Children's Aid Society (CAS)-Carrera Program
Michael A. Carrera, Ph.D.
Founded in 1984 by Dr. Michael A. Carrera at The Children's Aid Society (CAS), CAS-Carrera is an evidence-based program designed to develop young people’s capacity and desire to avoid parenthood and other risky behaviors during adolescence. The Carrera Adolescent Pregnancy Prevention Program is a seven-year program which relies on a holistic, youth development approach. It recruits disadvantaged boys and girls ages 10 to 11 years old and follows them through high school graduation and beyond. The Carrera Adolescent Pregnancy Prevention program consists of seven required components, and is delivered by trained and certified staff. The program may be integrated into the school day or implemented after school and in community-based locations.
CAS-Carrera begins working with boys and girls when they are 10 or 11 years old and retains them through high school graduation and beyond. The program serves young people and their families from disadvantaged urban, rural and suburban neighborhoods across the country. CAS-Carrera encourages programming targeted to varied populations. This may include gender specific cohorts and diverse communities such as Native American/American Indian populations, as well as vulnerable populations such as youth in foster care, and disconnected youth. The program was evaluated first with predominantly Hispanic and African American adolescents who were 13 to 15 years old when they enrolled in the program, and then with younger adolescents who were 11 to 13 years old at the time of enrollment. More recently, it was evaluated with students in 4th through 7th grades in elementary and middle schools.
The CAS-Carrera program can be implemented as an afterschool program or an integrated school model. The program was evaluated in after-school and community-based settings.
Shelia Reich, MSW
Deputy Director, National Implementation & Quality Assurance
The Children's Aid Society Carrera Adolescent Pregnancy Prevention Program
National Accreditation and Training Center
3710 University Drive, Suite 310
Durham, NC 27707
|Category||Component||Core Component||Component present||Notes||Lesson number(s) / activities where present|
|Content||Contraception - Condoms||Yes||Yes (both versions)||Major theme in all FLSE Programs from 7th to 12th grade.|
|Content||Anatomy/physiology||Yes||Yes (both versions)||Major unit in all FLSE Curricula as well as 6th-12th grade programming.|
|Content||Other||Yes||Yes (both versions)||Test Preparation||Major theme of academic enrichment component for participants in grades 6-12.|
|Content||Other||Yes||Yes (both versions)||Interview Preparation||Major theme of Job Club programming from 6th-12th grade.|
|Content||Other||Yes||Yes (both versions)||Career Readiness||Major theme of Job Club programming from 6th-12th grade.|
|Content||Other||Yes||Yes (both versions)||Finance Management/ security||Major theme of Job Club programming from 6th-12th grade.|
|Content||Volunteering/civic engagement||Yes (both versions)||Overarching theme of the Carrera Pregnancy prevention Program|
|Content||Morals/values||Yes||Yes (both versions)||Major unit in both FLSE and Power Group component from 6th-12th grade.|
|Content||Identity development||Yes||Yes (both versions)||Major unit in both FLSE and Power Group component from 6th-12th grade.|
|Content||Social support/capital||Yes||Yes (both versions)||Major unit in both FLSE and Power Group component from 6th-12th grade.|
|Content||Social influence/actual vs. perceived social norms||Yes||Yes (both versions)||Overarching theme of the Carrera Pregnancy prevention Program|
|Content||Social competence||Yes||Yes (both versions)||Major theme of power group component from 6th-12th grade.|
|Content||Normative beliefs||No||Yes (both versions)||Overarching theme of the Carrera Pregnancy Prevention Program|
|Content||Leadership||Yes||Yes (both versions)||Overarching theme of the Carrera Pregnancy Prevention Program|
|Content||Gender roles||Yes||Yes (both versions)||Major theme of FLSE component from 6th-12th grade.|
|Content||Gender identity||Yes||Yes (both versions)||Major theme of FLSE component from 6th-12th grade.|
|Content||Cultural values||Yes||Yes (both versions)||Major theme of power group component from 6th-12th grade.|
|Content||Conflict resolution/social problem solving||Yes||Yes (both versions)||Major unit in Power Group and minor unit in FLSE component from 6th-12th grade.|
|Content||Connections with trusted adults||Yes||Yes (both versions)||Major unit in both FLSE and Power Group component from 6th-12th grade.|
|Content||Communication skills||Yes||Yes (both versions)||Major unit in both FLSE and Power Group component from 6th-12th grade.|
|Content||Child development||No||Yes (both versions)||Major unit in 6th grade FLSE programming. Featured in Above the Waist, section on puberty.|
