Today, I Cried While Facilitating

Today, I cried for the first time while facilitating. It came from holding in the fear, sadness and disappointment of the events of this week. It came from watching the images of Neo-Nazi’s and white supremacists marching in the streets. Reading articles and editorials about where we are as a country.

I cried because it felt safe to cry. Among 25 strangers. 25 professionals that work all over North Carolina to promote adolescent health, sexual health among teens, teen parenting support and teen pregnancy prevention. I had never met any of them prior to today.

I facilitated a break-out session on Creating Buy-In and Addressing Resistance for your Adolescent Health Initiative. This is a workshop I’ve facilitated before that allows participants to talk about how they’ve created support, trust and buy-in among their community members, faith-based organizations and schools to support parenting teens, and teens that choose abstinence and teens that are sexually active. We discussed the continuum of passive resisters and sabotagers and why people resist sex education and prevention programs. As they participated in carousel and gallery walk activities, I feel safe among these people that are so passionate about youth in urban and rural communities across the state. I see all shades of skin in the ethnically diverse room, not knowing the invisible differences in each other that don’t show visibly, but aware they are there. Those differences are valuable and make our lives rich. But, we do have one thing in common- we want youth to thrive, be healthy, access information, product & services to advocate for their own health.

I don’t mention politics often during my facilitation events and keynote addresses. I know there are a variety of beliefs in audiences and I respect people’s values and life journeys. But, today, I was asked a question. One simple question. It came at the end when a woman raised her hand and said, “This isn’t about the content today, but I’m intrigued to ask you what you love most about your work.” I’m never asked questions like this in these settings. I wasn’t prepared how to answer. It honestly threw me off guard.

But, after a deep breathe, from my heart, I said, “The opportunity to work with communities all over the United States.” And, in that moment, I knew they heard my voice quiver. The events of this past week came up from my stomach into my tearful eyes and wavering voice. I could have stopped there, but I didn’t. I shared that 4 years ago I successfully completed a bike ride across the US solo and in that experience, I never once experienced a negative interaction with a human being. For 90 days. Across cornfields, and mountain ranges. Through incredibly rural communities and small cities. And, as I shared this, tears fell down my face. I didn’t apologize, but rather, said, “In light of this week’s events, I feel the need to share with all of you that my experience is that most Americans are good. Most Americans are genuine and care about each other- no matter who you are. And, that is why I do this work. I do this because of communities like yours, people like you who are passionate and willing to dedicate their professional lives to youth.” And with that, we ended. I saw heads nodding, and smiles and tears in that audience. I had many more people than usual come up to me after and give me hugs.

This is what life is about. Faith in others. Trust and vulnerability. Connection. That's why I do what I do.

What Do We Value?

By Liz Thorne

I have always worked in a job dedicated to service to others that is mission-driven. Here at Cairn Guidance, our mission is to create places of health and well-being where all youth are healthy, connected, educated and reaching their full potential. I’m willing to bet most people would agree this is a shared value. But how we get there is where we see so much divergence.

The recent decision by the Administration to cut $213 million dollars in programs and research to prevent teen pregnancy is a recent example of a policy that is not based in evidence or reason, and moves in the opposite direction of what we know works in preventing teen pregnancies. Here’s what we know.

Most young people will have sex before they are married. Regardless of whether you talk about it or not, young people will have sex before they graduate high school. Nearly half (41%) of high schoolers in the US have had sex.[1]

The teen pregnancy rate has been dropping for years. While rates of sexual activity have been stable, the teen birth rate has dropped precipitously for years. So what has changed? Studies point to increased use of contraception, including more effective methods like long acting reversible contraceptives (LARCs).[2] The American Academy of Pediatrics put out a policy statement in 2014 recommending LARCs as the first line contraceptive choice for youth who choose not to be abstinent. Another policy support- the Affordable Care Act required that insurance companies cover contraceptives like LARCs to make them more accessible and lessen the burden on publicly funded family planning programs.

