Strategic Action Plan

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Strategic Action Plan

2010 – 2015

1715 Lansing Ave., Suite 221

Jackson, MI 49202

(517)

768-2150

[email protected]

JAMES A. & FAITH

Michelle White, Coordinator

KNIGHT

FOUNDATION

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 2

Acknowledgements

The following people and organizations contributed to the development of this plan in

2009/2010:

Allegiance Health Big Brothers Big Sisters Center for Family Health

Cinamon Branigan, Community Member Daughters of Promise

Do’Chas II

Fetal Infant Mortality Review Team Integro llc

Jackson County Health Department

Jackson County Intermediate School District Jackson County Prenatal Task Force

Jackson County Youth Center

Jackson Public School District

Nancy James, Partnership Park Community Member

Northwest Community School District Planned Parenthood Mid and South Michigan

Springport Public Schools

Tammy Myers, Community Member Tishia Baltimore, Community Member United Way of Jackson County

An electronic version of this document can be found at:

www.tppijackson.org and www.uwjackson.org

“We need the knowledge to prevent ourselves

from living a life not intended.”

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Facts at a Glance, September 2010

TEEN PREGNANCY / BIRTH / STD DATA

In 2008, Jackson County had the 15th highest teen pregnancyrate of 83 counties in the state of Michigan. The Jackson County teen pregnancy rate was 66.7 per 1,000 women ages 15-19, while the Michigan rate was 54.1.1

Jackson County ranked 17th highest for the percentage of births to teens ages 15-19, a rate of 45.7 per 1,000 girls compared to a Michigan rate of 33.3 for 2008. There were 249 live births to teens in 2008 in Jackson County.1

Jackson County ranks 8th highest in the state of Michigan for teen rates of Chlamydia and 6th highest for rates of Gonorrhea based on 2008 rates.1

Approximately 20% of teen births in Jackson County are to mothers who already have one or more children. In 2008, 46 repeat teen births occurred, with a repeat teen birth rate of 8.4 per 1,000 females ages 15-19. The repeat teen birth rate for Caucasian females is 7.7 and for African American females is 13.8.1

In Jackson County, the risk of an African American teen female giving birth is 2.5 times that of a Caucasian teen female. The African American teen birth rate is 96.4 per 1,000 females ages 15-19 and for Caucasians the teen birth rate is 38.9. The City of Jackson has the 5th highest African American teen birth rate in Michigan in 2008.1

The risk of a Hispanic teen female giving birth is 1.8 times that of a non-Hispanic teen. The birth rate for Hispanic teen is 96.9 per 1,000 females ages 15-19.1

Fifty-seven percent of teen births in Jackson County take place in the City of Jackson. The teen birth rate for 15-19 year olds in the City of Jackson is 107.8 per 1,000 females, compared to a state rate of 33.3 for 2008.

This ranks the City of Jackson as the city with the 3rd highest teen birth rate in Michigan. The pregnancy rate for the City of Jackson is 168.6 per 1,000 females ages 15-19, compared to a state rate of 54.1. 1

Sixty-five percent of teen births in Michigan are paid for by taxpayers. In Michigan, the average annual cost associated with a child born to a mother age 17 and under is $4,951.2

RISK BEHAVIORS

In 2010, 41.1% of Jackson County 9th and 11th grade students reported that they have had sexual intercourse in their lifetime, compared to the state average of 45.6%. Specifically, 26.9% of 9th graders and 57.2% of 11th graders have had sexual intercourse in their lifetime.3

Among students who ever had sexual intercourse in the past three months, 61.5% of Jackson County 9th and 11th graders used a condom (9th grade – 67.3% and 11th grade - 58.8%), compared to a state average of 61.4%.3

Among students who ever had sexual intercourse during the past three months, 24.2% of 9th and 11th graders reported that they drank alcohol or used drugs before last sexual intercourse, compared to a state average of 24.7%.3

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 4 Among students who ever had sexual intercourse, 22.6% reported having a first partner who was three or

more years older, compared to a state average of 18.7%.3

IMPACTS OF TEEN PREGNANCY

Jackson County has a very high rate of confirmed victims of child abuse and neglect, with 840 victims in 2007.4 There is a higher rate of child abuse and neglect amongst teen

parents than parents who are older.

