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Implementing a Parent-Adolescent Communication Program. It’s time to Talk!. Facilitated by: Cindy Jo Gordon, RN University of Wyoming. Why is a program needed?. TEEN PREGNANCY-STATE. The Nevada state pregnancy rate : 84 per 1,000
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Implementing a Parent-Adolescent Communication Program It’s time to Talk! Facilitated by: Cindy Jo Gordon, RN University of Wyoming
TEEN PREGNANCY-STATE • The Nevada state pregnancy rate: 84 per 1,000 • This is compared to a National teen pregnancy rate: 67.8 pregnancies per 1,000
TEEN PREGNANCY-COUNTY • Teen pregnancy rate for Clark County: 64.1 per 1,000 • Lander County, Nevada which has a similar demographic profile to Moapa Valley experienced 73.5 per 1,000
Sexually Transmitted Infections • NV has an HIV infection rate of 19.7 per 100,000 • This places NV in top 15 states in US • Clark County’s combined AIDS and HIV incidence and prevalence of 349 per 100,000 (Packham & Griswold, 2011)
Sexually Transmitted Infections • STI rates in Clark County are the highest in the age categories of 15-17, 18-21 and 22-25 • Approximately 50% of STIs occur in young people between the ages of 18-24 years (Southern Nevada Health District, 2011)
Perceptions of Youth • In January 2011, The University of Nevada Cooperative Extension (UNCE) conducted a needs assessment of local high school students The survey was offered to senior civic students at MVHS, 90 students participated • 23 % of youth respondents considered teenage pregnancy a large problem • Only 9% of adults considered teenage pregnancy a large problem.(Bishop, 2011).
Perceptions of Parents • Parent Interviewee #1: “There is a great need for helping parents bring up uncomfortable topics with their kids. There could be more attention given to how to handle unwanted advancements assertively. • Parent Interviewee #2: “I have opted-out of the high school curriculum program due to concerns over content.”
School Health Curriculum What it’s missing An opt-in service. If students attend they will receive instruction on reproduction, communicable diseases, sexual responsibility and AIDs. Not attended by majority of student body. Students attending will not receive information on contraception. What it offers
Local Services Overview gaps Cappalappa Family Resource Center (CFRC) Nevada Community Prevention Coalition(NCPC) Pharmacy Limited availability Limited presence in past-focus on substance abuse Under utilized due to lack of anonymity Local resource
Area Service Overview gaps Comprehensive coverage in 35-45 mile radius (Complete list available to look at and/or a copy can be provided for you) Aimed at urban youth Teens without transportation or parental support will have little to no access to these services Area resources
Relevant National Goals, Objectives, and Policy Recommendations
Healthy People 2020 • Reduce teen pregnancy (FP-8) • Delay sexual activity (FP-9) • Increase use of condoms and contraception to prevent pregnancy and STIs (FP-10 and FP-11) • Increase numbers of adolescent who receive formal reproductive health education (FP-12) • Increase the proportion of adolescents who talked to a parent or guardian about reproductive health topics before the age of 18 years old (FP-13) (U.S. Department of Health and Human Services, 2012)
CDC Office of Adolescent Health • (a)“Include evidence-based sex education that provides accurate information and supports the needs of teens throughout their development, • (b) Include efforts to help parents and teens communicate effectively with each other, • (c) Ensure sexually active teens have access to effective and affordable contraceptives” (CDC, 2012)
National Campaign to Prevent Teen and Unplanned Pregnancy “Investing in a variety of innovative and user-friendly resources to help parents communicate their values on sex, love, and relationships to the next generation” (The National Campaign to Prevent Teen and Unplanned Pregnancy, 2010)
American Public Health Association • Continued promotion of abstinence as part of comprehensive K-12 sex education program • Sex-Ed should be non-judgmental and support parent-child communication and should not impose religious or ideological viewpoints upon student • Programs are “medically and scientifically accurate, age and context appropriate,” and evaluated for effectiveness (American Public Health Association, 2006)
Legislation (AB314) AB314 Introduced April 1, 2011: • Would have added safety and effectiveness of STD tests and treatments; dating violence; and safety, effectiveness, and side effects of contraceptive methods • Would have kept emphasis on abstinence from sexual intercourse • Would have changed parental consent for sex education courses from an “opt in” to an “opt out” policy (Nevada Legislature, 2013)
Policy Statement In order to improve reproductive health in high school students at Moapa Valley High School and thus contribute to reproductive health in Clark County and the State of Nevada it is proposed that Moapa Valley High School institute a program aimed at increasing the rate and effectiveness of parent-adolescent communication about sex-related topics. By providing this program with its educational tools and resources, local public schools and cooperative agencies will be providing the public health core function of assurance.
