A Community-Based Approach toTeenage Pregnancy Prevention

Leisa J. Stanley, PhD(c),MS

Associate Executive Director

Healthy Start Coalition of Hillsborough County

CityMatCH ConferencePittsburgh, PA

August 23-25, 2003

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

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

Teen Pregnancy Prevention Initiative (TPPI)– 1995-1996 community planning– 68 community agencies– Developed model for teenage pregnancy prevention

Primary – prevention of first pregnancySecondary – prevention of second pregnancy and healthy

pregnancy outcomeTertiary – finish school, child care, job training/placement

TPPI MODELTeenage Pregnancy Prevention Intervention

SCHOOLS

CareCoordination

PRIMARY SECONDARY

TERTIARY

Positive YouthDevelopment Programs

Curriculum Project Achieve ENABL Human Growth and

Dev. AIDS Education Life Management

After School Programs

School Athletics

Early Sexual AbuseID and Intervention

Education Support/Tutoring Programs

Mentoring Programs

Sibling Programs

Youth SheltersParenting

Early Substance AbuseID and PreventionMale Responsibility Programs

School HealthMental Health ESPDT

Community-Based Medical

WIC

Home Visitation Program

Healthy Start, etc.

GED

Job Training

Childcare

Parenting

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

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 children’s services council – funding priority

Legislative Support– Special local bill to fund school nurses - $500,000

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)

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)

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 (<= 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

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.

Advocacy & Fundraising

Funding Issues– Workforce Alliance Board – 67% budget reduction– Local Children’s 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 Children’s Services Council funding other 50%

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 (demographics;services)– Interim Indicators – pilot this fall (attitudes; beliefs)– Outcome Indicators (pregnancies; juvenile justice)

Key to advocacy and fundraising