1. Jefferson County Tennessee
Mandy Gill, Jennifer Reddin, Rachael Royston,
Davina Schnabel and Kellee Schmitt

2. Jefferson County Map

3. Teen Pregnancy Smoking Obesity
Major Problems
Teen Pregnancy
Smoking
Obesity

4. Why is this the Priority
Teen Pregnancy effects
- socioeconomic status
- education level
- graduation rate
- children of pregnant teens

5. Percent of High School Graduates

6. Median Household Income

7. Median Household Income
$39,580 Jefferson County $42,389 Tennessee $50,740 United States

8. Why is Teen Pregnancy a problem? Increases risk for-
Poverty
Decreased Educational achievement
Decreased prenatal Care
Increased Substance Abuse
Increased Exposure to Violence

9. Continued… Pregnancy induced hypertension Maternal Infection
Increased infant mortality rate
Low birth weights
Multigenerational cycle
Psychosocial consequences
Family dynamics changing

10. Why are Teens getting pregnant?
Pervasive Sexual Messages in Media
Lack of knowledge about sex and conception
Difficulty of access to birth control
Peer Pressure - New Fad
Lack of supervision
Lack of future orientation and maturity
Book page 615 Box 24-1

11. Factors of Jefferson County
-Lack of recreation
-Declining economy and lack of jobs
-Overcrowded schools
-Impact of religion

12. Recreation Not many after school programs Run down parks Nothing to do

13. Declining Economy Lack of jobs in Jefferson County
Jefferson County unemployment rate

14. Schools
School buildings are old Kids do not want to go to school High School is overcrowded ;

15. Religious Beliefs Tennessee is in the Bible Belt Religious beliefs
impact policies, laws,
social actions,
prejudices & stigma,
And expectations.
Churches support
abstinence only
programs
Religious Beliefs

16. Jefferson County Health Department
Resources Available

17. Resources Available Primary Prevention for Teen Pregnancy
Schools teaching only abstinence
Billboards
Health Department
Church Organizations teaching spiritual aspect
Primary Care Education

18. Resources Available Secondary Prevention for Teen Pregnancy
Pregnancy Tests Ultrasounds Medical Care Support Groups Housing Social Services Pregnancy Alternatives Referrals for Adoption Life Outreach Center

19. Resources Available Tertiary Prevention for Teen Pregnancy
Physician Education about birth control Few Daycares Life Outreach Center

20. Resources Needed

21. Resources Needed Primary Prevention for Teen Pregnancy
-Comprehensive sex education -Parental education -Access to Plan B

22. Resources Needed Secondary Prevention for Teen Pregnancy
-Support services including: parenting classes counseling for current/future life options prevention services housing options

23. Resources Needed Tertiary Prevention for Teen Pregnancy
Establishing daycares at schools
Parenting classes at daycares or schools
Continuing Education
Birth Control

24. A Social Action Approach to Change
Planning and Implementation Tennessee Comprehensive Sex Education Program (TCSEP)
A Social Action Approach to Change

25. Who and What needs to Change?
Tennessee state law
Wellness teachers
Daycares established
Parent Education
Acceptance from Churches

26. How to implement TCSEP
Begins with: Gathering information to be presented Gaining Support Establishing Funding
chuckk.sacreddigital.com/hand-shake-4.jpg

27. Implementing Comprehensive vs. Abstinence Only Statistics Costs
Educate Legislators about:
Comprehensive vs. Abstinence Only
Statistics
Costs

28. Recruiting Supporters
Supporting Parents
Local nurses, physicians, health departments, and school officials
Board of Nursing
American Nurses Association
American Medical Association
Planned Parenthood
tejaslearning.com/learningnext/nag=recruiting

29. Recruiting Supporters
American College of Obstetrician and Gynecologists
Mary Jane Gallagher, president and CEO of the National Family Planning and Reproductive Health Care Association
James Wagner, president of Advocates for Youth (both individuals involved nationally to change government funding towards comprehensive sex education)

30. Presented to State Legislators
Information needs to be presented to:
Senate Committee General Welfare
Health & Human Resources and its officers
Rusty Crowe, Chair
Bo Watson,Vice-Chair
Beverly Marrero,Secretary

31. Outcomes and Evaluation of TCSEP
Outcome Goal = decrease in teen pregnancy rates in Jefferson County Evaluation obtained through assessment of: -outcome attainment -appropriateness -adequacy -efficiency -process

32. Short Term Goal Attainment
Tennessee State Law Change
Parental Support and participation

33. Long Term Goal Attainment
Decrease in teenage pregnancy rate for Jefferson County
Parents are informed and actively supporting

34. Potential Funding for TCSEP
Health related fundraisers and organizations
Local Funding
Health Care Reform Bill
Grants from organization such as:
Planned Parenthood
National Family Planning and Reproductive Health Care Association
Advocacy for Youth
American Nurses Association
American Medical Association

35. Potential Funding For TCSEP
Outside private funding through education
State and federal funding which is currently being spent on abstinence only
Currently, TN utilizes almost $6 Million to teach abstinence only.

