The Maryland Department of Health (MDH), in collaboration with Healthy Teen Network, Johns Hopkins University, and state and county partners, aims to address health inequities among youth in rural communities with historically high adolescent birth and sexually transmitted infection (STI) rates by replicating evidence-based programs (EBPs) in multiple settings and with multiple age groups. Through the True You Maryland (TYMD) initiative (formerly the Maryland Optimal Adolescent Health Program), we have worked closely with county partners over the past 3 years to establish and enhance adolescent sexual health infrastructure in 2 regions, Northwestern Maryland and the Eastern Shore, that comprise 6 Maryland (MD) counties with high teen birth rates through the creation of local youth advisory boards (YABs); the integration of the evidence-based, comprehensive Positive Prevention Plus (3P) curriculum into 4 local school districts; and the implementation of over 120 events including community outreach, information sessions, youth community service, STI testing, food pantries, and parent workshops. We have collaborated with over 100 partner organizations across TYMD counties, engaged over 4,100 youth, 230 caregivers, and 4,500 community members, and reached over 2,000 youth with EBPs. We plan to expand this reach to 6,245 young people annually through multi-session EBPs in additional middle and high schools and community-based organizations (CBOs), and single-session EBPs in school-based health centers (SBHCs) and family planning clinics.
TYMD will utilize an evidence-based and systematic approach to planning, implementation, evaluation, and sustainability; implement EBPs proven to positively influence sexual health in schools, clinics, and community settings; leverage clinical connections to increase access to sexual health services; apply a systems-thinking approach to strengthen intersections and networks; and engage youth, parents and trusted adults to, ultimately, center their voice in our work and move closer to optimal health. The project components were selected to impact the factors that put young people at risk from teen pregnancy and STIs by implementing in settings that offer the greatest reach, include the most marginalized youth, and offer connections to critical resources and partners. Replication of EBPs will be at the center of this work, supported by community engagement and the implementation of support services and activities. TYMD chose schools, CBOs, and clinics for EBP implementation based on their ability to reach young people where they live, learn, work and play, the settings’ capacities to implement programs, and the fit of potential EBPs. With schools as the centerpiece of our approach, the additional implementation settings will serve youth where schools do not currently have the capacity to implement to scale and have the added benefit of reaching youth with compounding risk factors.