Supporting young people’s mental and sexual health in Greater Boston
Key evaluation findings + opportunities for future work
During the last year of funding for a sexual health program for Black and Brown young adults (18-25 years old) in Boston, the program team at Action for Boston Community Development (ABCD) - Health Services contracted MXM Research Group to conduct an evaluation. The goals of the learning partnership were to: 1) better understand young people’s health behaviors, as well as needs and gaps in sexual and mental services for young people; 2) better understand facilitators and barriers to accessing health information and services; and 3) identify opportunities to improve programs and to better serve young people.
What we learned
Across the short sprint evaluations, several key trends emerged:
Young people continue to struggle to navigate both their sexual health and their mental health - often, the two are closely connected. As one participant aptly put: “You need to be mentally healthy to be sexually healthy.”
Young people still face gaps in their knowledge of sexual and reproductive health and get caught up in myths and misconceptions around sexual health (e.g., effective safe sex methods, myths around when it is/isn’t possible to get pregnant). This is exacerbated by young people not having trusted, accurate sources of health information, and turning to their friends instead.
Young people are lonely and are struggling to form healthy peer and romantic relationships. In particular, young people struggle to navigate issues around consent, dating safety, and forming and maintaining healthy relationships. Social media also has negative impacts on young people’s mental health and the ways that they interact with others online (e.g., cyberbullying, being exploited by strangers online).
Lack of knowledge of where to get services, experiences of stigma/judgment when seeking care, lack of providers who represent and can relate to young people (especially providers of color), high costs of care, and lack of available appointments all pose barriers to young people achieving optimal well-being.
Opportunities
Through several iterative conversations between the MXM and ABCD teams, we have identified several opportunities for those looking to better support the mental and sexual health and well-being of young people of color in Greater Boston.
Funders
The sexual and mental health needs of young people are closely connected. Fund and support programs that recognize these areas of overlap and are prepared to implement interventions that address both.
Root causes of inequity (e.g., access to housing, availability of culturally-responsive care, etc.) continue to impact the engagement, participation and ultimately health outcomes of young people. Meaningfully engaging young people in programming often means attending to those needs. Support programs in their efforts to do intentional, meaningful youth engagement (e.g., paying young people for their time, providing transportation), and recognize that a one-size-fits-all approach often doesn’t work.
Service Providers + Anyone Working with Young People
Meet youth where they are. Integrating programming into existing spaces can be an effective way to overcome barriers to youth engagement and participation.
Build intentional, long-term and non-judgmental relationships with young people. Young people are looking for trusted adults who they can turn to with their questions and who will treat them with respect and without stigma or judgment.
Empower young people to advocate for themselves in healthcare and other service settings. Equip them with the skills to seek out accurate, reliable information related to their health.
Approach
The MXM team conducted the evaluation in three iterative, short-cycle phases, or “sprints.” Each evaluation sprint lasted between 1-3 months, and allowed for the MXM and ABCD teams to further refine our learning goals while building upon the foundation of knowledge established during the previous sprint.
Sprint 1: Community assessment of health trends for young people in Greater Boston. We used publicly available data (e.g., 2021 Youth Risk Behavior Survey data from Boston Public Schools, HIV/AIDS surveillance data from the Commonwealth) to understand sexual and mental health trends for youth and young adults. We also conducted a comparative assessment of what kinds of programs and services are already available to young people in Greater Boston.
Sprint 2: Mixed-methods evaluation to learn about the experiences and health behaviors of participants in a sexual health education program. Through focus groups and interviews, we spoke to 8 young people to learn about their experiences with the program, their experiences with health programs in general, as well as the barriers they face in accessing quality health programs and services.
Sprint 3: Stakeholder analysis to understand the landscape of mental and sexual health services available to young people. We interviewed 10 professionals in the Greater Boston area who provide services and programming to young people in the area. We asked interviewees to share their observations on the health of young people, what’s working in supporting young people, and where they’re seeing persistent gaps in serving young people.
Learn More at bostonabcd.org/health