Approximately 70% of teen mothers do not finish their high school education, which leaves them poorly qualified to enter the job market.5 More than 75% of teen mothers rely on public assistance within the

first five years of giving birth.5

Most teen mothers remain single, and less than 30% receive any kind of child support from the babies’ fathers.5

In 2007, 20.1% of children ages 0-17 in Jackson County live in poverty compared to a state rate of 19.3%.4 In 2008-2009, 47.2% of students in Jackson County schools received free or reduced price lunch, which is below 185% of the federal poverty level. Jackson Public Schools reported the highest rate of economically disadvantaged students with 70% of students receiving free or reduced-price lunch.6

Since 1996, Jackson County has experienced significantly higher infant death rates than the state of Michigan. Jackson County had 9.3 infant deaths per thousand, ranking 46 out of 54 reporting counties for the three-year average from 2005-2007.4

In 2008, 13% of all Jackson County live births were to teens and 14.3% of all Jackson County infant deaths were to teens. In addition, 36% of Jackson County mothers with an infant death had their first pregnancy at 19 years of age or less.7

Jackson County’s three year average from 2006-2008 for the African American infant mortality rate is 16.7 infant deaths per 1,000 live births, compared to the Caucasian infant mortality rate of 6.4. This produces an African American/Caucasian ratio of 2.6 to 1.7

OTHER RELATED INFORMATION

In 2010, 72.02% of 9th and 11th grade Jackson County students reported that they have talked with their parents or other adults in their family about what they expected them to do or not to do when it comes to

sex, compared to the state average of 70.9%.3

Juveniles accounted for 41.4% of Jackson sexual assault victims in 2006.8

In 2008, on average, 8.4% of Jackson County women received less than adequate prenatal care and 7.6% of women delivered a low weight baby (under 5.5 pounds).9

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Mission of the Teen Pregnancy Prevention Initiative

The mission of the Teen Pregnancy Prevention Initiative (TPPI) is to reduce the teen pregnancy rate and address contributing factors for Jackson County's young people. The TPPI is a community-wide effort led by the United Way of Jackson County and the Jackson County Health Department. The TPPI includes a diverse membership representing various sectors of the community, including parents, teens, community leaders, faith based groups, health care professionals, and individuals who are concerned about the issue of teen pregnancy in Jackson County.

Committees

The Teen Pregnancy Prevention Initiative is responsible for carrying out a process that integrates strategic planning and implementation. These processes include advocacy, evidence-based approaches, collaboration development, and impact assessment. Through use of a logic model, specific strategies have been identified through a community needs assessment process related to data surrounding areas of concern. Specific action steps have been laid out in order to accomplish outcomes for success in reducing the teen pregnancy rate in Jackson County.

Executive Committee

An Executive Committee for the TPPI was formed in 2008. The role of the Executive Committee is to: promote the mission and vision of the TPPI;make recommendations to the Advisory Committee regarding

organizational priorities, policies, governance concerns, and finances;oversight of Advisory Committee and subcommittees which include Parent and Community Education, Advocacy, and Strategic Planning; initiate and lead annual evaluation of initiative’s progress; and review and approve submitted reports as mandated by funding sources.

Advocacy Committee

The Advocacy Committee fosters relationships with Jackson County school districts and their local Sex Education Advisory Boards to provide technical assistance and encourage evidence-based sex education programming is in place to meets the needs of the students at each respective school. The committee strives to assist local high schools in offering comprehensive sex education. Additional goals of the Advocacy

Committee include increasing public awareness of the impact of teen pregnancy and promoting current programming for teens in Jackson County. Since 2007, the

TPPI Advocacy Committee has developed and implemented several media campaigns for Jackson County, targeting parents with the message of communicating with their teens and targeting teens with a ‘Pregnancy is Not OUR Legacy’ message. The ‘I WISH’ video was created in 2008 featuring real life stories and testimonies of teen parents in Jackson County. In the spring of 2009, ‘I WISH’ assemblies were held with several

school districts and continue to take place. The TPPI created a website at www.tppijackson.org and a Facebook group under Jackson County Teen Pregnancy Prevention Initiative.