|Content||Boundary setting/refusal skills||Yes||Yes (both versions)||Major unit in both FLSE and Power Group component from 6th-12th grade.|
|Content||Substance use cessation||Yes||Yes (both versions)||Major theme of power group, as well as a part of the individual medical services delivered throughout the program.|
|Content||Substance use - Other drugs||Yes||Yes (both versions)||Major theme of power group, as well as a part of the individual medical services delivered throughout the program.|
|Content||Substance use - Alcohol||Yes||Yes (both versions)||Major theme of power group, as well as a part of the individual medical services delivered throughout the program.|
|Content||Substance use - Abstinence||Yes||Yes (both versions)|
|Content||Brain development and substance use||Yes||Yes (both versions)|
|Content||Vocational/skills training||Yes||Yes (both versions)||Major theme for the education component of the Carrera program.|
|Content||Supplemental academic services||Yes||Yes (both versions)||Major theme for the education component of the Carrera program.|
|Content||School engagement||Yes||Yes (both versions)||Overarching theme of the Carrera Pregnancy Prevention Program|
|Content||Graduating from high school||Yes||Yes (both versions)||Overarching theme of the Carrera Pregnancy Prevention Program|
|Content||College preparation||Yes||Yes (both versions)||Overarching theme of the Carrera Pregnancy Prevention Program|
|Content||Self-regulation||Yes||Yes (both versions)||Major theme in all Power group programming from 6th-12th grade.|
|Content||Self-esteem||Yes||Yes (both versions)||Major theme in all Power group programming from 6th-12th grade.|
|Content||Sexual health||Yes||Yes (both versions)||Overarching theme of all FLSE Programming and lessons.|
|Content||STIs - Treatment||Yes||Yes (both versions)||Major theme in all FLSE Programs from 7th to 12th grade.|
|Content||STIs - Screening||Yes||Yes (both versions)||Major theme in all FLSE Programs from 7th to 12th grade.|
|Content||STIs - Prevention||Yes||Yes (both versions)||Major theme in all FLSE Programs from 7th to 12th grade.|
|Content||STIs - Information||Yes||Yes (both versions)||Major theme in all FLSE Programs from 7th to 12th grade.|
|Content||Sexual risk reduction||Yes||Yes (both versions)||Overarching theme of all FLSE Programming and lessons in grades 7-12.|
|Content||Sexual risk discontinuation||No|
|Content||Sexual risk avoidance||Yes||Yes (both versions)||Overarching theme of all FLSE Programming and lessons in grades 7-12.|
|Content||Sexual orientation||Yes||Yes (both versions)||Major unit in all FLSE from 6th to 12th grade.|
|Content||Contraception - Other||Yes||Yes (both versions)||Major theme in all FLSE Programs from 7th to 12th grade.|
|Content||Contraception - Pills, patches, rings, and shots||Yes||Yes (both versions)||Major theme in all FLSE Programs from 7th to 12th grade.|
The primary goal of CAS-Carrera is to help young girls and boys avoid becoming parents during the second decade of their lives while preparing them to fully develop and thrive. The CAS-Carrera program consists of seven components that reflect the core program content. The activities and overall engagement in each component is driven by a curriculum and/or protocols and guidelines designated by CAS-Carrera. The component objectives and essential elements are highlighted below:
- Education: Essential elements of the Education component are: 1) all youth will have an Individual Academic Plan (IAP) created by the Education team; 2) each young person receives a minimum of one hour of homework help, tutoring, enrichment, and/or remediation at least four times per week; 3) all school report cards and standardized test scores are collected from their schools; and 4) academic maintenance activities occur during the summer months and all young people also participate in project based learning activities.
- Job Club: Weekly exposure to the “world of work.” Essential elements of the Job Club component are: 1) each young person opens and maintains a savings account; 2) each young person earns a stipend for Job Club participation; 3) monthly bank trips enhance lessons on banking; 4) regular entrepreneurial activities teach young people skills that lead to an understanding of small business ownership; 5) community service opportunities; and 6) career exploration evolves over time.
- Family Life and Sexuality Education (FLSE): Essential elements of the FLSE component are: 1) weekly education sessions throughout the program year; 2) age and stage appropriate, medically accurate information, and instruction focused on developing sexual literacy; 3) emphasis on abstinence throughout the curriculum; 4) encouraging young people to talk with their parents about sexuality; 5) reproductive health counseling and care as needed; and 6) young people complete an annual FLSE survey.