36. Research to Support TCSEP
“Despite data demonstrating the success of programs that teach both abstinence and contraception in delaying onset of sexual activity, preventing pregnancy and STIs, and the failure of AOSEs [Abstinence-only Sex Education] to change adolescent behaviors, federal funding for AOSE increased three-fold between 2001 and 2008.”
The number of teen pregnancies each year has decreased since the peak in “In 2006, however, there was the first reported increase in births…since ’90/’91.” This may or may not be related to AOSE funding.
Oski, J. A. (2009). Counseling adolescents on contraceptive choices. Contemporary Pediatrics, 26(7), 31. Retrieved November 20, 2009 from CINAHL data base.

37. Research to Support TCSEP
“…compared to the control group, the abstinence-only programs had no impact on whether or not participants abstained from sex…age when teens started having sex..number or partners…rates or pregnancy or sexually transmitted disease.”
In fact, “abstinence-only participants in this program were more than likely than usual-care controls to report sexually transmitted infections, pregnancy and increased frequency of vaginal sex.”
Congress questions effect of abstinence-only approach. (2008). AIDS ALERT, June, 65. Retrieved November 20, 2009 from CINAHL database.

38. Research to Support TCSEP
“A good sex education program encourages self-esteem and responsible decision making in addition to containing specific information on sexual matters.”
“Data indicate that programs that provide a comprehensive sex education (discussion of abstinence, contraception, STDs) with a more balanced approach are more successful…”
“Comprehensive sex education programs delay the onset of sexual activity in teens, reduce the frequency of sex, reduce the frequency of unprotected sexual activity, and increase the use of contraceptives among sexually active teens, reduce the teen pregnancy rate, and lower the number of sex partners.”
A successful example of a comprehensive program is “Safer choices intervention program” which was implemented in California and Texas high schools. Teens were less likely to have sex, and sexually active teens were more likely to use contraceptives.
Community book p

39. Abstinence Only vs. Comprehensive
United States teen pregnancy rate is higher than most developed nations
Countries with lower rates than US received comprehensive sex education and contraceptives were available
Contraceptives advertised in the media in these countries

40. References
DeNavas-Walt, C., Proctor, B.D., & Smith, J. C. (2007). Income, Poverty, and Health Insurance Coverage in the United States: Retrieved September 23, 2009 from
DeNavas-Walt, C., Proctor, B.D., & Smith, J.C. (2008). Income, Poverty, and Health Insurance Coverage in the United States: Retrieved September 30, 2009 from
Maurer, F. A. & Smith, C. M. (2009). Community/Public health nursing practice: Health
for families and populations. (4th ed.) St. Louis: Elsevier.
Middle Tennessee State University. (2001). Jefferson County [Geographical Map].
Retrieved from
Jefferson%20County%20Map.jpg
New data cast doubt on abstinence-only programs: health advocates push for comprehensive sex ed. (2007, July). Contraceptive Technology Update, 28(7), Retrieved November 20, 2009 from CINAHL full text database.
Participatory Politics Foundation & the Sunlight Foundation. (2009). H.R Supporting the goals and ideals of a National Day to Prevent Teen Pregnancy. Retrieved October 21, 2009 from
Participatory Politics Foundation & the Sunlight Foundation. (2009). H.R Unintended Pregnancy Reduction Act of Retrieved October 21, 2009 from opencongress.org/bill/111-h463/show
Participatory Politics Foundation & the Sunlight Foundation. (2009). H.R Stop Obesity in Schools Act of Retrieved October 21, 2009 from /bill/111-h2044/show
Participatory Politics Foundation & the Sunlight Foundation. (2009). H.R Preventing Diabetes in Medicare Act of Retrieved October 21, 2009 from
Tennessee Department of Health. (2006). A Health Assessment of the Tennessee Department of Health: East Tennessee Region. 3rd ed. Knoxville, TN: TN Department of Health.
Tennessee General Assembly. (2009). Senate Standing Committee: General Welfare, Health & Human Resources. Retrieved November 20, 2009 from
U.S. Department of Health & Human Services. (2009). HOW HEALTH INSURANCE REFORM WILL BENEFIT TENNESSEE. Retrieved September 30, 2009 from healthreform.gov/reports/statehealthreform/tennessee.html
U.S. Census Bureau. (2006). The Small Area Health Insurance Estimates. Retrieved October, 7, 2009 from
U.S. Census Bureau. (2009). State and County QuickFacts: Tennessee. Retrieved September 22, 2009 from
U.S. Census Bureau. (2009). State and County QuickFacts: Jefferson County, Tennessee. Retrieved September 22, from qfd/states/47/47089.html
U.S. Department of Labor Bureau of Labor Statistics. (2009). Economic news release: Metropolitan area employment and unemployment summary: USDL Retrieved September 22, 2009 from metro.nr0.htm
U.S. Department of Labor Bureau of Labor Statistics. (2009). Local area unemployment statistics: Unemployment rates for states. Retrieved from
U.S. Department of Labor Bureau of Labor Statistics. (2009). Unemployment rates by county: Tennessee, July Retrieved fromhttp://data.bls.gov/map/servlet/map.servlet.MapToolServlet?survey =la&map =county&seasonal=u&datatype=unemployment&year=2009&period=M07&state=47

41. Questions?