Learning to navigate relationships, intimacy and romance is part of growing into an adult. Being in a healthy relationship takes skills and skills take practice. Plus, too many young people find themselves in unhealthy relationships that can derail their potential. Many of the programs funded through the Office of Adolescent Health focused on helping young people identify healthy relationships, including consent and how to make healthy choices aligned with their values.  Quality comprehensive sexuality education covers healthy relationships (including consent and how to get help if you are in an unhealthy relationship); abstinence as a healthy choice for our young people, contraception and building skills (like communication and negotiation). However, many young people in schools across our country do not have access to comprehensive sexuality education.

We have too far to go to head in the opposite direction. Even as teen pregnancy rates declined for all populations, there are still differences based on race and class that must be addressed. At least 1 in 5 women are sexually assaulted while in college. Young people must have access to information, health services, and opportunities to develop skills to keep themselves safe, healthy and able to learn.

[1] Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance System, 2015.

[2] Lindberg L, Santelli J, Desai S. Understanding the decline in adolescent fertility in the United States 2007-2012. Journal of Adolescent Health

From Evidence to Action

By Heather Deckard

The theme of the National Association of School Nurses (NASN) Annual Conference in San Diego, CA June 30- July 1 this year was From Evidence to Action. It was a great experience to represent the Dove Self Esteem Project (DSEP) as an exhibitor to share a range of curriculum-relevant teaching resources, developed in collaboration with educators and students. The DSEP tools take evidence to action and are proven to make a positive impact in body-confidence.

The DSEP Teachers program Confident Me[1]  has been proven to:

·      Improve body image

·      Boost self-esteem

·      Reduce social impairment (likelihood of opting out)

The DSEP lessons and materials were well received by school nurses from all over the US – many of whom shared they could use this project to augment their puberty lessons. Research shows that one in five high school students reported being bullied on school property. [2] We know that young people are bullied for a number of reasons, but appearance, including body shape, weight, and skin, are common. The school nurses we met with reported needing something on this topic for their middle school and high school students, as bullying, low self-esteem, and access to social media can impact student’s health and ability to learn. Those that do not teach were happy to pass the information onto their Health or Physical Education teachers.

The Evolution and Change One Thing films created by DSEP are engaging and impactful assets shared through the Confident Me! Toolkit, well-liked by educators and teachers, alike. Remember, the program is absolutely no cost! Find the programs here:

Cairn Guidance has partnered with the Dove Self-Esteem Project to reach young lives with self-esteem curriculum across the country.


[1]  Diedrichs, P.C., Atkinson, M.J., Steer, R.J., Garbett, K.M., Rumsey, N. & Halliwell, E. (2015). Effectiveness of a brief school-based body image intervention ‘Dove Confident Me: Single Session’ when delivered by teachers and researchers: Results from a cluster randomised controlled trial. Behaviour Research & Therapy, 74, 94-104. doi: 10.1016/j.brat.2015.09.004

[2] Youth Risk Behavior Surveillance System. High School Survey, 2015. Retrieved from

Cairn Guidance is now part of the Innovation Launchpad!

Post by Samantha Lowe

Cairn Guidance has recently made the move into a co-work space in downtown Morehead, KY. A co-workspace in Morehead?! I know, I was shocked as well. But nestled down by the Fuzzy Duck Coffee Shop on Main Street, there is a network of eager students and growing business owners. Since its’ creation, the Innovation Network has opened 13 locations throughout Kentucky, with the intent of "encouraging relationships, grow new and existing companies and create jobs". Each location is staffed by experienced and educated local business leaders to offer mentorship and support on entrepreneurial quests. Morehead's location also offers unique services to university students with workspaces, 3D printing services, and business creation mentorship.

The Innovation Network is partnered with the Kentucky Cabinet for Economic Development and Kentucky Science and Technology Corporation and has assisted over 1,300 companies, helped raise $785 million in funding for said companies, and supported over 6,500 Kentucky jobs. With a strong focus on STEM technologies and businesses, this is the type of job creation and support that Kentuckians need for a brighter economic future. The Innovation Network is a progressive idea in a small town and Cairn Guidance is excited to support and engage in our community’s growth! Since college is currently not in session, the space has been quiet and comfortable, and I am excited to see how it changes when classes begin!

