Program

Feb 23, 2012

OVERVIEW

The CAS-Carrera Program is an intensive, year-round, multi-year after-school program that is designed to promote positive youth development and positive reproductive health. At-risk 13- and 15-year-olds participate in the program through the end of high school. The program employs a holistic approach–addressing the various contexts (e.g, school, family) and needs (e.g, supportive relationships, social services) relevant to participants’ lives–and it provides a variety of activities and services, including employment and academic assistance, family life and sexuality education, performing arts experience, sports training, and mental and physical health care. An experimental evaluation showed that participation in CAS-Carrera led to increases in sexual health knowledge, health care and health behaviors, life skills, and academic skills. Participation also reduced the likelihood of pregnancy and childbearing and increased the use of Depo-Provera (a contraceptive) for females, and reduced the likelihood for males’ initiation of marijuana use.

DESCRIPTION OF PROGRAM

Target population: At-risk high school students between 13 and 15 years of age

The CAS-Carrera Program, started in 1984,
is an intensive, year-round, multi-year after-school program for high
school students; program services are typically available 5 to 6 days a
week. The program operates according to several key principles, such as:
(a) employing a “parallel family systems” approach, where staff treat the
teens as their own children; (b) treating each participant as if he or she
has potential; (c) employing a holistic approach to providing services,
whereby the services are tailored (when possible) to the interests and
needs of the participants; (d) developing a continuous and long-term
contract with participants, through which the teens have individual plans
tracked 12 months a year through the end of high school; (e) providing
services in the community for participants and their parents; (f)
practicing a non-punitive, gentle, generous and forgiving approach; and
(g) reducing program fragmentation by providing a variety of services at
one location in the participant’s community.

The
CAS-Carrera model is based on seven key activities and services.
Activities include: (a) a work-related intervention, called “Job Club,”
which includes stipends, the development of an individual bank account,
graduated employment experiences, and career awareness; (b) an educational
component involving individual academic assessment, tutoring, homework
help, PSAT and SAT preparation, and assistance with college entrance; (c)
family life and sex education; (d) self-expression through the arts; and
(e) participation in individual sports, to be continued over participants’
lifetimes. Services include (f) comprehensive medical care, including
reproductive health and contraception counseling, and (g) mental health
services, which provide counseling as needed.

·Length: Ages 13, 14 or 15 are eligible; participation
continues through the end of high school.

·Intensity:The program provides services five days a
week and on Saturdays during the school year. During summer breaks, the
program works to employ participants, and provides maintenance meetings
emphasizing sexuality education and academic skills.

·Service Delivery Mode: Administered in urban areas in
conjunction with other established community programs. Each program is
staffed by part-time employees as well as by a full-time community
organizer.

EVALUATION(S) OF PROGRAMPhilliber,
S., Kaye, J., & Herrling, S. (2001). The national evaluation of the
Children’s Aid Society Carrera-model program to prevent teen pregnancy.
Research Report. New York, NY: Philliber Research Associates.

Evaluated population: A total of approximately 1200 students in New York City, Maryland, Florida, Texas, Oregon and Washington were evaluated. Forty-seven percent of the sample was black; the balance comprised a number of other racial/ethnic backgrounds. About one-sixth of the families received public assistance or Medicaid and did not have a working adult in the house; another third lived in families with only one of those conditions. About half of the teens were from single-parent homes and homes that had one or more unemployment family members.

Approach:
Approximately 100 students at each site were recruited and randomly
assigned to the CAS-Carerra program or to an alternative (control)
program. Eligibility to participate was based on the following criteria:
the teens were not enrolled in an ongoing, structured after-school
program; they were ages 13, 14 or 15 on July 1, 1997, (New York) or
January 1, 1998 (other sites); and they were not pregnant or parenting at
the time of recruitment. On average, participants attended the program
for 12 hours per month over the three evaluation years, during which the
greatest amount of time was spent receiving educational support (tutoring,
etc.). By the end of the third year, the program reported a 70 percent
retention rate.

