Infórmate for Farmworker Teen Health “Teaching Notes”! the Notes Offer Suggestions and Resources for Program Coordinators Teaching the Content in the Infórmate Manual

MICHIGAN TEXAS 2111Golfside Dr. Suite 2B 437 S. Texas Blvd. Ypsilanti, MI 48197 Weslaco, TX 78596 P: 800-461-8394 P: 800-461-8394 F: 956-447-7908

Thank you for ordering the Infórmate for Farmworker Teen Health “Teaching Notes”! The notes offer suggestions and resources for Program Coordinators teaching the content in the Infórmate Manual.

IMPORTANT: Before using the lessons, we suggest you separate them and place them in the Manual before each corresponding chapter. For example, individually separate the “Teaching Notes” for “Chapter One: Being a Teen Health Aide” and place them before Chapter One in the Manual. This type of organization will make training preparation much easier.

mhpsalud.org

Infórmate for Farmworker Teen Health

”Teaching Notes”

This manual is protected by the United States Copyright Act of 1976.

Copying and use of this manual, in whole or in part, is permitted for your OWN use OR to benefit the health of migrant farmworkers and/or their communities. • You must credit MHP Salud in any use of this manual, or part of this manual. • This manual may NOT be copied for sale. • Please contact MHP Salud with any questions about the use of this manual or to receive future updates or revisions.

La copia y el uso de este manual, en su totalidad o en parte, está permitido para uso propio o para el beneficio de la salud de los trabajadores migrantes y/o de las comunidades en que residen los mismos. • Deberá darse crédito a MHP Salud en cualquier uso de este manual, o partes de este manual. • No se permite copiar este manual para venderlo. • Si tiene alguna pregunta acerca del manual o si desea recibir futuras revisiones o alteraciones del manual favor de contactar a MHP Salud.

(800) 461-8394 email: [email protected] web site: mhpsalud.org

Infórmate for Farmworker Teen Health Teaching Notes Outline

Introduction Health Education Materials List

Chapter 1: Being a Teen Health Aide Lesson 1: ¡Bienvenidos a Infórmate! Lesson 2: Communicating with Individuals Lesson 3: Popular Education & Facilitating Group Health Education Review

Chapter 2: Healthy Communities Lesson 1: Community Building Lesson 2: Racism, Ageism, & Classism Lesson 3: Sexism & Heterosexism or Homophobia Review

Chapter 3: Let’s Talk About Sex! Lesson 1: The Basics of Anatomy, Puberty, & Sex Lesson 2: Sexual Decision Making & Communication Review

Chapter 4: Birth Control Lesson 1: Knowledge Lesson 2: Making Decisions Review

Chapter 5: Sexually Transmitted Infections Lesson 1: The Basics Review

Chapter 6: HIV/AIDS Lesson 1: Knowledge Lesson 2: Attitudes & Behaviors Lesson 3: HIV/AIDS, Decisions, & Substance Abuse Review

Chapter 8: Violence Lesson 1: Relationship & Family Violence Lesson 2: Fighting & Gangs Review

Chapter 9: Safety in the Field & Safety in the Camp Lesson 1: Protecting Ourselves at Work Review

The purpose of these “Teaching Notes” is to provide ideas for facilitating a training program with Teen Health Aides in a way that encourages learning and critical thinking, stimulates personal growth and healthy decision making, and compels the Teen Health Aides to use their power and abilities to improve their own lives and the lives of those around them. Health education that helps people use their power to work together to address health problems can transform the world. Effective health education focuses on more than just facts. Even when we know all of the facts, we do not always make healthy decisions. Many times, we are unable to use health information because of the social, economic, cultural, educational, or political reality in which we live. Transformational health education goes beyond the bounds of facts to address our attitudes, beliefs, and behaviors. It sparks awareness of oppression, poverty, discrimination, and prejudice and facilitates critical thinking about the root causes of poor health. These “Teaching Notes” are intended to offer guidelines for learner- centered health education. Continue to rely on your own creativity and knowledge of your community. Incorporate ideas or effective teaching tools you have used in the past. Invite knowledgeable guest speakers. Listen to the Teen Health Aides and encourage them to give feedback about how and what they want to learn. Be flexible and look for unplanned learning opportunities. Look for thought-provoking news articles, movies, ads, and music. Encourage the Teen Health Aides to bring in materials they find interesting and useful. Sharing information, views, beliefs, values, and our life experiences are critical in creating a meaningful and powerful program. Using a learner-centered approach inherently creates an atmosphere in which everyone has something to bring to the table and, therefore, has more to invest in his/her own health and the well being of a community.

“Teaching Notes” Basics The “Teaching Notes” are a companion to the Infórmate for Farmworker Teen Health Manual. While these “Teaching Notes” offer specific activities and instructions, each program and organization should use or adapt them to meet its particular focus and needs. In other words, one program may choose to use the entire set of “Teaching Notes” as it is written, while a different program may choose to select particular lessons or activities that are relevant to their focus. The first page of every lesson contains an estimated time frame for the lesson, the lesson’s objectives, a list of activities, any needed supplies, and a story. Times have been estimated for each activity and for the total lesson. Actual times can vary based on the experience and mood of the group, the

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Introduction Page 2 discussion that results from an activity, or the facilitator’s style, among many other things. If a facilitator only has an hour but wants to do a lesson that will take an estimated two hours, he/she should feel free to cut out or to modify activities to suit their needs. It is important that each program facilitator, based on input from and observation of the group, decide on the most effective activities and time frames for their own purposes. The objectives relate to the learning goals for the Teen Health Aides. The “Before the Session...” section outlines the activities and reading that a facilitator can do to prepare for the lesson. Subsequent pages in each lesson give detailed instructions for the activities and include the objectives addressed, any necessary preparation, and estimated times for each activity. The supplies list on the first page of every lesson includes the materials needed for the lesson as well as suggested supplemental health education materials, such as pamphlets, videos, visual displays, and other materials. Specific supplemental materials referenced are listed in the Health Education Materials List in the “Teaching Notes.” The stories are addressed within the lessons and are intended to provide a catalyst to help the Teen Health Aides discuss their beliefs, feelings, knowledge and roles within their communities. Activities consist of icebreakers, activities, discussions, reading from the Manual, role-plays, videos, evaluations, and reviews. The Key shows the icons denoting the nature of the different activities in each lesson. Each of these activities is briefly described below:

Icebreakers Icebreakers are designed to get the Teen Health Aides ready to actively participate in the training session. Icebreakers may be games, stories, or other activities. Some icebreakers relate to the lesson topic, while others focus on fun, interactive activities that explore group dynamics.

Activities Activities are games or activities that involve direct and active participation.

Discussions Discussions are usually focused on a particular reading or topic. Discussion questions are included. The Program Coordinator or a Teen Health Aide may act as the facilitator for these discussions.

Manual Reading Reading from the Infórmate Manual can be read aloud by the Program Coordinator, a Teen Health Aide, or in a “read around” format, in which every Teen Health Aide takes turns reading a short section.

Role-Plays Role-plays offer the Teen Health Aides opportunities to act out scenarios or situations in order to practice responding to questions or situations or proactive risk avoidance techniques.

Videos Videos are intended to introduce and explore topics in a visual format and to stimulate discussion.

Evaluations Evaluations are completed at the end of each lesson either to measure how much the Teen Health Aides learned or to evaluate the quality of the lesson itself.

Review Review lessons are 30 to 45 minutes in length. They are designed to reinforce learning and provide the Teen Health Aides with a forum to exhibit the knowledge and skills they have acquired thus far. The Review icon corresponds with a ten-minute period at the end of every review lesson to revisit any questions, concerns, or misunderstanding that the Teen Health Aides may have. This time is intended to be flexible and to correspond with the needs of the group.

Facilitator’s Guides are included within the lessons and are clearly marked. They are intended to assist the facilitator by providing background information or pre-designed questions and answers, reducing the need for additional research, extensive time commitment for lesson planning, and familiarity with the lesson subject matter (although this is highly recommended). Materials requiring copying for handouts or for exercises are included at the end of each lesson. Handouts are listed in the Supplies list and are designed for a basic, black and white copy machine that uses letter-sized paper. Guest speakers may take the place of or reinforce particular topics in the “Teaching Notes.” Creative projects, field trips, or meetings with other groups

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Introduction Page 4 of adolescent peer educators are excellent ways to diversify training and to enhance the experience of the Teen Health Aides. Many facilitators are either quite familiar with their groups or will gain knowledge and familiarity of their groups while working with them. Using these “Teaching Notes” with a group will help a facilitator get used to not only the format and possibilities of the “Teaching Notes” but also to the style and preferences of the group.

Suggestions for Seasonal Programs Seasonal programs are often very intense. Some programs may have the time to cover each topic in the order of the “Teaching Notes.” Others may focus on knowledge acquisition first before moving into transforming that knowledge into attitude and behavioral change (i.e., risk reduction). Still others, pressed for time or concentrating on a particular topic, may choose to only cover a few chapters or lessons. Organizations should tailor the order of the training sessions to meet their needs. MHP Salud can suggest training schedules that fit the needs of a program.

Infórmate for Farmworker Teen Health

Health Education Materials

This list of health education materials is intended to serve as a comprehensive resource for the facilitator(s) of an Infórmate program. The materials are referred to within the “Teaching Notes” under the supplies sections. Some of the materials are meant for use within the actual lesson, others are supplemental, and some may be used as references for the facilitator. Teen Health Aides may use some of the materials listed below to educate their peers, families, and communities. Many of the companies and organizations listed have additional resources that facilitators may also consider ordering for their programs.

Chapter 1 Being a Teen Health Aide Lesson 3: Popular Education & Facilitating Group Health Education

1. Freire, Paulo. Pedagogy of the Oppressed.

Available at local bookstores.

2. Werner, David. 1992. Where There is No Doctor: A Village Health Care Handbook. “Words to the Village Health Worker.” Berkeley, California: Hesperian Foundation. Available in English and Spanish. $17.

Werner, David & Bower, Bill. 1982 (2001). Helping Health Workers Learn. Berkeley, California: Hesperian Foundation. Available in English and Spanish. $20.

The Hesperian Foundation 1919 Addison Street, Suite 304 Berkeley, California 94704 (510) 845-4507 fax: (510) 845-0539 (fax) [email protected]

3. Vargas Vargas, Laura & Bustillos de Núñez, Graciela. 1984. Técnicas participativas para la educación popular. Centro de Estudios y Publicaciones ALFORJA, San José, Costa Rica. Contact Centro de Estudios y Publicaciones ALFORJA for price.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Health Education Materials Page 2 Centro de Estudios y Publicaciones ALFORJA Apartado 369-1000 San José, Costa Rica 506-2531015 fax: 506-253-7023 [email protected] www.alforja.or.cr/

Chapter 2 Healthy Communities Lesson 1: Community Building

1. Freire, Paulo. Pedagogy of the Oppressed.

2. Werner, David & Bower, Bill. Helping Health Workers Learn. “Chapter 26: Looking at How Human Relations Affect Health.”

The Hesperian Foundation

Lesson 3: Sexism & Heterosexism or Homophobia

1. Lipstick. Video in English. A teenage girl struggles with issues of coming out as homosexual to her friends. 10 minutes. $30.

Scenarios U.S.A. 434 West 33rd Street, 12th Floor New York, NY 10001 (212) 252-9090 fax: (212) 247-6456 www.scenariosusa.com

Chapter 3 Let’s Talk About Sex! Lesson 1: The Basics of Anatomy, Puberty, & Sex

1. Today I Found Out. Video in English. A teenage girl thinks about her world and decision making after finding out her best friend is pregnant. 8 minutes. $50.

Scenarios U.S.A

2. “Male Facts” 50 for $18. “Female Facts” 50 for $18. “Pregnancy Facts” 50 for $18. “101 Ways to Survive Puberty” 50 for $16. “Menstruation Facts” 50 for $18.

ETR Associates P.O. Box 1830 Santa Cruz, CA 95061-1830 (800) 321-4407 fax: (800) 435-8433 www.etr.org

3. “Men, Babies & the Law: 15 Things You Should Know” 50 for $16. Pamphlet available in English and Spanish.

Journeyworks Publishing P.O. Box 8466 Santa Cruz, CA 95061-8466 (800) 775-1998 www.journeyworks.com

4. “The Facts of Life: A Guide for Teens and Their Families” 50 for $18. Pamphlet available in English and Spanish.

Planned Parenthood 434 W. 33rd Street New York, New York 10001 (800)-669-0156 www.plannedparenthood.org/store/index.html

Lesson 2: Sexual Decision Making & Communication

1. Just Like You Imagined? Video in English. Six teens think about love, relationships, dating, pregnancy, safer sex, and homosexuality. 9 minutes. $30.

Scenarios U.S.A.

2. “You Would if You Loved Me: How to Respond to Sexual Pressure” 50 for $16. “You’re Not Ready to Have Sex If…” 50 for $16. “20 Ways to Respond to Sexual Pressure” 50 for $16. Pamphlets available in English and Spanish

Journeyworks Publishing

3. “Safer Sex Self-Test: Protect Yourself” 50 for $16. Pamphlet available in English.

ETR Associates

Chapter 4 Birth Control Lesson 1: Knowledge

1. Contraception Samples Kit. Contact C.A.R.E or Health Connection for prices.

C.A.R.E. Inc. P.O. Box 8173 Saddle Brook, NJ 07662 (201) 440-4324

Health Connection 55 West Oak Ridge Drive Hagerstown, MD 21740 (800) 548-8700 fax: (888) 294-8405 www.healthconnection.org

Put together your own kit or ask local health clinics or other organizations to provide or donate some of the contents. Contents may include: • Male and female condoms • Birth control pill pack and dispenser • Model of Norplant (Note: Norplant is no longer used in the United States) • Model of hormonal ring • Model of hormonal patch • Diaphragm • Cervical Cap • Spermicide • Intrauterine Device (IUD) • Model penis • Model vagina

2. Anatomical Models (male and female). These companies offer various models. Prices vary.

Advocates for Youth 1025 Vermont Avenue, N.W. Suite 200 Washington, D.C. 20005

Health Edco P.O. Box 21207 Waco, TX 76702-1207 (800) 299-3366 ext. 295 fax: (888) 977-7653 www.healthedco.com

ETR Associates 3. “Birth Control Facts” 50 for $18. Pamphlet available in English and Spanish

ETR Associates

4. “Birth Control Choices for Teens” 50 for $12.50. “Your Contraceptive Choices” 50 for $12.50. Pamphlets available in English and Spanish

Planned Parenthood

Lesson 2: Making Decisions

1. Contraception Samples Kit

see above

2. Anatomical Models

see above

3. “Teensex? It’s Okay to Say No Way!” 50 for $12.50. Pamphlet available in English and Spanish

Planned Parenthood

4. “101 Ways to Make Love Without Doin’ It” 50 for $16. “101 Ways to Be Abstinent” 50 for $16. “101 Ways to Say NO to Sex” 50 for $16. Pamphlets available in English and Spanish

ETR Asscociates

1. “Sexually Transmitted Infections” 50 for $12.50. Pamphlet available in English and Spanish

Planned Parenthood

2. “STDs: Testing and Screening” 50 for $16. Pamphlet available in English

Journeyworks Publishing

3. “STD Facts” 50 for $18. Pamphlet available in English and Spanish.

ETR Associates

4. “Sexually Transmitted Disease (STD): A Picture of Health Display” Flipchart and Leader’s Guide $79.

ETR Associates

“Sexually Transmitted Disease (STD): A Picture of Health Display” Display $59.

ETR Associates

Chapter 6 HIV/AIDS Lesson 1: Knowledge

1. “HIV Facts” 50 for $18. Pamphlet available in English and Spanish

“HIV: Answers for Women” 50 for $16. “HIV: After the Test” 50 for $16. Pamphlets available in English

ETR Associates

2. “It Can’t Happen to Me! True Stories about Kids and AIDS” 50 for $12.50. Pamphlet available in English and Spanish

Planned Parenthood

3. “Cristina’s Story About HIV- For Hispanic/Latina Women” 50 for $55. “My Family Never Talked About AIDS—A Hispanic/Latino Man’s Story” 50 for $55. Pamphlets available in English and Spanish

Channing L. Bete Co., Inc. One Community Place South Deerfield, MA 01373-0200 (800) 477-4776 fax: (800) 499-6464 www.channing-bete.com

Lesson 3: HIV/AIDS, Decisions, & Substance Abuse

1. He Said/She Said. Video in English. A teen couple grapples with talking about safer sex. 3 minutes, 30 seconds. $50 (on the same video as Don’t Dance with Death).

Don’t Dance With Death. Video in English. A teen girl carefully considers condom use with the help of a trusted elder. The film uses the Mexican myth of the “Devil in the Dancehall.” 3 minutes, 30 seconds. $50 (on the same video as He Said/She Said).

Scenarios, U.S.A.

