Rural Communities Opioid Response Program - Pathways - Description of Proposed Program: The purpose of PATH (Preparing Adolescents Through Health Pathways) is to implement behavioral health career pathway opportunities for youth while developing innovative, peer-driven behavioral health support programs tailored for youth, which will ultimately support improved behavioral health care in the remote US Affiliated Pacific Island (USAPI) of the Marshall Islands. We will accomplish this purpose through our three overarching goals: 1) create pathway programs that expose youth to behavioral health careers and support their entry into structured training programs; 2) engage youth in designing and carrying out peer-led behavioral health initiatives; and 3) promote sustainability by developing innovative strategies that involve multiple sectors. PATH Network Partners include: Youth to Youth in Health, College of the Marshall Islands, Marshall Islands Epidemiology and Prevention Initiatives, the Ministry of Education, the Ministry of Health and Human Services, Majuro Baptist Christian Academy, Assumption High School, and the Community Health Institute DBA Community Connect. Needs Program Will Address: PATH will address specific needs in the Marshall Islands, a remote US Affiliated Pacific Island. The Marshall Islands are situated in a remote part of the South Pacific Ocean. The needs in the RMI are many and include: substance use, mental and behavioral health conditions, social determinants of health (SDoH), and a steadily increasing prevalence of behavioral health disorders such as depression, anxiety, bipolar, eating disorders, and schizophrenia. The RMI has one of the highest suicide rates in the world. Proposed Services: Goal 1 will create pathway programs that expose youth to behavioral health careers and support their entry into structured programs. Goal 1 has four objectives: 1) increase youth awareness of behavioral health careers through 10th grade health classes reaching ~320 youth each year in years 1-3; 2) facilitate behavioral health career exploration through summer internships reaching 20 youth each year for a total of 60 youth in Years 1-3; 3) in collaboration with the Ministry of Health and Human Services (MOHHS), the College of the Marshall Islands (CMI), and Community Connect, implement a formal CHOW training for high school juniors and seniors that provides 12 hours of college credit and a behavioral health upskilled certificate and trains 20 CHOWs per year for a total of 60 CHOWs over 3 years who are fully certified upon graduation; 4) provide intensive assistance in applying for higher education for behavioral health careers, reaching 300 youth in Years 1-3. Goal 2 will engage youth in designing and carrying out peer-led behavioral health initiatives. Goal 2 has four objectives: 1) work with Youth to Youth in Health, Inc. (YTYIH) to facilitate a Youth Leadership Council (YLC) with 18 youth participants representing different schools in the RMI; 2) engage YLC to conduct a youth behavioral health needs assessment; 3) engage YLC in identifying and selecting evidence-based, trauma-informed, peer-driven behavioral health programming to implement in their communities; 4) work with YLC and youth trained as CHOWs to implement at least one evidence-based, trauma-informed, peer-driven behavioral health program in their communities during Year 2 and beyond. Goal 3 will promote sustainability by developing innovative strategies that involve multiple sectors. Goal 3 has two objectives: 1) fully engage PATH Network Partners starting immediately upon award and continuing monthly in Years 1-3. and 2) create a multi-faceted sustainability plan by month 1 of year 3. Population Groups Program Will Serve: The intended recipients of PATH outreach program are middle school and high school aged youth (grades 7-12) living in the RMI. The total junior and senior high enrollment in public and private schools in the RMI is ~2,811 students.
