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4 Teen Pregnancy effects - socioeconomic status - education level - graduation rate - children of pregnant teens

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7 $39,580 Jefferson County $42,389 Tennessee $50,740 United States

8 Poverty Decreased Educational achievement Decreased prenatal Care Increased Substance Abuse Increased Exposure to Violence

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

10 - 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 -Lack of recreation -Declining economy and lack of jobs -Overcrowded schools -Impact of religion

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

13 Lack of jobs in Jefferson County Jefferson County unemployment rate

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

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

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17 - Schools teaching only abstinence - Billboards - Health Department - Church Organizations teaching spiritual aspect - Primary Care Education

18 Pregnancy Tests Ultrasounds Medical Care Support Groups Housing Social Services Pregnancy Alternatives Referrals for Adoption Life Outreach Center

19 Physician Education about birth control Few Daycares Life Outreach Center

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21 -Comprehensive sex education -Parental education -Access to Plan B

22 -Support services including: parenting classes counseling for current/future life options prevention services housing options

23 - Establishing daycares at schools - Parenting classes at daycares or schools - Continuing Education - Birth Control

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25 Tennessee state law Wellness teachers Daycares established Parent Education Acceptance from Churches

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

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

28 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 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 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 Outcome Goal = decrease in teen pregnancy rates in Jefferson County Evaluation obtained through assessment of: -outcome attainment -appropriateness -adequacy -efficiency -process

32 Tennessee State Law Change Parental Support and participation

33 Decrease in teenage pregnancy rate for Jefferson County Parents are informed and actively supporting

34 - 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 - 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 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 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 …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 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 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 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. (4 th 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 h2590/show Tennessee Department of Health. (2006). A Health Assessment of the Tennessee Department of Health: East Tennessee Region. 3 rd 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, 2009 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&peri od=M07&state=47

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