Chapter 7 Alcohol, Tobacco, & Other Drugs Lesson 1: Introduction

1. “Drug Facts” 50 for $18. Pamphlet available in English and Spanish

“101 Ways to get High Without Drugs” 50 for $16. Pamphlet available in English

ETR Associates

Lesson 2: Alcohol

1. Dead Drunk. Video in English. A young man kills a young woman in a drunk driving accident. He receives a unique punishment and struggles with his mistakes. 30 minutes. $89.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Health Education Materials Page 8 Produced by: Distributed by: Home Box Office Ambrose Video Publishing, Inc A Time Warner Entertainment Co. New York, NY 10036 1100 Avenue of the Americas www.ambrosevideo.com New York, NY 10036

2. “Drinking Facts” 50 for $18. “Incredible Alcohol Facts” 50 for $18. “101 Ways to Party Without Drinking” 50 for $16. Pamphlets available in English

ETR Associates

Lesson 3: Marijuana

1. “About Marijuana” 50 for $16. “Incredible Marijuana Facts” 50 for $18. Pamphlets available in English

ETR Associates

2. “Marijuana: A Picture of Health Display” Flipchart and Leader’s Guide $79.

ETR Associates

“Marijuana: A Picture of Health Display” Display $59.

ETR Associates

Lesson 4: Smoking & Tobacco

1. “Tobacco Facts” 50 for $18. “Incredible Tobacco Facts” 50 for $18. “101 Ways Not to Smoke” 50 for $16. Pamphlets available in English

ETR Associates

Chapter 8 Violence Lesson 1: Relationship & Family Violence

1. “Sometimes…It is Sad to be at Home” Booklet available in English and Spanish

Wayne County Coordinating Council to Prevent Domestic Violence Family Violence Council 600 Randolph Street, Suite 360 Detroit, MI 48226 (313) 224-6994 fax: (313) 224-6187

2. “Dating Violence is Never OK: A Teen’s Story” 50 for $55. “Violence in the Family-It’s Everyone’s Concern” 50 for $55. Booklet available in English and Spanish.

Channing L. Bete Co., Inc.

3. “Dating Dangers”

ETR Associates

4. “Love is Not ABUSE is not Love” Pamphlet available in English and Spanish

Liz Claiborne Inc. 1441 Broadway 15th Floor New York, NY 10018 (800) 449-7867

Chapter 9 Safety in the Field & Safety in the Camp Lesson 1: Protecting Ourselves at Work

1. “My Back Hurts” Bilingual information sheet

National Center for Farmworker Health, Inc. P.O. Box 150009 Austin, Texas 78715 (512) 312-7200 (800) 531-5120

2. “Back Care and Safe Lifting” $17.95 for 25. Pamphlet available in English

“Back Owner’s Manual” $1.59 each. “Understanding and Preventing Heat Stress” $1.59 each. Pamphlets available in English or Spanish

5. “Controlling Heat Stress Made Simple” Bilingual poster, document number 055-000-00474-9

U.S. Government Printing Office Superintendent of Documents Washington, D.C. 20402 (202) 512-1800 www.access.gpo.gov

Additional Resources

1. Changing Bodies, Changing Lives by Ruth Bell. Addresses a variety of teen concerns.

Three Rivers Press, New York www.randomhouse.com

2. Condoms and other safer sex items

Global Protection Corp. 12 Channel Street Boston, MA 02210 (888) 266-3665 fax: (888) 717-2200 www.globalprotection.com

3. Drunk/Intoxicated Simulators (goggles, activities, teacher’s guide)

DWI Simulator: D.W.Eyes Wreck Your Eyes Health Edco P.O. Box 21207 Waco, TX 76702-1207 (800) 299-3366 ext. 295 fax: (888) 977-7653 www.healthedco.com

4. Life Planning Education: A Youth Development Program. Training manual available in English or Spanish.

Advocates for Youth 1025 Vermont Avenue N.W., Suite 200

5. Nosotras Viviremos A set of teaching manuals available in Spanish and English for use with teenage female farmworkers and their mothers.

National Coalition of Advocates for Students 100 Boylston Street, Suite 808 Boston, Massachusetts 02116-4610 (617) 357-8507

6. Sex, etc. A newsletter put out by teens with an accompanying teaching manual.

Network for Family Life Education Center for Applied Psychology Rutgers University 41 Gordon Road, Suite A Piscataway, NJ 08854 (732) 445-7929 fax: (732) 445-7970 [email protected]. www.sxetc.org

7. Additional Sources of Curriculum, Newsletters, and Health Education Materials

Farmworker Health Services, Inc. 1221 Massachusetts Ave., NW Suite 5 Washington, D.C. 20005 (202) 347-7377 fax: (202) 347-6385 www.farmworkerhealth.org

Farmworker Legal Services of Michigan 34276 52nd Street P.O. Box 219 Bangor, MI 49013 (800) 968-4046 fax: (269) 427-1622 www.farmworkerlaw.org

HIV/AIDS Resource & Prevention Centers

MHP Salud 2111 Golfside Dr. Suite 2B Ypsilanti, MI 48197 P 800-461-8394 F 956-447-7908 www.mhpsalud.org

Michigan Resource Center 111 West Edgewood Blvd., Suite 11 Lansing, Michigan 48911 800-626-4636 fax: (517) 882-7778

Novela Health Education P.O. Box 800 Granger, WA 98932 (509) 854-2222 www.homestead.com/radiokdna/novela.html

National Institute on Drug Abuse (NIDA) P.O. Box 2345 Rockville, MD 20847-2345 (800) 773-8546 fax: (301) 468-6433 www.nida.nih.gov

Rural Women’s Health Project P.O. Box 12016 Gainesville, FL 32604 (352) 372-1095 (352) 338-8211 www.rwhp.org

¡Soy Unica! ¡Soy Latina! Via National Institute on Drug Abuse (NIDA) P.O. Box 2345 Rockville, MD 20847-2345 (800) 773-8546 fax: (301) 468-6433 www.soyunica.gov

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 1, Page 1 Chapter 1 Being a Teen Health Aide Lesson 1: ¡Bienvenidos a Infórmate! Estimated Time: 1 hour 30 minutes Objectives 1. To introduce the Teen Health Aides and staff to each other. 2. To establish group norms and ground rules. 3. To define “rights” and discuss the importance of balancing power and responsibility.

Supplies Before the Session … Newsprint 1. Read the Infórmate Manual, pages 1-7 & 10-11. Tape 2. Prepare the following: Markers Stand Up! Icebreaker Rope (at least six feet long) Copies of “Personal Introductions, Parts I & II Icebreakers Information,” “Oaths,” Introduction to Infórmate Discussion “Confidentiality What is a Right? Discussion Agreement” handouts Power & Responsibilities Tug-of-War Activity “A Teen Health Aide’s Story” Discussion Ground Rules Discussion

A Teen Health Aide’s Story You are a Teen Health Aide. A person you know, but aren’t close friends with, comes up to you and asks if she can talk with you alone. She looks nervous and a little bit embarrassed. You find someplace private to talk where you know you won’t be interrupted. She tells you that she thinks she is pregnant and is really scared because she doesn’t know what to do next. You tell her that you are glad that she told you and then ask her to explain her situation. She tells you the whole story, including the name of the guy, how her mom is going to be really upset, and that no one else knows. You listen carefully and then ask what information would be helpful for her and what you can do for her. She asks you about pregnancy and how she can talk to a doctor. You tell her about the stages of pregnancy and what she can expect if she decides to have the baby. You also tell her that there are a Planned Parenthood clinic and a migrant health center in town and that you can get her the phone numbers for both places. She thanks you. You arrange a time to meet again. Then she looks at you closely and says, “You won’t tell anyone, right?” You reassure her that you won’t.

A minute after you get home, your best friend runs over and says, “Was that Rosita?!? What did she want? I’ve heard all kinds of rumors about her!” Your best friend is popular and nice and knows everyone in the camp. What do you say to her?

Part 1: Icebreakers (20 min.)

Stand Up! (5 min.) Directions: • Read the list of statements below one by one. • After reading each statement, ask everyone to stand up who feels that the statement applies to him/her. Let everyone stay there for a minute and then sit back down. • Statements: I am glad it’s summer! I like playing sports. I have a pet. I have at least one sister. I have at least one brother. I want to learn about HIV and AIDS. I want to learn about alcohol and drugs. I want to make a positive difference in my camp!

Introductions (15 min.) Preparation: Tape up a piece of newsprint with the following words or phrases: Name Age Grade Favorite musician or band What my partner is most interested in learning this season Directions, Part 1: • Divide the Aides into pairs, and give them markers and scrap paper. • Let the Aides know that they will be introducing their partners to the rest of the group, and have them write down the information they collect. • Ask the Aides to get the following information from their partners: Name, age, grade, favorite musician or band, and what they are most interested in learning this season in the Infórmate program. • Give the pairs three minutes to collect this information. • Have the Aides introduce their partners to the rest of the group. They may refer to the piece of newsprint if they forget the different topics they should cover. Directions, Part 2: • Ask the group to arrange themselves in a line in the order of their birthdays (month and day). In other words, someone with a January 1st birthday would be at the beginning and Aides with December birthdays would be at the other end.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 1, Page 3 • Explain that no one should talk during this activity. They may use hand signals, gestures, or lip-reading to communicate. • Give the group five minutes to complete the line. • After the group has completed the line, ask everyone to say the month and day of their birthday to see if the group got the line in the right order! • Discuss: o Was it hard or easy? o What helped and what made it more difficult? o Can they think of anything that wasn’t done that would have made the activity easier to do? Why would that have made a difference? o How did not being able to talk make them feel? o Did they learn anything that can help them communicate well together throughout the season as Aides?

Part 2: Introduction to Infórmate (Objective 1) (15 min.)

Read pages 1-2 and 6 in the Manual. (10 min.)

Introduction to the Infórmate for Farmworker Teen Health Program (5 min.) Preparation: Prepare a piece of newsprint containing the names and explanations of the activities that the Aides at your site will be doing throughout the season. Select the appropriate activities from the descriptions below. Individual Encounters: Talking one-on-one or in small groups of three or four with other teens and kids about HIV, drugs, alcohol, STIs, and other things and helping them make healthy decisions for themselves. Group Health Education Sessions: Getting a larger group or even all of the teens in the camp to come to health education sessions. These can be information sessions about HIV and AIDS, games that show teens the dangers of drinking and driving, or a fun alternative to doing drugs. Theater Performances: Performing a play that the Aides have rehearsed together for all of the people at a camp, festival, church, or school. Newsletters: Creating a whole newsletter on topics like HIV, alcohol and other drugs, safety at work, and other things that will be distributed to every family in the camp. Directions: • Introduce staff members and their roles with the program (whether or not they are present).

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 1, Page 4 • Explain and describe the basic components of being an Aide by describing the activities the Aides will be doing. Use the prepared piece of newsprint as a guide. • To learn more about these activities, Aides may read pages 7, 10, and 11 in the Manual (optional).

Part 3: Rights & Responsibilities (Objectives 2 & 3) (55 min.)

What is a Right? (10 min.) Preparation: Prepare a piece of newsprint with the words: “What is a right?” Directions: • Ask the Aides to brainstorm what they think a right is. • Record responses on pieces of newsprint, or have each Aide write his/her responses on the pieces of newsprint. • Emphasize legal rights, the rights and power that the Aides have, and the connection between rights and power. For example, when a person has the right to vote, that person has power to influence who is elected. When a person knows a lot about HIV, he/she has power to affect what kind of information other people are exposed to and what they learn.

Power & Responsibility Tug-of-War (10 min.) Preparation: Get a rope, preferably a thick, strong rope that will not break. Ideally, this rope would be at least six feet long. Directions: • Divide the group in half, trying to get equivalent strength and weight in each group. • Tell one group that they represent “Power” and the other group that they represent “Responsibility.” • Ask all of the “Powers” to be on one side of the rope and one person from the “Responsibility” side to be on the other side. On “Go!,” let the tug-of- war begin. “Power” will usually win in this case. Discuss what happens when one side has too much power and not enough responsibility. • Reverse the situation. Have all of the “Responsibilities” on one side and only one “Power” on the other and have another tug-of-war. Discuss what happens when a person has too much responsibility and not enough power. • Have equal numbers of people on both sides and repeat the tug-of-war. Discuss why it is important to balance power and responsibility.

Read pages 3-5 in the Manual. (10 min.)

Read “A Teen Health Aide’s Story” (10 min.) Directions: • Read the story. • Discuss: o What POWER does the Aide have in this story? o What RESPONSIBILITY does the Aide have? o What would you do if you were the Aide in this situation?

Ground Rules (15 min.) Preparation: Make two copies of the “Oath” and “Confidentiality Agreement” handouts for each Aide and pass them out. Prepare a piece of newsprint by writing “Rights and Power” in one column and “Responsibilities” in another column. Prepare a second piece of newsprint that says, “Ground Rules.” Directions: • Ask the Aides to read each part of the “Oath” and “Confidentiality Agreement” handouts. • Discuss the promises the Aides make when they sign these documents. • Have the Aides sign one of each of the handouts and keep the second copies to take home with them. • Ask the Aides to think about this list. Discuss: o What are the things the Aides and staff should do to be responsible and respectful of each other? o What are the things the Aides should do to be respectful of the people in camps? o What are the things the Aides should do to be responsible citizens? • Ask the Aides to think about and then to write down the powers the Aides have, the responsibilities they have to one another as individuals, and the responsibilities the group has to the community. Discuss these together and record these thoughts on the piece of newsprint in the appropriate columns. • From these lists, the group should decide upon some ground rules. For example, if the group decides that each person has the right to say whatever he/she wants, there might be a responsibility to say things respectfully or to ask for permission to speak during discussions. In another instance, the group may think it has the power to educate both kids and parents. In that case, they may decide that they have the responsibility not to swear in front of anyone in their community when they are serving as Aides. • Write these on the “Ground Rules” piece of newsprint.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 1, Page 6 • Follow-up: The facilitator should type up the ground rules and distribute a copy to everyone at the next session.

Program Site/Lugar: ______Year/Año: ______

Name/Nombre: ______Age/Edad: ______

Birth date/Fecha de Nacimiento: ______Grade/Año Escolar: _____

Social Security Number/Número de Seguro Social: ______

Michigan Camp Address/Dirección: ______

Phone Number/Número de Teléfono: ______

Mailing Address/Dirección Postal: ______

Texas or permanent address, including state and country/Estado donde permaneces) Mailing Address/Dirección Postal: ______

Phone Number/Número de Teléfono: ______

Family Information/Infórmación de la Familia: (Names and ages/Nombres y edades) Parents/Padres:

Sisters/Hermanas:

Brothers/Hermanos:

Others who live in your home/Otros que viven en tu casa:

General Information/Información General: How many years have you migrated from one state to another?/¿Cuántos años tienes viajando de un estado a otro?

What do you like to do in your free time?/¿Qué te gusta hacer en tu tiempo libre?

What does being a Teen Health Aide mean to you?/¿Qué significa ser un Promotor/a de Salud para tí?

As A Teen Health Aide, I will:

• Stand up for what I believe in. • Be a positive role model for others in the camp and understand how the things I do affect what people think about me and about the program. • Show a caring attitude toward my community. • Teach others what I have learned. • Take a stand against racism, sexism, homophobia, violence and other forms of health problems in my camp. • Come to all the meetings and activities. • Talk to at least three people a week about health issues. • Help do group activities about health. • Keep the things people tell me confidential. This means I won’t tell others what a person has told me in private unless the person told me she/he is going to hurt herself or another person. If a person has told me that they plan to hurt themselves or another person, I will tell my Program Coordinator immediately. • Be a peacemaker.

I have read all the requirements of being a Teen Health Aide and I will do my best to fulfill my responsibilities in this position. I realize that I am in an important position to educate my community about health issues that affect teen farmworkers.

Signature:______Date:______

Witness:______Date:______

I agree to maintain confidentiality. In general, I will not discuss the private information of teens and kids, community members or others inappropriately or without the person’s permission.

Further, I understand that the only reasons for providing confidential information about a person to my Program Coordinator or to MHP Salud are to provide health and social services for the person or if the person has indicated that they are planning to hurt themselves or others. I will not provide confidential information to other Teen Health Aides or to other people unless I am helping the person receive health care or social services, and the person has given me permission to speak on his or her behalf.

I understand that I will be asked to leave MHP's programs permanently if I do not keep the private information of teens and kids, community members and others confidential.

Contracto para mantener la confidentialidad

Estoy de acuerdo con el requisito de mantener la confidentialidad. En general, no voy a discutir la información privada de los niños o adolescentes, miembros de la comunidad o otros sin razón o si la persona no me ha dado permiso.

Además, yo entiendo que las únicas razónes para compartir información confidencial de una persona a mi cordinadora o a MHP Salud es para proporcionarle servicios sociales o de salud a la persona o porque la persona indica que ella hace el plan para se hacer daño a ella misma u otra persona. No voy a proporcionar información confidencial a otras promotoras o a otras personas al menos que esta ayudará a la persona recibir servicios sociales o de salud y la persona me ha dado su consentimiento.

Yo entiendo que se me pedira que deje los programas de MHP Salud para siempre, si no guardo la información sobre los niños y adolescentes, los miembros de la comunidad y otras personas de manera confidencial.

______Firma de Teen Health Aide/Signature of Teen Health Aide Fecha/Date

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 2, Page 11 Chapter 1 Being a Teen Health Aide Lesson 2: Communicating with Individuals Estimated Time: 1 hour 45 minutes Objectives 1. To learn and practice communication skills. 2. To learn how to use two basic decision-making models. 3. To gain an understanding of empathy and nonjudgmental helping skills.

