1. Teen Pregnancy Kent County, MI
Karilyn Bufka
William McKinley
Jessica Riley
Kaylee Sullivan

2. Nursing Diagnosis
High incidence of avoidable teen pregnancy in teens ages years old in Kent County, MI related to unprotected sexual activity as evidenced by… (see next slide)
(Mathematica Policy Research, Inc., n.d.)

3. Statistics
Pregnancy rates for teens ages years old per 1,000 individuals:
Kent County: 61.5
Michigan: 53.6
(Michigan Public Health Institute, 2011)
Statistical evidence indicates this problem is appropriate for community nursing intervention due to higher rates in Kent County in comparison to rates overall in the state of Michigan.

4. Critical Area of Need: Analysis of Data ("Care foster care," 2012)
(Brann, 2012)

5. Causative/Modifiable Factors
Number of teens engaging in sexual intercourse
Lack of/insufficient contraceptive use
Lack of knowledge
Lack of supervision
Belief that “it won’t happen
to me”
(Black Youth Project, 2011)

6. Kent County Risks Modifiable: Nonmodifiable: Education programs
Teen Sexual Activity
Parent Involvement
Teen & Parent Knowledge
Nonmodifiable:
Demographics
Religious Denomination
(SPL, n.d.)

7. Barriers
Parents/targeted population unwilling to participate in program
Cost
Resistance from religious groups
(Rogers, 2012)

8. Health Belief Model Four Characteristics
Severity of the potential illness or physical challenge
Level of conceivable susceptibility
Benefits of taking preventive action
Barriers that stand in the way of taking action toward the goal of health promotion
(Harkness & DeMarco, 2012)

9. Health Belief Model Continued
Severity of the potential illness Premature sexual activity has many or physical challenge risks and consequences such as unwanted pregnancy and sexually transmitted diseases Level of conceivable Susceptible teenagers in Kent County susceptibility between the ages years old Benefits of taking Benefits include decreasing unwanted preventive action pregnancy, reducing the risk of sexually transmitted diseases, and strategies to strengthen parent-child communication Potential barriers Lack of education and lack of communication and decision making
(Harkness & DeMarco, 2012)

10. Existing Resources Michigan Teen Pregnancy Prevention Initiative
Reducing the Risk (RTR)
Talk Early & Talk Often workshops
School: Sex Education curriculum
Planned Parenthood
All appear to be adequate in information although statistical data proves resources are not recognized/enforced to the targeted population
Existing community resources indicates striving toward wanting positive outlooks for teens and likelihood of successfully addressing the problem

11. INTERVENTIONS
(eHow, n.d.)

12. Evidence Based Practice (EBP)
All programs should utilize Healthy Teen Network which provides the following:
Training in EBP
Technical Assistance (proper selection of programs)
Resources
(Healthy Teen Network, n.d.)

13. Interventions: Who Kent County Health Department
Michigan Department of Community Health
Community Members
Local Businesses
School Systems
Media
Health Care Providers
Planned Parenthood of West Michigan
Parents

14. Interventions: What Reducing the Risk (RTR)
16-session research-based curriculum designed to reduce the rate of teenage pregnancy and exposure to sexually transmitted diseases.
Topics covered include: STDs, HIV, abstinence and birth control methods
Targets youth between the ages of 14 and 18
Focuses on:
Delaying or reducing the frequency of intercourse
Increasing the use of contraception and condoms
How to obtain and use contraception
Risks/consequences of sexual activity
Decision making, negotiation and refusal skills
Tactics to prevent & delay sexual activity
Strategies to strengthen parent-child communication
(Access Kent, 2012)

15. Interventions: What (cont.)
Michigan’s Teen Pregnancy Prevention Initiative (TPPI)
Implementation of comprehensive, evidence-based interventions that target the sexual and non-sexual factors for ages 10 and 18 (up to 21 for special education populations) and their parents/adults/caregivers
Delayed initiation of sex
Increased condom or other contraception use
Promotes personal respect and responsibility
Builds skills for dealing with peer pressure
Age, gender and culturally relevant
14 hours of direct programming per youth per year are required
Skills such as communication, negotiation, refusal, decision-making, and resistance to peer/social pressure
State funded
(“Teen Pregnancy Prevention”, 2012)

