1. Frontline
Training
Curriculum

2. Frontline Training
Goals:
To help participants…
• Understand and empathize with adolescents’ concerns about health
care, including but not limited to confidentiality.
• Identify concrete strategies to establish trust with their adolescent
patients, such as ensuring confidential and low cost services.
LEARNING OBJECTIVES
By the end of this workshop, participants will be able to…
• Understand the role of frontline staff in improving sexual and
reproductive health outcomes for adolescents.
• Articulate crucial factors influencing adolescent behavior as it
relates to sexual and reproductive health care.
• Identify the policies regarding the 4 Cs, i.e., Consent,
Confidentiality, Care, and Cost, at their state, local and clinic
levels and communicate those to adolescent patients.
• Describe TACT: Tone, Attitude, Communication, and Time Out
and concrete strategies for improving communication with
adolescents.
MATERIALS:
• Adolescent Development worksheets
• 4 C’s: Clinic Personnel Needs to Know laminated handouts
• TACT: Communicating Effectively with Teens laminated handouts
• Frontline Standardized Patients Feedback Checklist
• Poster Sized Post-It’s
AGENDA: Introductions (5 min)
Icebreaker (10 min)
Adolescent Development (20 min)
Need to know: 4 C’s Discussion (10 min)
Adolescent Experiences (10 min)
Communication Strategies Lecture (10 min)
Practice (15 min)
Conclusion (5 min)

3. Post Test (5 min)
Begin the workshop by introducing yourselves as well as telling the group
what TORCH is.
Then explain that today, TORCH will be implementing AHCCP’s program. The
goal of AHCCP is to reduce communication barriers between adolescents and
health care providers. They achieve this by training TORCH teens to give
workshops both to their peers and to providers.
ICE BREAKER-Relating to the Adolescent Experience
Learning objectives: To get everyone comfortable and excited about the
workshop.
Time: 10 minutes
Materials needed: None
Directions:
a. Each Frontline Staff selects three words that described themselves as
a teen of about 16 years old and shares them with the group.
b. Break group into dyads (2’s) if there are more than 10 participants. If
group is small, just keep them together. A peer will facilitate the
groups.
c. In dyads, they will discuss their responses to the following questions:
i. What was it like when you first tried to access reproductive
health care? Who did you reach out to? How? What were
the results?
ii. What challenges do you face with your adolescent clients?
How are those similar to what you experienced as an
adolescent?
Transition (read aloud by Peer Leader): Now that we have thought
about what it was like to go to a sexual and reproductive health visit
as an adolescent, Pauline is going to discuss the stages of
adolescence with you.
Adolescent Development-(Pauline/Intern)
(Adapted from the NYC DOH Frontline Training Program)
Learning objectives: To help frontline staff have a better understanding of
adolescents at each stage of development (early, middle, and late).
Time: 20 minutes
Materials needed: Adolescent development worksheet

4. Directions:
a. Hand out adolescent development worksheet to each participant but
allow them to stay in their dyads to complete the worksheet.
b. Give participants 5 minutes to complete the worksheet in their groups.
c. Review the worksheet, explaining each answer.
d. Hand out the worksheet answer key with explanations.
Transition (read aloud by Peer Leader): Sometimes it is difficult to
remember all the information needed when interviewing an
adolescent who has come to the clinic for care. We have created a
mnemonic to help you remember the necessary information.
Need to Know: 4 C’s Discussion
Learning objectives: To ensure participants can identify their policies
regarding the 4 C’s (i.e., consent, confidentiality, care, and cost)
Time: 10 minutes
Materials needed: Poster Sized Post-It’s (4 C’s laminated hand out comes
after the post-test)
Directions:
Facilitate each “C” by having participants guess what each C could stand for.
Then write down each “C” on poster sized post-its and explain each one.
Care and Cost vary by on clinic and will be altered for each presentation.
a. Consent: If you are 17 or younger, you have the right to get
sexual health services without parental consent in New York.
That includes STI prevention, birth control access, and abortion.
The ONLY exceptions are the HPV vaccine and sterilization.
b. Confidentiality: Teens have the right to confidential sexual and
reproductive health services. That means that no one involved
in their care can disclose any information about those services to
anyone, including parents/guardians, partners, and friends.
Often teens do not know this is their right, so it is important to
remind them.
c. Care: ______________ Health Clinic offers the following sexual
and reproductive health services: pregnancy testing, STI testing
and treatment (including HIV testing), pap smears, routine gyn
exams, prenatal care, contraceptive management (including IUD
placement).
d. Cost: ____________ Health Clinic offers the following payment
options: sliding scale and a variety of insurance (too many to