Selection of a Program • Parents have been identified as the most important influence on youth sexual decision making • Teens continue to say that parents (46%) most influence their decisions about sex (Albert, 2010; National Campaign to Prevent Teen Pregnancy, 2001)
Selection of a Program (cont.) • The US Department of Health and Human Services Office of Adolescent Health identified 31 effective programs • Advocates for Youth discovered 36 programs that were able to affect the behaviors and/or sexual health outcomes of youth exposed to the program
Suggested Program: Talking Parents, Healthy Teens: A Worksite-based Program for Parents to Promote Adolescent Sexual Health
Key Features • The program consists of 8 weekly 1-hour sessions with groups of about 15 parents (designed to be done over lunch hour at work-site) • Interactive; focuses on building parents’ abilities, comfort and confidence • Each session builds upon previous sessions
Eight Sessions-Goals • Building your relationship with your child • Your adolescent’s development and new ways of communicating • Listening skills for talking about sensitive topics • Talking about sex: getting past roadblocks
Eight Sessions-Goals(cont.) • Helping your child make decisions • Assertiveness skills, abstinence, and contraception • More assertiveness skills, coping with conflict, and supervising your kids • Putting it all together and staying motivated
Cost • Implementation cost $543.03 (standard deviation, $289.98) per site • $28.05 per parent • Outcomes had favorable cost-effective ratios
Expected outcomes • Parents who participate in program will experience more confidence in their parental role • Parents will more likely to engage in conversations about sex-related topics
Expected outcomes • When parents engage in these conversations it is likely that their adolescents will: • delay initial intercourse • use contraception if sexually active • have fewer sexual partners during life-span • Results in a greater reproductive health and a reduced cost burden on society as a whole
Community Collaboration Recommend representatives from each school in Moapa Valley, CFRC, and NCPC
Secure Funding CFRC and NCPC have grant capabilities and grant money available for programs School can offer use of facilities
Introduce Program A collaboration also means collaboration in media efforts and participant recruitment
Evaluate Effectiveness What do parents think? What do teens think? More importantly what behaviors have changed?
References Advocates For Youth. (2008). Science & success: Executive summary, 3rd. ed.: Programs that work to prevent teen pregnancy, HIV,STIs in the US. Retrieved from advocatesforyouth.org: http://www.advocatesforyouth.org/publications/2094 Albert, B. (2010, December). With one voice: America's adults & teens sound off about teen pregnancy. Retrieved from thenationalcampaign.org: http://www.thenationalcampaign.org/resources/pdf/pubs/wov_2010.pdf American Public Health Association. (2006, November 8). Policy statement database: Policy number 200610. Retrieved from apha.org: http://www.apha.org/advocacy/policy Aspy, C., Vesely, S., Oman, R., Rodine, S., Marshall, L., & McLeroy, K. (2007, June). Parental communication and youth sexual behaviour. Journal of Adolescence, 30(3), 449-466. doi:http://dx.doi.org.libproxy.uwyo.edu/10.1016/j.adolescence.2006.04.007 Bishop, C. (2011). Moapa valley youth perceptions of community issues. Reno: University of Nevada Cooperative Extension. Retrieved from http://unce.unr.edu/publications/files/cd/2011/sp1108.pdf Boyas, J. F., Stauss, K. A., & Murphy-Erby, Y. (2012). Predictors of frequency of sexual health communication: Perceptions from early adolescent youth in rural arkansas. Child Adolescent Social Work Journal(29), 267-284. doi:10.1007/s10560-012-0264-2
