Exchanging Lessons in Baltimore: The Case for Integrated Approaches

Exchanging Lessons in Baltimore: The Case for Integrated Approaches

The three-woman team from Fronteras Unidas Pro Salud A.C., a Mexican civil society organization, flew 2,300 miles from Tijuana to Baltimore to learn about youth disconnection in the U.S. and share Pro Salud’s comprehensive, peer-to-peer strategy for addressing the needs of young people who are out-of-school and out-of-work.

What they discovered was a surprising similarity between the issues driving youth disconnection on both sides of the border, among them poverty; violence; a pervasive drug culture; family breakdown; and a lack of relevant education, training, and employment opportunities. 

“I can see here a lot of the same things we struggle with,” said Pro Salud Board Member Marionne Rubio. “I was thinking in the U.S. it would be different.” 

Brisa Armenta Cruz, Pro Salud’s Youth Program Coordinator agreed. “It’s been very valuable to see the problems in Baltimore. We have many similar issues in Tijuana.” 

The team’s four-day visit was part two of a (Re)Connecting Youth learning exchange that began in August when Pro Salud hosted three Baltimore government agency representatives in Tijuana. The pairing of the two teams was no accident with youth disconnection a potent reality in both cities. In Baltimore, an estimated one in five youth are not in school or work with the proportion nearing one in three in Tijuana. 

What made the second half of the exchange stand out wasn’t just the similarity in challenges participants address in their day-to-day work but their shared understanding of the complexity of opportunity youth needs and the importance of integrated solutions. 

“Disconnection is born out of multiple systems failures,” said Vira David-Rivera, Assistant Director of Adolescent and Reproductive Health for the Baltimore City Health Department and a member of the Baltimore exchange team. “Young people say, ‘we’re not disconnected, we’ve been pushed out.’ We need to look at the different points where they’ve been pushed out.”

Disconnection is born out of multiple systems failures. Young people say, ‘we’re not disconnected, we’ve been pushed out.' We need to look at the different points where they’ve been pushed out.

—Vira David-Rivera, Assistant Director, Adolescent and Reproductive Health, Baltimore City Health Department

To better understand the drivers of youth disconnection in Baltimore—and the services offered by their host agencies—the Pro Salud team met with staff at the Westside Youth Opportunity Center run by the Mayor’s Office of Employment Development, exchanged experiences with Baltimore City Public Schools’ Re-Engagement Center, toured a model community school, participated in a roundtable with Latino youth service providers, and heard from young leaders advising the Health Department’s Teen Pregnancy Prevention Initiative

For the Baltimore exchange members, these briefings provided a chance to learn more about innovations happening across their city. For both teams, the dialogues re-affirmed the importance of integrated approaches that place a premium on engaging youth as part of the solution

“Our purpose is to get to know young people and the barriers that kept them from attending school in the first place,” said Roger Shaw, Director of Multiple Pathways for Baltimore City Public Schools, of the Re-Engagement Center’s work over two years to support students who have previously dropped out of school or are at risk of dropping out. “You need to connect students to their passion and purpose. Otherwise, they’re not going to be successful.”

Shaw emphasized the Center’s pursuit of holistic approaches designed to counteract systemic challenges, for example, the stigma experienced by youth who have experienced the criminal justice system and the need for many students to earn an income while attending high school. “If City Schools implements a comprehensive re-engagement strategy, we can decrease dropout rates, transfer rates, chronic absenteeism, and increase graduation and retention rates,“ he said. “This has the opportunity to change Baltimore City as a whole.”

Representatives from Pro Salud and the International Youth Foundation meet with staff from the Baltimore City Public Schools’ Re-Engagement Center.

The importance of integrated approaches was also stressed during a visit to the Ben Franklin High School, once a failing school which now offers a robust example of the Community Schools model. Principal Chris Battaglia described the school’s role as a hub where youth and families can access broader services, including mental health counseling and crisis intervention. Programs are also underway that foster healthy relationships between youth and police, equip students with work readiness and financial literacy skills, and provide young mothers with onsite child daycare so they can return to school.

Examples of holistic programs like these struck a chord with Pro Salud team members who, on each stop along their visit, shared elements of its comprehensive eight-week training for youth. That model incorporates health education—along with life skills training, one-on-one mentoring, and job placement support, all delivered by trained youth. Over four years, 81 percent of program participants have returned to school, secured employment, or both.

Pro Salud: An Integrated Approach

Below are elements of Pro Salud’s holistic model emphasized by team members during their visit to Baltimore. 

  1. Community-Based Services—Rather than expect youth to travel to a location outside their neighborhoods, Pro Salud delivers its Órale training at community and rehabilitation centers throughout greater Tijuana. 
  2. Peer to Peer Learning—Young people are far more apt to listen to and respond to their peers. Pro Salud’s peer facilitators and counselors are university students or recent graduates who have studied psychology, social work, and related fields. Each receives thirty hours of training and follow-up support and commits to working with the program from six months to one year. 
  3. Creative Outreach—Because they’re not in work or school, youth experiencing disconnection can be hard to reach. To engage youth, “we go directly to their neighborhoods, to their homes, to parks, and places where they gather,” said Pro Salud’s Armenta. “We persuade them that this [the program] is something they should do for their lives.”
  4. Life Planning—Young people need help identifying career goals and the steps required to reach them. The Órale curriculum implemented by Pro Salud includes modules on life planning. With the support of a peer mentor and placement counselor, participants identify the short-term steps needed to achieve long-term goals.
  5. Health Education and Services—From reproductive health education and services to nutrition counseling, youth need to be informed by individuals they trust to make healthy decisions. “We don’t treat teenagers like they’re full of hormones and can’t make decisions,” said Armenta. “We show them the process they’re going through and try to remove the stigmas they face. It’s important that young people know their sexual and reproductive rights.” 
  6. Trauma-informed Care—Youth enrolled in the Órale program have access to trained psychologists, with individual and group therapy built into the eight-week experience. 
  7. Parent Engagement—Whether youth enroll and commit to a given program often depends on the level of support they receive at home. “We don’t tell them [parents] what to do,” said Armenta. “We take them back to their teenage years so they remember and can relate to what their kids need.” Parents—especially mothers—also serve as key promoters of Pro Salud’s outreach efforts in communities. 
  8. Follow up Support—The Órale model also includes four months of follow up support to ensure that trained youth have a qualified peer that can help them troubleshoot challenges and stay focused on goals. 
  9. Cross Agency Collaboration—To be effective, services need to be coordinated with those of other youth-serving entities. Over time, Pro Salud has formed partnerships with a range of government agencies and nonprofit service providers. The organization works with the police department, for example, to sensitize law enforcement officials around youth needs and violence prevention strategies. 

The Pro Salud model resonated with Baltimore practitioners, who also stressed the need for resources to strengthen and scale proven approaches.

Next Steps

The exchange concluded with the Baltimore partners expressing their desire to adapt elements of Pro Salud’s approach—particularly its Órale curriculum and peer-to-peer training—to address the needs of the city’s opportunity youth. 

The Health Department’s David-Rivera spoke in particular to the relevance of the Órale model, with its roots in Mexico, to Baltimore’s growing Latino youth population. 

Kerry Owings, Director of the Westside Youth Opportunity Center, referred to the program’s emphasis on peer-to-peer support as a welcome extension of the center’s caring adult model. 

In the weeks ahead, (Re)Connecting Youth will follow up with the exchange partners in Baltimore regarding grant opportunities, with the goal of adapting elements of Pro Salud’s model to strengthen existing programs and approaches in the city. 

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