Before the Session … Supplies 1. Read the Infórmate Manual, pages 7–9. Newsprint Markers 2. Prepare the following: Tape “Telephone” Icebreaker TV/VCR Practicing Listening Skills Role-Play Copies of “Healthy Decision-Making Helping Others Make Decisions Model,” “STAR Decision-Making Practice Individual Encounters Role- Method,” & “Using Decision- Making Models” handouts Play Copies of “Encounter Record” form Knowledge, Attitudes, Action! Evaluation

YOUR Story, I You are a Teen Health Aide. A girl you know comes up to you and wants to talk in private. She is afraid that she could be pregnant, because she has been having sex with her boyfriend. They have used condoms sometimes, but not all the time. She wants to get a pregnancy test, but she does not have any money and feel embarrassed about going to a doctor. She does not want to tell her parents anything. She also does not want to talk with her boyfriend about it, because she’s afraid he may break up with her. They have been dating for about four months, and she really likes him, but she is not sure that he wants a baby.

YOUR Story, II You are a Teen Health Aide. A young man comes to you. He says that he only drinks once in a while, but last night he nearly got in a car accident because he was drunk while driving. He says that his parents know that he drinks, but he has never gotten in trouble and does not drink in front of them, so they don’t say anything to him. He tells you that he likes how he feels when he drinks – he feels less shy – but he’s afraid that he’ll get in trouble like he almost did last night and then his parents would be mad.

Part 1: Icebreaker (5 min.)

“Telephone” (5 min.) Directions: Note: The point of this exercise is to demonstrate that communication can easily get confused or tangled up. • Have the Teen Health Aides sit in a circle. • Explain that we are going to play a version of the game “Telephone.” If someone has played it, ask that person to explain the rules to the group. One person starts by whispering something into the ear of the person sitting next to him/her. That person then has to lean over and whisper what he/she heard into his/her neighbor’s ear. Continue around the circle until everyone has had a chance to listen and pass on what was heard. The last person will say the statement out loud. • Whisper a sentence in the first Aide’s ear. This sentence should not be common and should have some rhyming or alliterative words. • The final Aide to hear the message states it aloud. The facilitator then says what the sentence really was. See how close the message is from start to finish!

Part 2: Basic Communication & Listening Skills (Objectives 1 & 3) (20 min.)

Read page 7 in the Manual. (5 min.)

Practicing Listening Skills (15 min.) Directions: • Divide the group into pairs. Have one Aide be the “listener” and the other the “talker.” • Without telling the “talker,” ask one “listener” to practice good listening skills. This means they can use body language, appropriate eye contact, and small noises (they may say, “um-hmm” or “yes” but nothing more than that) to indicate that they are listening carefully and attentively. • In another pair, ask the “listener” to practice bad listening skills (again, without telling the “talker”). This means that the “listener” may be wiggling a lot, looking at someone else, clicking a pen against a table, etc. • Let each “talker” talk for three minutes on a topic of his/her interest (the topics do not necessarily have to be health related. It is preferable that the Aides discuss something that is true in their lives rather than make something up. Suggestions: why I want to be an Aide, what my favorite

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 2, Page 13 thing in school was this year, what I plan to do this summer/season, etc.). • At the end of the three minutes, ask the “talkers” to discuss who was the better listener. • Ask the partners to switch roles. Without telling the “talkers,” assign the roles of “good listeners” and “bad listeners” to the listeners. Repeat the exercise. • Ask the Aides to brainstorm a list of things that Aides can do to show people that they are listening carefully. • Ask the Aides to brainstorm a list of things Aides should avoid doing when they are talking to people. • Record these lists on sheets of newsprint.

Part 3: Decision-Making Models (Objectives 2 & 3) (35 min.)

Read pages 8–9 in the Manual. (10 min.)

Helping Others Make Decisions (25 min.) Preparation: Copy the “Healthy Decision-Making Model” and “STAR Decision-Making Method” handouts. Make one copy of each “Your Story I” and “Your Story II” scenario. Directions: • Divide the Aides into two groups. • Give the “Healthy Decision-Making Model” handout to one group and the “STAR Decision-Making Method” handout to the other group. • Give each group one scenario, either the “Your Story I” or “Your Story II.’ • Give each group ten minutes to use their model to help the main character in the scenario figure out options and think about the consequences of those options. • Ask each group to make the decision they think their main character would make based on the options and consequences they wrote. • Ask one Aide from each group to present their options and decision. • Discuss: o How can the Aides use these decision-making models for themselves? o How can the Aides use the models to help their friends and family make decisions?

Part 4: Individual Education (Objectives 1-3) (40 min.)

Practicing Individual Encounters (40 min.) Preparation: Make copies of the “Practicing Individual Encounters” handout and the “Encounter Record” form (enough so that each Aide can have three). Prepare an “encounter form” on newsprint. Make this “encounter form” large enough so that all the Aides can see it. Directions: Part I: Getting familiar with the form. (10 min.) • Have the group pretend that you are a person who has come to them with a question: “What is HIV?” • Carefully go over the different sections of the “Encounter Record” form. Ask the Aides to fill out one of the forms as though they were having an encounter with you. Ask the Aides to fill out the form as you go through it, step by step. Answer any questions that the Aides have about the form. Part II: Plática (10 min.) • Ask one Aide to volunteer to practice an encounter with you. This time, you play the Teen Health Aide role. The Aide plays the role of a teen. • Have a plática with the Aide about the effects of alcohol on the body. Emphasize the conversation. Do not fill out all of the form while doing the encounter. • After you and the Aide have finished the plática, fill out the “encounter form” you have prepared on newsprint. Show the Aides how to summarize a plática and write that summary on an encounter form. Part III: Practice (20 min.) • Divide the group into pairs. Ask one member of each pair play the role of a Teen Health Aide and the other to play themselves. • Ask each Aide who is NOT playing the Teen Health Aide part to ask his or her partner a health-related question about alcohol, drugs, HIV, or another topic you have learned about. • Instruct each pair to have a plática, like a conversation that two people might normally have. • Give each pair about 5 minutes to have the plática. • Ask the Aide playing the Teen Health Aide to then fill out an encounter form, once the plática, or encounter, has been completed. • Go around and make sure that each Aide is filling out the form correctly. • Have the pairs then rotate pairs and roles, so that different people are working with one another and getting the opportunity to play both an Aide and an interviewee. • Repeat the above process.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 2, Page 15 • Ask each Aide to report on any difficulties he/she had completing the form. • Ask the Aides to talk about any challenges they anticipate with doing individual encounters. Discuss the Aides’ answers, reinforce the importance of individual encounters, and identify ways to complete good encounters.

Part 5: Evaluation (5 min.)

Knowledge, Attitudes, Action! (5 min.) Preparation: Write the following sentence starters, one on each piece of newsprint: Today I learned that… This session made me feel like… Now that I have this information, I will… Directions: • Ask each Aide to write one statement under each heading. If possible, give each Aide a different colored marker. • Review the responses with the group and reflect on ways to put knowledge into action.

Step One: What’s the challenge or decision to be made?

______

Step Two: Choices

1. ______

2. ______

3. ______

Step Three: Consequences (What will happen?)

Positive Consequences Negative Consequences Choice 1

Choice 2

Choice 3

Step 4: And the decision is …

______

What are the reasons for picking this decision?

______

STOP: In any situation, a person can stop, step back from the situation, and give themselves some time to think.

THINK: ACT: A There’s definitely person does a lot to think what they about! A person decided to can ask do. themselves what their options are. Then they can make a list of the good things and bad things about these options. REVIEW: How did the situation work out based on the person’s decision?

Stop: What is the situation? ______

Think: Good Things, Pros, Positives Bad Things, Cons, Negatives

______

Act: What is the decision? ______

Review: After a person has made their decision and acted on it, they ask themselves: • What happened? ______• Can I live with the consequences? Yes No Maybe • Is there a better way I can handle the situation next time? ______

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 2, Page 19 Infórmate Encounter Record Date ______Name of Teen Health Aide______Program Site: ______Camp Resident Name ______Age: 8 and younger (Children) ______Sex: Male ______9-12 (Pre-Adolescents) ______Female ______13-17 (Youth/Adolescents) ____ 18-24 (Young Adults) ______Family Member? Yes ___ No ___ 25+ (Adults) ______(parents, siblings, cousins, grandparents, aunts and uncles) Don’t Know ______Is this the first time you’ve done an encounter with this person? Yes _____ No _____ Question or Concern: ______What was the encounter about? (Put a check): _____ HIV or AIDS _____ Alcohol, Tobacco, or other Drugs _____ Birth control _____ Sex _____ STIs _____ Violence _____ Other (what? ______) Action or advice given: ______Did you give anything out to the person? # _____ Brochures/Pamphlets (subject: ______) # _____ Male Condoms # _____ Female Condoms # _____ Other (what? ______) How long did you talk with this person? ______

Do you need to follow-up with this person? ____ Yes _____ No If yes, when is the next encounter? Date: ______

What would this person like to talk about the next time you talk? _____ HIV or AIDS _____ Alcohol, Tobacco, or Other Drugs _____ Birth Control _____ Sex _____ STIs _____ Violence _____ Other (what? ______)

Program Coordinator’s Initials: ______Comments: ______

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 2, Page 20 Infórmate Registro de Encuentro Fecha ______Nombre ______Lugar del Programa: ______Nombre del Residente del Campo ______Edad: 8 y más joven (Niños) ______Sexo: Hombre ______9-12 (Pre-Adolescentes) ______Mujer ______13-17 (Jovenes/Adolescentes) ____ 18-24 (Adultos Jovenes) ______¿Pariente? Sí _____ No _____ 25+ (Adultos) ______(padres, hermanos, primos, abuelos, o tíos) No sé ______

¿Es la primera vez que haces un encuentro con esta persona? Sí _____ No _____

Problema o Pregunta: ______¿Sobre qué fué el encuentro? (Ponga un “X”): ___ El VIH o SIDA ___ Alcohol, tabaco y otras drogas ___ Anticonceptivos ___ El sexo _____ ETSs _____ Violencia _____ Otro (¿que? ______) Acción: ______¿Distribuiste algo a esta persona? # _____ Folletos (tema: ______) # _____ Condones # _____ Condones de mujer # _____ Otro (¿qué? ______) ¿Cuántos minutos habló con esta persona? ______

¿Tienes que hacer seguimiento con esta persona? ____ Sí _____ No Si sí, ¿cuándo es el próximo encuentro? Fecha: ______

¿Qué otro tipo de información quiere esta persona la próxima vez que hablen? ___ El VIH o SIDA ___ Alcohol, tabaco y otras drogas ___ Anticonceptivos ___ El sexo _____ ETSs _____ Violencia _____ Otro (¿que? ______) Iniciales del Coordinador del Programa: ______

Comentarios: ______

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 3, Page 21 Chapter 1 Being a Teen Health Aide Lesson 3: Popular Education & Facilitating Group Health Education Estimated Time: 1 hour 30 minutes Objectives 1. To understand the purpose and philosophy of popular education. 2. To learn basic techniques of participatory education. 3. To practice planning and facilitating a group health education session.

Before the Session … Supplies Markers 1. Read the Infórmate Manual, pages 10-12. Newsprint (suggested readings for Program Coordinators: Tape Pedagogy of the Oppressed by Paulo Freire, Copies of “Dinámicas,” Introduction of Where There is No Doctor and “Ideas for Group Health Helping Health Workers Learn by David Education,” “Group Educational Session Planning Werner). and Evaluation Form” & 2. Prepare the following: “Group Health Education “Pablo’s Story” Icebreaker Sign-In Sheet” handouts Popular Education Philosophy Discussion Dinámica Soup! Activity Basic Steps for Group Health Education Discussion Group Health Education Session! Role- Play Review “Pablo’s Story” Evaluation

Pablo’s Story

Pablo lives in Texas from November to May and then comes to Michigan to pick berries and other crops during the summer. He works in the fields during the day from June to October. He goes to school for two months in Michigan and the rest of the time in Texas. Pablo is a Teen Health Aide.

Jane is one of Pablo’s teachers at school. Jane speaks Spanish and English and knows a lot about migrant farmworker families. She teaches bilingual classes and helps Pablo and others with their homework.

Esteban is the crew leader of the camp where Pablo and his family live. Esteban threatens people sometimes, but he has never kicked anyone out of the camp and usually treats people OK. Esteban and the grower get along.

Colleen is the Program Coordinator for Infórmate. She is bilingual and gets along with the Teen Health Aides. She teaches them about HIV and AIDS, drugs, and lots of other stuff. She grew up in Michigan but has never done farmwork.

Part 1: Icebreaker (10 min.)

“Pablo’s Story” (10 min.) Directions: Note: The group will discuss these questions again in the evaluation. • Read “Pablo’s Story.” • Discuss: o Who knows the most about migrant farmworkers in this situation? Why? o Do different people know different things? o Is everyone’s knowledge and experience equal in this situation? Why or why not?

Part 2: Introduction to Popular Education (Objectives 1 & 2) (20 min.)

Popular Education Philosophy (10 min.) Preparation: Prepare a short (three to five minute) talk on the key characteristics of popular education, including: Popular Education is based on the experiences of members of the community (in this case, the experiences of the Teen Health Aides and their peers). Everyone should be included in learning and teaching. Everyone has equally important information and experience. Always try to discover what the root causes of a problem are (for example, why are Latinos disproportionately at risk for HIV?). People work together to solve problems. It is important to use what has been learned to improve the lives of people. We are working for a world that is egalitarian; that means that we want a world where everyone is treated fairly and has what they need (food, shelter, education, health care, safety, freedom) to live. Popular educators use games, activities, theater, stories, and other things to get a group involved and thinking! Directions: • Deliver the presentation. Write or show key points as you talk. • Ask the Aides what they think. Give them some time to talk about popular education. Discuss: o What does popular education mean to you? o How is popular education different from education at school? o What do you like about popular education?

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 3, Page 23 o What do you find challenging about popular education? o How could you use popular education as an Aide?

Dinámica Soup! (10 min.) Preparation: Copy the “Dinámica” handouts. Directions: • Ask the Aides to pick between two and four of the dinámicas in the handouts to play. • Play each dinámica selected for approximately two minutes. • Before beginning the dinámica, ask the Aides to explain the purpose of each dinámica and how they would use it in a group health education session. Encourage Aides to look for meaning, or “teachable moments” associated with each game.

Part 3: Group Health Education (Objectives 2 & 3) (45 min.)

Read pages 10-12 in the Manual. (10 min.)

Basic Steps for Group Health Education (10 min.) Preparation: Copy and pass out the “Ideas for Group Health Education!” handout. Prepare a brief presentation on the outline of group health education sessions based on the suggestions below and the handout. 1. Welcome: Welcome everyone. Explain what you are going to do. 2. Introductions: Introduce yourselves. Have people introduce themselves. Play a dinámica. 3. Content: Do the main activity or activities! This may be a game, several games, a video, a theater performance, or something else! 4. Summary: Review the main points to make sure people understood the lesson. Ask if anyone has questions. Remind people that they can talk with you after the session or during the week. Thank people for coming! Directions: • Deliver Presentation. • Ask for any questions or additional ideas.

Group Health Education Session! (25 min.) Preparation: Copy and pass out the “Group Educational Session Planning and Evaluation Form” and “Group Health Education Sign-In Sheet.” Prepare to facilitate or assist with group facilitation. Directions: • Carefully go through the “Group Educational Session Planning and Evaluation Form” with the Aides. Ask the Aides if they have any questions. • Planning: Ask one Aide to facilitate the planning of a group health education session. Ask the group to plan a session, using the form. The facilitator should record the group’s plans on the form. The group should make decisions on the following: topic of session, what they want the participants to learn, the activities, their roles in the group session, and any materials they will need. This will take approximately ten minutes. • Practice Session: Have two Aides serve as the facilitators while the rest act as participants. The facilitators should make sure the participants sign in correctly. They should start the session and go through each of the four steps (welcome, introduction, content, and summary). This will take approximately five minutes. • Evaluation: Have the group evaluate the session by filling out the Evaluation section of form. This will take approximately five minutes.

Part 4: Evaluation (15 min.)

Review “Pablo’s Story” (10 min.) Directions: • Look at “Pablo’s Story” again. • Ask the Aides to reconsider their responses to the questions. • Have they changed their minds on anything? • What do the Aides think Pablo can do as an Aide to help this situation improve?

Trust Circle (15 min.) Preparation: This is a good activity to do outside in a grassy area. Directions: • Have the teens and any staff arrange themselves in a standing circle. • Explain to the teens that the following activities have to do with trust. Now that the teens have been working together for several weeks, ask them in what ways trust has played a part in their work (individual encounters, working with one another, working with you and other Infórmate staff, etc.). • Going around the circle, have each teen mention one characteristic that is really important in a trustworthy person (confidential, respectful, good listener, takes what other people say seriously, etc.). • Have one volunteer stand in the center of the circle. The remaining members of the circle need to move inwards until the circle is very tight, with everyone standing shoulder to shoulder and NO GAPS. • Have the members of the circle arrange their legs as though they were about to start running—one foot in front of the other with weight balanced equally between them, both knees bent. Then have everyone put both their arms up in front of them, elbows bent. You may want to demonstrate this position. This is called the “ready” position. • Explain that by sharing the strength of the group and standing in the “ready” position, the group can catch the person in the middle as they fall, even if we don’t know when and in which direction he/she is going to fall. Remind the group that taking things seriously is important for the person in the middle to able to trust us to catch him/her and prevent him/her from falling and getting hurt. • Have the teen in the middle stand perfectly straight with his or her arms crossed over the chest. Ask the teen to close their eyes and remember to NOT BEND when falling. This is the “falling” position. • Double check that there are no gaps in the circle. Ask the teen in the middle to say, “I’m ready” when he/she is ready to fall and the group to respond, “we’re ready,” before the teen begins falling (usually backwards is more comfortable to start). Pass/push/bump with person in the middle within the circle a few times. • Give everyone, including the staff, a turn in the middle. Note: if you have very small teens and one significantly larger person, if may not be a good idea to put this person in the middle.