To find more information on the Morehead Location please visit:

To find more information on the Innovation Network please visit:

From Engagement to Partnership: How do organizations build youth-adult partnerships?

By Liz Thorne

Last week I had the pleasure to facilitate a school based health center partnership meeting in Deschutes County (central Oregon). County organizers wanted to focus on youth engagement and have young people be involved in the meeting. Partners from county public health, SBHC clinics, health systems, dental providers, mental health providers and the school districts were all in attendance.  Members from the Sisters High School Youth Action Council (YAC) sat on an expert panel and discussed how SBHCs have impacted their lives, the health issues facing young people, and the personal impact of being engaged on council. The youth helped me facilitate parts of the meeting and provided honest and insightful commentary on how to better leverage SBHCS and engage young people. Not surprisingly, the youth were consistently listed as the best part of the meeting in evaluations!

The day included conversations about organizational readiness and what it takes to institutionalize youth engagement in an authentic way (read: not just having a youth panel at an annual meeting!).  Based in best practice, we know that the structure and values of an organization have to clearly prioritize youth/adult partnerships. So, what does that look like?

·      Clear roles and responsibilities for young people.  With a variety of ways to be engaged (think communications and outreach, research, advocacy).

·      Clear recruitment and sustainability plans.

·      Resource dedication (time, funds, physical space).

·      Support and training for adults and young people.

·      Leadership buy-in.

Leadership buy-in was consistently cited as a challenge to doing this work. How can we build leadership buy in? Here are some suggestions on how to create leadership to effectively engage youth:

·      Connect youth engagement to organizational accountability measures.  Effective youth/adult partnerships lead to an increased sense of belonging and connection. Sense of belonging is consistently related to attendance at school, grades and likelihood of graduating.

·      Look for a way to stick a toe in. Deschutes County Public Health is in the process of making the Youth Action Council a class for credit during the school day at one high school. Students would have an opportunity during this class to work on and implement a Youth Participatory Action Research curriculum.  I have had the opportunity to experience this in other schools that require a service-learning project. It is an effective way to start to build youth/adult partnerships into the system.

·      Find a champion. Maybe it’s a parent. A young person. A supportive principal. Who will be the best messenger? Who will be a strong connector? Sometimes, it ain’t you.

What are other examples of how you have successfully built youth partnership into what your organization does? What was the tipping point? I’d love to hear more success stories from across the country and share them out! You can contact me at:



Dove Self Esteem Project National Cadre Introductions!

Cairn Guidance is proud to introduce the 2017 Dove Self-Esteem Project National Cadre members, representing thirteen states around the country. 

These educators participated in a rigorous application process to represent this national cadre. They are passionate about the health, well-being and academic success of youth. The cadre members were selected from many applicants across the US and comprise a mix of both new and experienced professionals that include health teachers, physical education teachers, public health professionals, school nurses and school counselors.

During their term, the cadre will play an essential role in providing FREE professional development to educators across their region. The cadre members will provide quality support, awareness and training on the Dove Self Esteem Project called Confident Me!.

Rachel Callaway, AZ

Rachel Callaway, AZ

Rachel works for the local county health department and they help give many resources to wellness coordinators at over 100 schools.  Rachel says the reason she is interested in being a Dove Ambassador is that, “I realized after researching the program that had I had this information as a pre-teen, I may have had more success during those troubling years.”

Angie is a middle school health and physical education teacher. Angie says “middle school is the most awkward stage of life and self-esteem can be made or broken during this time period. It is crucial to show this age group critical thinking skills about the media and social skills to deal with the pressures of puberty.” She also says, “Positive self-esteem is important because it creates humans that are more effective and productive. With positive self-esteem people respond to others and themselves in healthy and positive ways. IN the end this creates a better society.”

