with trained teachers and tutors driven by Individual Academic Plans (IAP) for each participant
• Employment/Job Club: Weekly exposure to the world of work, including earning stipends, opening bank accounts, exploring career choices, and participating in entrepreneurial projects
• Family Life and Sexuality Education (FLSE): Weekly comprehensive, medically accurate sexuality education sessions taught in an age-appropriate fashion by a trained professional
• Self-Expression: Weekly music, dance, writing and drama workshops led by theater and art professionals, where children can discover talents and build self-esteem
• Lifetime Individual Sports: A fitness program emphasizing sports that build self-discipline and can be played throughout life, including golf, squash, swimming, and others
• Full Medical and Dental Care: Comprehensive medical and dental services provided in partnership with local providers
• Mental Health Services: Weekly discussion groups led by licensed social workers/clinicians; individual counseling, case management, and crisis intervention as needed

Child/Adolescent Services

The Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program (CAS-Carrera) directly provides services to children and addresses the following:

• High rates of teen pregnancy; boys causing pregnancies; school failure and school dropout; inadequate medical and dental care; undiagnosed mental health problems; financial illiteracy; poor college and career exposure; limited opportunities for individual sports and self-expression; and lack of hope for a fulfilling life

Recommended Intensity

Afterschool Programming: 15-20 hours per week; Integrated School Model: Program schedules are developed based on school day schedules, numbers of students, and grades served. Both the afterschool and integrated school model develop weekly schedules that reflect component dosage requirements.

Recommended Duration

45-48 weeks per year inclusive of summer program, with specific schedules and program times organized around school schedules and dismissals. Efforts should be made to provide programming/maintenance activities on Saturdays and during holidays/school breaks when possible to maintain program continuity.

Delivery Settings

This program is typically conducted in a(n):

• Community-based Agency / Organization / Provider
• School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

Homework may be assigned depending on the activity and/or corresponding curriculum guidance. CAS-Carrera also provides regular school homework help, tutoring, and enrichment opportunities.

Resources Needed to Run Program

The typical resources for implementing the program are:

Dedicated program and staff space, access to technology

Prerequisite/Minimum Provider Qualifications

Provider/staffing qualifications are delineated by role. Mental health staff members are required to be Master's level, licensed clinicians. Emphasis is placed on youth development experience and superior engagement skills in all staff positions.

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

CAS-Carrera provides pre-service and ongoing training and technical assistance (TA) on the overall program model, the core principles and philosophy, component milestones and related curricula, and performance management. In addition, tailored trainings and TA sessions are provided to address site specific and emerging needs.

Training is provided in a variety of formats including in-person and on-site, as well as via distance learning and webinars. Agencies that are local to New York City/northeast region may receive training in the program's New York offices or on-site; national program replications can receive training at the program's National Accreditation and Training Center (NATC) in Durham, North Carolina or on-site.

Number of days/hours:

Minimum of 3-5 full days; monthly 2-hour maintenance training; weekly supervision

Pre-Implementation Materials

CAS-Carrera has due diligence criteria and tools related to assessing organizational alignment and capacity to effectively implement a program replication. These materials are shared with providers to help them determine their readiness for implementation and are provided support from CAS-Carrera. Contact Shelia Reich, Deputy Director, National Implementation & Quality Assurance at sheliar@childrensaidsociety.org for more information.

Formal Support for Implementation

CAS-Carrera provides training, technical assistance (TA), and overall fidelity management supports for all program replications.

Fidelity Measures

All CAS-Carrera program sites are trained to use their performance management system, the Carrera Management Information System (CMIS), which allows programs to efficiently measure and report on key metrics including attendance and progress toward component milestones. CAS-Carrera Fidelity Managers also regularly monitor key measures through site visits, observations, and data collection.

Contact Shelia Reich, Deputy Director, National Implementation & Quality Assurance at sheliar@childrensaidsociety.org for more information.

Established Psychometrics

There are no established psychometrics for The Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program.

Fidelity Measures Required

No fidelity measures are required for The Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program.

Implementation Guides or Manuals

Program materials and overall support for pre-program implementation include:

• Core program principles and philosophy
• Program planning
• Implementation and maintenance
• Component training
• Performance management

Contact Shelia Reich, Deputy Director, National Implementation & Quality Assurance at sheliar@childrensaidsociety.org for more information.

Implementation Cost

There are no studies of the costs of The Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program.

Research on How to Implement the Program

Research has not been conducted on how to implement The Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program.

Child Welfare Outcome: Child/Family Well-Being

"What is included in the Relevant Published, Peer-Reviewed Research section?"

• Philliber, S., Kaye, J. W., Herrling, S., & West, E. (2002). Preventing pregnancy and improving health care access among teenagers: An evaluation of the Children’s Aid Society-Carrera Program. Perspectives on Sexual and Reproductive Health, 34(5), 244–251. https://doi.org/10.2307/3097823

  Type of Study: Randomized controlled trial

  Number of participants: 484

  Population:

  • Age — 13–15 years
  • Race/Ethnicity — Intervention Group: 60% Black, 39% Hispanic, and 1% Other; Control Group: 52% Black, 45% Hispanic, and 3% Other
  • Gender — 243 Male and 242 Female
  • Status — Participants were non-pregnant or parenting adolescents ages 13–15 years.

  Location/Institution: New York City

  Summary:

  The purpose of the study was to evaluate the Children’s Aid Society (CAS)–Carrera program [now called The Children’s Aid Society-Carrera Adolescent Pregnancy Prevention Program (CAS-Carrera)] in reducing adolescent pregnancy. Participants were randomized to either the (CAS)–Carrera program or to a services as usual control group. Measures utilized include study developed questionnaires. Results indicate that 79% of participants remained in the (CAS)–Carrera program for three full years and that female participants in the intervention group had significantly lower odds than those in the control group of being sexually active and of having experienced a pregnancy. They also had significantly elevated odds of having used a condom and a hormonal method at last coitus. However, participation in the (CAS)–Carrera program created no significant impact on males’ sexual and reproductive behavior outcomes. Nonetheless, program participants of both genders had elevated odds of having received good primary health care. Limitations include a lack of generalizability due to ethnicity and possible contamination of the control group due to participants being able to attend different programs on-site.

  Length of controlled postintervention follow-up: 3 years.

• Coalition for Evidence-Based Policy. (2012). Social programs that work: Carrera Adolescent Pregnancy Prevention Program. https://evidencebasedprograms.org/programs/carrera-adolescent-pregnancy-prevention-program/

• Haberland, N. (2015). The case for addressing gender and power in sexuality and HIV education: A comprehensive review of evaluation studies. Click here for article.

• Office of Adolescent Health. (2015). TPP Resource Center: Evidence-based programs. https://www.hhs.gov/ash/oah/grant-programs/teen-pregnancy-prevention-program-tpp/evidence-based-programs/index.html