A Reduction of Risk Behaviors Through Teen Interactive Theater Education (TITE)

Teen Interactive Theater Education (TITE) is an innovative positive youth development program that engages young people in the consideration of pertinent topics in today's society through the use of experiential activities such as writing and performing skits about avoidance of risky behaviors. Theatrical youth programs such as TITE can help adolescents develop skills needed to manage emotional situations in real life (Larson & Brown, 2007). Furthermore, skills-based programs that engage adolescents in community-based activities have been shown to reduce risky behaviors (Sikkema et al., 2005). This article provides a brief overview of the TITE curriculum, the theory behind its inception, and the expected outcomes as a result of youth participating in this program.

Overview of TITE Curriculum

The TITE curriculum incorporates various experiential activities to engage youth in the development and delivery of original skits associated with risky behaviors. Since 2004, over 200 youth have participated in TITE, ranging in age from 14 to 23 years, in a major metropolitan area in the southwestern United States. Nearly two-thirds (63%) of the participants identified themselves as Hispanic; 21% as Native American; 7% as other; 4% as White; and 5% as Black.

This program has been offered at seven alternative high schools, where students met daily for up to 30 hours per semester as part of an elective class. Initially, participants are engaged in challenge activities to build trust and cooperation. TITE provides lessons on relationships, critical thinking, values, and life skills that culminate in a "performance" in which teens teach other teens and parents about risk prevention. Early on in the program, participants help define the norms of the group and create a safe and welcoming environment though a facilitated process lead by an adult program leader.

The primary objective of TITE is to provide opportunities for youth to learn and teach about behaviors associated with risk, such as drug and alcohol use, early sexual activity, dating violence, and smoking, through an experiential discovery process. Participants select the topics they see as important to youth, conduct research on the topics, develop original scripts, rehearse, and then perform their skits in front of peers, parents, or younger audiences such as middle school students. Each performance allows for a question-and-answer period. Some skits are interrupted with questions posed to the audience such as, "what do you think the main character should do in this situation?"

Theoretical Underpinnings

TITE is designed to increase participant knowledge of the risks and consequences of risky behaviors; improve decision-making and problem-solving skills; build capacity for youth to work together; and enhance reading, writing, and speaking abilities. The program is grounded in the six elements of positive youth development as defined by Eccles (2002), Kirby and Coyle (1997), and Catalano, Berglund, Ryan, Lonczak, and Hawkins (1998). Below are several examples of how these elements are applied through TITE.

• Structure begins with the initial activity of identifying the responsibilities of the three roles of the youth: actor, audience, and educator. These roles, along with clear boundaries and expectations, guide attitudes and behaviors throughout TITE (replacing "ground rules") and help create a physically and psychologically safe environment.


• Youth learn experientially through activities guided by adults that focus on skills (teamwork, play writing, acting rehearsals) and build confidence (a willingness to participate, examine, and share personal stories).


• In this youth-adult partnership, both bring experience and knowledge from different backgrounds and life events and serve as group educators in preparation for teaching others.


• Group cohesiveness and belonging develop as all participants examine social norms alongside their own personal values.


• TITE culminates in an original performance that serves as an educational and interactive learning experience for an audience of slightly younger teens.

TITE is also grounded in the nine principles of effective prevention programs (Nation, Crusto, Wandersman, Kumpfer, Seybolt, Morrissey-Kane, & Davino, 2003), as illustrated by the following examples.

• Through brainstorming, the youth identify teen issues that are then researched and presented/taught to other teens.


• TITE youth become the experts on risk and protective factors and the educators and mentors of other teenagers. Youth choose from multiple teaching styles such as plays, monologues, posters, interviews, or group process.


• Experiential, interactive learning is used in TITE to educate the educators who then educate their peers.


• Adults work side-by-side with the TITE teens to research age-appropriate education, cultural traditions, and social norms that they then incorporate into their presentations.