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Teen and Parent Education Committee

The Teen and Parent Education Committee oversees the implementation of evidence based and promising programs targeting teens and their parents/guardians in Jackson County. The original focus of the committee was to educate parents on teen pregnancy and the importance of communicating with young people in an effective way, but has been expanded to provide programming directly to teens as well. Programs that have been funded by the TPPI Parent and Community Education Committee to date include: LEAP through Word of Light Christian Center, House to House by the Prenatal Task Force, the Daughters of Promise program, and Parent Teen Connectedness workshops.

Strategic Planning Committee

The Teen Pregnancy Prevention Initiative (TPPI) Advisory Committee conducted a strategic planning process from April 2006 through 2007. Through this process, three goals were identified as priority areas for the initiative. Since the release of ‘Pursuing Hope for Our Youth’ in early 2008, the TPPI has celebrated many accomplishments and encountered numerous challenges. New gaps in teen pregnancy prevention

programming have become evident in 2009 and funding continues to be an ongoing struggle for the initiative. As a result of generous funding from the James A. and Faith Knight Foundation and the United Way of Jackson County, the TPPI brought together a committee of vested members to update the strategic action plan for teen pregnancy prevention for 2010 – 2015.

History and Accomplishments

The TPPI began meeting in November of 2005 and went through a one year strategic planning process into early 2007 to develop a plan for teen pregnancy prevention. A common theme of lack of hope in Jackson’s low-income neighborhoods was a reoccurring topic throughout this process. As a result, the TPPI funded community-wide programs for high risk teens and parents over the next two years, and pursued funding for the Carrera program.

The TPPI was successful in accomplishing many tasks since its inception which include:

A decrease in the teen pregnancy rate. From 1990 to 2008, the Jackson County teen pregnancy rate decreased by 41% with a drop from 113.9 to 66.7 per 1,000 women ages 15-19. Specifically since 2005, the teen pregnancy rate has decreased by 9%

which may be as a result of the extensive work the Teen Pregnancy Prevention

Initiative has done as a collaborative effort. Although is it difficult to identify the

specific reasons for this dramatic decline, local agencies and school districts who have been working together on this issue can be proud of the success gained.

Teen Pregnancy Rates

(Rates per 1000 women, aged 15-19)

0 20 40 60 80 100 120

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Call to Action Community Presentation. Part of this organized strategic planning effort included developing a document that summarizes the strategic planning process from 2006-2007 titled

‘Pursuing Hope for Our Youth.’ A “Call to Action” community event was held in March of 2008 for 140 concerned agencies and individuals as a kick-off of the TPPI strategic plan for Jackson County. Over 200 copies of the document have been distributed in the past 2 years.

Creation of the ‘I WISH’ video. A local teen pregnancy video titled ‘I WISH’ was produced by the TPPI

Coordinator and Tammy Myers, Labor and Delivery Nurse at Allegiance Health. The video was completed in the fall of 2008 featuring eight local teen parents discussing their experiences and challenges as teen parents. Over 70 copies have been distributed to local school districts and agencies to reach middle and high school students. Three versions of the video were created along with a discussion guide: abstinence only, comprehensive, and condensed. In the fall of 2009, a statewide version of the ‘I WISH’

video was created and to date over sixty copies have been purchased across the state of Michigan. ‘I WISH’ in-school assemblies took place beginning in the spring of 2009. Nearly 4,200 students have seen the video along with drama performances and/or testimonies of teen parents through ‘I WISH’ Assemblies at high need Jackson County schools in the past two years.

Secured funding. Funding for the TPPI has continued to be secured from the United Way of Jackson County for the past four years and from the James A. and Faith Knight Foundation for 2010. This continues the mission of the TPPI and for three active subcommittees to meet specific objectives in the coordinated community-wide plan. An additional $53,000 in Healthy Michigan funding was given to the TPPI in 2008 from the Michigan Department of Community Health. In addition, the Michigan Department of Education received a grant to the Centers for Disease Control (CDC) bringing in $11,000 each year for the next 4.5 years for the House to House program. As a result of receiving the additional funding for the House to House program through the CDC, a third gathering focusing on parent teen communication around sexuality was created. Hundreds of high risk parents have been reached with these carefully designed gatherings as a result of this funding.