1“El Pueblo Manda” and “El Cartero” are from Vargas Vargas, Laura and Bustillos de Núñez, Graciela. 1984. Técnicas participativas para la educación popular. Centro de Estudios y Publicaciones ALFORJA, San José, Costa Rica.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 3, Page 26 Trust Fall Preparation: See above. Directions: • Have the teens, and staff, pair off according to approximate size/weight. • Explain that this exercise is similar to the prior one, except one person is responsible for catching his or her partner alone. • Have one member of each pair stand in the “ready position” while his or her partner stands directly in front in the “falling” position. The person in the falling position will fall backwards into his or her partner’s arms, with eyes closed, after repeating the “I’m ready” “I’m in the ready” sequence. Note: Demonstrate first. • Change positions.

Circle Sitting Preparation: This is a good activity to do outside in a level area. Directions: • Ask the teens how long they could remain in a sitting position (knees and waist bent 90°) without a chair. Note: Most should say, “not long at all.” Challenge any teens who say they can last a really long time. Make sure they use proper form. • Remind the teens that there are some challenges that are much easier to do when you share the burden with other people. This activity illustrates this. • Have the group stand in a tight circle, with everyone facing the back of the person in front of them and putting their hands on that person’s shoulders. Have everyone take 2 steps inward until everyone is squished together. • Explain to the group that you will all slowly sit down on the knees of the person behind on the count of three. Repeat this activity until the group is able to successfully do circle sitting.

El Pueblo Manda Preparation: This a good activity to help teens concentrate. Directions: • Explain that you will demonstrate an action or gesture. • If you say, “El Pueblo Manda” before doing the action, then everyone must act it out. • If you do not say El Pueblo Manda but say something like El Pueblo Dice or El Pueblo Preguntase before doing an action, then everyone should stand still. • If a person starts doing an action when you haven’t said, “El Pueblo Manda,” then he/she becomes the next person to lead the group.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 3, Page 27 • Likewise, if a person does not do the correct action when you have said, “El Puebo Manda,” then that person becomes the leader. • Do the actions quickly to make the game fun and fast-paced!

El Cartero Preparation: This is a fun, fast-paced game for youth of all ages! Directions: • Form a circle of chairs, with one less chair than the number of people present. • Everyone sits on a chair except for one person. This person is designated as the first mail carrier and starts the game standing in the middle of the circle. • The person in the middle says, “The mail carrier (el cartero) is coming from Texas (or México, or wherever) and has a letter for everyone who is wearing black (or who is wearing a ring or who knows one fact about HIV, etc.).” • All of the people who are wearing black (in this example) and the person in the middle must find new seats. • The person who remains in the middle without a seat continues the game with a new statement, substituting where the mail carrier is coming from and what characteristics the people have who are receiving letters. • Continue playing until everyone has had a turn to be the mail carrier or until time permits.

Group education has a lot of advantages: • Everyone can learn from one another • People can do activities together that they cannot do alone • People may have questions that they did not even think of until someone else asks! • It is FUN!

A Group Health Education Session or Theatrical Performance has four main parts: Welcome: Aides can thank people for coming and explain the purpose of the session.

Introductions: Introductions help people get to know one another and feel more comfortable in a group. Doing a dinámica or game can help people have fun and get ready to participate in the rest of the session.

Planned Activities: These are the main parts of the group health education session. What should the participants learn? How are they going to learn it? What can the Aides do to help the participants learn?

There are LOTS of activities that Aides can do: • Theater performance • Health Lotería (Bingo) • Videos • Guest Speakers • Sharing personal experiences • Myth/Fact games • What is Your Risk? activity • Jeopardy game • $10,000 Pyramid game • Fun quizzes • Discussions • Health “Baseball” game • Read a story • Demonstrations • Interactive theater • Many more!!! Choose the activity or activities that will fit the audience the best!

Summary and Review: Aides can summarize the lesson and review what happened during the session. It is important to get feedback from the participants to know what they learned!

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 1: Being a Teen Health Aide Lesson: 3, Page 29 Infórmate for Farmworker Teen Health Group Educational Session Planning and Evaluation Form

Name: Date:

Type of Activity (mark one):

○ Small group activity ○ Camp-wide Activity

Topic:

PLANNING

Why did you choose this topic?

List the major ideas or skills you want the participants to learn: 1. ______

2. ______

3. ______

Welcome Activity: ______Who will facilitate the Welcome activity? ______Introductions: ______Who will facilitate the Introductions? ______Planned Activities: 1. ______Who facilitates? ______2. ______Who facilitates? ______3. ______Who facilitates? ______4. ______Who facilitates? ______

What materials are needed? ______

IMPLEMENTATION PASS A SIGN-IN SHEET AT EVERY EVENT!

Date and Time of Group Health Education Session: ______Site: ______Location: ______Record at Activity (complete this in addition to the sign-in sheet): Male Female Total in age group How many were family members? (brother, sister, parent, cousin, aunt, uncle of Aide) 8 and younger 9-12 (pre-teens) 13-17 (teens) 18-24 (young adults) 25+ (adults) Not known TOTAL NUMBER OF ATTENDEES: ______How many brochures were distributed? ______How many condoms were distributed? ______How many female condoms? ______How many other materials were distributed? _____ (specify material: ______) Total Time spent at group health education session: ______mins.

EVALUATION What were the participants MOST interested in? ______How well do you think the participants learned the skills and ideas you presented? ______

______Why or why not did they learn these skills or ideas? ______Were the activities effective? ______

Were the materials used (if any) effective? ______How would you evaluate the planning of the session? Excellent Very good Good Fair Poor Comments: ______How would you evaluate the response of the participants? Excellent Very good Good Fair Poor Comments: ______How would you evaluate the group’s performance at the session? Excellent Very good Good Fair Poor Comments: ______

What would you do differently at the next group health education session? ______

Infórmate Group Health Education Session Sign-In Sheet

Welcome. Thank you for coming! Please print your name and age on the form.

¡Bienvenido! ¡Gracias por venir! Favor de escribir su nombre y edad en la forma.

Name Age Are you related (brother, Nombre Edad sister, parent, cousin, aunt, or uncle) to one of the Teen Health Aides? Yes or No

¿Es un pariente (hermano, padre, primo, tio) a uno de los Teen Health Aides? Sí o No

Review Estimated Time: 30 minutes Before the Session … Supplies 1. Prepare the following: Copies of “Healthy Decision- Using Decision-Making Models Making Model” & “STAR Discussion Decision-Making Method” Basic Steps of Group Health Education handouts from Chapter 1, Lesson 2 Discussion Copies of “Making Decisions” Review handout Pens or pencils Newsprint Easel Markers

Using the Decision-Making Models (10 min.) Preparation: Copy the “Health Decision-Making Model,” “STAR Decision-Making Method,” and “Making Decisions” handouts. Directions: • Divide the Teen Health Aides into pairs. • Give each pair a “Making Decisions” handout, and assign each pair one of the scenarios. • Give the “STAR Decision-Making Method” handout to half the pairs and the “Healthy Decision-Making Model” to the remaining pairs. • Give each pair five minutes to use their model to come up with options and make a decision about how to address the issue in the scenario. • Ask each pair to explain which model they used and how they made their decision.

Basic Steps of Group Health Education (10 min.) Preparation: Set up a pad of newsprint and an easel. Directions: • Ask the Aides to identify the four steps of group health education.

Facilitator’s Guide Welcome Introductions Planned Activities Summary and Review

• Give the Aides a topic such as HIV or Marijuana. Ask them to plan a group health education session, including activities for each of the different steps. They may simply outline their ideas. • Record their plan on pieces of newsprint.

Review (10 min.) Directions: • Ask the Aides if they have any specific questions. • Review these or additional topics that the Aides did not remember or understand.

Making Decisions

Scenario #1: Monica is trying to decide whether or not to have sex with her boyfriend Jesús. She loves Jesús and wants to have sex, but she also does not want to get pregnant or get a sexually transmitted infection (STI).

Scenario #2: David really wants to go to a party on Friday night. He knows that people will be drinking beer and liquor at the party. David does not want to drink, but he knows that he can be talked into it pretty easily. He does not want his parents to be disappointed in him or his friends to make fun of him.

Scenario #3: Sandra is considering using marijuana. She knows that using marijuana is illegal, but she wants to see what pot is like. Sandra does not want to mess up her chances of getting a job or of getting into college.

Copyright © 2003 MHP Salud mhpsalud.org Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 1, Page 1 Chapter 2 Healthy Communities Lesson 1: Community Building Estimated Time: 1 hour 40 minutes (using Mapping the Community, Option II) Estimated Time: 3 hours 10 minutes (using Mapping the Community, Option I) Objectives 1. To recognize and understand the strengths and weaknesses of one’s own community. 2. To make a map of one’s community in order to analyze it in concrete terms. 3. To identify avenues for positive change and to begin planning concrete steps to create change. Supplies 4. To review ground rules and make the season’s Newsprint Markers goals clear. Rulers (optional) Pencils Drawing materials Before the Session … Copies of the “Mapping 1. Read the Infórmate Manual, pages 14-16 & 26-27. the Community: (suggested readings for Program Coordinators: Things to Look For!” Pedagogy of the Oppressed by Paulo Freire and & “Dinámicas” Chapter 26 of Helping Health Workers Learn by handouts Sketch of the community Werner & Bower). calendar(s) 2. Prepare the following: ¿Quién Empezó el Movimiento? Icebreaker “A Community’s Story” Discussion What is Community Discussion Mapping the Community, Options I & II, Activity Mapping the Community Discussion Making a Difference Discussion What Do You Think of Your Community Now? Evaluation

A Community’s Story Once upon a time, there was a community. It had kids, teenagers, parents, grandparents, and other adults. It had houses, cars, and a couple of streets. Most everyone knew everyone else in this community. Its families were good families.

Sometimes, however, the community was sad. Some of its kids were bored because they didn’t have good places to play. The communal washing machines did not work all of the time. Some people smoked marijuana. Last summer, two teenagers died in a drunk driving accident. The community knew those teens and wanted to see them grow up and follow their dreams.

Every year, the community grew new grass, brought in water, and kept the streets clear. The community knew that it could not solve all of its problems by itself, though. It depended upon the people to make good decisions.

Part 1: Icebreaker (5 min.)

¿Quién Empezó el Movimiento? (5 min.) Directions: • Ask the group to form a circle. • Explain the game. One person will be designated as the “guesser,” and a second person will be designated as the “leader.” This person will begin a movement (clapping, swinging one arm, shaking a leg, etc.). All of the other people in the circle need to follow this movement, and any changes of the movement, as soon as they see it. However, they must be subtle. • The first “guesser” must leave the circle while the “leader” is chosen. Once he/she returns and stands in the middle of the circle, he/she must try to guess who is starting the movements. • Once he/she figures out who the “leader” is, the “leader” must leave and be the next “guesser.” • Repeat a few rounds.

Part 2: What is Community? (Objective 1) (20 min.)

“A Community’s Story” (10 min.) Directions: • Read the story. • Discuss the questions. These responses will be reviewed in the evaluation. Discuss: o What is good about your community? o What is bad about your community? o How can people help their communities?

What is Community? (10 min.) Directions: • Discuss: o What does community mean to you? o Why do we talk about community in Infórmate? • Read pages 14-16 in the Manual and compare the content to the Teen Health Aides’ answers.

Part 3: Mapping the Community (Objectives 1 & 2) (Option I: 2 hrs. 15 min. OR Option II: 45 min.) Note: Two approaches to this project are presented here. The goal of the community mapping activity is to create a visual representation of the community that sheds new light on the community’s strengths and weaknesses and allows

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 1, Page 3 for a clearer analysis. Option I is designed to allow the Aides to go out into their communities. This option requires significantly more time but can be very helpful. Option II takes less time but requires that the Aides already be familiar with the geographic layout and characteristics of their community.

Mapping the Community, Option I (2 hrs.) Preparation: Prepare a sketched map of the community, divided into sections. Copy and pass out the “Mapping the Community: Things to Look For!” handout. Gather together drawing materials, rulers, and other decorating tools. Directions: • Before going outside, discuss the purpose of this project (creating a visual representation of a community in order to view it in a new light and allow clearer analysis of the community’s strengths and weaknesses). • Show them a prepared map of your neighborhood or workplace (a quick sketch is fine) to show an example of the types of things that could be included when mapping a community. • Give directions for completing the map: o Go out into the camp to map the community using the handout with suggestions o Stay together as a group o Go to one section of the community at a time o Do not interrupt people if they do not want to be interrupted o Interacting with people outside of the Aides’ group is fine, as long as it’s relevant to the activity. • Designate one person to sketch in the attributes of each section. All Aides should contribute things they see, smell, observe, or notice. Make sure the whole group agrees on the components included in the sketch before going on to the next section. • When completed, assemble or re-draw the map to form a representation of the entire community using drawing materials, rulers, and any other decorative tools.

Mapping the Community, Option II (30 min.) Preparation: Note: This option requires the Aides to prepare and draw maps of their neighborhoods or camps prior to the session. Provide Aides with the necessary materials (including the “Mapping the Community: Things to Look For!” handout) and instructions for creating community maps one session prior to the Community Building session. Ask the Aides to come prepared by making their own maps and/or notes BEFORE

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 1, Page 4 the session. These maps will then be combined into one large map during this session. Directions: • Ask each Aide to present his/her map. • Ask all of the Aides to create one large community map using their own sketches. The comprehensive map should contain all of the components the Aides included in their individual maps. • Remind the Aides to add in any of the things on the “Mapping the Community: Things to Look For!” handout that are missing.

Mapping the Community (15 min.) Preparation: Write “Strengths” on one piece of newsprint and “Things that need to be improved” on a second piece. Tape the pieces of newsprint on the wall. Directions: Note: Strengths may not be as easily identifiable as weaknesses. Weaknesses can be determined relatively easily from the map, i.e. too much garbage, no area to play, a lot of junk cars, houses look bad, etc. It is important to remember that both strengths and weaknesses are also not always easy to see. For example, a major strength in the community may be that people go to work regularly, or that there is a Camp Health Aide, or that there are impromptu soccer games every Friday night. Weaknesses may include a lot of people drinking and driving or smoking in the camp, or that girls don’t have a place to meet and play. Encourage the Aides to think broadly about what they notice in their communities! • Ask the Aides to think about the strengths and weaknesses of their community and record these under “Strengths” and “Things that need to be improved,” respectively. • Explain that this list will be helpful in completing the next activity.

Part 4: Ways to Change the Community for the Better! (Objective 3) (20 min.)

Read pages 26-27 in the Manual. (5 min.)

Making a Difference (15 min.) Note: Keep principles of Frierian community building and change in mind throughout this activity. The activities in this lesson relate to one another, in that after increasing awareness of the strengths and weaknesses of one’s community, people can begin to assess their own power to produce positive change. Preparation:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 1, Page 5 Write “Ways to Change the Community for the Better!” on a piece of newsprint. Tape this to the wall. Have markers on hand. Directions: Note: If the Aides do not decide on a project during this session, follow-up with them during the next session and make a decision. • Brainstorm and write down ideas of how the Aides can make positive changes that improve the health of their community. Ideas can be big or small, but the Aides need to feel that they can accomplish them. Possible ideas include: Raising money for two “real” soccer goal nets Putting posters around the camp asking people not to drink and drive Sponsoring an alcohol and other drug-free event each month Cleaning up the garbage in the camp once a month Asking the grower/landowner for space to build a small playground (this is a big project, especially if the Aides want to try to build a playground on the land) Many others! • For each idea, estimate how much time the project would take. Remember to include fundraising time, if needed. • Ask the Aides to decide as a group which project they want to take on. Remind them of the time each project is estimated to take and ask them how strongly they feel about the project. Also remind them that they are expected to finish what they start, so they need to pick a realistic project.

Part 5: Evaluation (10 min.)

What Do You Think of Your Community Now? (10 min.) Directions: • Review the questions for “A Community’s Story.” • Ask the Aides to think of the community in the story as THEIR own community. • Have the Aides changed their responses to the questions since the beginning of the session? If so, discuss why.

Buildings (homes, workplaces, equipment garages, etc.)

Playgrounds or open spaces for playing

Parks

Streets

Rivers, creeks, or lakes

Trails

Garbage cans or dumps

Areas for parking cars

Cars

Fields or spaces where people work

Places where there are bad smells

Wells or reservoir areas

Fun, safe places to hang out

Many, many other things!

