A continuous quality improvement process applied to the Need to Know teen pregnancy prevention program for systems-involved youth identified seven key areas for curriculum improvement across ten implementation cycles with youth and six with caregivers.
The Need to Know (N2K) program was implemented with 102 youth and 84 caregivers across multiple partner sites during the study period.
The N2K program consists of distinct modules tailored separately for systems-involved youth and their caregivers.
Purposeful sampling was used to select youth participants at each partner site.
The CQI process identified seven areas for curriculum improvement in the N2K program.
The CQI process involved multiple iterative implementation cycles to refine the teen pregnancy prevention curriculum.
This research describes how a team used a continuous quality improvement (CQI) process to develop and refine a sexual health education program called 'Need to Know' (N2K) for young people who are involved in systems like foster care, juvenile justice, or residential treatment centers. These youth — often called 'systems-involved youth' — face unique challenges and vulnerabilities that standard teen pregnancy prevention programs may not adequately address. The program was tested with 102 young people and 84 of their caregivers between July 2019 and March 2020, with the team running multiple rounds of the program and collecting feedback each time to make improvements. Through this iterative testing process, the researchers identified seven main areas where the curriculum needed to be improved: making the content more streamlined, adding more hands-on activities, adjusting the material to better match participants' reading and comprehension levels, incorporating more trauma-informed approaches, adding mindfulness strategies, better meeting youth at their current emotional state, and improving how facilitators are trained to deliver the program. The caregiver portion of the program was embedded into professional development training at partner sites rather than delivered separately. This research suggests that using a continuous quality improvement approach — testing, gathering feedback, and repeatedly refining a program — is a valuable way to adapt sexual health education for populations with complex needs. Rather than deploying a fixed curriculum, this method allows programs to be responsive to the lived experiences of vulnerable youth. The findings highlight that programs serving systems-involved youth need to pay particular attention to trauma-informed care and facilitator training to be effective.
Dierschke N, Todd J, Schmidt S, Plastino K. (2025). A continuous quality improvement process to create a sexual health curriculum for systems-involved youth.. Evaluation and program planning. https://doi.org/10.1016/j.evalprogplan.2025.102567