- Self-Expression: Essential elements of the Self-Expression component are: 1) activities including music, dance, theatre, acting, fine arts, pottery, collage, painting, and drawing; 2) opportunities for project-based activities; and 3) young people are exposed to at least two self-expression activities during the year.
- Lifetime Individual Sports: Essential elements of the Lifetime Individual Sports component are: 1) young people learn skills in various lifetime sports such as golf, squash, tennis, martial arts, horseback riding, fencing, and swimming; 2) young people are exposed to at least two lifetime individual sports during the year.
- Full Medical and Dental Care: Essential elements of the Medical and Dental component which are provided as needed are: 1) access to annual comprehensive medical and dental services; 2) comprehensive physical and oral exams; a dedicated primary health care provider; 3) health education; specialty follow-up as needed; urgent care visits; reproductive health care; and vision screening.
- Mental Health Services: Essential elements of the Mental Health component are: 1) weekly socialization groups called Power Group, which focus on group work activities and theme- based discussions facilitated by a licensed mental health professional; 2) access to case management, crisis intervention, and counseling needed; 3) collaboration with FLSE staff as necessary.
CAS-Carrera also includes a Parent Family Life and Sexuality (PFLSE) program that provides the opportunity for parents and caregivers to engage in a multi-week series designed to help caregivers increase their sexual literacy, improve communication skills with family members, and develop a holistic definition of sexuality.
The Carrera program relies on a comprehensive, above the waist approach to sexual education and youth development that avoids fragmentation. Carrera utilizes a family systems approach and considers youth to be “at-promise” instead of “at-risk”. Each of the seven components incorporate a mix of classroom-based and individually tailored activities. The types of activities include: discussions on academic and sexual health topics, sports to foster discipline and healthy lifestyle, counseling and case management, weekly art and music sessions to foster and encourage creativity, and individualized medical and mental health care.
The CAS-Carrera program structure is centered on the seven fundamental components which are delivered in a prescribed fashion to meet the dosage requirements of the program model. Organizations seeking to replicate CAS-Carrera must implement all seven components. In the after-school context, programming is provided daily – 15-20 hours per week, 45-48 weeks per year, inclusive of the summer program. The specific schedules and program times are organized around school schedules and dismissals. The education component involves one-hour sessions of tutoring, homework help, enrichment, or remediation four or more times a week, including a summer program. The Family Life and Sexuality Education (FLSE) component involves one 45-minute session of in-classroom interaction, classwork, discussion, and demonstration (as needed), taking place once a week during the school day. For community centers, after-school programs and summer programs, the FLSE component involves one hour-long session of similar structure, once a week.
Programming is delivered in a group format with optimal staff to student ratios at 1:15. Sample rotation schedules are provided by CAS-Carrera. Efforts should be made to provide programming/maintenance activities on Saturdays and during holidays/school breaks when possible to maintain program continuity. The program structure and dosage requirements for the Integrated School Model are the same, with program schedules developed based on school day schedules, numbers of students, and grades served.
CAS-Carrera formal program launches typically coincide with late summer/early fall school openings. A best practices program launch is preceded by at least 6 months of collaborative planning and preparation, and a (modest) summer program offering where participants and staff have an opportunity to get to know one another and build group cohesion in advance of formal programming. CAS-Carrera provides a formal implementation plan/roadmap to program partners, which includes specific implementation tasks and related timelines associated with a best practices program launch.
CAS-Carrera programs must hire a full-time Program Coordinator, a full-time Community Organizer, and at least part-time staff to lead each of the component areas. While CAS-Carrera maintains specifications for staffing in terms of required positions and time allocations/scheduling, it is important to note that overall determinations about staffing are a function of cohort size and an analysis of the needs of students to be served. CAS-Carrera provides job descriptions as well as considerations for budget/salary allocations, and scheduling for the program positions. A sample staffing pattern is provided below:
Sample Staffing Pattern: Afterschool Cohort of 60 Students:
- Program Coordinator (1) F/T
- Community Organizer (1) F/T
- Job Club (1) P/T
- Education Coordinator (1) P/T
- Teacher (2) P/T
- Tutors/Group Leaders (2) P/T
- Licensed Mental Health Specialist (1) P/T
- Family Life & Sex Education (1) P/T
- Lifetime Individual Sports
Sample Staffing Pattern: Integrated School Model Cohort of 80-100 Students:
Program Coordinator (1) F/T
Community Organizer (1) F/T
Job Club (1) P/T
**Education Coordinator (1) P/T
**Tutors/Group Leaders (2) P/T
Licensed Mental Health Specialist (1) F/T
Family Life & Sex Education (1) F/T
**Lifetime Individual Sports
For the Integrated School Model and After-school programs that serve a larger number of students, the core positions remain. However their designation as PT may be adjusted to FT to ensure adequate component/classroom coverage. Additionally, staffing positions such as a Medical Services Coordinator may be included for programs with large student numbers. CAS-Carrera will generate customized, site-specific staffing templates based on the number of youth served.
