Innovative Approaches for Integrating Preconception Health Concepts into Adolescent Health Efforts

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Innovative Approaches for Integrating Preconception Health Concepts into Adolescent Health

Efforts

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A young person who has undergone puberty but who has not reached full maturity; a teenager.

Age range: 10-24 years old

Adolescence is the bridge period between adulthood

and childhood – it is a transitional stage marked by

physical and mental developmental changes

ad o les cent – adj.⋅ ⋅ ⋅

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Quick Stats

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Adolescent population is increasing in numbers!

Adolescents are increasing in ethnic diversity.

Characteristics of adolescent experience changing –

the current generation of youth is one that can be

characterized in part by “firsts.”

Disparities – adolescent population experiencing

significant racial, ethnic, geographic,

socioeconomic, and other disparities.

Stats …Stats …

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Why preconception health for Why preconception health for adolescents?adolescents?

Our FrameworkOur Framework

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……To Bridge Adolescent and To Bridge Adolescent and Women’s Preventive Health (A Women’s Preventive Health (A Life Course Approach)Life Course Approach)

Our FrameworkOur Framework

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……To Lay the Foundation for To Lay the Foundation for Lifelong Positive Reproductive Lifelong Positive Reproductive Health OutcomesHealth Outcomes

Preconception | Birth | Early Childhood | Preconception | Birth | Early Childhood |

Adolescence | Young Adulthood | Adolescence | Young Adulthood |

Adulthood | Midlife | Old Age | DeathAdulthood | Midlife | Old Age | Death

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Timing matters Timing matters ……As the border between adulthood and

childhood, adolescence is a critical time for

health promotion

Many adolescents behave in risky ways or live

in environments that not only affect their

immediate health, but also have a significant

impact on their health as adults.

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The intersect … The intersect …

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Key Facts - Reproductive and Sexual HealthKey Facts - Reproductive and Sexual Health

~48% of teens have had sex; 35% are currently sexually active

~15% of teens have had sex with 4 or more partners

~62% of sexually active youth used a condom at last intercourse

~23% of sexually active youth used drugs/alcohol prior to last

sexual intercourse

In 2006, 14% of HIV cases reported to CDC was among young

people aged 13-24

1 in 4 U.S. teen girls has sexually transmitted infection (more than

3 million teens)

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The strategy … The strategy …

The Preconception Health & Adolescents Action Learning Collaborative

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Our strategy … Our strategy …

#1: Individual responsibility across the lifespan (“reproductive awareness”)

#2: Consumer Awareness

#4: Interventions for Identified Risks

#8: Public Health Programs and Strategies

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Created partnership between Women’s and Adolescent Health Created partnership between Women’s and Adolescent Health

Teams & ASTHOTeams & ASTHO

Worked with advisory group to shape the projectWorked with advisory group to shape the project

Working with teams to support integration of guidelinesWorking with teams to support integration of guidelines

Providing on-going financial and technical supportProviding on-going financial and technical support

Helping teams assess learning and revise strategiesHelping teams assess learning and revise strategies

Helping teams evaluate their effortsHelping teams evaluate their efforts

Evaluating our effortsEvaluating our efforts

Analyzing implications for the broader communityAnalyzing implications for the broader community

Disseminating resultsDisseminating results

Our strategy … Our strategy …

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Explore implications of taking CDC guidelines and Explore implications of taking CDC guidelines and

transferring to practicetransferring to practice

Build partnerships Build partnerships

Discover barriers and enablers of changeDiscover barriers and enablers of change

Create strong, visible leaders/champions for this ideaCreate strong, visible leaders/champions for this idea

Create and implement action plansCreate and implement action plans

Assess learning and revise strategiesAssess learning and revise strategies

Evaluate strategiesEvaluate strategies

Share learningShare learning

State teams …State teams …

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Participating states …Participating states …

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• Tools & ResourcesTools & Resources

• Reproductive life plansReproductive life plans

• Website for youth and young adultsWebsite for youth and young adults

• Information disseminationInformation dissemination

• AwarenessAwareness

• PartnershipsPartnerships

• PHA SymposiumPHA Symposium

SuccessesSuccesses

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It can be done!!!!It can be done!!!!

• Framing can be challenging, but not Framing can be challenging, but not impossibleimpossible

• Partnerships! Partnerships!