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 2, Page 7 Chapter 2 Healthy Communities Lesson 2: Racism, Ageism, & Classism Estimated Time: 1 hour 35 minutes Objectives 1. To understand how race, ethnicity, stereotypes, and discrimination are related. 2. To validate and explore Teen Health Aides’ experiences with racism and discrimination based on ethnicity. 3. To validate and explore Aides’ experiences with ageism. 4. To validate and explore Aides’ experiences with classism. 5. To encourage the Aides to consider ways that they can address negative social influences in the community either individually or in coordination with other people.

Before the Session … Supplies: 1. Read the Infórmate Manual, pages 17- Large nametag stickers 19, 22-25, & 135-136. Markers, different colors 2. Prepare the following: Newsprint Identity Tag Icebreaker Tape Race, Ethnicity, Class, & Copies of “José’s ‘But Why…?’ Story” Discrimination Discussion handout (optional) “José’s But Why…? Story” Discussion Balloons Energizer Balloon Game Evaluation Paper and pens

José’s But Why…? Story (full story appears at the end of the lesson) José is sixteen years old and travels with his family from Texas to Michigan every summer to work in an apple orchard. He and his best friend, Ben Smith, love airplanes. They both dream of learning to fly. Ben’s family is wealthy, but he’s waiting to take flying lessons until after the summer. By then José will hopefully have been able to save some money, so the two can take the lessons together. José misses Ben when he’s in Michigan, but he knows he needs to make money for his family. The summer is when the family earns the most, since neither of José’s parents speak or read much English and they have been unable to find good paying jobs in Texas. This season, José is hoping that he will be able to work part time in the orchard’s office to make some extra money to pay for flying lessons….

Part 1: Icebreaker (10 min.)

Identity Tag (10 min.) Preparation: Note: As the facilitator, you may have to participate in this activity, helping to start conversations with the “new identities,” especially if the Aides are unfamiliar with terms like “lesbian” or “social worker.” Be sure to follow up with a discussion of identities and stereotypes, using the questions below as a guide or starting point. Write each of the following “identities” on sticker nametags: A sixteen year-old mother in a migrant farmworker family A young, black man A middle-aged, white police officer A lesbian (a gay woman) doctor A poor, white girl who is ten years old A female African American social worker An elderly, Latino man Directions: • Explain to the Aides that they will each be given a different identity on a sticker nametag that they cannot see because it will be stuck on their backs. Everyone else will be able to read who they are, but they won’t know themselves. Give the Aides an example of an identity, i.e., a middle-aged, Mexican-American teacher. • Stick one identify tag on each Aide’s back. • The Aides should pretend they are all meeting one another for the first time. Have the Aides interact with each other, based on each other’s new identities. • At the end of a few minutes, have everyone try to guess “who” they are based on how they were treated. Discuss: ○ How did you figure out your identities—what tipped you off? ○ What does this activity have to do with stereotypes (define if necessary)? ○ Why do we use stereotypes when we talk about or interact with other people, especially if they are a different ethnicity, sexual orientation, gender, age, or economic class than we are? ○ Where do you think stereotypes come from?

Part 2: Race, Ethnicity, Stereotypes, & Discrimination (Objectives 1-4) (60 min.)

Read page 17 in the Manual. (5 min.) • Discuss:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 2, Page 9 o How would you describe the “-isms” in your own words? o What are other words for “prejudice” and “discrimination?”

Read pages 18-19 and 135-136 in the Manual. (10 min.)

Prejudice and Discrimination (20 min.) Directions: • Ask the Aides to each think of one or two examples of either prejudice or discrimination, especially as they relate to racism, ageism, and classism. These examples can be from their own lives, from something they’ve seen on the news or in a movie, or from a friend’s or relative’s life. They should write these ideas on slips of paper. • Collect the slips of paper. • Designate one side of the room the “worst” side and one the “best” side. • Read the examples on one of the pieces of paper. Ask the Aides to “rate” the acts or experiences of prejudice and discrimination by walking to one side of the room or the other or by standing somewhere in between, depending on how bad or harmful they think the prejudice and discrimination is. • Ask the Aides why they chose to stand where they did after each example is read. • Discuss: o Why did you rate the prejudices and discriminations the way you did? o What makes one act of prejudice or discrimination worse or better than another? o Do you think it matters to the person who is being discriminated against which type of prejudice or discrimination is better or worse?

Read pages 22-25 in the Manual. (10 min.)

Brainstorm (15 min.) Preparation: Prepare a piece of newsprint. Directions: • Ask the Aides to brainstorm ideas of how they, as Aides, can help stop or prevent prejudice and discrimination. • Record their responses on newsprint. Keep this newsprint for the lesson on sexism and heterosexism.

Additional Discussion Questions Note: These questions are intended to help stimulate or focus a discussion. You may not need any of them or you can select those that seem most relevant to the group or discussion. • Discuss: ○ What do you think about racism, classism, and ageism? ○ How many different “races” are there? ○ What is it that differentiates them? ○ How is race different from ethnicity? ○ How are culture and stereotypes related? ○ What are do hate crimes and how they are related to race, ethnicity, and culture? ○ Ask the Aides to voluntarily share any experiences they have had with racism and/or discrimination based on ethnicity—as victims, observers, or perpetrators. Discuss how some forms of racism are more obvious than others. ○ How do class and/or economic status affect your lives? ○ How are class and race/ethnicity related? ○ What stereotypes are there about people of Mexican descent? ○ What stereotypes are there about migrant farm workers? ○ How does our society treat old people? ○ How does our society treat young people? ○ Are any of these stereotypes true? Are they true for everyone who is a farmworker or are they common among farmworkers? ○ Where do these stereotypes come from? ○ How do stereotypes develop and change?

Part 3: Putting It All Together (Objectives 1-5) (20 min.)

“José’s But Why…? Story” (20 min.) Preparation: The purpose of But why…? stories is to encourage readers to examine the social factors and underlying roots of oppression that influence people’s lives and their well-being. Depending on how the line of questioning goes, you may need to prepare to redirect the questions to touch on all the relevant points. Read or make copies and pass out “José’s But Why…? Story” located at the end of the lesson. Directions: • Read “José’s But Why?...Story” out loud. • After reading the story, ask the group, “Why won’t José be able to take flying lessons?” After one of the Aides has responded, ask, “but why?” When an Aide then elaborates, again respond, “but why?” Example:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 2, Page 11 You: “Why won’t José be able to take flying lessons?” Aide: “He lost an eye.” You: “But why did he lose the eye?” Aide: “It took too long to find the hospital.” You: “But why?” Aide: “The woman refused to give them directions.” You: “But why?” Aide: “She was scared of them.” You: “But why?” Aide: “José was covered with blood.” You: “But why would that scare her?” Aide: “Maybe she thought he had been shot.” You: “But why would she think that?” Aide: “Maybe she thought he was in a gang.” You: “But why?” Aide: “Because he was a young Latino man.” You: “But why would she think that?” Etc., etc. • To wrap-up, discuss: o What do you think of the story? o Was what happened to José fair? o What could you do or say as Aides if you were with José at different times in the story (after talking to the boss, in the truck asking for directions, after José had lost his eye)? o What could José’s community or family do to prevent something like this from happening again? (Examples: Help find English or skills training classes so people like José’s parents could get better paying jobs in Texas. Try to get orchards to provide protective eyewear. Establish Camp Health Aides who would be responsible for helping people deal with things like injuries and finding medical care.)

Part 4: Evaluation (5 min.)

Energizer Balloon Game (5 min.) Preparation: Write fun questions on slips of paper. Make sure there is one for each Aide. Have the questions relate to the topic, such as: What was the best part about being a little kid? What are you most looking forward to when you become an adult? What’s the best part about being the age that you are now? What’s your favorite part of your culture/ethnicity? What’s your dream job?

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 2, Page 12 What’s one sentence you wish to never hear an adult say again? What adult has influenced you the most and how? Fold the papers, and put one in each balloon. Blow up the balloons. Directions: • Ask the Aides to stand in a group. • Tell them that their task is to pick a balloon, pop it using only their body—they can’t use pens or other sharp objects—and answer the question. • Throw the balloons into the air and let the Aides select them. Re-group, and have each Aide present his/her question and answer.

José is sixteen years old and travels with his family from Texas to Michigan every summer to work in an apple orchard. He and his best friend, Ben Smith, love airplanes. They both dream of learning to fly. Ben’s family is wealthy, but he’s waiting to take flying lessons until after the summer. By then José will hopefully have been able to save some money, so the two can take the lessons together.

José misses Ben when he’s in Michigan, but he knows he needs to make money for his family. The summer is when the family earns the most, since neither of José’s parents speak or read much English and they have been unable to find good paying jobs in Texas.

This season, José is hoping that he will be able to work part time in the orchard’s office, because the boss said he was the most helpful and responsible worker last year. The office plays much better than working in the orchard, and José would be make some extra money to pay for flying lessons.

When José arrives at the orchard in Michigan, he asks the boss if he can work part time in the office. The boss says, “The stuff we do in the office is too complicated for you. I need someone who can read and write English. I can’t risk having you mess something up just because you don’t understand English well.” The boss hired a white, high school student instead. José was really disappointed. He knew the boss was wrong about him—he aced all of his English classes in school—and he wanted more than anything to be able to afford flying lessons.

One day, while working in one of the apple trees, José got a stick caught in his eye. Some of the workers threw him in the back of a truck but didn’t know how to get to the nearest hospital. When they tried to ask a woman on the street, she gasped at José’s bloody face and rushed away. Because it took so long to find the hospital, José’s eye had to be removed. José will never be able to take flying lessons now.

Copyright © 2003 MHP Salud mhpsalud.org Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 3, Page 15 Chapter 2 Healthy Communities Lesson 3: Sexism & Heterosexism or Homophobia Estimated Time: 2 hours 10 minutes Objectives 1. To become more aware of the oppression of women and sexual minorities. 2. To help create more tolerance and empathy among the Teen Health Aides for people who experience sexual oppression, such as women, gays, lesbians, and bisexuals.

Before the Session … 1. Read the Infórmate Manual, pages Supplies 20-25. Newsprint 2. Prepare the following: Tape Three different kinds of Beyond the Limits Icebreaker stickers The Words We Use Activity Pens and pencils The Gender Game Activity Markers Who is Gay? Activity Index cards Myths about Gays & Lesbians TV/VCR Copies of the “Beyond the Limits” Activity handout Coming to Terms with Materials from Health Education Homosexuality Video Materials List: Fighting Discrimination Video: Lipstick Discussion Photos of people – these can be cut out of magazines, What We Think & Do gathered from home, etc. Evaluation 3. Preview video: Lipstick

Santiago’s Story Santiago finally told his mother he was gay when he was 21.

He had always known he was gay. In high school, though, he had called other kids “fag,” “queer,” “homo,” or “sick.” He threatened and bullied any boy who was slightly weak or had any feminine qualities. He went out on dates with girls and made out with them a few times but never enjoyed it. At times Santiago felt so sad and hopeless of ever being accepted if the truth came out that he considered committing suicide.

When Santiago was eighteen and just about to graduate from high school, he began to accept that he was gay. He slowly stopped calling people names. But after high school, he did not answer any calls from friends he had in high school. He still does not tell people if he is gay. If someone asks, he usually tells the truth, but he feels awkward talking about it. He’s still afraid that people will think he has AIDS or that he will sexually abuse their children.

Part 1: Icebreaker (10 min.)

Beyond the Limits—Challenging Ourselves (10 min.) Preparation: Copy and pass out the “Beyond the Limits” handout and pencils. Directions: • Tell the Aides to follow the handout instructions. Give them about five minutes to complete the activity. • Ask if anyone completed it correctly. • Show the correct solution.

Facilitator’s Guide Think Outside the Box!

● ● ●

• Discuss: ○ What does this activity mean? ○ What does it have to do with today’s topic?

Part 2: Oppression & Gender (Objectives 1 & 2) (35 min.)

Read page 20 in the Manual. (5 min.)

The Words We Use (15 min.) Preparation: Tape up four pieces of newsprint on the wall. Print each of the following on different pieces: Female Sex Parts Male Sex Parts Women

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 3, Page 17 Homosexuals Directions: Note: It is fine to agree that some slang words are appropriate, but make sure that the Aides know the correct words (those that are not sexist, homophobic, or meant to be insulting). • Ask the Aides to list on the pieces of newsprint all of the slang words they have heard used to refer to female sex parts, male sex parts, women, and homosexuals. • Give each of the Aides three different kinds of stickers (for example, different colored stars): One sticker represents words that are sexist or homophobic. Another sticker represents words that are used to insult people. The final sticker represents words that are neutral or are the correct dictionary definition. • Have the Aides go to the lists and put their stickers next to the words in order to categorize them. A word may have several different stickers. • Facilitate a discussion about the different interpretations and categorizations. • Ask the Aides which words they think should be used in the group’s future discussions.

The Gender Game: Distinguishing between “Sex” and “Gender” (15 min.) Preparation: On one side of the room, tape a piece of newsprint marked “sex.” On the opposite side of the room, tape a piece of newsprint marked “gender.” Directions: • Ask the Aides if they have heard of the term gender. Ask them if they understand the difference between gender and sex.

Facilitator’s Guide Sex is something related to nature and biology—the way that a person is, physically, when he/she is born and can’t change.

Gender is related to what others expect of you because of your sex. It’s related to how you are taught to behave, how you are nurtured, and how people treat you.

• Clarify that on some surveys and forms gender and sex are used to refer to the same thing, but they really have different meanings. • Point out the designations of the different sides of the room. • Ask everyone to stand up. Tell the Aides you will read a series of statements, and that they must decide if the statement relates to gender or to sex. They must move to the corresponding side of the room.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 3, Page 18 1. Women give birth to babies; men do not. (Sex) 2. Little girls play with dolls; boys like war toys. (Gender) 3. In one case, when a child brought up as a girl learned that he was actually a boy, he started to get better grades in school. (Gender) 4. Women get paid less than men for doing the same work. (Gender) 5. Women can breastfeed babies; men can bottle feed babies. (Sex) 6. Men’s voices change during puberty; women’s do not. (Sex) 7. A boy is more likely to rape a girl than vice versa. (Gender) 8. In a study of 224 cultures, there were five cultures in which men did all the cooking and 36 in which women did all the house building. (Gender) 9. It is easier for a girl to get an STI during unprotected sex with an infected partner than for a boy. (Sex) 10.Most scientists and mathematicians are men. (Gender) • Discuss: ○ What are the differences between the statements having to do with sex and gender? ○ Did any of the statements surprise you? ○ Do you think all of these statements are fair and always or usually true? ○ What do these statements have to do with you and peer education?

Part 3: Oppression & Sexual Orientation (Objectives 1 & 2) (60 min.)

Read page 21 in the Manual. (5 min.)

Who is Gay? (15 min.) Preparation: Find and bring photos of people. These people may be celebrities or famous, family and friends, models from catalogs, or anyone else you can find. (If they are not out of a publication, though, make sure you have the person’s permission to use them.) Directions: • Show one photo at a time to the Aides. • Ask them to guess who is gay (homosexual) and who is heterosexual. • Discuss: o Why did you think some people were gay and some were not? o Are there certain features or characteristics that are “gay” or “straight”? o What do you assume about a person’s sexual orientation when you first meet them?

Myths about Gays & Lesbians (15 min.) Preparation: On one side of the room, tape a piece of newsprint marked “fact.” On the other side, tape a piece of newsprint marked “myth.” Directions: • Point out the designations of the different sides of the room. • Read the following statements about gays and lesbians out loud, and ask the Aides to move to the corresponding side of the room. 1. Most gay people are white. 2. Most lesbians wish they were men. 3. There are gay farmworkers. 4. A gay man usual acts feminine. 5. A person can grow up to be a heterosexual adult if he/she is raised by gay parents. 6. Gay people choose or decide to be gay. 7. Gays should not be teachers because they would try to make their students gay. 8. Lesbians have a very low risk of getting HIV through sex with other women. 9. Most child molesters are gay. 10.There is nothing wrong with hating gay people. • After reading each statement, discuss why the Aides chose to stand where they did. Be careful not to make the Aides feel stupid, bad, or wrong for selecting a particular side, but discuss the truth behind these statements. • Point out that our society tells a lot of lies about people who are oppressed. It can be hard to unlearn what we have been told by our parents, our friends, our religion, the media, and our culture. • Ask the Aides why it is important for them to think about the assumptions and beliefs they hold about homosexuals and how these affect how they communicate with others.

Coming to Terms with Homosexuality (25 min.) Preparation: Bring TV/VCR and the video and the video, Lipstick. Directions: • Read “Santiago’s Story.” • Watch Lipstick. • Discuss:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 3, Page 20 o What are some of the feelings or fears that Emily and Santiago are dealing with? o How would you honestly have responded if you had been one of Emily’s friends? o How would you interact with Santiago during the period of his life when he was a bully? o Do you think that all teens who are struggling with being gay are “noticeable” to the people around them? o Is it possible that there are people you know struggling with this right now? o What could you do to help them?

Part 4: Addressing Prejudice & Discrimination (Objectives 1 & 2) (20 min.)

Read pages 22-25 in the Manual. (10 min.)

