A Community-Based Approach to Teenage 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

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) – 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

TPPI MODEL Teenage Pregnancy Prevention Intervention SCHOOLS Care Coordination PRIMARY SECONDARY TERTIARY Positive Youth Development Programs Curriculum  Project Achieve  ENABL  Human Growth and Dev.  AIDS Education  Life Management After School Programs School Athletics Early Sexual Abuse ID and Intervention Education Support/ Tutoring Programs Mentoring Programs Sibling Programs Youth Shelters Parenting Early Substance Abuse ID and Prevention Male Responsibility Programs School Health Mental Health ESPDT Community-Based Medical WIC Home Visitation Program Healthy Start, etc. GED Job Training Childcare Parenting

Child Health Investment Project (CHIP) – 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 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 5 th -9 th 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 School System – Prevention Specialists – Five prevention specialists in ten middle schools Same areas as Success Centers – Teach ENABLE curriculum to th graders – Provide individual and group counseling to 405 middle school students (6 th -8 th 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 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 – year old – 35.5% reduction – 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