A Community-Based Approach to Teenage Pregnancy Prevention

1
A Community-Based Approach toTeenage Pregnancy
Prevention

• Leisa J. Stanley, PhD(c),MS
• Associate Executive Director
• Healthy Start Coalition of Hillsborough County

CityMatCH Conference Pittsburgh, PA August 23-25,
2003
2
Project Partners

• Healthy Start Coalition
• Leisa J. Stanley, PhD(c), MS Associate Executive
  Director
• Pamela Sullins, RN, Director of Development
• John Harris, MPA, Information Systems Manager
• Hillsborough County School System
• Mary Ellen Gillette, RN, Former Director of
  School Health and Social Services
• Hillsborough County Health Department
• Faye Coe, RN, Assistant Community Health Nursing
  Director
• Tampa Bay YMCA
• Bobbi Davis, PhD, Grants Administrator
• Renee Rivera, Program Manager, Success Centers

3
Coalescing the Community What we did to make
teenage pregnancy prevention a priority

• Child Watch
• October 1994
• 30 key community business leaders
• Speech Facts versus Myth of Teenage Pregnancy
• Site Visits
• Report State of Teenage Pregnancy in
  Hillsborough County

4

• Teen Pregnancy Prevention Initiative (TPPI)
• 1995-1996 community planning
• 68 community agencies
• Developed model for teenage pregnancy prevention
• Primary prevention of first pregnancy
• Secondary prevention of second pregnancy and
  healthy pregnancy outcome
• Tertiary finish school, child care, job
  training/placement

5
TPPI MODEL Teenage Pregnancy Prevention
Intervention
SECONDARY
TERTIARY
PRIMARY
School Health Mental Health l ESPDT
Positive Youth Development Programs

• Curriculum
• Project Achieve
• ENABL
• Human Growth and Dev.
• AIDS Education
• Life Management

GED
Job Training
After School Programs
SCHOOLS Care Coordination
School Athletics
Childcare
Early Sexual Abuse ID and Intervention
Education Support/ Tutoring Programs
Parenting
Mentoring Programs
Sibling Programs
Youth Shelters
Home Visitation Program Healthy Start, etc.
Parenting
Early Substance Abuse ID and Prevention
Community-Based Medical WIC
Male Responsibility Programs
6

• Child Health Investment Project (CHIP)
• 1996-1997 - advocacy
• Need to secure hub of model in school system
• Involvement of same agencies as in TPPI
• Nurse in every school
• Identification of at-risk youth in school
• Referrals out to community-based agencies
• Contact for community to become involved in
  schools
• Linkage of students with health insurance/medical
  providers

7
Advocacy for TPPI/CHIP

• Briefing papers/proposals/presentations supported
  by data and research
• Written endorsements from 15 key agencies
• Editorials in two major papers
• Tampa Tribune
• St. Petersburg Times
• Presentations to key funders
• School Board
• County Health Plan
• Board of County Commissioners
• Local childrens services council funding
  priority
• Legislative Support
• Special local bill to fund school nurses -
  500,000

8
Primary Prevention - 1998

• YMCA Success Centers
• Four Success Centers
• Location selected by zip code and school district
  based on teen birth rate in that area
• After school program and all day summer program
• Served 297 youth in the 5th-9th grades
• Services/educational areas (11,378 contacts)
• Gender Specific (2625 contacts)
• Developmental (4562 contacts)
• Community Service (840 contacts)
• Educational/Vocational (2676 contacts)
• Progress Meeting (668 contacts)

9
Primary Prevention - 1998

• School System Prevention Specialists
• Five prevention specialists in ten middle schools
• Same areas as Success Centers
• Teach ENABLE curriculum to 2800 6th graders
• Provide individual and group counseling to 405
  middle school students (6th-8th grades)
• 3095 contacts
• 1091 individual contacts
• 2044 group contacts
• Gender Specific (536 contacts)
• Educational/Vocational (584 contacts)
• Developmental (1158 contacts)
• Community Services (384 contacts)
• Progress Meeting (210 contacts)

10
Secondary and Tertiary Prevention - 1998

• Healthy Start - Intensive Teen Parenting Program
• 4 community health nurses 1 social worker
• Minimum of bi-weekly home visits or school visits
• Services
• Served 356 pregnant and parenting teens (lt 16
  years old)
• 6000 services provided
• 2151 face to face encounters 708 non face to
  face encounters
• Education provided included family planning,
  parenting education, breastfeeding education
  smoking cessation
• Education and referrals regarding completing
  school/GED
• Securing subsidized child care Internet
  Parenting Class

11
Outcomes

• Reduction in Teenage Live Birth Rate
• 10-14 year old 35.5 reduction
• 15-17 year old 31.4 reduction
• Repeat Live Births 6.9 reduction
• Reduction in Low Birth Weight Births to Teens
• Reduction in Infant Deaths to Teens
• 5 pregnancies this past year for females enrolled
  in primary prevention programs. 1 dropped out of
  school.

12
Advocacy Fundraising

• Funding Issues
• Workforce Alliance Board 67 budget reduction
• Local Childrens Services Council
• County Commission
• Advocacy
• Newspapers (press releases, editorials and Letter
  to the Editor)
• Elected officials
• Presentations and office visits
• Presence at board and county commission meetings
• BOCC voted to fund 50 of need in partnership
  with local Childrens Services Council funding
  other 50

13
Evaluation Framework

• Empowerment Evaluation Model
• Included all of our partners (continuous)
• Outlined data to collect and what to measure
• Evaluation Components Logic Model
• Process Indicators (demographicsservices)
• Interim Indicators pilot this fall (attitudes
  beliefs)
• Outcome Indicators (pregnancies juvenile
  justice)
• Key to advocacy and fundraising