Monday, October 1, 2012

The CATCH Program: A Hit or Miss?

The CATCH Program: A Hit or Miss?

The New York Times article: “More Access to Contraceptives in City Schools” (September 23, 2012)

A new program titled CATCH (Connecting Adolescents to Comprehensive Healthcare) started in January 2011 among 14, now 13, New York City high schools. CATCH offers reproductive health services, including condoms, birth control pills, pregnancy tests, and Plan B which are all distributed to students 17 years old and under  by health department officials and school nurses. Before the program started, parents and families received forms to choose if they want to participate in the CATCH program or opt out of it. Only 1-2% of families chose to not participate, which can be a surprising statistic. 

The New York City Department of Education barely mentions the CATCH program on their website (see link below). They only discuss the program in terms of it being new, but they do not give any more information. 

Questions and Concerns:
  • As sexuality educators, we need to concerned with how schools are communicating sexuality topics that are discussed in schools with parents and families. How was this “form of consent” sent home? What did it say? How was it supposed to be returned back to the school? Did it give correct and detailed information about each reproductive service, especially Plan B? Point of discussion: What is the best way to communicate and educate a new program like CATCH to parents and families? 
  • Being an advocate for comprehensive sexuality education, the CATCH program has potential to decrease adolescent unwanted pregnancies, STIs, and HIV. As students are using these services, what type of education are they receiving from the health department officials and school nurses? Are they taking time to have conversations with students using these services? Point of discussion: For students that are participating in the CATCH program services, should there be education in the process of utilizing these products and services? What could that education look like? 
  • What are the strengths and weaknesses of the CATCH program? 


  1. Point of Discussion 1

    Following your second link, I found a page for the Department of Education's Condom Availability Program. In this program's guidelines it dictates the following:

    "The Parental Opt Out Letters must be sent to parents of students new to the school. If parents opt their children out, a list of the students’ identification numbers (without names) must be given to all health resource room staff. This “opt-out list” must be maintained confidentially. Letters must be placed in New Student Orientation Packets yearly."

    I would agree with all of these stipulations for communicating the new program to the parents. These annual letters should include a description of the services provided, a list of health care providers working at the school, and rational for the program. Also, I would suggest that the same letter be mailed to the student's home address to help ensure the parents receive the information.

    In my personal experience, I never gave my parents half of the handouts that I was ordered to give them. Also, I signed a parent's signature on a majority of the required paperwork. Therefore, if the school really wants to ensure the parents receive the information, they will provide the three above avenues to do so.

  2. Great topic Stephanie! When I first heard about this happening in NY high schools I was so happy about the services being offered, but then I had many of the same questions running through my mind. In terms of the Point of Discussion about the type of education that the students will be receiving with the contraceptive services: I would hope that the nurse and/or health department officials would be required to provide a mini-education session (much like you would hope any doctor/clinician would give a patient using any of these forms of contraception) to any student accessing the CATCH program.

    Going off of personal experience as a former NY high schooler I remember having condoms being available at my school but the only way you could have them is if you talked to one of the PE/Health teachers. Now in theory this is great and I would support having a program like that in all high schools, but the way my PE teacher talked to students was invasive and definitely not sex positive to say the least. I remember going to get condoms for a friend that was too shy to get them for herself and being asked multiple questions about if I was going to use the condoms and if I knew all the risks involved with having sex of any kind even with protection (talk about fear-based education). For schools involved with the CATCH program, or any others like it, I would suggest that the nurses/educators be required to use approved lessons plans or talking points with students that come to access the services. I would also suggest that they are required to have Professional Development on birth control updates, sex positivity, student privacy, etc. These measures could try to ensure that the students feel safe and able to go access these services and that the information they will be given is medically accurate and up to date.

    I think one great benefit to the CATCH program is that since the students could see the nurse/health department official on a regular basis when they are in school they could then ask more follow-up questions and have continuing education about not just the contraception they were provided, but also their relationships and any other sexuality topic on their minds. This is definitely something that teens would not be able to do if they were receiving their birth control through a doctor/medical center - especially if they cannot drive or access the medical care without a parent's help. Having the education be right at their fingertips could increase use of contraceptives and condoms as well as decrease user-error.

  3. Stephanie, you raise a lot of really great questions about this initiative. I think that, like most things in our field, most of the programs that are put into place are less of a fantastic idea and more of a step in the right direction. So I'm a little on the fence about how I feel about this, especially since a lot of information isn't available.