‘Pregnancy is Not OUR Legacy’ slogan. Teens from Jackson High School came up with the ‘Pregnancy is Not OUR Legacy’ slogan in the fall of 2008. This slogan

has been used in successful media campaigns and in schools across Jackson County. The message has become very popular with teens to wear on t-shirts and bracelets.

Media Campaigns. Several media campaigns have taken place and have included billboard campaigns, television and radio advertisements, and parent education packets. Two radio ads and four different television spots were created targeting parents and teens. The billboards featured “Mom, Dad, Talk to Me about Sex…” and “Pregnancy is NOT Our Legacy” messages.

Goals and Objectives for Community Action Plan

Due to a crumbling Michigan economy and loss of many stable funding sources, several teen pregnancy prevention programs in Jackson County and statewide were eliminated in 2009. This created many new

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 8 critical gaps in services for teen pregnancy prevention. In March of 2009 the realization that funding for the Carrera program could not be obtained at that time due to hard economic times became clear. As a result of the detrimental effects of losing prevention programs that the community had in place for years, the need for additional strategic planning became evident. In early 2010, the TPPI began the process of updating the Strategic Action Plan. A team of dedicated TPPI Executive Committee members began working on developing strategies to meet the current gaps in services.

The TPPI has relied upon data derived from the Michigan Department of Community Health Vital Statistics Division to monitor the Jackson County data surrounding teen pregnancy and sexual health related issues. In 2010, the Michigan Profile for Healthy Youth (MiPHY) was administered to Jackson County school districts in grades 7, 9, and 11. The MiPHY is a tool to measure all key health behaviors and risk and protective factors. Based on the information and problem areas identified through public health and risk behavior data, specific needs and problem statements have been created in hopes of reducing the teen pregnancy rate in Jackson County. In addition, a survey took place in January 2010 with the TPPI Advisory Committee members to determine priority areas for the future. By combining the data with the priorities of the Advisory Committee, six goal statements have been strategized.

1. Build Community-Wide Infrastructure

Overview

The TPPI depends on infrastructure as the organizational structure in which teen pregnancy prevention programs and services are delivered. It includes people and institutions as well as schools, clinics, and governmental agencies. Relationships are a critical component and include collaborative efforts of agencies, individuals, school districts, and the target population. Teen pregnancy prevention is related directly to many social issues. Investing in quality education, employment opportunities, emotional health improvements, and family and social support systems will help to improve teen pregnancy rates in Jackson County.

Outcomes

Secure sustainable public and private support to implement strategies for youth development, teen pregnancy prevention programming, and comprehensive sexuality education;

Increased knowledge, support, and involvement of a positive approach to sexuality education and positive youth development for teen pregnancy prevention demonstrated by parents, educators, community members, and policymakers.

Strategies

Secure funding from federal, state, and local governments, foundations, and other sources for:

Evidence based teen pregnancy prevention programming in schools and community based organizations for teens;

Community and school-based clinical services;

Coordination of teen pregnancy prevention county-wide;

Resources for technical support for local schools and agencies for program development;

Training educators, policymakers, and service providers to increase knowledge and skills in youth development approaches for pregnancy prevention.

Build collaborative relationships among young people, parents, faith communities, and other community agencies, providers, and policymakers to:

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Increase awareness and education on teen pregnancy prevention and community resources;

Expand programming, clinical services, and effectiveness in approaches;

Garner input and participation from a range of concerned individuals regarding the issue of pregnancy prevention.

