Dr. Villarruel Works with the Centers for Disease Control to Disseminate her Work
Dr. Villarruel’s research provides a curriculum for teaching Latino teens about improving their sexual health whose data speaks to its success.
As an undergraduate, Dr. Antonia Villarruel wasn’t interested in research. Partly, she explains, this was because she wasn’t studying at a major research institution, but a major factor was also that when she was an undergraduate, nursing research was simply not a prominent field. Clearly things have changed, both for Dr. Villarruel and for the profession. Now she serves as the associate dean for research and global affairs at the University of Michigan School of Nursing and she is the author of an intervention that is sweeping the nation. Recently featured as part of the Agency for Healthcare Research and Quality’s (AHRQ) Innovations Exchange, her intervention – Cuidate! (“Take Care of Yourself”) - which “focuses on reducing the risk of sexually transmitted diseases, including HIV/AIDS, and pregnancy among Latino teenagers” has become part of the national arsenal available to healthcare and other professionals dedicated to health promotion in communities.
In essence, the program is a 6-hour curriculum taught to a group of 8-10 young males and females. A unique aspect of the program is that it does more than consider the cultural elements at play when talking about sexual health in Latino communities; it uses the community’s values as the very basis of the discussion. These are values with which Dr. Villarruel is very familiar, having herself grown up as a Mexican-American in a bi-lingual household in southwest Detroit: “What the intervention does is help kids understand their own cultural values and then understand how they influence sexual decisions and behavior.” When asked for an example, she points to the stereotype of “machismo,” or the idea that males are supposed to manly, supposed to be “macho.” There are numerous ways that this stereotype plays out, but in relation to sexual health, machismo can include the notion that a man can do “whatever he wants with whomever he wants and that he can make decisions for others,” both concepts that do not bode well for a young man’s inclination to practice safe sex. As Dr. Villarruel explains, “We try to take these ideas and reframe them. For instance, guys are supposed to be ‘macho’ because it’s means they’re strong, and part of being strong is taking care of yourself, your family, and your sexual partner. Therefore, wearing a condom, for instance, can become part of being macho.”
The program uses this same approach with females, delving into the cultural gender roles that might dissuade young women 
from insisting on an approach to sex that protects their health. Through conversation, curriculum facilitators can provide an alternative view of these gender roles that enables young women to initiate a discussion about using protection with a partner. Thus, the idea is not to change or to replace the cultural values of the intervention participants or of their community; it is to reframe these values such that they can co-exist with a proactive approach to sexual health. Dr. Villarruel adds, “I don’t promote kids having sex, and I think teens are too young to have sex, but it’s not what I think. It’s about what adolescents think. I know that providing knowledge and skills up front helps them make better choices if they’ve decided they’re going to have sex. When we ask them to put lubrication on a condom or practice putting a condom on a penis model, they tend to think it’s gross and sticky. That’s the point, and if you’re not comfortable with it, then you probably shouldn’t be having sex. Actually a lot of kids come to that realization through the intervention.”
Clearly a massive effort, Dr. Villarruel says the process of creating and refining this intervention as a body of scholarship has been her biggest accomplishment as a researcher. “The important thing is that we have provided evidence of a program that is effective in increasing condom use, in delaying adolescent sex, in decreasing the frequency of sex, and in limiting the number of sexual partners,” she says. And, because of its effectiveness, Dr. Villarruel has been able to work with the Centers for Disease Control and Prevention (CDC) to prepare the program for wide distribution: “It’s a way to work with adolescents, parents, and the community on this important issue. It’s translating the knowledge of what works in theory into something that really works in practice.”
On top of having worked with a national government organization and having the data to prove the magnitude of her accomplishment, there are more subtle reminders of Dr. Villarruel’s research success as well: “I’ve been in contact with a girl in high school out west who wants to use my intervention in her community. I told her she’ll have to get some adults together to help her, and she responded saying that she’s organized a meeting for parents. Her commitment to her community is really something else.” And Dr. Villarruel’s commitment both to the larger community of Latino youth as well as to advancing the field of nursing research are to be equally admired.
