Reasons For Choosing The Intervention
Reasons For Choosing The Intervention
Gwinnett County has grown considerably, and it is the second biggest populated county in Georgia. As a result of the rapid growth, the county has realized new challenges and opportunities. The county needs to understand of forces that affect health in order to improve and maintain its health status. The population in the county increased from 352,910 to 726,273 between 1990 and 2005 according to US census (Gwinnett county health department, 2007). The population mainly consists of youngsters. Teen pregnancy in the county is a major issue as the number of teenagers dropping out from school due to teen pregnancy is high. Teen pregnancy is high among children aged between 10 and 19 years. The teen pregnancy rate increased greatly from, 2000 to 2004. That is from 26.4 to 27.7 (Gwinnett county health department, 2007). The teen pregnancies increase as the age increases (Gwinnett county health department, 2007). The teen pregnancies differ from one race to another. The rates of teen pregnancies are high among Hispanics followed by whites. The rates of teen pregnancies among Hispanics were 90 in 2004 and whites 25.5. The high rate of sexual activity among teenagers presents serious problems for them and the community.
The sexual activity has led to early pregnancies, sexually transmitted diseases and emotional trauma. It has also affected their education. Middle and high school students engage in sexual; activity in the county. Several factors have contributed to the high incidence of adolescent pregnancy in Gwinnett County. Examples include inadequate knowledge and peer pressure. Also, social problems affecting the community have resulted to teen pregnancy. They include chronic poverty, poor health, and lack of employment, alcoholism in homes, and minimal hope for a better tomorrow (Georgia Statistics System, 2011). The high rate of teen pregnancy has led to selection of the intervention. The teenage prevention program aims to impact on adolescents, families and the Gwinnett County community at large. This is through the provision of adequate information to influence teenagers on the importance of making the right choices. Furthermore, the program aims to provide education on life skills, empower them with knowledge and to motivate them to look forward for a better and brighter future. Teenagers will also be encouraged to make the right choices concerning their sexuality, such as, delaying sex, and staying healthy and protect themselves (National Institute for Health and Clinical Excellence 2007).
History
Teen pregnancy has occurred throughout the United States history. Teen pregnancy is considered an urgent problem as the number of young children giving birth has increased. The high incidence of teen pregnancy has resulted to medical and health complications. Also, it has to less schooling as teenagers do not get the opportunity to complete their studies. In addition, teen pregnancy has led to high dropout rates and increase in poverty. Almost 1 million adolescent girls become pregnant in US every year. As a result, states have established teen pregnancy prevention programs to reduce the rate of adolescent pregnancies. For instance, Georgia has developed various prevention programs to prevent pregnancy among adolescents. Government, nongovernmental organizations and hospitals, have created awareness about teen pregnancy in Gwinnett County. Whites, Hispanics, African Americans and other groups in Gwinnett County have recorded high rates of teen pregnancy (Jones & Domenico, 2007).
Pertinent Statistics
The teen pregnancy in US has reduced since 2004.329,797 babies were to girls aged 15 years and 19 years. The teen pregnancy reduced by 8% between 2010 and 2011. The birth rate among girls aged 15 years and 17 years reduced by 11%. Also, the birth rate for girls aged 18 years and 19 years reduced by 7%. The decline is attributed to teen pregnancy awareness and use of birth control (CDC. (2012). Also, the number of teens sexually active has reduced and hence reduced the rate of teen pregnancy (Georgia Statistics System, 2011). Georgia is in the 13th position of states with the highest rate of teen birth in the United States. Georgia and Gwinnett County had a high incidence rate of adolescent pregnancy from 1999 to 2008. Georgia had an incidence rate of 36.6 and Gwinnett County 27 from 1999 to 2008. Georgia and Gwinnett County have a high rate of dropout. Georgia has a high rate of drop out compared to other states. A total of 19,752 students in 9th, 10th, 11th and 12th grades dropped out of school in 2008. Also, 1,565 students in 9th, 10th, 11th and 12th drooped out of school in Gwinnett County in 2008. By 22 years, only 50% of teen mothers manage to receive their high school diplomas. Only two percent of teenage mothers manage to complete their college education. Factors like teen pregnancy have led to increase in the dropout rate (Georgia Statistics System, 2011). These statistics clearly indicate the need to have a prevention plan on teenage pregnancy in Gwinnett County, Georgia.
Development Plan
Week One: Class will focus on factors leading to teenage pregnancy and possible prevention.
Week Two: The class will learn about statistics regarding teenage pregnancy.