Brett Delaney, Iowa

Brett Delaney, Iowa

Brett teaches middles school students and coach softball. “Self-esteem, body image, and body confidence is something that is addressed on a daily basis. Finding a way to make a personal connection to the individual or situation is the most important step to the ability to teaching/ helping others. The opportunity to share the power of this program is very intriguing.  Most times when people think of body image, self-esteem, and body confidence they think of females.  Being a male I think I could bring a unique experience to influence others to address all parties present in a given classroom.”

Brandon Wolff, KS

Brandon Wolff, KS


Brandon Wolff, Kansas
Brandon is a Middle School Physical Education and Health teacher and coach of football, basketball and track. “Self-esteem must be the FOUNDATION of helping students understand themselves and their fitness.  My goal is for students to be physically active for a lifetime, but I must focus on EACH student's INDIVIDUAL NEEDS. Being a Dove Ambassador will help me become a better advocate for students.  This opportunity allows me to spread a message about the importance of self-esteem among kids especially middle schoolers.”

Danielle Petrucci, MA

Danielle Petrucci, MA

Danielle is a middle school Life Skills teacher giving students a chance to think about who they are today and what kind of adult they want to become socially, emotionally, physically, and academically.  Danielle said, “I was interested in becoming a Dove ambassador to help young girls and boys understand that their worth goes far beyond their body image. When they break through the barriers of negative body talk, they can begin to thrive in life where nothing holds them back.”

Monica Coleman, MS

Monica Coleman, MS

Monica works with school staff to reduce teen pregnancy and STDS. She is also counsels middle school students. Monica says the Dove Self-Esteem Project fits in nicely to the work she is already doing.


Kelle Carbone, NY

Kelle Carbone, NY




Kelle is a special educator and believes that discussions regarding body confidence and self-care are far and few between within the field. Kelle says, “I truly wish to promote holistic education to students who are often not considered regarding topics of sexuality and the body.” He says he became interested in being a Dove Ambassador because “as someone who identifies as a member of the LGBT community, I realized the dire importance of body confidence education in order to create inclusive and safe environments.”


Tara Cooper, NJ

Tara Cooper, NJ



Tara is a middle school health and physical education teacher. She is also a track coach, CPR instructor, personal trainer/ group exercise instructor and now a new mom.  Tara says, “Feeling good about yourself in body, mind and spirit is crucial at any age, but especially those in the middle school years. Working in a middle school I wanted to jump at the opportunity to share this powerful program and message to may students and colleagues.” 

Margaret Hornbeck, NM

Margaret Hornbeck, NM


Margaret is a middle school physical education teacher. She is also a coaches soccer and most recently finished her National Board Certification.  Margaret is excited for this adventure with the Dove Self-Esteem Project.



SHELLY KLUTZ, North Carolina
Shelly works as a school nurse in which they teach 5th grade puberty and reproductive health. Self image is part of there curriculum as well. She also works one on one with students who suffer from eating disorders. Shelly says “ I struggled with positive self-esteem as a teenage myself. Once of my reasons of going into school nursing (nursing in general) was to work with students and hope to be a positive influence in their lives. This school year we had a student with an eating disorder pass away. So this project cam at a good time for school system.”

Kylie Pybus, OR

Kylie Pybus, OR

Kylie works with high school students at Milwaukie and Rex Putnam High Schools every day. Kylie says “We have conversations about self-confidence, stress, mental health, and so much more. I am excited to collaborate with Cairn Guidance and the Dove Self- Esteem Program to further this work.”


Annette Fecera, PA

Annette Fecera, PA

ANNETTE FECERA, Pennsylvania 
Annette teaches high school health and loves every minute of it! She says, “As a female, I can definitely relate to having issues with self-esteem especially with the messages that the media sends. I want to help students who may have the same struggles!”

Jennifer is an 18-year Health Education veteran. She has seen how confidence (in any realm) is paramount to believing in the power of living a healthy lifestyle. She cherishes the opportunity to shift the mindset of someone struggling with negative self-image through the Dove Self-Esteem Program, Confident Me!