2. Provide Educational Programs and Services for Teens

Overview

According to a recent survey conducted with the TPPI, increasing programs offered to teens ranked highest among strategies to focus on by Advisory Committee members. In narrowing down priorities for teen programming, it became evident that the TPPI could benefit from youth involvement and specific direction from our target population. Youth participation is essential for effective teen pregnancy prevention strategies. According to Advocates for Youth, involving young people may provide the following benefits:

fresh ideas, unrestricted by the way things have always been done;

new perspectives on decision making, including more relevant information about young people's needs and interests;

candid responses about existing services;

more effective outreach that provides important information peer to peer;

greater acceptance of messages, services, and decisions because youth were involved in shaping them;

increased synergy from partnering youth's energy and enthusiasm with adults' professional skills and experience;

enhanced credibility of the organization to both youth and advocates.

Young people in Jackson County need effective, evidence-based, age-appropriate, medically accurate, abstinence-based comprehensive, long-term teen pregnancy prevention in school and community settings in order to make a significant reduction in the teen pregnancy rates. In 2008, Jackson County had the 15th highest teen pregnancy rate of 83 counties in the state of Michigan. The Jackson County teen pregnancy rate was 66.7 per 1,000 women ages 15 - 19, while the Michigan rate was 54.1.1 Jackson County ranked 17th highest for the percentage of births to teens ages 15-19, a rate of 45.7 per 1,000 girls compared to a Michigan rate of 33.3 for 2008. There were 249 live births to teens in 2008 in Jackson County.1 Sexually transmitted disease rates are very high among young people in Jackson County. Jackson County ranks 8th highest in the state of Michigan for teen rates of Chlamydia and 6th highest for rates of Gonorrhea based on 2008 rates.1

Fifty-seven percent of teen births in Jackson County take place in the City of Jackson. The teen birth rate for 15-19 year olds in the City of Jackson is 107.8 per 1,000 females in that age range, compared to a state rate of 33.3 for 2008. This ranks the City of Jackson as the city with the 3rd highest teen birth rate in Michigan. The pregnancy rate for the City of Jackson is 168.6 per 1,000 females ages 15-19, compared to a state rate of 54.1 and a national rate of 41.5.1,11 The certainly justifies the need to focus intensive, evidence-based teen

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 10 pregnancy prevention programming in Jackson County and to develop specific strategies targeting the City of Jackson and Jackson Public School District.

Outcomes

Increase teen participation in comprehensive teen pregnancy prevention programs;

Increase demonstrated knowledge and skills for pregnancy prevention and risk reduction strategies by youth;

Delayed initiation of teen sexual activity and increased number of sexually active teens utilizing contraception;

Improved access and utilization of sexual health services including contraception among young people.

Strategies

Create TPPI Teen Advisory Council of Jackson County teens;

Solicit and respond to youth feedback to improve the work of the TPPI and improve service delivery;

Implement evidence based teen pregnancy prevention programs or promising approaches based on research;

Advocate for age-appropriate comprehensive sexuality education beginning in late elementary school, middle school, and high school;

Include sexuality education that includes information on puberty and human development, sexually transmitted

infections, healthy relationships, stereotypes, abstaining from or delaying sex, communication, decision making, contraception, peer pressure, refusal skills, and community resources;

Expand access and services through faith communities, juvenile justice, employment programs, foster care, community centers, and schools;

Improve accessibility to birth control in outlying areas;

Establish safe places for teens (after school/summer programming);

Ensure that teen pregnancy prevention services are welcoming and offered around teen schedules;

Use creative strategies (Internet, social networking websites, video, cable access, etc.) and youth voices to increase awareness of teen pregnancy and related issues;

Engage the media to promote messages of pregnancy prevention and risk reduction for teens.

“Being a TPPI member is one of the best tools I can carry in life.

I am not only giving myself more education about healthy sexuality,

I am also helping to solve the issue by being more aware and able

to educate my peers.”

