1. LAKE COUNTY Group 2 Elaine Yeiter, Alisha Gross, Colette Pelky, and Lauren Zink

2. ASSESSMENT OF COMMUNITY POPULATION The towns in Lake County are; Baldwin, Branch, Chase, Idlewild, Irons, and Luther. There is an estimated 11,386 people in Lake County in 2013. 3.6% of the people are under the age of 5. 17.2% of the people are under the age of 18. 25.9% of the people are over the age of 65. The population in Michigan is 9,895,622 5.8% of the people are under the age of 5. 22.7% of the people are under the age of 18. 15% of the people are under the age of 65.

3. ASSESSMENT OF COMMUNITY RACE & ETHNICITY Race and Ethnicity in Lake County 87% are Caucasian 9.2% are African American 0.9% are American Indian/Alaska Native 0.2% are Asian 2.5% are Hispanic Race and Ethnicity in Michigan 80.1% are Caucasian 14.3% are African American 0.7% are American Indian/Alaska Native 2.7% are Asian 4.7% are Hispanic

4. ASSESSMENT CONTINUED The median household income is $29,379 The median household income is $29,379 Michigan is $48,441 Michigan is $48,441 People below poverty level is 27.9. People below poverty level is 27.9. Michigan is 16.8% Michigan is 16.8% High school graduates are 80.3% High school graduates are 80.3% Michigan is 88.9% Michigan is 88.9% Bachelor’s degree or higher at 8.4% Bachelor’s degree or higher at 8.4% Michigan is 25.9% Michigan is 25.9% Jobless rate 10.6% Jobless rate 10.6% Michigan is 7.2 Michigan is 7.2 Teenage Pregnancy Rate is 69.7 per 1,000 females Teenage Pregnancy Rate is 69.7 per 1,000 females Michigan is 45.0 per 1,000 females Michigan is 45.0 per 1,000 females

5. ANALYSIS Teen Pregnancy benchmarks Teen Pregnancy benchmarks Lake County- 69.7 per 1,000 females Lake County- 69.7 per 1,000 females DHD#10- 47.7 per 1,000 females DHD#10- 47.7 per 1,000 females Michigan- 45 per 1,000 females Michigan- 45 per 1,000 females Contributing Factors Contributing Factors Low household income Low household income Low graduation rate Low graduation rate Lack of education Lack of education Betty Neuman’s System Model Betty Neuman’s System Model Focuses on response to environmental stressors (such as poverty and lack of education in this case) which could explain the higher teen pregnancy rates in Lake County compared to the benchmarks Focuses on response to environmental stressors (such as poverty and lack of education in this case) which could explain the higher teen pregnancy rates in Lake County compared to the benchmarks

6. RESOURCES The Michigan Department of Community Health’s Teen Pregnancy Prevention Initiative The Michigan Department of Community Health’s Teen Pregnancy Prevention Initiative Planned Parenthood of West & Northern Michigan’s Safer Choices Project Planned Parenthood of West & Northern Michigan’s Safer Choices Project Being mostly rural areas many of the resources that are available in Lake County are not easily accessible Being mostly rural areas many of the resources that are available in Lake County are not easily accessible Other disciplines would include social workers, teachers, doctors and other educators. Other disciplines would include social workers, teachers, doctors and other educators.

7. HEALTHCARE Number of people per health care provider: Number of people per health care provider: Primary Care Physicians – 5,770:1 (Michigan – 1,268:1) Primary Care Physicians – 5,770:1 (Michigan – 1,268:1) Dentists – 1,643:1 (Michigan – 1,522:1) Dentists – 1,643:1 (Michigan – 1,522:1) Mental Health Providers – 5,749:1 (Michigan 661:1) Mental Health Providers – 5,749:1 (Michigan 661:1) Leading cause of death per 100,000 Leading cause of death per 100,000 Heart Disease – 282.5 (Michigan – 197.9) Heart Disease – 282.5 (Michigan – 197.9) Cancer – 179.3 (Michigan – 174.9) Cancer – 179.3 (Michigan – 174.9)

8. AREAS OF CONCERN/WEAKNESSES Poverty level Jobless rate High school graduates Median income PCPs per person Mental Health Provides per person Teenage pregnancy rates

9. STRENGTHS Rates of STIs in 2013 Rates of STIs in 2013 0 cases of Gonorrhea (Michigan – 10,553) 0 cases of Gonorrhea (Michigan – 10,553) 17 cases of Chlamydia (Michigan – 45,091) 17 cases of Chlamydia (Michigan – 45,091) HPV Vaccination Rates in 2015 HPV Vaccination Rates in 2015 Females – 34.5% (Michigan – 26.9%) Females – 34.5% (Michigan – 26.9%) Males – 24.5% (Michigan – 13.7%) Males – 24.5% (Michigan – 13.7%)

10. COMMUNITY DIAGNOSIS Ineffective individual coping: related to lack of education and healthcare, along with poverty. As evidence by the teenage pregnancy rates. Altered health maintenance: related to lack of material resources. As evidence by the number of people of lake county per primary care providers. Anxiety: related to poverty. As evidence by the jobless rate and lack of education after high school.