Evaluation
data were drawn from various sources, including annual participant
surveys; pre- and post-tests of knowledge on sexuality topics; a number of
drug-use outcomes; attendance data; follow-up data collected by program
staff; and interviews of program staff, conducted by the research team.

Results:
There were a number of significant differences between the CAS-Carerra
group and the control group, on health habits, sexual knowledge, and
sexual behaviors. Compared with the control group, program participants
made significantly greater gains over two years on an exam covering
sexuality knowledge (e.g., information on physiology, contraception,
gender differences, pregnancy), and were significantly more likely to have
four or five desirable health outcomes (e.g., medical check-up last year,
teeth checked in the last year, etc.), to have gotten their health care
at a place other than the emergency room, to have had a social assessment
at their last exam, to have had the hepatitis B vaccine, and to have made
a reproductive-health visit.

Certain other
program outcomes differed by participant gender. At the three-year
follow-up, female participants were significantly more likely to have used
Depo-Provera, and had significantly lower rates of pregnancies and births,
compared to control females. Compared to control males, CAS-Carrera males
were significantly less likely to have initiated marijuana use. No other
drug outcomes (ever using alcohol, marijuana, or cocaine, and initiation
of alcohol and cocaine use) were significant for either gender.

Within the
category of life organization and technical knowledge, CAS-Carrera
participants were significantly more likely than control students to have
bank accounts, to have had work experience, to use word processing
programs, and to use the Internet and e-mail. CAS-Carrera females,
especially, were significantly more likely to use the computer and use it
more often, and to use word processing programs and e-mail. CAS-Carrera
males were significantly more likely to use the Internet.

In the area
of school preparation, program participants, especially males, were
significantly more likely than the control teens and control males,
respectively, to believe that the quality of their schoolwork had
improved. On verbal and math portions fo the PSAT, Carerra teens were
significantly more likely to have higher scores than the control group,
and Carrera females were significantly more likely than control females to
have higher scores on the verbal portion. Carrera teens were also
significantly more likely to have made college visits.

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,
244-251.

Evaluated population: The sample included 484 adolescents (268 females and 216 males) between ages 13 and 15. Fifty-six percent of participants were black; the remainder were Hispanic (42 percent) or some other race/ethnicity(2 percent). The majority of participants lived in single-parent homes, and 21 percent of participants lived in a household with no working adult and received public assistance.

Approach:
Children were randomly assigned to the Children’s Aid Society’s Carrera
Program, or to their usual youth program (which, at most sties was the was
the agency’s regular youth program that included recreational activities,
homework help, arts and crafts, or only drop-in privileges at the
agency). All children were followed for three years. Odds of current
sexual activity, use of a condom together with a hormonal contraceptive,
pregnancy, and access to good health care (check up frequency and quality)
were assessed.

Results:
The program had a retention rate of 79 percent for the full three years.
Analyses were split by participants’ gender. Females in the Carrera
program were less likely to be sexually active, less likely to say they
had had sex when pressured, and less likely to have experienced a
pregnancy than were participants in the control group. Though condom use
was fairly similar for participants in the Carrera program and the control
group, females in the program were more likely to have used a condom
combined with another highly effective method (for example, a hormonal
method of contraception) the last time they engaged in sexual activity.
Males in the Carrera program were no different from the control group in
sexual and reproductive behavior. Both males and females in the program
were more likely than controls to have received good primary health care.

SOURCES FOR MORE INFORMATION

References

Philliber,
S., Kaye, J. & Herrling, S. (May, 2001). The national evaluation of
the Children’s Aid Society Carrera-model program to prevent teen
pregnancy.
New York: Philliber Research Associates.

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,
244-251.

Web Site:
www.childrensaidsociety.org

KEYWORDS:Males and Females (Co-ed); Black or African American; Hispanic/Latino;
Adolescence (12-17); High Risk; Condom Use and Contraception; Academic
Achievement; Marijuana Use; Illicit Drugs; Teen pregnancy; After School
Program; Tutoring; Other Physical Health; Reading/Literacy; Mathematics;
College Enrollment/Preparation; Employment/Earnings; Other
Self-Sufficiency.

Program
information last updated 2/23/2012

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