Fighting Discrimination (10 min.) Preparation: On one side of the room, tape a piece of newsprint marked “Discrimination Hurts.” On the other side, tape a piece of newsprint marked “My Commitment.” Directions: • Ask the Aides to brainstorm ways that discrimination and prejudice hurt a community. Write their answers on the “Discrimination Hurts” piece of newsprint. • Ask the Aides to brainstorm things they can do to stop discrimination and prejudice in their communities. Ask each Aide to make a commitment to do at least one of these things during the season. Ask them to write their ideas on the “My Commitment” piece of newsprint.

Part 5: Evaluation (5 min.)

What We Think & Do (5 min.) Preparation: Pass out index cards and pencils or pens. Directions: • Ask the Aides to write down the following questions and their responses on the cards. What is one thing that surprised you during today’s session? What is one thing you are going to do as a result of today’s session (as an Aide or for personal reasons)?

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Lesson: 3, Page 21 • Let them know that you will be collecting the cards and that sharing their answers with the entire group is optional. • Ask for volunteers to share their answers. • Collect the cards. Follow up on any issues in future sessions as needed.

Beyond the Limits!

Figure out a way to connect all the dots using four straight lines without lifting your pencil from the paper. Lines can cross, but they cannot trace over one another. ● ● ●

● ● ●

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 2: Healthy Communities Review, Page 23 Chapter 2 Healthy Communities Review Estimated Time: 30 minutes Before the Session … 1. Prepare the following: Supplies The “-isms” Circles Activity Music and CD/cassette player or Review radio

The “-isms” Circles (20 min.) Directions: • Divide the Teen Health Aides into two equal groups, with one group forming an inner circle and the second forming a circle around the outside of the first group. Have the members of the two circles walk in opposite directions. • After a few seconds stop the music, and ask the Aides to stop and pair up with the person standing closest to them in the other circle. • Read each statement out loud, and ask the Aides to react to it, talking about it with their partners for about one minute.

Facilitator’s Guide All people pretend not to be racist even though they are. If people had jobs, they would not be poor. I would feel bad if my best friend told me he/she was gay/lesbian. When people look at someone, they see race first and other things second. Teenagers are considered second-class citizens. It is not possible to be racist against white people. Television shows stereotypical images of people. Being sexist is better than being racist. I think of myself as equal to everyone else. Teens commit more crimes than adults. Gay, lesbian, bisexual, and transgender people should be able to be legally married. It would not be a big deal for me to date someone outside my race. It is OK for police to stop any man of color if he is the same race as a suspect. It is a person’s own fault for being poor. I have a responsibility to end the “-isms.”

• Repeat this exercise so that the Aides talk to different people and respond to various statements. • In a large group, share some of the comments that came up about racism, sexism, homophobia, classism, and ageism.

Review (10 min.) Directions: • Ask the Aides if they have any specific questions. • Review these or additional topics that the Aides did not remember or understand.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 1, Page 1 Chapter 3 Let’s Talk About Sex Lesson 1: The Basics of Anatomy, Puberty, & Sex Estimated Time: 2 hours 30 minutes Objectives 1. To understand female and male reproductive anatomy. 2. To discuss the physical changes that occur during the teen years (puberty). 3. To help the Teen Health Aides, both male and female, understand the menstrual cycle. 4. To discuss sex and sexuality. 5. To gain a brief understanding of Supplies pregnancy—the basics, its effects on Sets of the following: a pear, the body, and prevention. two almonds or grapes, single strands of licorice, & a cardboard roll of toilet Before the Session … paper 1. Read the Infórmate Manual, pages 29- Sets of: a small banana, 46. single strands of red & black licorice, a walnut in 2. Prepare the following: its shell, & play dough El Cartero Icebreaker Newsprint Male Anatomy Activity Tape Female Anatomy Activity Pens and markers Reproductive Anatomy Discussion TV/VCR Potato or ball Mapping the Changes of Puberty Music and CD/cassette Race Activity player or radio Puberty Discussion Materials from Health What is Menstruation? Education Materials List: “Telephone” Activity Video: Today I Found Out Pamphlets: “Male Facts,” Males & Menstruation Discussion “Female Facts,” Sex Rights & Responsibilities “Menstruation Facts,” Activity “Pregnancy Facts,” “101 Teen Pregnancy Video Ways to Survive Puberty,” Hot Potato Evaluation “Men, Babies, & the Law,” 3. Preview video: Today I Found Out & “The Facts of Life”

Javier’s Story Javier is thirteen years old and is very interested in girls. He has a hard time talking with them, though, because he is afraid that he will say something stupid. He’s also nervous about what happened the last time he saw a cute girl.

Javier and his friend Ramón were at the movies when he saw this girl from his class. He could feel his face getting hot and then felt his penis get erect just looking at her. Javier has also woken up to find something wet and sticky between his legs a couple of times. He feels embarrassed when his friends talk about “doing the nasty,” “wet dreams,” “blow jobs,” and “hard-ons.” He doesn’t want to admit what is happening to him, but he also wants to sound like he knows what he’s doing with the girls.

Part 1: Icebreaker (10 min.)

El Cartero (10 min.) Directions: • Form a circle of chairs, with one less chair than the number of people present. Everyone sits on a chair except for one person. This person is designated as the first mail carrier and starts the game standing in the middle of the circle. • The person in the middle says, “The mail carrier (el cartero) is coming from Texas (or México, or wherever) and has a letter for everyone who is wearing black.” • All of the people who are wearing black and the person in the middle must find new seats. • The person who remains in the middle without a seat continues the game with a new statement, substituting where the mail carrier is coming from and what characteristics the people have who are receiving letters. • Continue playing until everyone has had a turn to be the mail carrier or as long as time permits. • Be creative in linking the game to the focus of the program. For example, say, “The mail carrier has a letter for anyone who, “has been an Aide before,” “is a teenager,” “has talked about sexual decision making,” etc.

Part 2: Male & Female Anatomy (Objective 1) (40 min.)

Male Anatomy (15 min.) Preparation: Create sets of supplies for each pair and the facilitator. Directions: • Divide the Aides up into pairs, and give each pair a set of fruit. Explain that: the small banana represents the penis single strands of black and red licorice are the vas deferens and urethra, respectively a walnut in its shell is the prostate play dough can be shaped into the testes and scrotum • Instruct the pairs to assemble the male reproductive system to the best of their ability without referring to the Manual. Check their progress, and answer questions without revealing too much.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 1, Page 3 • Have each pair present its version of male anatomy. Ask them to try to explain the purpose of each organ, and let them know it’s OK not to know. Later, you will explain these more thoroughly. • When everyone is done, assemble your own version and compare to the Aides’. • Read pages 33-34 in the Manual, and explain the function of each organ.

Female Anatomy (15 min.) Preparation: Create sets of supplies for each pair and the facilitator. Directions: • Follow the same directions as used above, except this time for female anatomy. Explain that: A pear represents the uterus Two walnuts or almonds (or similar nut or fruit) represent ovaries Two strands of licorice represent the fallopian tubes The cardboard roll of toilet paper represents the vagina • Read pages 35-36 in the Manual to explain other parts of the female anatomy.

Reproductive Anatomy (10 min.) Directions: • Discuss: o How familiar were you with female and male anatomy before this exercise? o What did you learn? o Why is it important for you to know this information? o How many teens are familiar with reproductive anatomy? o What can you do to help them? o What does this have to do with health, HIV, substance abuse, etc? o What is the problem with only women knowing about their bodies and only men knowing about theirs? • Read page 29 in the Manual.

Part 3: Puberty (Objectives 2 & 3) (30 min.)

Mapping the Changes of Puberty Race (20 min.) Preparation:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 1, Page 4 Draw life-size outlines of a woman’s body and a man’s body on large pieces of newsprint (two of the Aides could be traced by their peers). Directions: • Divide the Aides into two groups, according to sex. • Give the woman’s body to the boys and the man’s to the girls. • Explain to the Aides that there are many physical and mental changes that result from puberty for males and for females. Have the Aides try to identify as many as they can in five minutes. • Ask each group to race to write and draw the changes that happen during puberty on the appropriate parts of the body. Tell them they can write changes in thinking or maturity near the head. • Go around and check their work, and let them know how many items they are still missing. • After ten minutes or when the first group is finished (whichever comes first), bring both groups back together to present their drawings and point out any missing items. • Read pages 31-32 and 39 in the Manual to see how the drawings compare to the changes described in the text.

Puberty (10 min.) Directions: • Read “Javier’s Story” together. • Discuss: o What is happening with Javier? o Why do you think he feels embarrassed when his friends talk about sex? o Is there anything that could have helped Javier deal with or prepare for what’s happening? o As an Aide, what would you say to Javier if he came to you and explained what he was going through? • Knowledge check. Discuss: o Why do the changes associated with puberty happen? o What do they indicate about the body and its functions? o How does going through puberty make a person different from being a kid? o What does this have to do with having sex? • Ask the Teen Health Aides to think about some things they have personally experienced going through puberty. They do NOT have to discuss their thoughts aloud. • Discuss: o Why do you think people are often uncomfortable talking about the physical changes associated with puberty—menstruation, wet dreams, body odor, etc?

Part 4: Menstruation (Objective 3) (20 min.)

What is Menstruation? “Telephone” (10 min.) Directions: • Have the Aides sit in a circle. • Explain that this game is to see what they already know about menstruation. • Explain that we are going to play a version of the game “Telephone.” If someone has played it, ask that person to explain the rules to the group. One person starts by whispering something into the ear of the person sitting next to him/her. That person then has to lean over and whisper what he/she heard into his/her neighbor’s ear. Continue around the circle until everyone has had a chance to listen and pass on what was heard. The last person will say the statement out loud. • This version of “Telephone” has an additional twist—each person must add a short piece of additional information that relates to the topic onto the end of the sentence. • Whisper, “menstruation is when a girl bleeds because…” in the first Aide’s ear. Continue on until the last person’s turn. The final Aide to hear the message states it aloud. Then the first person says what the beginning of the sentence was. • Read pages 37-38 in the Manual, and compare the information with what the group ended up with.

Males & Menstruation (10 min.) Directions: • Discuss: o Why is it important that boys learn about menstruation? o Does this change anything? o Just for the guys: What is PMS? What do the letters stand for? What do you think girls and women experience if they have PMS? o Why might it be helpful for a guy to be able to talk about menstruation with his sister, girlfriend, or wife?

Part 5: Sex & Sexuality (Objective 4) (25 min.)

Read pages 40-41 in the Manual. (5 min.)

Sex Rights & Responsibilities (15 min.) Preparation: Prepare and hang up a piece of newsprint that says, “Sexual Rights and Responsibilities.” Directions: • Ask the Aides to develop a list of sexual rights and responsibilities for themselves. • After they have developed the list, ask if there should be different lists for girls and for guys. Ask them why or why not, and what they would put if there were two (or three) lists (one for girls, one for guys, one for both)? • Read page 30 in the Manual, and add any additional rights to the list.

Read pages 45-46 in the Manual. (5 min.)

Part 6: Pregnancy (Objective 5) (20 min.)

Read pages 42-44 in the Manual. (5 min.)

Teen Pregnancy (15 min.) Preparation: Bring TV/VCR and the video, Today I Found Out. Directions: • Watch Today I Found Out. • Discuss: o Do you think teens are mature enough to be parents? o Do you agree with the main character and her beliefs? o Should teens wait to have sex until they are adults and ready for adult responsibilities? o How easy is it to “wait until I’m ready for the responsibility?” o Do you know any teen parents? What are their lives like? o How is teen pregnancy different for males than for females?

Part 7: Evaluation (5 min.)

Hot Potato (5 min.) Preparation:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 1, Page 7 Bring a “hot potato” (a ball or a real potato). Plug in the CD, tape player or radio in a place where the Aides cannot see it well. Get it ready to be turned on and off. Directions: • Ask the Aides to form a circle (sitting or standing). • Explain that the Aides should toss the “potato” to one another while the music is playing. When the music stops, the person holding the “potato” must answer a question about the story or about anything else that they learned during the session. • Ask each person at least one question. Examples: What did you like about today’s session? What did you dislike about today’s session? What is one thing you learned today?

Copyright © 2003 MHP Salud mhpsalud.org Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 2, Page 9 Chapter 3 Let’s Talk About Sex! Lesson 2: Sexual Decision Making & Communication Estimated Time: 1 hour 50 minutes Objectives 1. To discuss the various factors that can influence whether or not teens have sex. 2. To help the Teen Health Aides think critically about how to make decisions about sex. 3. To practice communication skills necessary for negotiating sexual situations.

Before the Session … Supplies 1. Read the Infórmate Manual, Newsprint pages 8-9. Tape 2. Prepare the following: Pens and markers, different colors Balloons Rhythm and Movement Copy of the “Role-Playing Icebreaker Scenarios: Sexual Decision Pressure & Influence Making and Communication” Discussion handout Sexual Decision Making Video Scissors TV/VCR “Lisa’s Story” Discussion Materials from Health Are You Ready for Sex? Quiz Education Materials List: Activity Video: Just Like You Imagined? Gender Switch! Activity Pamphlets: “You Would if You Communication & Sexual Loved Me,” “You’re Not Ready to Have Sex If,” “20 Ways to Decisions Roles-Play Respond to Sexual Pressure,” & Knowledge, Attitudes, Action! “Safer Sex Self-Test” Evaluation 3. Preview video: Just Like You Imagined?

Lisa’s Story Lisa has been dating Manuel for two years. They have a lot of fun together and have been talking about getting married someday. Lisa does not believe in having sex until marriage. Manuel thinks that if they’re going to get married, they should have sex. One night, they go to a party and get really drunk. They are kissing and touching each other. Manuel asks Lisa to have sex with him….

Part 1: Icebreaker (10 min.)

Rhythm and Movement Game (10 min.) Directions: Note: this exercise is intended to move the Aides out of their comfort zones and to let them have some fun and be able to laugh at one another in good fun. • Ask the Aides to stand in a circle. • Ask for a volunteer to be the leader. • That Aide should go to the middle of the circle and do a movement AND a noise that they don’t usually do in everyday in life. Encourage the leader to have fun with it, to laugh, to do something that is hard to imitate. • The Aide next to the leader then has to go to the middle of the circle and try to exactly imitate the movement and sound. • When every Aide has had a chance to try imitate the leader, that leader choose another Aide to be the leader. • Process repeats.

Part 2: Pressure and Influence (Objectives 1 & 2) (35 min.)

Pressure & Influence (10 min.) Directions: • Discuss: o Why do teenagers decide to have sex? o What does “sex drive” mean? o Can a person control his/her sex drive? o Are there pressures or cultural issues for farmworker teens that make it harder for them to make healthy decisions about sex? o Are there pressures or cultural issues for farmworker teens that make it easier for them to make healthy decisions about sex? o Is it harder for boys or girls to say no to sex? o What is good sex? o How does good sex relate to drugs and alcohol? o How does good sex relate to HIV?

Sexual Decision Making (15 min.) Preparation: Bring TV/VCR and the video, Just Like You Imagined? Directions: • Watch Just Like You Imagined?

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 2, Page 11 • Discuss: o What types of things did Willie (the boy from the party) say to Kristie to convince/manipulate her to have sex with him? o Why did Erica (the girl who gave her boyfriend a blow job) decide to give Matt a blow job? o Why did Gary (the gay man who worked in the clinic) decide to go out with Enrique? o What were all the characters thinking about when making the decision to engage in sexual activity? [Themselves] o Who else will be affected by the pregnancy, herpes, etc.? [Families, future partners, future children, sometimes friends, etc.] o Why do you think the teenagers in the movie didn’t think about how their sexual decisions will affect them and their futures? o Who influences teens’ decisions to have sex? o Who has the biggest influence?

“Lisa’s Story” (10 min.) Directions: • Read “Lisa’s Story” out loud. • Discuss: a. Why do you think Lisa does not want to have sex? b. What are some reasons Manuel might give for wanting to have sex? c. What influences make it more likely that Lisa and Manual will have sex? d. What factors could help Lisa with following through on her decision not to have sex? e. How might the situation at the party end?

Part 3: Sexual Decision Making (Objectives 1 & 2) (20 min.)

Are You Ready for Sex? Quiz (20 min.) Preparation: Tape a piece of newsprint on the wall, and distribute pencils or pens. Gather brochures that give examples of questions/quizzes for the Aides to use for ideas. Directions: • Explain to the Aides that they are going to develop a “quiz” that they can use with their peers to help them decide whether or not they are ready for sex. They may also want to publish it in their newsletter. • Read pages 8-9 in the Manual. Provide the Aides with a variety of brochures on sexual decision making that provide examples of questions and quizzes for the Aides to get ideas from.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 2, Page 12 • Start the Aides off with a couple of questions on a piece of newsprint. For example: o Are you ready to take care of a baby? o How do you think you will feel about yourself if you have sex? • As the Aides offer questions, prompt them to explain why these questions are important. Discuss: o What would some questions be? o What things do people need to consider before they decide whether or not to have sex? • Turn this piece of newsprint into a poster. Let the Aides design the poster, decorate it, and do the lettering. • Follow-up: Make letter sized copies of the “quiz” and give it to the Aides so that they can use it during encounters with their peers.

Part 4: Communicating about Sex (Objective 3) (40 min.)