11. VALIDATION Implementing a plan to decrease the amount of teenage pregnancy. Ideal to check over a period of time to see if the course of action implied has been successful. Implementing a plan to decrease the amount of teenage pregnancy. Ideal to check over a period of time to see if the course of action implied has been successful. More programs for education specifically in sexually education need to be implemented. In a course of two years it would be ideal to check back to see if program was successful in decreasing the amount of teen pregnancies. More programs for education specifically in sexually education need to be implemented. In a course of two years it would be ideal to check back to see if program was successful in decreasing the amount of teen pregnancies. More primary care physicians are needed in lake county for more resources. More primary care physicians are needed in lake county for more resources.

12. EVIDENCE BASED INTERVENTIONS Margolis, A., L & Roper, A., Y. (2014). Practical experience from the office of adolescent health’s large scale implementation of an evidence-based teen pregnancy prevention program. Journal of Adolescent Health, 54(3), pp S10-S14. doi: 10.1016/j.jadohealth.2013.11.026. Teen Pregnancy Prevention (TPP) started in 2010 and is one of six major evidence-based policy initiatives in the federal government. 75 million dollars to 75 grantees to recreate EB programs 25 million dollars to 24 grantees to create new programs The designs are evaluated by the Office of Adolescent Health (OAH). Program was created to Reduce the rates of pregnancies and births to youth in the target areas. Increase youth access to evidence-based and evidence-informed programs to prevent teen pregnancy. Increase linkages between teen pregnancy prevention programs and community-based clinical services. Educate stakeholders about relevant evidence-based and evidence-informed strategies to reduce teen pregnancy and data on needs and resources in target communities.

13. EVIDENCE BASED INTERVENTIONS Secura, G. M., Madden, T., McNicholas, C., Mullersman, J., Buckel, C. M., Zhao, Q., & Peipert, J. F. (2014). Provision of no-cost, long-acting contraception and teenage pregnancy. New England Journal Of Medicine, 371(14), 1316-1323 8p. doi:10.1056/NEJMoa1400506 Teenage births cost $10 billion dollars in increased public assistance and health care in 2010. The contraceptive CHOICE Project was created to provide counseling about contraceptives and free contraceptives to teenage girls between the ages of 14-17 years old. There was a total of 1404 adolescents who participated. Participates were followed for 2-3 years. The rates of pregnancy, birth, and abortion per 1000 teens in the CHOICE program were 34, 19.4, and 9.7 The rates of pregnancy, birth, and abortion per 1000 teen in the U.S. were 57.4, 34.4, & 14.7.

14. THEORETICAL SUPPORT Kohler Et. Al (2007) found that sex education verse abstinence only education has reported to reduce the rate of teen pregnancy by 50%. Kohler Et. Al (2007) found that sex education verse abstinence only education has reported to reduce the rate of teen pregnancy by 50%. Providing more free sex education and free contraceptives in schools in lake country will help decrease the rate of teen pregnancy. Providing more free sex education and free contraceptives in schools in lake country will help decrease the rate of teen pregnancy. Kohler, K. P., Manhart, E. L., & William E. L., (2007). Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy. Journal of Adolescent Health 344-351. Kohler, K. P., Manhart, E. L., & William E. L., (2007). Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy. Journal of Adolescent Health 344-351.

15. PLANNING Who: Female teenagers What: Reduce teen pregnancy When: May 2, 2017 Where: Lake County Why: Studies show babies are often born at low birth weights, teenagers are less likely to graduate from high school and teenage pregnancy poses a substantial financial burden to society How: Educating teenagers on safe sex

16. SMART GOAL Teenage pregnancies in Lake County will be reduced 2% by May 2, 2017.

17. EVALUATION Providing more education to students about abstinence and safe sex when abstinence is not possible in school and at home will result in a decrease in teen pregnancies one year from now. These results will show in OB/GYN offices and reflect in Lake County teen pregnancy rates.

18. REFERENCES http://www.fishweb.com/maps/lake/ - picture slide 2 http://www.fishweb.com/maps/lake/ - picture slide 2 http://www.fishweb.com/maps/lake/ civilityconsulting.com – picture slide 3 civilityconsulting.com – picture slide 3 civilityconsulting.com news.wabe.org – picture – slide 4 news.wabe.org – picture – slide 4 news.wabe.org Margolis, A., L & Roper, A., Y. (2014). Practical experience from the office of adolescent health’s large scale implementation of an evidence-based teen pregnancy prevention program. Journal of Adolescent Health, 54(3), pp S10-S14. doi: 10.1016/j.jadohealth.2013.11.026. Planned Parenthood. (2013). Reducing Teenage Pregnancy. Retrieved from https://www.plannedparenthood.org/files/6813/9611/7632/Reducing_Teen_Pregnancy.pdf Secura, G. M., Madden, T., McNicholas, C., Mullersman, J., Buckel, C. M., Zhao, Q., & Peipert, J. F. (2014). Provision of no-cost, long-acting contraception and teenage pregnancy. New England Journal Of Medicine, 371(14), 1316-1323 8p. doi:10.1056/NEJMoa1400506 Nanda nursing diagnosis list. (2016).Retrieved from http://www.nandanursingdiagonosislist.orghttp://www.nandanursingdiagonosislist.org

19. REFERENCES CONTINUED Kohler, K. P., Manhart, E. L., & William E. L., (2007). Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy. Journal of Adolescent Health 344-351. Kohler, K. P., Manhart, E. L., & William E. L., (2007). Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy. Journal of Adolescent Health 344-351.