Week Three: Parents from the community: Despite the wide range of emotions that parents will be feeling when they learn that their teenage daughter is pregnant or their son has fathered a child it is necessary for them to be supportive. This program will call upon parents to attend to the teenage session, where they will learn the topics being taught to their children. Special sessions will be given to parents to discuss the available options on pregnancy. This includes discussions on what they expect during pregnancy and after birth. The parents will also talk about the baby’s father, and learn about his background. When the son is responsible for pregnancy, his parents should make efforts of identifying the girl, and providing the necessary support. They will assist their daughters and sons get medical attention and ensure that they remain healthy. They will assist in making preparations for the arrival of the baby. Lastly, they will be encouraged to accept to be grandparents.
The Fourth week: Will deal with education on health screening, availability of contraceptives, and on sex education. Some aspects for the week include education of sexually transmitted diseases in women and men, contraception and cervical screening. Participants will be educated on the models of behavior change so as to reduce unwanted pregnancies and STDs.
Week Five: The teenagers to watch videos about other teenagers and their stories of being teen mothers, their struggles and how having babies affect their lives.
Week Six: Guest speakers from various sectors in the community will provide professional information on how to best handle teen pregnancy. Other speakers will also come from the business industry and government representatives.
The Implementation Process
Week One: Topic was on factors leading to teenage pregnancy and possible preventions
The teenagers learned how various factors contribute to teenage pregnancies. Some of the factors the teenagers learned included inadequate sex education, sexual abuse, alcoholism and drug abuse, peer pressure and high poverty rate. The teenagers learned how the factors increase the risk of teen pregnancies. For instance, they learned how taking alcohol at a tender age and peer pressure forced youths to engage in sexual activity.
Week Two: Explanation about statistics regarding teenage pregnancy, with this the teenagers will be able to learn and compare the number of teenagers pregnant in the U.S. Georgia and also in their community (Gwinnett County).
The teenagers reviewed teen pregnancy statistics in the United States, Georgia and Gwinnett County. This enabled them to compare the adolescent pregnancy statistics in their community, state with the country statistics. This enabled them to understand teen pregnancy is a major issue in the country, community and state level.
Week Three: I invited only the parents from the community to attend classes and we discussed different topics about teenage pregnancy and how to cope with their pregnant teenagers.
Involving parents enable the discussion of various issues on how to handle and eliminate teen pregnancy. Parents contributed in discussions on the different measures and approaches that they can use to deal with teen pregnancy. Parents noted that they played an essential function in preventing teen pregnancies. They identified different strategies to prevent teen pregnancies. Encouraging communication between them and their teens, with regard to their sexuality enables parents to guide the teens on how to avoid pregnancy at early ages. Parents can also encourage abstinence among youngsters. Appropriate sex education can enable a community to reduce cases of teen pregnancy.
Week Four: Discussion on contraceptive availability, health screening and sex education.
The teenagers were taught the importance of contraceptives in preventing teenage.pregnancies. They were encouraged to use different types of contraceptives such as condoms, birth control pills, shots, morning-after pill and other contraceptives. The teenagers did not have sufficient knowledge on how to use the contraceptives effectively. Also, the teenagers were educated on the importance of health screening in preventing pregnancy. This is essential as some of the teens get pregnant but realize after a long period of time. Health screening enables such teens to have the appropriate health services during their pregnancy. Some of the teenagers were screened for pregnancy. Sex education also took place to enlighten the teens on how to handle sex.
Below is also some of the websites I used in teaching them about different types of birth controls.
http://www.nhs.uk/Livewell/Sexandyoungpeople/Pages/Videotypesofcontraception.aspx
http://www.emedicinehealth.com/birth_control_pictures_slideshow/article_em.htm
Week Five: The teenagers watched videos about other teenagers and their stories of being teen mothers; their struggles and how having babies affect their lives
The movies were reality based teen pregnancy genre that educated both parents and teenagers. One of this video was theTLC special.The movie showsthe intense emotional journey of a pregnant teenager who decided to keep a pregnancy and how the pregnancy affected her life. The other movie was about teenage mothers telling their stories about how having a baby affected their lives. After watching these videos, teenagers were given time to discuss on the issues learnt.
Week Six: I invited different guest speakers in to talk about teenage pregnancy and other resources available in the community.
I invited guest speakers from various sectors in the community to speak about adolescent pregnancy. They provided professional information on how to best handle teen pregnancy. Other speakers came from the business industry and government representatives. They used the education program specific strategies to educate boys. Such strategies involved using fathers, male trainers, and their male athletic team coaches as the boy’s role models. They taught the teenage boys on the positive views of becoming a man such as appreciating and respecting girls and not seeing them as sex tools. They were taught on consequences of teenage sex, such as, the risks of contracting STDs and HIV/AIDs, unwanted pregnancies, and the burden of becoming a teenage father. They were taught that manhood was all about taking responsible healthy choices on their sexuality.