JULIE KING, South Dakota 
Julie is an 18-year veteran of Middle School Counseling. She has used the Dove Self-Esteem Program, Confident Me! with her 5th and 6th grade students.  She is excited to be part of the Dove Self-Esteem Project and to bring it to others in her state. 

The Case for More Love in Education

By Liz Thorne

I was recently in Austin, Texas for the 6th annual Ready by 21 Annual Meeting. Organized by the Forum for Youth Investment, the meeting focuses on ensuring all youth are ready and prepared to meet life’s demands. It brought together folks in youth development, program quality, education, government and community based organizations all focused on ensuring youth are ready.

A major focus of the meeting was on promoting equity through the lens of readiness as a right. It’s not enough to help young people beat the odds but we need to work with the adults and leaders in communities to change the odds.

Research tells us that just one supportive adult relationship can help buffer young people against risk and help them overcome challenging life circumstances. But let’s zoom out and talk about supportive communities, or as Dr. Shawn Ginwright describes, radical healing.

In his keynote, Dr. Ginwright compared the idea of radical healing to experiments conducted on plants. Researchers would place one plant in a chamber of poisonous gas to test the plant’s response. As you might expect, the plant shriveled and died. But, when the researchers placed multiple, or a community, of plants they didn’t die. Rather, they cleaned the air of the poisonous gas. Together the community of plants garnered their collective strength to change their circumstances.

How can we harness the collective strength of communities to change the odds for youth? During Dr. Ginwright’s address on radical healing, there were three thoughts going through my head as this relates to our work in adolescent and school health:

  • We have to take care of the adults in schools. Youth are often placed at the center of our work. Resources, opportunities, and training must be made available to provide physical, emotional and professional support to the adults that show up every day. Particularly, educators and professionals working in economically disadvantaged schools or communities, and those who have faced generations of trauma and marginalization.
  • We need more opportunities for Participatory Action Research or experiential learning opportunities.  PAR is one way for young people to reach into their community, examine the context and begin to understand and garner their strength as an agent of change.
  • There is room in ESSA for a focus on readiness, but we need advocates in the states. ESSA provides an opening, but we will need to focus on state-level efforts to address social, emotional and physical needs of students and staff in schools. (Check out our ESSA State Plan Page for more information). 
Power without love is reckless and abusive, and love without power is sentimental and anemic. Power at its best is love implementing the demands of justice, and justice at its best is power correcting everything that stands against love.
— Martin Luther King Jr.

Whether you call it a supportive relationship, radical healing or trauma-informed education, to me it all boils down to one thing. More love in education. Showing, not just telling our young people, that they are valued. Demonstrating they are valued by equipping them with the skills to harness their power and change their environment for the better. Dr. Enwright ended his keynote with a quote from Dr. King that I think sums up the relationship between love and power.





Lasting Clinic Standing

Written by Samantha Lowe

Born and raised in Kentucky, I have seen how difficult it is to persuade the population on the necessity of in school and community based health education, where 25.2% of adults smoke cigarettes, with the national rate ranging from 9.3% to 26.5% across all states. Overall, Kentuckians tend to be less concerned with their health.

Kentucky residents were large beneficiaries of Obamacare and Medicaid expansion, but this did not change residents understanding of its' worth. Kentuckians then proceeded to keep red state traditions alive and vote for a president who promised to replace the system.  And, in 2015 the population voted in a Governor, Matt Bevin, who allows his conservative religious views to influence policy. Unfortunately, these decisions are beginning to elicit change, but not in the best interest of Kentuckians. Governor Bevin has described himself as “unapologetically pro-life” and is attempting to make Kentucky the first state to have residents without access to abortion services.

