Perspectives on Implementation: Challenges and Successes of a Program Designed to Support Expectant and Parenting Community College Students in Rural, Midwestern State.

OBJECTIVES: Expectant and parenting students (EPS) at community colleges are an underserved and often under-resourced group. In a rural, Midwestern state, the department of public health was awarded the Pregnancy Assistance Fund (PAF) grant to assist this population. This paper outlines the results of the implementation evaluation and offers suggestions for programs and evaluators working with this population in the community college setting. METHODS: We conducted a multicomponent evaluation utilizing quantitative and qualitative methods. Evaluation activities included tracking activities/services, surveys and interviews with participants, and interviews with community college staff implementing grant activities. The research team calculated frequencies for quantitative data and coded qualitative data for themes. RESULTS: Data from the community colleges and students' self-reports revealed that EPS most commonly received concrete support from the program, often in the form of stipends or gift cards. Students reported that concrete support was beneficial and helped to relieve financial stress during the semester. Students' major barriers to participation were lack of knowledge about the program and busy schedules that prevented them from accessing PAF services. Staff reported that difficulty identifying EPS and the short one-year project period were major implementation challenges. CONCLUSIONS FOR PRACTICE: We recommend that community colleges work to identify EPS, use fellow EPS to recruit program participants, and implement programming that works with the students' schedules.

Lessons from the field: A mixed methods analysis of hair stylists' reflections on their experience as lay health educators.

Beauty salons are unique settings to provide community-based health education. The Speak UP! Salon Project trained hair stylists to deliver health messages related to reducing unintended pregnancy to female clients in the 18-30-year age range. The project ran from 2009 through 2011. Midway through the project, we held focus groups with stylists and administered a questionnaire as concurrent process evaluation measures. Forty-seven of the ninety-three stylists then active in the project attended one of eleven focus groups. The focus groups included questions about stylists' experiences and their reflections on their role as lay health educators. Using Krueger's qualitative methodology, we systematically analyzed the focus group transcripts. Six themes emerged from the focus groups, including stylists' ability to deliver lay health education, increased comfort levels, stylists' self-monitoring, support materials, messaging outside the target audience, and intangible benefits to the stylists. The questionnaire included twenty-six items and provided quantitative support for identified themes. Findings indicated that stylists were a strong and willing community partner for delivering health education, they received substantial positive feedback from clients, and their efforts reached individuals far beyond the target audience; however, professional health educators must provide substantial training and support to ensure the program's success.

The Speak UP! Salon Project: Using Hair Stylists as Lay Health Educators About Unintended Pregnancy.

The Speak UP! Salon Project trained 126 hair stylists from 60 salons as lay health educators to increase knowledge about contraceptives and inform clients about financial support for long-acting reversible contraceptives at local family planning clinics. Stylists' informal social support system, combined with the rapport built with clients over time, make them excellent candidates for lay health educator projects. This 3-year salon-based intervention was implemented in nine counties in a Midwestern state. Results from a subsample of participants who completed an online questionnaire (n = 177) indicate that hair stylists are a feasible method to link target populations to health information and to the health care system. The benefits and challenges of collecting data in a salon environment are also discussed.