16. Interventions: What (cont.)
Talk Early & Talk Often
Aimed at helping parents of middle school youth talk with their child about abstinence and sexuality
Two hour workshop
Free admission
Parents will:
Learn ways to open the door to conversation about abstinence and sexuality
Learn how to recognize and use teachable moments to communicate important facts and values
Have the opportunity to practice answering difficult questions
Learn to listen and respond with greater confidence and skill (
(R u TETOing?, 2012)

17. Interventions: Where
Schools with a pre-existing sex education curriculum for RTR
Castro (2012)

18. Direct and Indirect Measures
Sex education curriculums can assess direct measures of teen comprehension regarding pregnancy by incorporating learning tools such as term papers, presentations, and class projects
Indirect measures of teen comprehension of pregnancy in Kent County, MI would be evaluated by city reports and statistics

19. During school hours After school hours Weekdays during office hours
Interventions: When
During school hours
After school hours
Weekdays during office hours
(Dougherty, 2011)

20. Interventions: How Health fairs held at schools
Pass out information at local businesses
Incorporate Reducing the Risk curriculum into sex education classes
Take home project for students (life-like infant)
Information provided to parents through parent/teacher conferences and mailings
Incorporate technology in learning about safe sex practices

21. EVALUATION

22. Anticipate < 6 month – 1 year for change in behavior to occur
Desired Outcomes/Goals
No noted teen pregnancies
Increased compliance
Increased knowledge and awareness
Anticipate < 6 month – 1 year for change in behavior to occur

23. Healthy People 2020 Objective: Reduce teen pregnancy
Target Rate: 36.2 per 1,000 individuals
Current Rate: 40.2 per 1,000 individuals
Reduction goal: 10%
(United States Department of Health and Human Services [HHS], Healthy People 2020, 2011).

24. Indications of Success
Decreased number of pregnant teens (ultimate goal)
Increased knowledge
Increased contracts to maintain abstinence
Participation of parents/role models
Attendance of targeted population
(USQEDU, 2012)

25. Evaluation Survey (Parents, Teens, & Educators) Hospital Records
Pre/Post Intervention
School Reports (time dedicated to sex education)

26. References
Access Kent (2012). Health education programs. Retrieved from
Harkness, G.A, & DeMarco, R.F. (2012). Community and public health nursing: Evidence for practice. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.
Healthy Teen Network (n.d.) Evidence Based-Resource Center. Retrieved from
Michigan Public Health Institute (2011) community health needs assessment and health profile. [PowerPoint slides]. Retrieved from
R u TETOing? (2012) What is TETO? Retrieved from
Teen Pregnancy Prevention Initiative (2009). Retrieved from
United States Department of Health and Human Services, Healthy People (2011, June 29). Healthy People 2020 Objectives. Retrieved from

27. Photo References
Black Youth Project (2011). Teen Pregnancy Way Down, But Not for Everyone. Retrieved from Brann, J. B. (Photographer). (2012). Teen pregnancy rate. [Web Photo]. Retrieved from Castro, M. (2012). Should sex education be taught in middle school? Retrieved from Dougherty, V. (2011). Should sex-education programs be brought into Mecklenburg County public schools? Retrieved from eHow (n.d.). How to avoid teenage pregnancy. Retrieved from

28. Photo References
Healthy Teen Network (n.d.) Evidence Based-Resource Center. Retrieved from Mathematica Policy Research, Inc. (n.d.) What Is the Evaluation of Adolescent Pregnancy Prevention Approaches? Retrieved from Rogers, S.T. (2012). A Message from Dentists in Colorado Springs: Stubborn Teens, Listen Up! Retrieved from SPL (n.d.). Consultation Skills - Managing teenage pregnancies. Retrieved from USQEDU (2012). No title. Retireved from

29. Photo References
(2012). Care foster care programs criminal justice to avoid teen pregnancy. (2012). [Print Photo]. Retrieved from KB&name=.. care foster care programs criminal justice to avoid teen pregnancy&p=teen pregnancy&oid=1985e234d a50b68ffe764334&fr2=piv-web&fr=yfp-t-701&tt=..+care+foster+care+programs+criminal+justice+to+avoid+%3Cb%3Eteen+pregnancy%3C%2Fb%3E&b=0&ni=96&no=10&ts=&tab=organic&sigr=12p6lttck&sigb=138gb4thv&sigi=1272shkb2&.crumb=ejDhHR6x0Td