Evaluation Plan
The teenagers took a pre and post survey to determine their knowledge and effectiveness of the program. The pre survey determined what the teenagers knew about teen pregnancy and prevention. The survey determined teenagers’ knowledge about contraceptives, abstinence and causes of teen pregnancy. The post survey determined the effectiveness of the teen pregnancy program. It evaluated teenagers’ knowledge about teen pregnancy and prevention after attending the lessons. In addition, the post survey determined teen behavior after completing the programs. The pre and post survey consisted of several questions related to teen pregnancy. The pre test survey showed that teenagers had limited knowledge on teen pregnancy and prevention. The teenagers had limited knowledge about contraceptives and abstinence. Also, they had inadequate knowledge about causes of teen pregnancy and effects. Teenager behavior changed after participating in the program as they had sufficient knowledge. The pre and post survey is shown at the appendix.
Analysis of the results of Intervention
A total of 40 teenagers and their parents were educated on teen pregnancy. That is 20 girls and 20 boys. The teens did not have sufficient knowledge before participating in the program. They had no sufficient knowledge about causes of teen pregnancies such as alcohol, peer pressure and poverty. Only a small number of teens (10) knew that alcohol, poverty and peer pressure led to irresponsible sexual behaviors and hence teen pregnancies. Additionally, teens had no knowledge about sexually transmitted diseases and teen pregnancies. Only 5 had knowledge about sexually transmitted diseases and teen pregnancies. Moreover, the teens did not have adequate knowledge on teen pregnancy and contraceptives. 2 had knowledge on teen pregnancy and contraceptives. They did not know other contraceptives available apart from condoms and pills. The teens did not know where to get birth control. Those who knew about condoms and pills were unable to get or buy them and used them rarely. The teens did not know the importance of abstinence in preventing teen pregnancies and how teen pregnancies affected their studies and life in the future. Only 10 know the significance of abstinence in preventing teen pregnancies and how teen pregnancies affected their studies and life in the future. Lack of sufficient knowledge on adolescent pregnancy made it hard for them to abstain (Mueller, Gavin, Kulkarni, 2008).
Based on the evaluation and data analysis, results showed that teenager’s behaviors had improved. A huge number of teenagers (35) were practicing abstinence. The teenagers (30) were also able to make safer choices that they are proud to have made. Most teenagers discussed sexual issues with their parents and enabled them to make appropriate choices (Beckett, Elliot & Martino, 2010). Also, a good number of parents (35) reported that their children had at least once asked them questions on what they learned in the class. Additionally, lower pregnancy rates were reported among sexually active teenagers as they used contraceptives. 20 teenagers were sexually active and used contraceptives. Only 1 pregnancy was reported during the implementation process. The change in behavior and lower rate of pregnancy among teens is attributed to increase in knowledge on adolescent pregnancy. The teenagers became aware of teen pregnancy, causes, effects and prevention after participating in the program. Therefore, the program was effective as most teenagers changed their behavior and made right choices when it came to sex (Trenholm, 2008). The results are shown in the appendix under results section.
Cultural/ethical Issues
Several cultural and ethical issues were evidenced when implementing the teen pregnancy prevention program. Teenage pregnancy elicits various cultural and ethical issues. One of the issues regards the moral concept of teens becoming pregnant. Some of the citizens in the community believed teenage pregnancy was due to moral decadency in the society. They claimed that parents are somewhat at fault for their children’s deeds. This is since they do not slot in the teens in talks that relate to how they should handle sex. Others attributed teen pregnancy to the lack of adherence to cultural. In the current society, there is acceptance of teen pregnancy as a normal and usual thing. By not adhering to cultural beliefs, the society results to acceptance of the new standards and the way of living (McHugh, 2008).
Another issue with regard to ethics is the practice of sex education. Some parents believe that it is not ethical for them to talk about sex education. They claim that by introducing the subject at the early age, it would further worsen the situation. It is the view of some of the citizens in the community that the practice of sex education should only be after the teenage years. This is, however, a misconception by some of the citizens as it is always better taking precautionary measures. Sex education is one of those precautionary measures that ought to take place so as to enlighten teenagers on how they should handle sex. There was also another cultural issue that is with a view to the employ of contraceptives. There are claims that the use of contraceptives encourages teens to engage in sexual activities (McHugh, 2008). This is because they know that, by using contraceptives, they would eliminate the possibility of getting pregnant. Some of the citizens, therefore, are against the use of contraceptives and only call for emphasis on abstinence (Trenholm, 2008).