References (cont.) Bunker, S. (2013, January 9). Youth event gets word out on drug abuse prevention. Moapa Valley Progress. Retrieved from http://mvprogress.com/2013/01/09/youth-event-gets-word-out-on-drug-abuse-prevention/ Cappalappa Family Resource Center. (n.d.). Cappalappa family resource center. Retrieved from mvcfrc.org: http://www.mvcfrc.org/ Centers for Disease Control. (2010). Fast stats: Teen births. Retrieved from cdc.gov: http://www.cdc.gov/nchs/fastats/teenbrth.htm Centers for Disease Control. (2011). Sexual behaviors: Adolescent and school health. Retrieved from cdc.gov: http://www.cdc.gov/HealthyYouth/sexualbehaviors/index.htm Centers for Disease Control and Prevention. (2011). NCHHSTP Atlas. Retrieved from gis.cdc.gov: http://gis.cdc.gov/GRASP/NCHHSTPAtlas/main.html Centers for Disease Control and Prevention. (2012, December 17). Reducing teen pregnancy: Engaging Communities. Retrieved from cdc.gov: http://www.cdc.gov/features/teenpregnancy/index.html#healthcareProviders Clark County School District. (2001, June 28). Clark County School District Regulation. Retrieved from ccsd.net: http://www.ccsd.net/district/policies-regulations/pdf/6123_R.pdf Kost, K. H. (2010). U.S. teenage pregnancies, births, and abortions: national and state trends and trends by race and ethnicity. Retrieved from guttmacher.org: http://www.guttmacher.org/pubs/USTPtrends.pdf
References (cont) Kost, K., & Henshaw, S. (2013). U.S. Teenage pregnancies, births and abortions,2008: State trends by age, race and ethnicity. Retrieved from Guttmacher Institute: http://www.guttmacher.org/pubs/USTPtrendsState08.pdf Ladapo, J., Elliott, M., Bogart, L., Kanouse, D., Vestal, K., Klein, D., . . . MA, S. (2013, Jan 31). Cost of talking parents, healthy teens: A worksite-based intervention to promote parent-adolescent sexual health communication. Journal of Adolescent Health, 00795-1(12), S1054-139X. doi:10.1016/j.jadohealth.2012.11.015 Martino, S. C., Elliott, M. N., Corona, R., Kanouse, D. E., & Schuster, M. (2008, March 1). Beyond the "big talk": The roles of breadth and repetition in parent-adolescent communication about sexual topics. Pediatrics , 121(3), e612. doi:10.1542/peds.2007-2156 National Campaign to Prevent Teen and Unplanned Pregnancy. (2012, December). Policy brief: Key points about teen pregnancy prevention. Retrieved from thenationalcampaign.org: http://www.thenationalcampaign.org/resources/pdf/briefly-policy-brief-key-points-tpp.pdf Nevada Legislature. (2013, February 18). NELIS: Committee on education. Retrieved from nelis.leg.state.nv.us: https://nelis.leg.state.nv.us/77th2013/App#/77th2013/Committee/BillStatus/Assembly/Education
References (cont.) Packham, J., & Griswold, T. (2011). Nevada rural and frontier health data book (2011 Edition ed.). Reno: University of Nevada, School of Medicine. Schuster, M., Eastman, K., & Corona, R. (2006, October). Talking parents, healthy teens: A worksite-based program for parents to promote adolescent sexual health. Preventing Chronic Disease, 4(3), A126. Sexuality Information and Education Council of the United States. (n.d.). Nevada comprehensive sex education bill exempted from consideration due to state’s fiscal deficit. Retrieved from siecus.org: http://www.siecus.org/index.cfm?fuseaction=Feature.showFeature&featureID=2003 Summerville, B. (2010). Comparing teenage pregnancy rates and teenage birth rates between states that do and do not mandate sex or STD/HIV education programs (Master's theses.). Retrieved from retrieved from: https://ideals.illinois.edu/bitstream/handle/2142/18302/summerville_brian.pdf?sequence=1 Sutton, M. L. (2013). 73. Impact of parent-child communication interventions on sexual behaviors and sex-related cognitive outcomes of black/african american and hispanic/latino youth: Implications for HIV/STI disparities and prevention efforts. Journal of Adolescent Health, 52(S1), S56-7. doi:http://dx.doi.org.libproxy.uwyo.edu/10.1016/j.jadohealth.2012.10.133 The National Campaign to Prevent Teen and Unplanned Pregnancy. (2010, May). 2010 Policy Agenda. Retrieved from thenationalcampaign.org: http://www.thenationalcampaign.org/resources/pdf/Briefly_PolicyBrief_2010_Policy_Agenda.pdf U.S. Department of Health and Human Services. (2012, October 30). Healthy people 2020: Family planning objectives. Retrieved from HealthyPeople.gov: http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=13
Images • Retrieved April 12, 2013 from: http://www.dreamstime.com/royalty-free-stock-photos