    I think that /absolutely/ there should be education that goes with these services. It's awesome that the services are being provided, but what good are they, really, if students don't know how to use them (particularly effectively and safely)? It would be awesome if this information could be included in their regular sexuality education classes, but it might also be useful to have a peer education counsel -- a group of students in the school who are trained to answer questions and run workshops on these issues and services; that way, there would be ongoing support for the student body from non-authority figures, which is important. It might also be helpful to set up a website (at /least/ with resources) with information and to keep a binder or two of information with the nurse and/or guidance department, so that students could have access to the information that they need.

    All-in-all, I think that this program will likely do more good than harm, and hopefully it works out, but I do think that it could be better arranged and implemented.

  4. Definitely a great topic to start the blog with Stephanie! I remember reading about this program during the Spring semester last year, and I too have mixed feelings about it. Just because I love to dig endlessly to find answers to my questions, I did find the same information Sasha mentioned about the Consent form being sent home to parents (see some additional info - including a sample consent form - on the NY Department of Education School-Based Health Center webpage:

    In order for parents to opt their child out of reproductive services such as pregnancy tests or receiving contraception, they had to sign & return the consent form to the school. However, if the parent fails to do those things, offering contraception to minors without parental consent is in accordance with NY law (The New York Civil Liberties Union discusses Minors Rights here:

    I also found the School-Based Health Center Enrollment Tool Kit pdf where they offer recommendations for lack of returned consent forms ( - it is the first resource listed). An activity for following-up with parents is even provided on page 11 of the toolkit and offers great tips for doing all you can to get consent forms distributed to & returned by both students & their parents.

    Regarding the best way to communicate a program like CATCH to parents, I would start with the school's condom availability program mentioned by Sasha already (more details about that program here: Then, I would explain how providing contraception and pregnancy tests are really just a natural progression from that condom program & they share an overall goal of preventing teenage pregnancy and contraction/transmission of STI's, HIV/AIDS, etc. - especially with the teen pregnancy and subsequent drop out rates discussed on one of my all-time favorite blogs:

    I definitely agree with Bryce & Melissa - I am disappointed at the lack of information about education provided/not provided to the youth using these products & services. For most cases, I think at least 1 educational session should happen with the nurse & student to inform them of all their options. Then, an educated decision can been made by the student at a follow-up appointment, and a prescription can be written.

    The article I provided above, mentioned most of the schools offering CATCH are located in black & latino working class areas. Unfortunately, I have no idea if this is true or not since I'm from Ohio LOL. However, if this statement is accurate, I am interested to see if/when CATCH becomes offered in middle and/or upper class, mainly Caucasian areas. I am interested in observing the extreme differences, which I believe will present themselves, in discussions & opinions surrounding the program when that happens!

    Again, great topic Steph! :)

  5. Thanks for bringing this to our attention, Stephanie! As brought up by other commenters, one of the things that I would like to more about this program is what training the nurses and other student health professionals at these schools are undergoing in order to be fully prepared to work with students around sexuality issues. If Bryce's experience of getting condoms in a NY school holds true, then having these services won't actually do much good since many students may feel too intimidated or alienated to use them. And, as Melissa said, it would help greatly if, in addition to these medical services, students have comprehensive sexuality education as part of their regular coursework--there would be less chance of feelings of intimidation or alienation if the school environment supports a sex-positive environment in the first place. But the fact, as stated in the article, that 567 students received Plan B and 580 received birth control in the 2011-2012 school year is heartening.

    It is also interesting to me that information about the CATCH program does not seem to be more easily accessible on the NYC Department of Education website. Doing a quick search on that site for both "Connecting Adolescents to Comprehensive Healthcare" and "CATCH" yield results that are alarmingly empty of information appropriate for either parents or students. I think that making the information more readily available on the DOE website would be a huge first step in educating parents about the programs--at least those who are web-savvy. And more and more parents are becoming web-savvy, although I'm not sure what the stats are for lower-SES neighborhoods. But having the info online could be a good resource for those parents who hear something about the program, even if, as in Sasha's case, their kids don't bring home the parental opt-out form. Then they could just go there to learn more, and even download the opt-out form.

    I look forward to learning how this program affects abortion, HIV and STI transmission rates in the coming years.

  6. My first concern was about consent forms, too! I wonder how many of them actually made it to the parents to sign off on, and not just forged by the students. A think a great way of ensuring that parents have all the information would be to hold a short, informative meeting about it. I'm sure that attendance would be rather minimal, but it would at lest be something. I imagine that holding such a meeting would be a great way to hash out some FAQs to send out to parents who were not able to attend the meeting.