In the past year, the Bevin administration has impacted services offered to the community at two out of only three places in the state to receive women's reproductive healthcare. Planned Parenthood in Louisville no longer offers surgical services, while the administration forced theEMW Women's Clinic in Lexington to completely close its doors to the community.  Governor Bevin then ordered the EMW Women's Surgical Center in Louisville, KY (the last clinic available in the state to receive abortion services)  to close on April 3rd, 2017. Thankfully the ACLU and the EMW Surgical Center sued on the basis that the closure "will have a devastating impact on Kentucky women", while the ACLU has called the attempted action "an attempt to ban abortion in Kentucky." The clinic was granted the ability to stay open, but the fight for its longevity is not over. With two anti-abortion clinics on the same block the EMW Women's clinic in Louisville, KY has seen a lot of action, with volunteers lining up in orange vests to protect patients from harassment to protestors wearing the same vest attempting to redirect women into one of the pro-life clinics. The clinic has become the last battle ground for women's reproductive rights in the state.

Cairn Guidance believes that access to care, services and information is essential to all Americans. 

As the clinics license is up for reevaluation in May, the next few months are pivotal times of support.  If you are interested in expressing your voice please follow the link below:

Contact Matt Bevin here.

Source Articles:>


OEA Choice Trust's School Employee Wellness Conference

Kudos to OEA Choice Trust! Their sixth annual School Employee Wellness (SEW) Conference was a huge success. The conference, held in Oregon during spring break, attracts many public health partners, community based organizations, teachers, superintendents, principals, school nurses, human resource directors, and other types of educators that work in school systems. The event is up to 275 participants from 50 their first year!

Best part of the SEW conference is seeing colleagues that I've known for over 10 years!

Best part of the SEW conference is seeing colleagues that I've known for over 10 years!

This conference does an incredible job of walking the talk. It's held in Bend, a beautiful area of Oregon and each morning prior to opening sessions, group yoga, runs and walks are offered. Mid-afternoon, Zumba, walks, runs, essential oils and healthy snack learning boosts are offered. The food was colorful and nutrient rich. There were times to network, tell your story, connect and find opportunities to find intersections of your work with others. 

I facilitated two sessions, one on School Health Advisory Committees and their role in sustaining a school health initiative, and, Creating Buy-In and Addressing Resistance for your School Employee Wellness Program. Both were well attended with great participation in activities and rich dialogue. 

I love being asked to present at this conference for a variety of reasons, but most importantly, I love hearing the stories schools share to create a culture of health for their school staff. The examples of taking care of your employees so that they can do their best jobs with kids, so that they are present, so that they are healthy, and, so they stay in their position (retention). This event is a perfect example of the Whole School, Whole Community, Whole Child Framework in action. Taking one component- employee wellness, but using a coordinated, collaborative approach that engages public health, parents, internal educators, leadership, community partners, grocery stores, gyms, health care systems and policy makers to support one of the most important jobs in this country!

Every Student Succeeds Act: A Snapshot of State Plans

States are in the process of finalizing their plans for implementation of the Federal Every Student Succeeds Act (ESSA). ESSA gives states new opportunities to more fully integrate health into education policy and practices. Several policy and funding provisions in ESSA are aimed toward supporting student social-emotional, physical, and mental health and ensuring that all students attend school in a safe, supportive environment.

Cairn Guidance is launching a State ESSA Plan Webpage for educators, school health professionals, parents, students and other champions to use as a tool to quickly see what their state’s ESSA plan includes in key sections around supporting the whole child; comparing that to other states across the country; seeing the strengths of the plan; and sharing opportunities for improvement or continued advocacy.

The plans are dynamic and changing, as many states have opportunities for public comment or input in the coming weeks and months. We are also monitoring developments in state plans due to the release of modified guidance from the US Department of Education.Please continue to check back as more and more state plans will be added. Also, please reach out to if you have feedback, comments or suggestions to your state’s ESSA Plan overview.

Any interest in technical assistance related to these state plans? Examples of what to say at a town hall event? Need examples of specific content to email your Superintendent or Commissioner? Dr. Kymm Ballard is a proud partner of ours working on this project. Contact her for support and technical assistance at: