THURS-083 - Overcoming Marginalization in Program Evaluation: Intersecting Race, Socioeconomic Status, and Intellectual Ability

Brief Abstract Summary: In this presentation, participants will learn about the challenges of evaluating the "Using the Connect" (UTC) intervention, a game-based curriculum, and its impact on marginalized youth with diverse learning abilities. The southeast Texas teen birth rate in 2024 was nearly double the U.S. rate for females aged 15-19, highlighting the need for innovative prevention programs. Our organization implemented UTC during a randomized controlled trial in the summer of 2024, targeting middle school youth in urban Texas communities (n=321) with data collection managed remotely by an organization in Ohio. While program evaluation policies for sexual reproductive health in marginalized populations can enhance privacy, they may also lead to compounded marginalization, affecting health equity and social justice. Cultural competence is crucial in developing equitable evaluation practices and standard proactive strategies, especially for at-risk groups.

Detailed abstract description: As of 2024, the U.S. teen birth rate for females aged 15-19 is 13.2 births per 1,000 women. The rate for southeast Texas is nearly double the national rate at 20.3 births per 1,000 teens. Therefore, it is essential to evaluate innovative adolescent pregnancy prevention programs. Our organization implemented Using the Connect (UTC), a game-based curriculum to reduce adolescent pregnancy, during the randomized controlled trial of summer 2024 in urban Texas community organizations serving middle school youth (n=321). A remote evaluation team in Cincinnati, Ohio managed data collection and retention methods. During the implementation survey procedures, our team identified evaluation challenges and strategies for equitable improvements in future implementation periods.
Program evaluation policies for children’s and adolescent sexual reproductive health programs implemented in marginalized populations can help facilitate an environment of privacy. However, particular evaluation practices during survey procedures can result in compounded marginalization, compromising health equity and social justice for these vulnerable populations. Compounded marginalization plays a significant role in perpetuating health inequities by layering multiple forms of disadvantage on youth who belong to multiple marginalized groups (e.g., a person who is a racial minority, lower SES, and intellectually challenged). This intersectionality exacerbates their health disparities because they face multiple, overlapping barriers to accessing healthcare and other resources.
Conventional program evaluation policies often assume that all data collection methods universally apply to every population of interest. Unfortunately, standardized program evaluation practices lacking cultural competency can impede achieving health equity and justice for all. When program evaluation procedures do not consider intersecting identities that include intellectual challenges, they can lead to a series of events that create a domino effect of compounding marginalization and health inequities for those populations. Cultural competence is pivotal in developing program evaluation policies and practices, especially for at-risk groups. Cultural considerations in pilot testing and the use of assistive technologies are some of the ways to develop equitable evaluation practices for young, diverse learners. Proactive strategies in program evaluations should be the norm and rule versus being the exception to the rule.
This presentation will describe the challenges of program evaluation policies for an innovative game-based intervention Using the Connect (UTC) and their impact on multiple marginalized youth with diverse learning abilities. We will also identify strategies to overcome challenges restricting or reducing access to adolescent pregnancy prevention.