Gender Switch! (20 min.) Preparation: Write each of the following statements at the top of a different piece of newsprint. What do Guys say when they want to have sex? What do Girls say when they want to have sex? What do Guys say when they do not want to have sex? What do Girls say when they do not want to have sex? Tape up the two “girl” questions on a wall and the “guy” questions on the opposite wall. Directions: • Divide the Aides into two groups, according to sex. • Ask the girls to write down the types of things that girls say when they want to have sex on the appropriate piece of newsprint. Have them also write down what girls say when they don’t want to have sex. Have the boys do the same, for the two “guys” questions. • Give each group five minutes to write down as many reasons as they can think of. Tell them to leave some spaces underneath each statement. • Now have the two groups trade their pieces of newsprint, so that the groups have the statements for the opposite sex. Have both groups add any additional reasons they come up with to the lists. • Ask the girls to read in front of the entire group all the reasons listed on the piece of newsprint about things girls say when they want to have sex. Then have them read all the things girls say when they don’t want to have sex. • Have the boys then do the same for the two pieces of newsprint relating to what guys say.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Lesson: 2, Page 13 • Now have the two groups trade their pieces of newsprint again, so that the groups have the statements for the opposite sex. • Now have both groups select four or five statements to respond to, writing their responses underneath. Responses should reflect positive, healthy decision-making skills. They do not have to reject sex; rather, the responses should be reflective of the knowledge the Aides have gained and their ability to translate that knowledge into a statement. • Now have members of both groups read out loud what they wrote. • Discuss: o Are these reasons and responses realistic? o Do they reflect what teens really say? o What, if any, differences are there in the reasons and responses given by boys and girls. o Discuss the gender differences in the responses. Why are boys expected to want to have sex while girls are expected to say “no” to sex? Do all boys and girls act this way? o Do girls risk more than boys if they decide to have sex? Why or why not?

Sexual Decision Making & Communication (20 min.) Preparation: Copy the “Role-Playing Scenarios: Sexual Decision Making and Communication” handout, and cut it into separate strips so there’s one for each pair. Directions: • Put the Aides in pairs (preferably with one male and one female in each) in which they will play two characters who are trying to decide whether or not to have sex. Give each pair a role-playing scenario. • Ask them to list the things that people should discuss before they decide to have sex. Before they practice their role-play, ask them to come up with a list of four reasons why their characters may feel the way they do. They can be beliefs, experiences, attitudes, or relationship issues. • Let each group perform its role-play in front of the group. Discuss: o What is happening in this role-play? o Why is it happening? o Have you been in situations like this, or do you know someone in this position? o What should they do?

Part 5: Evaluation (5 min.)

Role-Playing Scenarios: Sexual Decision Making and Communication

Scenario #1: María decided that she wants to have a sexual relationship with Javi. They talked it over, and she wants to go on birth control pills. But the clinic is far away and she needs her mother to drive her there. María’s mother is very shy and has never talked to her daughter about sex. She also does not like Javier. Show the conversation that happens between María and her mother.

Things to think about: When would be a good time for María to bring this up with her mother? How do you think her mother would respond? What are some things the person playing the mother could say?

Scenario #2: Mark went away for the summer. He had a steady girlfriend who he really loved back home but had sex with someone else during the summer without using a condom. Now he and his steady girlfriend are talking about having sex together for the first time, and he has to tell her about his past. Show the conversation that happens between Mark and his girlfriend.

Things to think about: How should he bring up the subject? How would his girlfriend really react? What method of birth control should they use?

Scenario #3: Giselle and her friend, Angela, made out with each other at a party last week. Now Giselle is a little embarrassed, because she doesn’t know Angela that well. When Angela dropped by Giselle’s work yesterday, she whispered in her ear that she can’t wait to see her again, in private. Giselle is sure that Angela wants to go further with their physical relationship, but she would be more comfortable just being friends for now. Show the conversation that happens between Giselle and Angela.

Things to think about: Why do you think Giselle changed her mind about getting involved with Angela sexually? How could Giselle explain herself without hurting Angela’s feelings? What might Angela say?

Copyright © 2003 MHP Salud mhpsalud.org Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Review, Page 17 Chapter 3 Let’s Talk About Sex! Review Estimated Time: 45 minutes Before the Session … Supplies 1. Prepare the following: A deck of playing cards Decisions & Consequences Activity Potato or ball Hot Potato Activity Music and CD/cassette player or Sex or Not? Discussion radio Newsprint Review Tape Markers

Decisions & Consequences (10 min.) Directions: • Explain that the results of decisions are not decided entirely by chance, but they can differ depending on the situation. In other words, two people can make the same decision, and different things will happen. • Explain the rules of the game. In this exercise, playing cards will tell the future. Each card means something different, depending on its color and number. Tell the Teen Health Aides that you are going to read a situation in which a young person needs to make a decision and has two to three options to choose from. • Read Situation #1 and the Decision options, and ask each Aide to make a decision (encourage them to select a variety of choices, even if they wouldn’t make that choice in real life, to make the exercise more interesting). • Ask one Aide to say his or her decision out loud. • Ask the Aide to draw a card from the deck. Explain the consequences of his/her choice using the Facilitator’s Guide below. • Repeat the process with each Aide. • Ask if everyone is happy with his/her decisions and the results. • Go through the same process with Situation #2.

Facilitator’s Guide Situation #1 You are asked to deliver a fifty dollar package. The person who wants you to make the delivery tells you that if you do a good job, he will pay you one hundred dollars. If something goes wrong, however, you are responsible for the package and will owe him fifty dollars. Will you deliver the package?

Decision #1: You decide to deliver the package. Black Number Card: You deliver the package and collect the money.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Review, Page 18 Red Number Card: You got robbed of the package and owe the guy fifty dollars. Black Face Card (Jack, Queen, King or Ace): Your mother finds the package and gets angry at you for having drugs in the house. She flushed the package down the toilet and wants you to see a drug counselor. You also owe the guy fifty dollars. Red Face Card: The person you deliver the package to is an undercover cop, and you get arrested for handing illegal drugs.

Decision #2: You decide not to deliver the package. Black Number Card: Nothing happens. Red Number Card: Your friend, who made you the offer, thinks you’re a jerk. Black Face Card: Your friend, who made you the offer, respects your decision and treats you with more respect now. Red Face Card: Your paycheck gets stolen. You realize you would have had the money you need if you had delivered the package.

Situation #2 You are alone with someone you’ve known forever who you really would like to date. The person tells you that he/she wants to have sex with you, and you don’t need to worry about diseases or pregnancy because he/she tested negative for HIV and is sterile. What do you do?

Decision #1: Go ahead and have sex without a condom. Black Number Card: You didn’t get any STIs, and your partner/you didn’t get pregnant. Red Number Card: Your partner/you got pregnant. She/he lied to you about being sterile. Black Face Card: She/he gave you genital herpes, and she/he doesn’t know the results of the pregnancy test yet. Red Face Card: She/you didn’t get pregnant, but you got HIV. Your partner’s HIV test results were from two years ago, and she/he had contracted HIV since then.

Decision #2: You decide to have sex using a condom. Black Number Card: Nothing bad happened. Red Number Card: You’re a little embarrassed about the condom, but you did not get any diseases or get her/get pregnant. Black Face Card: She/he is happy that you wanted to use a condom. She/he wanted to, too, but was too embarrassed to ask. Red Face Card: She/he refuses to have sex with you if you insist on using a condom.

Decision #3: You decide not to have sex. Black Number Card: She/he gets upset and says, “If you really loved me, you’d have sex with me.”

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 3: Let’s Talk About Sex Review, Page 19 Red Number Card: She/he is angry and pressures you to have sex. Later on she/he tells everyone all sorts of bad things about you. Black Face Card: She/he is pretty understanding and doesn’t take your decision personally. She/he does say that she/he wants to date other people, though. Red Face Card: She/he is cool with it and asks you to explain why. You explain your decision and make a date to see each other the next night.

Hot Potato (15 min.) Preparation: Bring a “hot potato” (a ball or a real potato). Plug in the CD, tape player, or radio in a place where the Aides cannot see it well. Get it ready to be turned on and off. Directions: Note: You may shorten this game to reflect the information you want to emphasize or to accommodate a shorter training time. This game can also be adapted to help the Aides work with their peers. • Ask the Aides to form a circle (sitting or standing). • Explain that the Aides should toss the “potato” to one another while the music is playing. When the music stops, the person holding the “potato” must answer a question from the following list:

Facilitator’s Guide Q: What’s the difference between “sex” and “gender?” A: Sex is biological and cannot be changed; gender is the way society thinks about, nurtures, and treats people.

Q: What’s wrong with a fifteen-year-old male who still hasn’t shown any of the changes associated with puberty? A: Nothing. Teenagers mature at different rates.

Q: What part of the male’s body produces sperm? A: The testes.

Q: What does ejaculate mean? A: When males shoot semen (cum) out of their penis.

Q: What does it mean if a male is circumcised? A: A boy who is circumcised has had the foreskin of his penis removed.

Q: True or false-You cannot be a man and be a virgin? A: False.

Q: How long can sperm live inside a female’s vagina and uterus? One hour, one day, or three to four days? A: Three to four days.

Q: What does ovulation mean? A: When the egg leaves the ovary to travel to the uterus.

Q: How many eggs are released from a female’s ovaries each month? A: Usually one.

Q: What is the blood from the period for? What purpose does it serve? A: The body prepares blood and tissue to support a fetus. If the egg is not fertilized, the body gets rid of this blood and tissue. This is called menstrual blood.

Q: How many days are in a menstrual cycle for most females? A: About 28, although it varies for every woman.

Q: What time of the monthly cycle can a woman get pregnant? A: Any time. She can even get pregnant while having her period.

Q: Why might a female not get a period? A: Pregnancy, irregular periods (totally normal, especially for girls and younger women), certain types of birth control, menopause, a lot of exercise, too young, etc.

Q: Name four different kinds of risks associated with having sex. A: Pregnancy, STIs, emotional risks (regretting the decision, feeling bad about one’s self or partner, fearing parents’ reactions, etc.), and social risks (how parents, friends, teachers, and others might change how they feel or treat the person).

Q: True or false-females always have orgasms during vaginal sex. A: False.

Q: What are different ways males and females can have orgasms? A: Oral, anal, or vaginal sex, masturbation, while dreaming, looking at an arousing picture or reading a sexy book, etc.

Q: What should someone do if the condom he/she used during sex broke? A: Get emergency contraception from a doctor or clinic immediately. Females can use emergency contraception to keep from getting pregnant. Both partners should get tested for STIs and HIV (wait three months to get tested for HIV).

Q: If a male does not ejaculate (“cum”) inside the female’s vagina, can she get pregnant? A: If a female gets sperm inside her vagina (from pre-cum, for example), she could get pregnant.

Q: Does someone choose to be a homosexual? A: No. Homosexuality is an inborn trait, like brown eyes or light skin.

Q: Can a female get pregnant the first time she has sex? A: Yes.

Q: If a female has sex and then does not get her period, should she wait until the next month to get a pregnancy test? A: If she has reason to believe she might be pregnant (she had unprotected sex), she should get a pregnancy test as soon as possible.

Sex or Not? (10 min.) Directions: • Divide the Aides into two groups. • Read the scenario out loud: Scenario: Monica is trying to decide whether or not to have sex with her boyfriend, Jesús. She loves Jesús and wants to have sex, but she does not want to get pregnant or get a sexually transmitted infection. • Tell the Aides that they have two minutes to think of as many things Monica should consider before making her decision as they can. Each group should write their list on a piece of newsprint and let the other team see their answers. • When two minutes have elapsed, ask the groups to tape their lists up. • Compare answers, and congratulate the groups on coming up with good ideas.

Review (10 min.) Directions: • Ask the Aides if they have any specific questions. • Review these or additional topics that the Aides did not remember or understand.

Copyright © 2003 MHP Salud mhpsalud.org Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 1, Page 1 Chapter 4 Birth Control Lesson 1: Knowledge Estimated Time: 1 hour 45 minutes Objectives 1. To examine Teen Health Aides’ knowledge and attitudes about sex. 2. To provide the knowledge and skills necessary to use/instruct others on different forms of birth control.

Before the Session ... Supplies 1. Read the Infórmate Manual, pages Bananas or penis model 48-52. Newsprint Markers, different colors 2. Prepare the following: Tape What’s Your Sex IQ Icebreaker Scissors What are Effective Methods? Copies of “What’s Your Sex IQ?” Activity & “Condom Use Sequence What are Different Methods Cards” handouts Bottle with large opening Like? Activity Scissors “Margarita’s Story” Discussion Materials from Health Education Condom Sequence Race Activity Materials List: Spin the Bottle Evaluation Kit: Birth Control (optional) Models: Penis & Vagina (optional) Pamphlets: “Birth Control Facts,” “Birth Control Choices for Teens,” & “Your Contraceptive Choices”

Margarita’s Story Margarita is sixteen and in love with Frank. She thinks they might get married some day. Margarita’s best friend, Sarah, and her boyfriend use the withdrawal method, and it’s worked for them so far. Margarita wants to start having sex with Frank but doesn’t want a baby or an STI. She’s afraid of going to the doctor, because she doesn’t like needles of any kind, such as the Depo Provera shot. Instead, she buys some spermicide at the pharmacy, and she and Frank use that.

Two months later Margarita started throwing up a lot and felt strangely all the time. Sarah insisted that she visit the clinic, and the doctor determined that Margarita was pregnant. Margarita was confused, because she and Frank used protection— spermicide—every time they had sex. How could she be pregnant?

Part 1: Icebreaker (15 min.)

What’s Your Sex IQ? (Objective 1) (15 min.) (Adapted from the Sex, etc. website) Preparation: Copy and pass out the “What’s Your Sex IQ” handout. Directions: • Break the Aides up in pairs, and ask them to fill out the quiz together. • When everyone is done, review the answers using the Facilitator’s Guide:

Facilitator’s Guide 1. Today, most fifteen year olds are still virgins. True. Lots of teens aren’t having sex. 2. Most teens who have sex do it with someone they think they love. True. 3. Most teens use some sort of protection the first time they have sex. True. Most teens use condoms the first time they have sex. 4. Most teens who use condoms use them every time they have sex. False. Less than half of teens who use condoms say they use them every time. 5. Contraception failure is the cause of most teen pregnancies. False. Seven out of ten teens who get pregnant didn’t use contraception at all. 6. Most teen pregnancies occur among teens who have been sexually active for a long time. False. Almost half of pregnant teens got pregnant within six months of losing their virginity. Some teens get pregnant the first time they have sex. 7. Approximately one out of every ten girls gets pregnant before turning twenty. True. The rate of teen pregnancy has actually decreased for the first time in years, but a lot of young girls are still getting pregnant. 8. Most states require a parents’ permission for teens to get contraception. False. Most states have low-cost family planning clinics that welcome teens and can keep a secret. 9. Most teens talk about sex with their partners before doing it. False. A little communication goes a long way toward preventing pregnancy, disease, and broken hearts.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 1, Page 3 10. Getting pregnant and having a baby is the girl’s problem. False. Although teen moms often take on more responsibility for raising their children, fathers may be legally required to pay child support. Many fathers also provide for their children’s other needs, including love, emotional support, food, clothing, and shelter.

• Have the Aides add up the number they got correct and figure out how they rate: How Did You Rate? 8 to 10------You really know a lot about teens and sex. 6 to 7------Pretty good, but you need to learn a few facts. 5 or less----You need to learn more to be an effective Teen Health Aide. • Ask the Aides how they rated and if they were surprised by any answers.

Part 2: Birth Control Methods (Objective 2) (65 min.)

What are Effective Methods? (25 min.) Directions: • Ask the Aides to brainstorm all the ways a person can prevent pregnancy and many STIs. Write these on a piece of newsprint. Give hints or provide any additional methods that the Aides are missing until the list is complete.

Facilitator’s Guide Women’s condom Men’s condom Abstinence Dental dams/cut non-lubricated condoms (for oral sex) Outercourse

• On a second piece of paper brainstorm forms of contraception that only prevent pregnancy, not STIs.

Facilitator’s Guide Natural condom (animal skin) IUD Emergency contraception Diaphragm Depo Provera/Lunelle Cervical cap Norplant Spermicide Ring Sterilization Patch The pill Natural methods (fertility awareness, breastfeeding, and others)

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 1, Page 4 • On another piece of paper, brainstorm methods that do not prevent pregnancy or STIs effectively. Encourage the Aides to think of rumors or non-traditional methods they have heard of:

Facilitator’s Guide Fertility awareness (Rhythm method) Withdrawal Standing up Douching Sex during the girl’s period Breastfeeding after the first six months of the baby’s life

• On another piece of paper, brainstorm ways of combining different methods to increase their effectiveness:

Facilitator’s Guide Hormonal method + condom (male or female) Hormonal method + condom (male or female) + spermicide Condom (male or female) + spermicide Diaphragm/cervical cap + spermicide Hormonal method + diaphragm/cervical cap Hormonal method + diaphragm/cervical cap + spermicide

• On another piece of paper, brainstorm methods of birth control that should NOT be combined, because it decreases their effectiveness:

Facilitator’s Guide Female condom + male condom Two male condoms

What are Different Methods Like? (15 min.) Preparation: Assemble a birth control kit with male and female condoms, models of barrier methods such at the diaphragm and the cervical cap, spermicides, hormonal methods (pill, ring, patch), and a model IUD. This exercise is most effective if the facilitator is able to “show and tell” the methods and allow the Aides to look closely at and handle the different methods. You may also wish to compile statistics relating to teen sexual activity, teen pregnancy, and teen birth control use in your community Directions: • Use the birth control kit (optional) or graphical depictions to illustrate effective methods and demonstrate/describe how each

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 1, Page 5 method works. Again, it is best if you are able to concretely show the methods, and, if possible, to demonstrate their use on models. • Discuss key points about birth control. o Why certain methods fail—usually because the directions are not followed properly. o The common, easily avoidable reasons condoms break. For example, they are rolled onto the penis upside down, they are used with an oil based lubricant, the tip wasn’t pinched properly, or the vagina/anus being penetrated wasn’t lubricated enough. Otherwise, condoms are very effective. o Which methods are available to teens and how teens can get birth control. It is important to note that some methods, including male and female condoms, are available without going to a doctor. Others, including all of the hormonal methods, require that a girl see a doctor in order to get a prescription for birth control or to get a method fitted or inserted. o Why certain methods, such as sterilization, natural methods (withdrawal and fertility awareness), and the IUD are not usually recommended for teens. Due to the rapidly changing nature of teens’ bodies and minds, birth control methods that depend on regular menstruation, permanent decisions, or a steady, monogamous relationship are often not recommended for teens.