**Staffing for Education including number of education staff, designation as PT or FT, and areas specialty are determined in conjunction with school-based assessments of student academic needs. Lifetime Individual Sports and Self-expression may be school led or enhanced/enriched by CAS-Carrera program support/resources.
**Positions may be hired as a P/T staff or as a vendor/contracted service
CAS-Carrera provides a formal implementation plan/roadmap with specific implementation tasks and related timelines associated with a best practices program launch. Additionally, the following are some of the tools available through the National Training Center:
- Training Tools/Component Curricula: CAS-Carrera provides training manuals, component curricula, and protocols that guide program implementation, content delivery and instruction. Materials include the newly developed middle school curriculum entitled “Above the Waist – Sexuality Education Beginning with the Brain.” The FLSE, Job Club, and Mental Health/Power Group components have designated curricula.
- The Medical and Dental Component has CAS-Carrera generated protocols for service delivery. The Education Component is guided by grade level academic objectives; templates for the Individual Academic Plan (IAP) are provided. Guidance is provided for the design and implementation of Lifetime Individual Sports and Self Expression.
- CMIS Licenses/Access: CAS-Carrera provides access to, and training on CMIS and performance metrics; program replications have real time access to CMIS data including system Help Desk functionality.
- Content Specialists: In addition to Fidelity Managers, CAS-Carrera provides component specific TA and training through the use of Content Specialists who are expert in designated fields of study.
Carrera programs must have dedicated administrative and program space including space to accommodate the Full-time Program Coordinator and Community Organizer, space for component leaders to prepare and store materials, and space with access to IT connections or computers for required data entry/monthly reports.
Carrera program sites must have access to an area that will accommodate all 60+ teens and program staff for fellowship time (dinner/snack), space for teens to place their belongings, a minimum of 4 rooms that can comfortably accommodate a group of 15 teens and component leaders for program rotations, and a private office to conduct individual counseling sessions and/or family meetings.
Additional considerations for implementation of the program in Integrated School Model Settings are:
- Dedicated administrative space for program staff; access to IT connections/computers for required data entry/monthly reports
- Ability to utilize classrooms and/or other facility space for component and overall program
- School day schedules that can accommodate CAS-Carrera component integration; school-led activities such as music or art may fulfill some related component requirements
- Feeder school patterns that are conducive to retaining and serving youth as they transition from middle school to high school and overall scaling of the program are critical. Schools that serve grades 6-12 on the same campus/facility are ideal
- Close proximity to medical providers
- Grade/cohort sizes of a minimum 75-80 students is preferable.
- Access to private offices to conduct individual counseling sessions and/or family meetings when necessary.
The CAS-Carrera National Accreditations and Training Center (NATC) provides ongoing technical assistance, training, and overall Fidelity Management services related to the launch and maintenance of CAS-Carrera replications. The main elements of CAS-Carrera Fidelity Management are highlighted below:
- Performance Management and Evaluation: CAS-Carrera program replications are required to collect and track key programmatic metrics and progress toward concrete milestones in each component in the Carrera Management Information System (CMIS), a customized information technology system (for which ongoing TA is available). CAS-Carrera also provides tools and support for program evaluation strategies utilizing standardized survey instruments and assessment tools.
- Program Planning: CAS-Carrera provides TA and assistance for program planning and implementation activities including: the development of an implementation planning template and timeline; site selection; participant recruitment; component planning; rotation schedules; staffing; scheduling; stakeholder outreach and communications; and an overall program implementation and maintenance strategy.
- On Site Fidelity Management: Each program replication is required to have a designated Fidelity Manager, typically a full-time CAS-Carrera employee. The Fidelity Manager provides on-site TA, training, and support in addition to ongoing engagement with the Program Developer/Sr. Leadership Team Members, and school leadership teams and boards as needed, along with CAS-Carrera staff.
- Component Curricula/Protocols and Program Materials: CAS-Carrera provides curricula, related protocols, and milestones for component and overall programming. In addition, sample/stock program materials including applications, consent forms, promotional materials, etc. are provided to partner agencies.