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3. Expand and Strengthen School-Based Teen Pregnancy Prevention Programming

Overview

Evidence-based sex education in local school districts is a need that expands throughout Jackson County. Young people need effective evidence-based, age-appropriate, medically accurate, abstinence-based

comprehensive teen pregnancy prevention in school and community settings. Special attention needs to be focused on schools in Jackson County as schools play an important role in reaching a captive audience of students, can have a great impact based on the policies set forth by Sex Education Advisory Boards, and by tracking success by use of the Michigan Profile for Healthy Youth (MiPHY) survey. Specific goals for school-based strategies are listed below:

Middle School Sex Education - There is data to support that there is good reason to be concerned about sexual activity among middle school aged young people, ages 12-14. According to the 2010 MiPHY Report for Jackson County, 8.4% of 7th graders had already been sexually active and 26.9% in 9th grade. This proves the importance of recognizing the need to educate youth early, before they allow themselves to become at risk of pregnancy and sexually transmitted diseases, which also includes establishing puberty education in upper elementary years. According to the January 2010 survey conducted with the TPPI, middle school

programming was rated as a top priority for Jackson County. In addition, the majority of Jackson County middle schools previously received at least 5 hours of abstinence education along with refusal skills in the Promoting Abstinence for Teen Health program. This program was eliminated in December of 2008 and reached 1,800 teens each year. At this time, Health Education is not mandated at the middle school level. The majority of Jackson County school districts are not providing adequate, evidence-based sex education at the middle school level.

9th Grade Follow-Up Education - According to the MiPHY 2010 data, 41.1% of Jackson County 9th and 11th grade students reported ever having sexual intercourse

in their lifetime, compared to the state average of 45.6%. Specifically, 26.9% of 9th graders and 57.2% of 11th graders ever had sexual intercourse in their lifetime (Michigan average 27% for 9th grade and 53.8% for 11th grade.) The TPPI is concerned about the high rates of sexually active teens by 11th grade in Jackson County being 3.4 percentage points higher than the state average. Currently, the majority of high schools teach the required semester of health education in the 9th grade, leaving three years of high school without follow-up sex education. There is a great need for follow-follow-up education programs to be provided after 9th grade at the high school level which in turn would help reduce the high rates of sexual activity by 11th grade in Jackson

County.

Improve Condom Usage Rates Among Sexually Active Teens - Among students who ever had sexual

intercourse in the past three months, 61.5% of Jackson County 9th and 11th graders used a condom (9th grade – 67.3% and 11th grade - 58.8%), compared to a state average of 65%.4 Condom usage rates among all

categories remain significantly lower than the state average. Increasing the condom usage rates will help decrease the teen pregnancy rate and high sexually transmitted infection rates Jackson County is

Teens Who Have Had Sexual Intercourse

0% 10% 20% 30% 40% 50% 60% 70%

Grade 9 Grade 11 Males Females Total Jackson County 2010 MiPHY Michigan 2009 YRBS

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 12 experiencing. In addition, teens in areas of Jackson County outside of the City of Jackson indicate they have a difficult time accessing condoms in the areas they live in.

Special attention needs to be devoted to ensuring that teens in outlying areas have access to condoms.

Decrease Sexual Activity with Older Partners - Among students who ever had sexual intercourse, 22.6% reported having a first partner who was three or more years older, compared to a state average of 18.7%.3 In particular, 9th grade students report a higher percentage of older

partners than the state average (29.1% compared to 27.8% respectively) and 11th grade reports a Jackson County average of 19.1% compared to a state average of 18.0%. Programming needs to be geared towards younger teens to discuss the risks of dating someone older.

Outcomes

Ensure minimum standards for school-based teen pregnancy prevention programming throughout Jackson County school districts

o Provide resources and technical assistance to local school Sex Education Advisory Committees in the areas of evidence-based sex education strategies;

o Decrease the percentage of sexually active teens by 11th grade in Jackson County; o Improve condom usage rates among

sexually active teens.

Strategies

Develop and expand puberty education in upper elementary years county-wide;

Advocate and ensure Middle School-based evidence based sex education county-wide;

Provide follow-up sex education after 9th grade to address high rates of sexually active 11th grade teens;

Develop tool kit for schools on pregnancy prevention resources.

