At a glance
- The Teens Linked to Care program addressed substance use and sexual risk among youth in rural communities.
- The program created a collaborative, safe environment for adolescents.
- The aim was to increase their knowledge and skills about HIV, sexually transmitted infections, and substance use prevention.
Background
Teens Linked to Care (TLC) was a multiyear project to develop and implement prevention strategies for youth. Specifically, TLC addresses substance use and sexual risk among youth in high-risk rural communities.
TLC was a pilot program during its first 3 years. The goal was to develop a way for schools to address HIV, sexually transmitted infections (STIs), teen pregnancy, and high-risk substance use (prescription, illicit, or injection drugs). Schools would work with youth through education, primary prevention, and early detection screening. The TLC framework was used and evaluated to determine if any positive changes occurred because of TLC.
The program was a collaboration among CDC, the CDC Foundation, and the Conrad N. Hilton Foundation. Also collaborating were two pilot sites: Scott County School District 1 (Austin, Indiana) and The Brighton Center/Newport High School (Campbell County, Kentucky). In the first 3 years, the Portsmouth County Health Department (Portsmouth, Ohio) was also a pilot site. The program began in 2015 and ended in 2022.
Why it matters
Adolescents who use drugs and alcohol are more likely to engage in sexual risk behaviors
Substance use and progression to addiction can occur in adolescence. Substance use increases the likelihood that adolescents will engage in risk behaviors that can have dramatic, lasting effects.
Adolescents with substance use disorders have higher rates of physical and mental illnesses. These adolescents also have diminished overall health and well-being. Primary prevention of substance use is a way to prevent infectious diseases and protect the health of adolescents.
Toolkit
The TLC Toolkit provides schools with instructions on how to implement a program to address youth HIV, STDs, pregnancy, mental health challenges, and high-risk substance use.
Effect
Of the students screened for risky substance use through TLC, the program's effects showed that:
- 27% received brief intervention by a health care provider.
- 25% were referred to substance use treatment.
Evaluation
The CDC Foundation and CDC staff routinely did needs assessments to monitor progress, processes, and outcomes. Some evaluation findings showed:
- Increases each year in students participating in the TLC program.
- Shifts in program focus reflecting changes in the community. For instance, there was a focus on safe and supportive environments due to school closures during the COVID-19 pandemic.
- Decreases in substance use in TLC sites compared to non-TLC sites.
Accomplishments
TLC combined substance use prevention and sexual risk prevention in rural school-based settings. The TLC sites implemented activities through their Youth Advisory Boards (YAB) and Community Advisory Boards (CAB). The sites successfully:
- Implemented new health education curricula, reaching all students.
- Developed and distributed materials, such as directories and fliers, promoting youth-friendly health service providers in their communities. Accordingly, this offered students increased access to HIV, STI, and substance use screening and testing, as well as other health services.
- Worked with local health departments to offer health screenings. The screenings could identify those most at risk for HIV, STIs, teen pregnancy, and substance use.
- Collected data about student opinions and experiences with bullying at school—and resulted in a review of school bullying policies.
- Worked with their community's drug-free coalition. This offered resources and increased youth and adult knowledge in substance use and prevention.
- Produced anti-bullying and anti-opioid campaign videos. The videos promoted positive school environments where students feel safe from bullying and the risk of substance use.
Next steps: caring for teens
Programs like TLC need to be used in schools and communities affected by the current drug epidemic. TLC can serve as a blueprint for schools in rural communities to address adolescent sexual risk behaviors and substance use.