Community-based Approaches to Reducing STDs (CARS):
Michigan Uses Youth as Experts
The CARS initiative was established and funded by CDC’s Division of STD Prevention beginning in 2011. The program was developed to support the planning, implementation, and evaluation of innovative projects that: 1) reduce STD disparities; 2) promote sexual (personal) health; and 3) advance community wellness.
During Phase 2 of the CARS initiative, from September 2014 to 2017, the University of Michigan (UMich) used community engagement methods to address STD disparities among young, gay or bisexual men and transgender and gender nonconforming youth aged 15-29 in Southeast Michigan.
UMich recruited a Youth Advisory Board of eight members reflecting the population of interest who identified and designed the following two interventions to address social determinants of health impacting STD disparities in the community:
Health Access Initiative – A free training program for health clinics and centers to improve sexual health care offered to LGBTQ+ youth and promote cultural competence and humility of providers.
Advocacy Collective – A group of young advisory board members serving as consultants working to advance LGBTQ+ health promotion by educating and advocating through workshops, presentations, and digital media.
10 conferences and professional gatherings where young board members presented
500 medical and social services providers reached by presentations
24 high-quality LGBTQ+ friendly resources created by the board
When youth community members are called on to participate with a professional organization to identify and design program interventions, often there is a threat of youth serving as a “token” or symbolic representation of involvement in the processes, as opposed to authentic community engagement. In such cases, youth may be asked their opinions and thoughts but are not given the power to make decisions and have a real impact on the work.
In order to avoid tokenism and ensure that youth had power in the CARS project, UMich used their young board members as experts. They adopted the perspective that the lived experience of youth was just as valuable and important as practice and theoretical expertise of the adult professionals involved in the project.
UMich used multiple strategies to successfully engage their board members as experts on the project:
Compensation – Board members were hired as temporary part-time employees of UMich and paid appropriately for time spent on the project. They were also given business cards for networking that helped them feel “legitimate” as advocates.
Training – They were provided 26 trainings during the project that enhanced their skills and equipped them as experts. They even helped identify training topics they wanted to cover, which allowed them ownership in the project process.
Professional Development – In addition to training, board members were given professional development opportunities, such as a summer internship program and job shadow day. They were assisted in composing resumes and cover letters, which were sent to partnership organizations to match youth to internships. During the paid internships, they also honed their skills in services provision, program development and evaluation, grant writing, and outreach, among others.
Intervention Involvement – After board members chose and designed the ‘Health Access Initiative’ intervention, they gave input and feedback on the scope and implementation of the trainings, collaborated on implementation of trainings and technical assistance, and created resources and materials for participating health clinics and centers.
Advocacy – As part of the Advocacy Collective, the board presented at 10 conferences and professional gatherings, reaching approximately 500 medical and social service providers on LGBTQ+ cultural humility practices and youth involvement in structural change programs. They also created six digital media products, including podcasts and videos addressing issues faced by LGBTQ+ youth, and consulted with six organizations to offer expertise on improving sexual health programs.
Community engagement projects can avoid tokenism by treating and positioning community members as experts.
Providing training and professional development opportunities can position community members to be project experts.
Creating avenues for community members to share their expertise through advocacy, consultation, and involvement in the intervention helps to avoid tokenism.
By using youth as experts, UMich was able to avoid tokenism and successfully engaged youth in increasing access to STD prevention services to advance community wellness and address STD disparities. Board members reported leaving the project as stronger advocates and community leaders, feeling a deep sense of accomplishment. They also reported experiencing personal and professional growth because of the project.
I feel like everyone who leaves this project is going to go away feeling like better trained community leaders, which I think benefits the community.
– YAB member
For more information about the CARS initiative, please visit https://www.cdc.gov/std/health-disparities/cars.htm