    While being concerned about the education that the students are receiving is important, I'm also wondering the type of training the health department officials are receiving. I am sure that they are knowledgeable about the medial aspect of sexuality (contraception and STIs) but I would love to find out if their work is also sex positive.

    I totally understand the need for parental consent on these services, but I have a major concern. What about how the child feels? If a child is placed on the opt out list by the parent, but is in need of these services, where are they going to go? Ideally, the staff would provide the child with resources, but what if the child is too ashamed or scared of going anywhere else. I'm afraid that this would discourage them from seeking services now that they have been denied once. I don't know that this is something that would happen often, but I would like to know how these situations would be handeld. Like Josh, I definitely look forward to seeing the outcome of this program!

  7. Hello Everybody,
    Call me Yossarian because I am all about discussing this CATCH. Great points by everyone so far. I think the most interesting part of the original story and post by Stephanie involves the consent forms. I don't think there should have been any consent forms sent out and that opting out of this program shouldn't be allowed. I did some research regarding opting out and in New York state the only curricula that parents can pull their kids from is sex ed. It is definitely a debate between parents rights and the school. There is a good article about it at I think that treating sexuality education or programs about sexual health differently within the schools by sending out consent forms when consent forms are not sent out regarding other subjects immediately sets the standard in parents' minds that sexuality ed is different and problematic or a waste of time. Only when sexual health has the same standards and is viewed with the same necessity as math will it be successful in schools.

  8. I agree, great way to begin, thanks Stephanie. The first thing that came to mind when I read about the NYC CATCH program was the failed attempt by the Superintendent of Schools in Provincetown, Massachusetts to institute a K-12 condom accessibility possibility throughout her district. Provincetown, as some may know, is an interesting town at the end of Cape Cod, which has been home to a large fishing community, artists, writers, playwrights,and, of late, it has become a home for LGBT people of many stripes.

    You'd think Beth Singer, the superintendent, would have an easy time creating access for the students to contraceptives, but the backlash was fierce and fast-moving. This happened in June, 2010 and here is a link to an article from the Boston Globe describing the hue and cry: which is quite interesting because it speaks to another sexuality education issue. That is, to remember that, even in a gay-friendly resort, there are also people who live there who are trying to eke out a living on an annual basis. Beth Singer forgot about those folks -- the parents of her students -- when she signed off on the new policy.

    Not only do we, as sexuality educators, have to think about offering educational services with condoms, but we have to think about how to explain to those policy-makers that they need to create policies that speak to the multiplicity of audiences and cultural groups in their respective domains. I'm not saying cowtow to the rightwing, but I am saying we need to get them to think about readiness, cultural barriers, and strengths of each of their communities. Those fishing families are probably just as concerned about good sexuality education for this kids as the LGBT folks, but they just need to know that their needs are being taken into account as well.

  9. In comparison to the South, the sheer notion of this pretty much blows my mind. I can't imagine anything like that happening here in Georgia except -maybe- if it was offered at private schools.

    That said, I agree with what everyone has posted. I agree with Melissa that while the program can be beneficial, peer-education could exponentially increase its effectiveness. What stuck out most to me, aside from the lack of accompanying education for what was being offered was how technical it all is, for lack of a better word.

    In high school, since sex education was nil, I learned about all the technical things about sex from books and research. I don't know how many times I studied the diagrams of how to put on a condom, and I generally knew how birth control worked (since I had to be on it for non sexual reasons). I was essentially taught to fear sex because it was all disease-ridden and pregnancy inducing. While I was all prepared for that, I would have never been prepared for the affective bit that can surround intercourse, especially when it's a new frontier.

    So, I agree with the need for education concerning proper and effective usage of the products being offered, but I can only hope if and when the day comes that it is available, affective dialogue is included as well.

  10. Toni, I couldn't agree more about the need for affect-based education and the word value keeps coming to mind. When I was a part of the group assessing K-12 sexuality education curriculum for my state, I was exhorted to leave "values" out of any changes. Taken in a cultural context, what that meant to me was that the conservative forces which have denigrated sexuality education to fear-based STI, HIV, and pregnancy prevention have also "de-valued" the work both in terms of content and context. We need more sexuality educators like you who understand the need for inclusion of the emotional and interactive basis for it. That would certainly increase the value.