Read pages 48-52 in the Manual. (15 min.)

“Margarita’s Story” (10 min.) Directions: • Read “Margarita’s Story” out loud. • Discuss: o What factors caused Margarita to get pregnant? o What information could have helped her prevent the pregnancy? o What different places or people can teens access to get answers to their questions about birth control?

Part 3: Condoms (Objective 2) (15 min.)

Condom Sequence Race (15 min.) Preparation:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 1, Page 6 Make two copies of the “Condom Use Sequence Cards.” Cut them in half, creating cards that each have one step involved in using a condom. The order below, from top to bottom, is the correct sequence for using a condom properly.

Facilitator’s Guide 1. Discuss using condoms with your partner. 2. Check whether the condom is expired, the package has holes, the package has been stored someplace hot or cold, or the condom has been previously USED. If any of these apply, throw it away. 3. Carefully remove the wrapper. 4. Pinch the tip of the condom, leaving ½” at the tip. 5. Unroll the condom over the erect penis, all the way down to the pubic hair. 6. Have sex while holding the base of the condom the entire time. 7. Ejaculate. 8. Before the penis becomes soft again, prepare to pull the penis out. 9. Hold the base of the condom when pulling the penis out. 10. Remove the condom. 11. Throw the condom away.

Directions: • Break Aides up into two groups, and give each group a set of cards. Tell them they have to put the cards in the proper order of how to use a condom properly. • When they think they are right, check their work. The first team to finish correctly wins. • Have the winning team go over its steps. Correct any misinformation. Emphasize that these directions represent the most careful, most recommended way to use a male condom. Condom use may still prevent pregnancy and STIs if they are not used in exactly this fashion, but these directions give the most secure way to use a condom. • Have Aides practice the proper way to put on a condom, using a banana or penis model.

Part 4: Evaluation (10 min.)

Spin the Bottle (10 min.) Preparation: Write fun questions on slips of paper. Make sure there is one for each Aide. Use the following questions:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 1, Page 7 What else do you need to know about birth control to feel comfortable helping other teens select a method? Did you learn anything surprising today? What are the most important things to remember when using a condom? Do you think it’s better to wait until others ask you about birth control or to bring up the topic yourself? Name the most effective way you can think of for preventing pregnancy and STIs? Name the most effective combination of birth control methods you can think of for preventing pregnancy and STIs. What do you think is the coolest way to refer to condoms/using condoms using slang words? Fold the papers, and put all into one, large bottle that has a large mouth or opening and a cap. Directions: • Ask the Aides to sit in a circle. • Explain that you will start by spinning the bottle. • Whoever is closest to the cap of the bottle when it stops moving must select a piece of paper from inside the bottle. • That Aide must read the question out loud and give his or her thoughts. • The Aide that answered the last question will then spin the bottle for the next Aide. • Process repeats • Everyone should have a chance to respond to a question.

Answer True or False and check your answers with the Facilitator’s Guide.

1. Today, most fifteen year olds are still virgins.

2. Most teens who have sex do it with someone they think they love.

3. Most teens use some sort of protection the first time they have sex.

4. Most teens to use condoms use them every time they have sex.

5. Contraception failure is the cause of most teen pregnancies.

6. Most teen pregnancies occur among teens who have been sexually active for a long time.

7. Approximately one out of every ten girls gets pregnant before turning twenty.

8. Most states require a parents’ permission for teens to get contraception.

9. Most teens talk with their partners about sex before doing it.

10. Getting pregnant and having a baby is the girl’s problem.

How Did You Rate? 8 to 10------You really know a lot about teens and sex. 6 to 7------Pretty good, but you need to learn a few facts. 5 or less----You need to learn more to be an effective Teen Health Aide.

Condom Use Sequence Cards

Discuss using condoms with your partner.

Check whether the condom is expired, the package has holes, the package has been stored someplace hot or cold, or the condom has been previously USED. If any of these apply, throw it away.

Carefully remove the wrapper.

Pinch the tip of the condom, leaving ½ inch at the tip.

Unroll the condom over the erect penis, all the way down to the pubic hair.

Have sex while holding the base of the condom the entire time (recommended for safest use).

Ejaculate.

Before the penis gets soft again, prepare to pull the penis out.

Hold the base of the condom when pulling the penis out.

Remove the condom from the penis.

Throw the condom away.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 2, Page 15 Chapter 4 Birth Control Lesson 2: Making Decisions Estimated Time: 1 hour 50 minutes Objectives 1. To discuss and explore sexual decision making and communication as they relate to different methods of birth control. 2. To review the knowledge and skills necessary to use/instruct others about different forms of birth control. 3. To enable Teen Health Aides to select/advise others about appropriate forms of birth control.

Before the Session ... Supplies 1. Read the Infórmate Manual, Copy of the “Four Stories” handout pages 8-9 & 48-65. Bananas or penis models 2. Prepare the following: Blindfolds Newsprint Trust Circle Icebreaker Scissors Abstinence Discussion Markers, different colors Pros & Cons Activity Tape Who is Responsible? Materials from Health Discussion Education Materials List: Model: Penis (optional) “Four Stories” Role-Play Kit: Birth Control (optional) Condom Demonstration Pamphlets: “Teen sex? It’s Activity Okay to Say No Way!,” “101 Birth Control Review Ways to Make Love Without Evaluation Doin’ It,” “101 Ways to Be Abstinent,” & “101 Ways to Say NO to Sex”

Four Stories Julia: “I am a fifteen year old girl. I have had two boyfriends and have had sex with both of them. What kind of birth control is best for me?”

Gerardo: “My girlfriend and I have been together for a year. She was the first person I have ever had sex with, and she’s tested HIV negative. We only have sex with each other, about three or four times a week. She can be kind of forgetful. What kind of birth control should we use?”

Lupe: “I’m too shy about my body to touch myself down there, but I started having sex with my fiancé. We will probably want a baby a year after we get married. First I want to finish school.”

Alejandra: “My partner refuses to use condoms and doesn’t want me to use birth control. But my mom would kill me if I got pregnant, and I wouldn’t be able to finish school. What birth control could I use?”

Part 1: Icebreaker (15 min.)

Trust Circle (15 min.) Preparation: This is a good activity to do outside in a grassy area, but it can be done inside, too. Note: if you have very small Aides and one significantly larger Aide or other person, if may not be a good idea to put this person in the middle. Directions: • Have the Aides arrange themselves in a standing circle. • Explain to the Aides that the following activity involves trust. Now that the teens have been working together for several weeks, ask them in what ways trust has played a part in their work (individual encounters, working with one another, working with you and other Infórmate staff, etc.). • Going around the circle, have each person mention one characteristic that is really important in a trustworthy person (confidential, respectful, good listener, takes what other people say seriously, etc.). • Ask on Aide to stand in the center of the circle. The remaining members of the circle need to move inwards until the circle is very tight, with everyone standing shoulder to shoulder and NO GAPS. • Have the members of the circle arrange their legs as though they were about to start running—one foot in front of the other with weight balanced equally between them, both knees bent. Then have everyone put both their arms up in front of them, elbows bent. You may want to demonstrate this position. This is called the “ready” position. • Explain that by sharing the strength of the group and standing in the “ready” position, the group can catch the person in the middle as they fall, even if we don’t know when and in which direction he/she is going to fall. Remind the group that taking things seriously is important for the person in the middle to able to trust us to catch him/her and prevent him/her from falling and getting hurt. • Have the person in the middle stand perfectly straight with his or her arms crossed over the chest. Ask the person to close their eyes and remember to NOT BEND when falling. This is the “falling” position. • Double check that there are no gaps in the circle. Ask the person in the middle to say, “I’m ready” when he/she is ready to fall and the group to respond, “we’re ready,” before the person begins falling (usually backwards is more comfortable to start).

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 2, Page 17 Pass/push/bump with person in the middle within the circle a few times. • Give everyone a turn in the middle, unless an Aide really does not want to do it or if you do not think the Aides in the circle will be able to support a particular Aide.

Part 2: Abstinence (Objective 1) (10 min.)

Read page 53 in the Manual. (5 min.)

Abstinence (10 min.) Directions: • Discuss: o What are some reasons teens have sex? o What are some reasons teens choose NOT to have sex? o Is sex good, bad, or both? Why? o What are some signs that someone may be ready to have sex? o What are some signs that someone may NOT be ready to have sex? o What role does love play in sex? o Why is abstinence so difficult to maintain? • Together make a list of reasons why many teens decide NOT to have sex. Discuss the reasons, and talk about how they relate to both virgins and people who have had sex before but want to wait before having it again (“born again virgins”). • Refer to abstinence pamphlets for more information.

Part 3: Choosing Birth Control (Objectives 1-3) (60 min.)

Pros & Cons (20 min.) Preparation: On one piece of newsprint write the following methods of birth control: Male condom Fertility Awareness Method Female condom Abstinence Spermicide Outercourse Depo Provera/Lunelle IUD Patch Diaphragm The pill Sterilization Withdrawal

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 2, Page 18 Directions: • Ask the Aides which birth control method they think works the best and why. After hearing their opinions, point out that each birth control method has pros and cons, also known as good things or bad things, depending on who is going to use it. • Brainstorm and write on newsprint a list of the most important things to consider in making a choice about contraception. Make sure to include: o Risk of getting HIV or another STI o How effective is the birth control at preventing pregnancy? o What will the girl do if she gets pregnant? o What will a guy do if he gets someone pregnant? o How comfortable is a teen with his or her body? Some birth control methods require a good understanding of one’s own body o How much does a teen trust their partner or partners? o How much does the birth control cost? o Where can a teen get birth control? o Does a teen have to go to a doctor to get the birth control? o Will the teen’s parents find out if he/she is using birth control? o Does the teen have any health problems that could make a difference in what kind of birth control they use? (like smoking, blood clots, urinary tract infections, high blood pressure, migraines, and allergies to latex or to spermicide) • Divide the group into pairs. Using the list of Pregnancy/STI Prevention Methods, assign each pair two or three methods of contraception to “present.” Have the Aides look at pages 48-62 in the Manual. Using this information, ask each pair to make a list of “pros” and “cons” for each method they have been assigned. Explain that pros are good or positive things about something and cons are bad or negative things. Each pair should prepare a list of as many pros and cons for each method as they can. The Aides can also use things from the Birth Control Kit as visual aides. • Have each pair present their pros and cons lists and methods to the rest of the group. They should concentrate on giving the most important or main points. Each presentation should only be five minutes or less. • Invite the others

Read pages 63-65 in the Manual. (10 min.)

Who is Responsible? (10 min.) Directions: Note: Conversation on this topic may be lengthy. You may wish to limit the time for this discussion to fit the group’s goals and time constraints.

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 2, Page 19 • Write on a piece of newsprint: “Women and men should be equally responsible for preventing pregnancy.” • Ask the Aides whether they agree with this statement and if they think that is true in real life. • Ask them to imagine that there is a birth control pill for boys. Discuss: o Would the girls trust a boy who said he was “on the pill?” Why or why not? o Why do boys trust girls when they say this? • Talk about what happens when a girl gets pregnant unintentionally. Help the Aides see that girls have extra risks associated with having sex that boys often do not. • Brainstorm how boys can support girls in using birth control. Make sure they bring up: Getting to a clinic Getting tested for STDs Helping her remember to take her pills Having and knowing how to use condoms • Now have the Aides explore how they can convince other teens, both males and females, of the importance of using birth control. Make sure they feel comfortable addressing common misunderstandings and reasons why teens don’t want to use contraception. • Write these ideas on a piece of newsprint.

“Four Stories” (20 min.) Preparation: Copy the “Four Stories” scenarios, and cut each scenario into a separate strip. Pass each out to a different Aide. Directions: • It can be difficult to decide which method of protection is best for each person. Remind the Aides that there are no easy answers. • Read pages 8-9 in the Manual on making good decisions. • Have the first Aide read a scenario. Have the Aide role-play the character as though he/she was coming to the Aides (the rest of the group) for help and advice. The group can interview him/her to make sure they consider all the relevant factors. The Aide playing the character can make up responses based on what he/she feels is realistic. • Repeat with the remaining scenarios.

Part 4: Condoms, Again (Objectives 2 & 3) (10 min.)

Condom Demonstration (10 min.) Directions:

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Lesson: 2, Page 20 • Have Aides practice the proper way to put on a condom again, using a banana or penis model. • Ask for a few volunteers. Have them sit on chairs in front of the group. • Ask the group where they think most teenagers have sex, especially whether they are light or dark places (typically, teens have sex in dark places). • Since many teens have sex in the dark, they won’t be able to see the condoms to put them on. • Blindfold the Aides who volunteer, and have them try to remove condoms from their packages and put them on bananas or penis models properly. • Discuss the purpose of this exercise, and what Aides can do to make sure they can use/help others use condoms properly.

Part 5: Evaluation (10 min.)

Birth Control Review (10 min.) Preparation: Bring a birth control kit or a graphical depiction of birth control methods. Set one of these up on a table or some place where the whole group can see the kit or graphic. Directions: • Ask the Aides to number themselves off. • Explain to the Aides that you are going to hold up or point to a form of birth control. You will then ask the Aide that is number 1 to tell the group what that form of birth control is and to name one pro (good thing) and one con (bad thing) about that method of birth control. This should be done as quickly as possible. • Each Aide gets a turn to name the form of birth control and to list at least one pro and at least one con.

Julia: “I am a fifteen year old girl. I have had two boyfriends and have had sex with both of them. What kind of birth control is best for me?”

Lupe: “I’m too shy about my body to touch myself down there, but I started having sex with my fiancé. We will probably want a baby a year after we get married. First I want to finish school.”

Copyright © 2003 MHP Salud mhpsalud.org Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Review, Page 23 Chapter 4 Birth Control Review Time Required: 40 minutes Before the Session … 2. Prepare the following: Supplies Birth Control Pictionary Activity Easel Review Newsprint Markers, different colors Scissors Copy of “Birth Control Pictionary” handout Hat or bowl Timer or watch Birth Control Pictionary (30 min.) Preparation: Prepare an easel with several pieces of newsprint on it. Gather markers of various colors. Copy, cut, and fold the “Birth Control Pictionary” handout words. Mix them up in a bowl or hat. Directions: • Explain to the Teen Health Aides that they are going to play a version of Pictionary, in which all the words have to do with sex, birth control, or related issues. • Divide the Aides into two teams. • The teams will alternate turns. One member of each team will draw while the other members of the team try to guess what word(s) they are drawing within a five-minute time limit. • Drawing team members must choose a slip of paper with a word on it from the hat/bowl. He/she cannot trade it in if he/she doesn’t like it. • Drawing team members cannot make any noises or gestures! They cannot write symbols or words (unless in the situation described below) on the piece of newsprint. If team members guess one of the words on the card, before guessing the entire thing, the drawing team members may write down that word. • Make sure all Aides rotate to get a chance to draw. • Each word(s) that is guessed within the five-minute time limit is worth ten points. If a team does not guess the word(s) within the five minutes, the other team gets the opportunity to guess the word for five bonus points. • This version of Pictionary has an additional twist. The guessing team can earn an additional three points for each educational fact that they can tell the whole group. The opposing team can also earn three bonus points for adding a fact that hasn’t already been said. For example, if the word was “Hormones,” one Aide might explain that these are chemicals

Copyright © 2003 MHP Salud mhpsalud.org “Teaching Notes” Chapter 4: Birth Control Review, Page 24 in the body that tell the body to change and develop. It is up to the facilitator to determine if the answers are worthy of three points. • Whichever group earns the most points wins!

Review (10 min.) Directions: • Ask the Aides if they have any specific questions. • Review these or additional topics that the Aides did not remember or understand.

Birth Control Abstinence Male Condom Female Spermicide Pills Condom

Sexually Withdrawal Diaphragm Depo- Pregnancy Transmitted provera Infections

Monogamous HIV test Intrauterine Kissing Clinic Relationship Device

Teen Parent Hugging Outercourse Reservoir Emergency Tip (of a Contraception condom)

Talking with Alcohol Drugs your Protection Responsibility boyfriend/ girlfriend

Pros and Your Religion Friends Pressure Cons Parents