• Youth voiceYouth voice

• MalesMales

Lessons LearnedLessons Learned

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Look to the Future …Look to the Future …

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Know Your Plan… Know Your Plan… Just One Click Away:Just One Click Away:

South CarolinaSouth Carolina

Adolescent Preconception HealthAdolescent Preconception Health

InitiativeInitiative

Breana Lipscomb, MPHBreana Lipscomb, MPHSC Department of Health and Environmental ControlSC Department of Health and Environmental Control

1331 Elmwood Avenue, Suite 140, Columbia, SC 29201 www.teenpregnancysc.org PH: 803-771-7700

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South Carolina’s TeamSouth Carolina’s Team SC Campaign to Prevent Teen SC Campaign to Prevent Teen

PregnancyPregnancy

SC Department of Health and SC Department of Health and Environmental ControlEnvironmental Control

SC Department of EducationSC Department of Education

Teen Health CenterTeen Health Center


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PregnancyPregnancy





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Know Your Plan… Know Your Plan… Just One Click Away:Just One Click Away:

South CarolinaSouth CarolinaAdolescent Preconception HealthAdolescent Preconception Health

InitiativeInitiative

Breana Lipscomb, MPHBreana Lipscomb, MPHSC Department of Health and Environmental ControlSC Department of Health and Environmental Control


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PregnancyPregnancy





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PregnancyPregnancyPreventionPrevention Preconception HealthPreconception Health

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Population Left BehindPopulation Left Behind

Older youth harder to reach and often “left Older youth harder to reach and often “left behind” in health interventionsbehind” in health interventions– 94% of men and 86 of women 18-29 believe 94% of men and 86 of women 18-29 believe

pregnancy should be plannedpregnancy should be planned– 86% of men and 88% of women 18-29 say it is 86% of men and 88% of women 18-29 say it is

important to avoid pregnancy right nowimportant to avoid pregnancy right now– Only about 50% are well protected against Only about 50% are well protected against

pregnancypregnancy

(Fog Zone, National Campaign to Prevent Teen and Unplanned Pregnancy)(Fog Zone, National Campaign to Prevent Teen and Unplanned Pregnancy)

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Only Part of the Only Part of the Message…Message…

Pregnancy prevention is only part of the Pregnancy prevention is only part of the message message

Older youth also need to know how to Older youth also need to know how to stay healthy:stay healthy:– NutritionNutrition– ExerciseExercise– Substance useSubstance use– Reproductive life planningReproductive life planning– Goal settingGoal setting

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Know Your Plan…Know Your Plan…

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Know Your Plan…Know Your Plan… The Process The Process

Decided to target older youth Decided to target older youth – Partner with a health center in a high needs Partner with a health center in a high needs

area to promote preconception health and area to promote preconception health and pregnancy preventionpregnancy prevention

Gathered TeamGathered Team Worked with AMCHP technical assistance Worked with AMCHP technical assistance Outcome: Outcome:

– Brochure/ Flyers to Promote Preconception Brochure/ Flyers to Promote Preconception HealthHealth

·

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Know Your Plan…Know Your Plan… The The ResearchResearch

Literature ReviewLiterature Review

Focus Groups (3 groups, 27 youth)Focus Groups (3 groups, 27 youth)

Site Visit to health center serving target Site Visit to health center serving target populationpopulation

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Focus Group Findings:Focus Group Findings: Use Use internet and social media internet and social media to connect with young to connect with young

people people

Images should be Images should be boldbold, , colorful colorful and and eye catchingeye catching

Youth want to see people who “Youth want to see people who “look like themlook like them” – age, race, ” – age, race, gendergender

Youth want to Youth want to hear from other youthshear from other youths

CelebrityCelebrity culture is powerful culture is powerful

Messages should emphasize the Messages should emphasize the present, not the futurepresent, not the future

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Focus Group FindingsFocus Group Findings

BROCHURESBROCHURES

AREARE NOTNOTTHE ANSWERTHE ANSWER

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Serendipity Serendipity

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Know Your Plan…Know Your Plan… The The CollaborationCollaboration

SC Campaign was developing a youth SC Campaign was developing a youth website with pregnancy prevention focuswebsite with pregnancy prevention focus

Partnered with SC Campaign to include Partnered with SC Campaign to include preconception health informationpreconception health information

Tested youth site with target population in Tested youth site with target population in December 2010December 2010

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January 4January 4thth 2011 Launch 2011 Launch

www.carolinateenhealth.com

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Know Your Plan…Know Your Plan… The The EvaluationEvaluation

Website hitsWebsite hits

Friends and tweetsFriends and tweets

Number of placements in health centers, Number of placements in health centers, colleges, and other youth gathering pointscolleges, and other youth gathering points

Improvement and expansion of contentImprovement and expansion of content

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January 4January 4thth – May 4 – May 4th:th:

– 3,222 unique visits 3,222 unique visits

– 19,257 page views19,257 page views

– 67% new visits67% new visits

– 47 states47 states

– 58% of visitors visiting site directly; 32% referred from 58% of visitors visiting site directly; 32% referred from other sites, including Facebook, our corporate website, other sites, including Facebook, our corporate website, etc.; 10% referred from search engineetc.; 10% referred from search engine

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Bounce rate: 38%Bounce rate: 38% Average # of pages viewed: 4Average # of pages viewed: 4 Length of time on site: 3:13Length of time on site: 3:13 Most viewed pages:Most viewed pages:

– Teen ExpressionsTeen Expressions– Know the FactsKnow the Facts– Know Your PlanKnow Your Plan