A primary component of TITE is cross-age teaching. Research has shown that younger children often respond more enthusiastically to modeling by teens than by adults. There are benefits for the teens as well, as cross-age relationships reinforce learning for the teen teachers (Hoover & Weisenbach, 1999). In addition to developing leadership skills and learning to be positive role models for youth, teen leaders tend to start "listening to their own advice" and begin to make responsible choices and are less likely to engage in risky behaviors (Marczak & Peterson, 1999). Glik, Nowak, Valente, Sapsis, and Martin (2002) posit that engaging adolescents in the delivery of prevention messages to younger youth can have an impact on older youth by improving their own wellbeing.

Adult leaders receive 3 days of training on the curriculum, participate in experiential activities, and receive a debriefing from the trainer at the conclusion of the training. The adult leaders teach the curriculum primarily by way of example and leadership rather than lecture.

Expected Outcomes

Participation in TITE is expected to be associated with:

1. A positive change in knowledge about the risks and consequences of teen sexual activity, pregnancy, STDs, teen dating violence, substance use;


2. A positive change in risk avoidance skills; and


3. An increase in positive individual characteristics (e.g., self-esteem, self-efficacy, coping skills, empathy, and sense of control over one's future) and interpersonal relationships (e.g., parent, peer, and dating).

The evaluation of the TITE program used a pre-post survey (n = 194, 77% of total participants completed both a pre and post survey), portions of which are compared with a base-line statewide survey of prevention programs. Youth report on areas of self efficacy such as decision-making abilities and control over goals, as well as interpersonal skills such as contributing as a member of a team, treating others with respect, and responding to negative peer pressure. At the conclusion of the TITE program, youth also participate in a focus group, which helps inform the future development of the program.

As part of the evaluation, respondents were asked the reasons they believed they might choose not to have sex, such as concern over getting an STD or not being ready to have sex. Results are shown in Table 1. Possible responses were: "Agree" (3), "Not Sure" (2), and "Disagree" (1). Six items showed significant change from pre- to post-survey: "I could get an STD," "My parents would be really upset...," "I want to save my virginity for the person I marry," "I could get AIDS," "I am not ready to have sex" (p < .05), and "I am committed to abstinence until I am married" (p < .01).

Summary

In summary, TITE focuses on strengthening protective factors such as promoting communication in relationships, self-confidence, self-esteem, and positive peer support and is a comprehensive positive youth development program reaching teens at both the micro and macro level (e.g., academic, interpersonal, and organizational). The curriculum is being prepared for peer review.

References

Catalano, R. F., Berglund, M. L., Ryan, J. A. M., Lonczak, H. S., & Hawkins, J. D. (1998). Defining and evaluating positive youth development. In Positive youth development in the U.S.: Research findings on evaluations of positive youth development programs. Retrieved on December 22, 2009, from: http://aspe.hhs.gov/HSP/PositiveYouthDev99/chapter2.htm

Eccles, J. S. (Ed.) (2002). Community programs to promote youth development. Washington DC: National Academies Press.

Glik, D., Nowak, G., Valente, T., Sapsis, K., & Martin, C. (2002). Youth performing arts entertainment-education for HIV/AIDS prevention and health promotion: Practice and research. Journal of Health Communication, 7, 39-57.

Hoover, A. B., & Weisenbach, A. (1999). Youth leading now: Securing a place at the table. New Designs for Youth Development, 15, 29-36.

Kirby, D., & Coyle, L. (1997). Youth development programs. Children & Youth Services Review, 19, 437-454.

Larson, R. W., & Brown, J. R. (2007). Emotional development in adolescence: What can be learned from a high school theater program? Child Development, 78, 1083-1099.

Marczak, M. S., & Peterson, D. J. (1999). University of Arizona prevention program: University of Arizona evaluator's report (Project No. APH 00361-04). Tucson, The University of Arizona, Division of Family Studies and Human Development.

Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). What works in prevention: Principles of effective prevention programs. American Psychologist, 58, 449-456.

Sikkema, K. J., Anderson, E. S., Kelly, J. A., Winett, R. A., Gore-Felton, C., Roffman, R. A., Heckman, T. G., Graves, K., Hoffmann, R. G., & Brondina, M. J. (2005). Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments. AIDS: Official Journal of the International AIDS Society, 19, 1509-1516.