4. Prevent Repeat Pregnancies for Teen Parents

Overview

Teen parents have a higher rate of becoming pregnant a second time as a teenager. Approximately 20% of teen births in Jackson County are to mothers who already have one or more children. In 2008, 46 repeat teen births occurred, with a repeat teen birth rate of 8.4 per 1,000 females ages 15 - 19. The repeat teen birth rate for Caucasian females is 7.7 and for African American females is 13.8.1 The rate for Hispanic females is less than 6 occurences, in which rates are not be calculated because the data does not meet standards of reliability or precision. 0% 10% 20% 30% 40%

Grade 9 Grade 11 Males Females Total

Sexually Active Students Whose Partner Was 3 or More Years Older

Jackson County 2010 MiPHY Michigan 2009 YRBS

Condom

Usage Percentage During Last Intercourse

0% 10% 20% 30% 40% 50% 60% 70% 80%

Grade 9 Grade 11 Males Females Total

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 13 Although many agencies recognize teen pregnancy as a

problem in our community, there are few pregnancy prevention strategies in place to combat this problem. Teen mothers need an intervention tailored specifically to address factors relevant to their circumstances.

Interventions and support services need to include support from other teen mothers, provide needed skills for

parenting their child, assist in the development of healthy relationships, and provide comprehensive sex education. Comprehensive interventions aimed at parenting teens may bring about positive outcomes for both teen mothers and their children.

Outcomes

Reduce the rate of repeat teen pregnancy for Jackson County teen parents;

Increase positive life outcomes for teen mothers and fathers and their children.

Strategies

Develop home-based case management programs for teen parents and their children;

Offer group supports and parenting classes for teen parents;

Establish use of parenting and child development curricula for teen parents through home based education sessions;

Provide referrals to community resources;

Develop school-based groups for teen parents to assist in developing healthy relationship skills and improve parenting skills;

Ensure that teen parents have access to affordable contraception services;

Encourage teen parents to accomplish educational goals to completel high school or obtain a GED;

Expose teen parents to educational/vocational training to help reach employment goals;

Improve teen parents independent living skills through hands on learning techniques (i.e., budgeting, cooking, safety);

Utilize creative approaches to develop teen parents’ self-concept and self-efficiency.

5. Address Disparities in Adolescent Risk Behaviors

Overview

Disparities in health risks are not evenly distributed across populations of young people in Jackson County. Family income, age, race, gender, identity, sexual orientation, and age all influence sexual health outcomes. Identifying inequities in adolescent risk behaviors is the first step in developing programs that can work towards eliminating them.

In Jackson County, the risk of an African American teen female getting pregnant is 2.5 times that of a

Caucasian teen female. The African American teen birth rate is 96.4 per 1,000 females ages 15 – 19 and for Caucasians the teen birth rate is 38.9. The repeat teen birth rate for Caucasian females is 7.7 and for African American females is 13.8. The City of Jackson has the 5th highest African American teen birth rate in the Michigan in 2008.1 The risk of a Hispanic teen female giving birth is 1.8 times that of a non-Hispanic teen. The birth rate for Hispanic teen is 96.9 per 1,000 females ages 15-19.1

2008 Repeat Birth Rates

(Rates per 1000 females, aged 15-19)

6.4

8.4

0 2 4 6 8 10

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Outcomes

Engage underrepresented and underserved young people and community members in planning processes;

Decrease health inequities among adolescents regarding teen pregnancy and sexual health.

Strategies

Support actions to eliminate social inequities related to employment, education, poverty, and health care that contribute to high teen pregnancy rates;

Increase evidence-based programs offered to target culturally specific needs;

Ensure that programs are guided by meaningful input from underserved and underrepresented young people;

Connect underserved populations to programs and community resources;

Involve diversity and broad representation in the TPPI Advisory Committee and subcommittees.

6. Provide Parent Education

Overview

It is well documented that parents can have a tremendous impact on the sexual decision making of teens, helping them to abstain from sexual intercourse and avoid early pregnancy, STI’s, and HIV. It is crucial that parents reach and connect with adolescents before they adopt risky behaviors. The earlier and more often parents have open and honest dialogue with their adolescents the less likely they will engage in risky behaviors. An important finding is that teenagers who feel highly connected to their parents and report that their parents are warm, caring, and supportive are far more likely to delay sexual activity than their peers. This protective effect does not simply apply to sexual activity, but for all risky behaviors.10