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Know Your Plan…Know Your Plan… The The SuccessesSuccesses

Strong Partnerships improved our product Strong Partnerships improved our product

SC Campaign’s website improved:SC Campaign’s website improved:– Youth testers liked having information about Youth testers liked having information about

more general health issuesmore general health issues– Less intimidating for youth Less intimidating for youth

Opportunities for cross promotionOpportunities for cross promotion

Great Support from AMCHPGreat Support from AMCHP

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Know Your Plan…Know Your Plan… The Lessons The Lessons LearnedLearned

Talk to target population Talk to target population

Find partnershipsFind partnerships

Leverage other fundsLeverage other funds

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Know Your Plan…Know Your Plan… The The ChallengesChallenges

Stay FlexibleStay Flexible

Change the plan when neededChange the plan when needed

Understand that web development takes timeUnderstand that web development takes time

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Know Your Plan…Know Your Plan… The Next The Next StepsSteps

Promotion, promotion, promotionPromotion, promotion, promotion

Marketing:Marketing:– Wallet cardsWallet cards

– QR CodesQR Codes

Distribute wallet cards to:Distribute wallet cards to:– All public health centers in SCAll public health centers in SC

– Youth serving organizationsYouth serving organizations

– Community CollegesCommunity Colleges

– Urgent Care OfficesUrgent Care Offices

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Contact Me!Contact Me!

Breana LipscombBreana [email protected]

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AMCHP Action Learning Collaborative , Team Members:

State of Oregon Public Health : Bob Nystrom, & Emilee Coulter-Thompson,Contact: Julie McFarlane , [email protected] 971-673-0365

Oregon Health Sciences University Michelle Berlin and Lisa Isabel

Women with Disabilities Health Equity Coalition (WowDHEC)Portland State University (PSU) Marjorie McGee

National Youth Leadership Network (NYLN), Stacey Milbern

Gimpgirl.com (GGC), Jennifer Cole

Community Youth Representative, Marneet Lewis, Portland Community College

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No recommendations exist, yet 1 in5 women in the U.S. has a disability (16.8 to 28.6 million)

Young women with disabilities are much less likely to receive adequate preconception health support and services, including reproductive health care cost and insurance issues inability to get an appointment inability to find a health care provider who

understood or was willing to treat their disability

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Self identified and doesn’t require equipment or alternative formats (difficulty seeing, hearing, or self care)

Sometimes or often needing ADA accommodations (movie captions, large text/Braille, ramp or elevator)

Self identified and using equipment (cane, wheelchair, or amplified telephone)

Other people see me as disabled (due to cancer, HIV,or Fibromyalgia)

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Team formed a mutual understanding of the issues.

Data Analysis and literature review.

Involving youth with disabilities on the team.

Survey is complete. Analysis is under way and results will be used to inform the final recommendations. Stay tuned for the final recommendations!

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On-line survey promoted through chat-rooms,

e-mail, listservs for young people with disabilities Data from the first 50 surveys (May 25th 2011) Age Range 18 – 28 Female 60%; Male 38% 25% from Oregon, (other States included

CA., NY, TX, PA, FL, & WA)

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Respondents concerns related to the health of Young Adults with Disabilities: Safety from violence, abuse,

bullying, and/or harassment (24%) Access to health care services

(16%) Access to mental health services

(13%) Being included in sex education

classes (12%)

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• “People often forget that people with disabilities have sexual feelings at all. People assume that goes away when full use of the body/mind does”.

• “…Health care professionals and those responsible for sex education doesn’t view people with disabilities as being capable of having romantic and/or sexual relationships.”

• “When it comes to young adults with disabilities and sex we mostly get treated like a child.”

• “[it is challenging] to find Doctors who believe people with disabilities should be having sex.”

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Activities took more time than anticipated.

Maintaining membership over an extended period of time, when some are volunteers.

Budget was very small $2,500. IRB view of Disability under a Medical

Model vs Team view of Disability

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Youth with disabilities were engaged in the process.

Understanding of the Disability, Preconception, and Youth Health frameworks.

A survey of youth with disabilities ensured input from the target population

• The work of the Team will be shared at two state and three national conferences. Possible publication of the final recommendations.

Stay tuned for the recommendations to be released Fall 2011.

Contact: [email protected]

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Personal note …Personal note …

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Questions?

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AMCHP Staff:AMCHP Staff:Sharron Corle – Sharron Corle – [email protected] Hawkins – Jessica Hawkins –

[email protected] Pressfield – Lissa Pressfield –

[email protected] Cristina Sciuto – Cristina Sciuto –

[email protected] ASTHO Staff:ASTHO Staff:Ellen Pliska – Ellen Pliska – [email protected]

PHA 6 States:PHA 6 States:OhioOhioOregonOregonMissouriMissouriPennsylvaniaPennsylvaniaSouth CarolinaSouth CarolinaUtahUtah

Documents

Innovative Approaches for Integrating Preconception Health Concepts into Adolescent Health Efforts