5. list). Additionally, adolescents are seen regardless of their ability
to pay. Montefiore has a special billing code for these patients
("S13") which means that they can receive confidential services
without charge and without sending explanation of benefits
(EOB) information to their homes.
Transition (read aloud by Peer Leader): The 4 C’s were designed
as a way to remember what information is most important to
adolescents, and can make or break their health care experience.
Because of this we are going to share some positive/negative
experiences we have had at health clinics.
Adolescent Experience
Learning objectives: For participants to understand positive and negative
behaviors of frontline staff from real life adolescent experience.
Time: 10 minutes
Materials needed: None
Directions:
Teens will share positive and negative experiences they have had with
frontline staff in clinical settings, identifying specific issues. Number of
positive and negative experiences told by each peer leader will be
determined by time availability. **Think of mystery shopper calls or
personal experience**
Transition (read aloud by Peer Leader): Now that you have a better
idea of what makes a positive and negative healthcare experience
for an adolescent, we are going to discuss communication strategies
you can use to make adolescents’ visits as healthy and productive as
possible, using our acronym TACT.
Communication Strategies Lecture
Learning objectives: To provide an acronym that reminds participants of
communication strategies to use with adolescents
Time: 10 minutes
Materials needed: Poster Sized Post-its (TACT laminated hand-out will be
distributed after the post-test)

6. Directions:
Teens should read the introduction and then write TACT acronym on poster-
sized post-its and have the participants try and guess what the letters stand
for. As participants guess, teens will write the terms on the board and give
the following explanations for each term.
Introduction: As frontline staff you are often the first people that teens
encounter so your communication strategies can make or break their visit.
Teens are going to recognize not just what you say but how you say it and
your body language. We will now explain what each letter of our acronym
TACT means.
a. Tone: Have welcoming body language (open, facing teen) and
friendly tone of voice, not rushed.
b. Attitude: Be non-judgmental, avoid assumptions about age,
gender, sexual orientation, ethnicity, religious and
cultural/language backgrounds.
c. Communication: Ensure confidentiality; limit use of medical
terminology; practice active listening; and use age-appropriate
language.
d. Take Time Out: Check in with the teen to be sure s/he
understands the conversation; know the next steps to take to
ensure the best health care possible for the teen, and confirm that
you have used the appropriate communication strategies.
Transition (read aloud by peer leader): Now that you can identify
how to best communicate with an adolescent, you are going to get a
chance to practice the 4 C’s and TACT.
Practice
Learning objectives: To give participants a chance to watch and learn
best practices of interacting with adolescent patients.
Time: 15 minutes
Materials needed: None
Directions:
Split group of participants up depending on their interaction with teens.
Group one, which primarily interacts with teens on the phone goes to one
side of the room while group two, which primarily interacts with teens in
person, goes to the other side.

7. Once on each side of the room, each of us is going to play a character with
an adolescent health issue. We will either pretend to be on the phone asking
a questioning about health services, or we will pretend to come into the
clinic.
Follow up questions: After completing practice rounds with each group,
ask the following questions of the group.
a. How did you feel during this activity?
b. Was there anything that surprised you?
Conclusion and Post-Test
Learning objectives: To wrap up the workshop and confirm participants’
understanding of main ideas.
Time: 5 minutes
Materials needed: Post-Tests, 4 C’s laminated handouts, TACT laminated
handouts, AHCCP brochures
Distribute post-tests and explain this is to measure their understanding of
the workshop and demonstrate improvements for the workshop.
After collecting the post-tests, hand out the 4 C’s and TACT laminated hand-
outs. Explain that these can be hung or kept near their desk to remind them
of what topics are necessary to cover with adolescents and the best
practices on how to communicate with teens.
Also, hand out AHCCP brochures so the clinic has more information about
the program.