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

Grade 9 Grade 11 Males Females Total

Jackson County 2010 MiPHY Michigan 2009 YRBS Percentage of Teens Who Have Ever Talked with a

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 15 Parents across the state and in Jackson County have consistently shared through survey tools that they want their children to be taught about reproductive health and other risky behaviors. They have also shared that they want the information to be shared while their children are still young, usually before they are sexually active. According to local survey results, a majority of parents value sex education for their children and believe this will have an impact on their children as they are entering adolescence. In 2008, 72.0% of 9th and 11th grade Jackson County students reported that they have ever talked with their parents or other adults in their family about what they expected them to do or not to do when it comes to sex, compared to the state average of 70.9%.3

Outcomes

Educate parents and the community on teen pregnancy and the importance of communicating with young people in an effective way;

Increase parents’ comfort level in talking with their children about abstinence and sexuality.

Strategies

Offer tools for parents on communication skills with their child/teen regarding sexuality education;

Seek out creative ways to educate parents and caregivers on the importance of sexuality education with their children;

Collaborate with programs utilizing a peer education model;

Partner with existing agencies to develop strategies for collaboration to educate parents and encourage parent/child connectedness;

Implement neighborhood and parent education models;

Engage the African American community to encourage parent/child connectedness;

Develop plan for the faith community to educate parents on the importance of parent/teen communication regarding values and sexuality.

Strengths, Weaknesses, Opportunities, and Challenges Analysis

In March of 2010, a Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis took place with over 20 TPPI Advisory Committee members to guide the TPPI framework for the next three years.

In summary, the strengths discussed in the analysis include: Consistent leadership and history since 1990, passion and experienced coordination, reliable data tracking systems, sharing of resources through

community collaborative, I WISH Video, funded programs, “champions” at local schools for the issue of pregnancy prevention, health education mandates for high school health education, teen enthusiasm, and a decrease in rates since 1990.

TPPI weaknesses that were generated through the analysis include: lack of diversity on TPPI (racial, socioeconomic, gender, faith-based), presence in the community/not being used as a resource, lack of

marketing plan, continuity of funding, low meeting attendance, lack of middle school programs and mandated health education, and recent loss of programs.

Opportunities discussed were: Diversify and grow membership, Teen Advisory Council, federal funding available, teacher involvement, more media exposure/marketing plan, TPPI committee members need to

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Teen Pregnancy Prevention Initiative Strategic Action Plan 2010 - 2015 Page 16 educate other collaborative groups, interns/volunteers, develop resource kit, speakers’ bureau, parent

education website links on TPPI webpage, and state website – include link on local school websites.

Threats discussed include: economy, challenges with school funding, and stress level of parents which leads to not making this a priority; lack of certified health teachers at secondary level; sex education not mandated in schools; funding restrictions; access issues to birth control; money for clinical services for teens;

politics/controversy of issue; free government programs; socially accepted; and the cycle of teen parents/young irresponsible parenting.

“We, as teenagers, need to understand

the extent of our choices and the consequences

that could occur if we choose to ignore the truth.”

(17)

References

1

Michigan Department of Community Health, Vital Statistics, 2008

2_{By the Numbers, The Public Costs of Teen Childbearing, Hoffman, Saul D., Ph.D., October 2006} 3_{Michigan Profile for Healthy Youth (MiPHY) 2010, Michigan Department of Education}

4

Kids County in Michigan Data Book, 2009

5_{Child Trends; from Wertheimer, Richard and Moore, Kristin, Childbearing by Teens: Links to Welfare Reform, No. A-24 in Series,}

“New Federalism Issues and Options for States,” The Urban Institute, 1998

6

Center for Educational Performance and Information, http://www.michigan.gov/cepi/0,1607,7-113-21423_30451_36965-210564--,00.html

7_{Jackson County Fetal and Infant Mortality Review Report 2008} 8

Jackson County Sexual Assault Task Force Data Collection Project, 2006

9

Kids County, Community Level Information on Kids, Jackson County,

http://datacenter.kidscount.org/data/bystate/stateprofile.aspx?state+MI&loc=3781

10

Resnick, Journal of American Medical Association, 1997

11