- Ongoing Training, TA, and Component Support: CAS-Carrera provides required pre-service and ongoing training and TA on the overall program model, the core principles and philosophy, component milestones and related curricula, and performance management. In addition, tailored trainings and TA sessions are provided to address site specific and emerging needs.
Organizations replicating the CAS-Carrera program are required to sign an MOU with CAS-Carrera, as the program developer, which details mutually agreed upon roles and responsibilities relative to maintaining fidelity to the program model and provides a framework for a mandatory fee structure related to CAS-Carrera fidelity management.
Pre-service training and ongoing professional development are required, to ensure that new staff receive required pre-service training on the model’s core principles and philosophy and are sufficiently trained to be able to expertly execute the model as prescribed by their role.
Orientation for new staff as well as training is offered through the CAS-Carrera National Accreditation and Training Center (NATC) in Durham, NC and/or the New York Carrera offices. Training may also be conducted locally.
- NATC orientations cover the following topics: History, mission, and guiding principles: CAS-Carrera core values and philosophy, Logic model, Holistic definitions of sexuality, in-depth component training on milestones and expectations, and overview of CAS-Carrera’s performance management system.
- The NATC pre-service and ongoing service trainings for designated component/administrative staff consist of: Component staff trainings on relevant curricula, and training on roles and responsibilities for all program staff.
- Trainings are provided as convenient for program sites. These may include: on site/in person trainings; distance learning modules (skype, webinars); and/or site based or regional meetings.
CAS-Carrera does not pay for travel; however the costs for initial and ongoing trainings are included as a part of CAS-Carrera Fidelity Management during the grant period.
|Citation||Setting||Majority Age Group||Majority Racial/Ethnic Group||Gender||Sample Size|
|After school||13 or younger||African American or Black||Youth of any gender||338|
Philliber et al. 2002
|After school||14 to 17||African American or Black||Youth of any gender||484|
|After school||13 or younger||African American or Black||Youth of any gender||204|
|A separate recent study conducted by another researcher evaluated the program using a randomized controlled trial that involved 338 students attending 4th through 7th grades in elementary and middle schools in Chicago. The study randomly assigned youth to either a treatment group that received the CAS-Carrera program after school hours or a control group that received academic and health support services and enrichment activities. Surveys were administered before the program started (baseline) and again every six months after the baseline for four years.
For the last follow-up, conducted about four years after the baseline, the study found no evidence of statistically significant program impacts on sexual initiation or on having sexual intercourse without using any effective method of birth control in the last three months.
The study also examined outcomes related to the implementation of the program, such as number of sessions that were scheduled and attended. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.
Philliber et al. 2002
|The program's evidence of effectiveness was first established in a randomized controlled trial involving adolescents recruited from six New York City agencies serving disadvantaged, inner-city populations. Within each agency, study participants were randomly assigned to either a treatment group that received the intervention or a control that received each agency's regular youth programming, which included recreational activities, homework help, and arts and crafts. Surveys were administered immediately before the program (baseline) and then annually for three years.
The study found that three years after the study started, female adolescents participating in the program were significantly less likely to report having been pregnant or being currently sexually active. The study found no statistically significant program impacts on having caused a pregnancy or on being sexually active for male participants.
The study also examined program impacts on a measure of dual contraceptive use (condom and a hormonal contraceptive method) at last intercourse. Findings for this outcome were not considered for the review because they did not meet the review evidence standards. Specifically, findings were reported only for subgroups of youth defined by sexual activity at follow up. Additionally, the study examined program impacts on health care outcomes such as receipt of medical checkups, vaccinations, and dental care. Findings for these outcomes were not considered for the review because they fell outside the scope of the review.
|A more recent study conducted by a separate group of researchers evaluated the program with a younger sample of adolescents and using a quasi-experimental design. The study involved a sample of sixth and seventh grade students in Georgia. The study compared a sample of 119 students who volunteered to participate in the CAS-Carrera program with a comparison group of 85 students recruited from the afterschool programs of three local Boys and Girls Clubs. Surveys were administered immediately before the program (baseline) and then annually for three years.
The study found that a year after the program started, adolescents in the intervention group were statistically significantly less likely than those in the comparison group to report having ever had sexual intercourse. The study found no statistically significant program impacts on reported rates of having had sex without a condom or other birth control. For the follow-up surveys conducted two and three years after the program started, the study found no statistically significant program impacts on rates of sexual initiation or unprotected sex.