Barriers and How to overcome them
Several barriers affected the implementation of the program. One of the barriers during implementation of the project was conducting health screening of the teens. Most of the teens were afraid of undergoing screening as they feared the outcome of it. They feared discovering they were pregnant. The teenagers did not want their parents to know as it would result to severe punishment. Therefore, getting all teens in the community to undergo the screening was challenging (Peterson, 2006). Another key barrier was communication. Some teenagers were not able to communicate effectively with regard to their view and challenges with teen pregnancy and were unwilling to forward information. Therefore, they communicated poorly as they did not have the intent of discussing the subject. Finally, the community perception regarding sex education made it hard to implement the program. Some parents believe educating children on sex education promotes irresponsible sexual behaviors while others support sex education. The varied views regarding sex education made it hard to convince parents and children to take part in the program (Peterson, 2006).
Several strategies were used to overcome the barriers. The parents were encouraged not to victimize pregnant teens. This encouraged the teens to undergo the screening since they recognized that they had the support of their parents. Also, the parents and teens were informed about the benefits of the program to encourage them to participate (Peterson, 2006).
Nursing Process
Nurses played a crucial role at the primary level. They educated and counseled teenagers about pregnancy prevention. They also taught teenagers about family planning and delay of pregnancy to adulthood. The teenagers were educated on different contraceptives and how to use the contraceptives effectively. The teenagers were educated on how to delay pregnancy by abstaining from sex (Cleveland Metropolitan School District, 2006). At a secondary level, the nurses identified early teen pregnancies and encouraged the teens to seek medical care. They identified factors that prevented pregnant teens from seeing early medical care such as failing to notice their pregnancy early. The nurses also educated teenage mothers on the right diets and the right food for weaning children. The nurses also informed the teens of available options like abortion, adoption or keeping the baby (Fox, 2008).
At the tertiary level, the nurses focused on prevent teen pregnancies by educating teens. They also encouraged positive parent and infant interaction for teen mothers. In addition, the nurses educated teen mothers on child development and parenting (Cleveland Metropolitan School District, 2006).
Improvements to the Plan
The development plan needs to be improved in order to make the teen pregnancy prevention program successful. The development plan can be improved by increasing the time for each activity in the plan. The time for every lesson should be increased from one week to 3 weeks in order to ensure teens and parents acquire appropriate knowledge. Extending the time for each lesson will enable teens acquire sufficient knowledge about teen pregnancies and hence make proper choices. Further, extending the time for every activity will enable the nurse to evaluate the impact of the program effectively. It is hard to determine behavioral change among teens immediately after completing the program. 6 six weeks might not be enough for teens to change their behaviors and make proper choices. Therefore, the development plan can take 3 months to give teens time to change and determine whether the intervention is successful or unsuccessful.
Reference
Beckett, M, Elliot, M, & Martino S. (2010). Timing of parent and child communication about sexuality Relative to Children’s sexual behavior. American Academy of Pediatrics, 32. P 129130
CDC. (2012). About Teen Pregnancy. Retrieved from http://www.cdc.gov/teenpregnancy/aboutteenpreg.htm on 26/12/2012
Darroch, J.E. (2000). Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries. Family Planning Perspectives: Vol. 32, No.1.
Fox, M. (2008). Factors causing teen pregnancy. Retrieved from http://ezinearticles.com/?Factors-Causing-Teen-Pregnancy&id=132175
Georgia Statistics System. (2011). Demographic profile. Retrieved from http://www.georgiastats.uga.edu/counties/121.pdf
Gwinnett county health department. (2007).2006-2007 Gwinnett community health status report. Retrieved from http://www.nonprofithealthcare.org/resources/CommunityHealthStatusReport-GwinnettExample.pdf on 26/12/2012
Hoffman, S.D. (2003). Effects of Teen Childbearing on the Mothers. New York.
Jones, K.H., & Domenico, D.M. (2007). Adolescent pregnancy in America. Journal for vocational social needs education, vol 30, issue no 1
Kirby, D. (2007). Emerging answers: research findings on programs to reduce teen pregnancy and sexually transmitted diseases. National Campaign to Prevent Teen and Unplanned Pregnancy
McElroy, S. (1996). The Impacts of Teen Childbearing on the mother and the Consequences of those Impacts for Government. Washington, DC: The Urban Institute Press.
Mueller, T., Gavin, L., & Kulkarni, A. (2008). The Association Between Sex Education and Youth’s Engagement in Sexual Intercourse, Age at First Intercourse, and Birth Control Use at First Sex.’ Journal of Adolescent Health 42: 89-96.
National Institute for Health & Clinical Excellence.(2007). One to One Intervention to Reduce the Transmission of Sexually Transmitted Infections (STIs) Including HIV. London: NICE.
Peterson, E. (2006). Children of early child bearers as young Adults. Economic costs and social consequences of teen pregnancy. Washington, DC: The Urban Institute Press.
Tall, H. (2011). Developing health services designed for young people. British Journal of School Nursing, Vol 6, p 193-8
Trenholm, C, et al (2008). Impacts of abstinence education on teen sexual activity. Journal of Policy Analysis and Management 27, 255-276.
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