Innovative Approaches for Integrating Preconception Health Concepts into Adolescent Health Efforts

1. Innovative Approaches for Integrating Preconception Health Concepts into Adolescent Health Efforts

2. ad⋅o⋅les⋅cent – adj. 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

3. Quick Stats

4. Stats … 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.

5. Our Framework Why preconception health for adolescents?

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

7. …To Lay the Foundation for Lifelong Positive Reproductive Health Outcomes Preconception | Birth | Early Childhood | Adolescence | Young Adulthood | Adulthood | Midlife | Old Age | Death

8. 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.

9. The intersect …

10. Key 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)

11. The strategy … The Preconception Health & Adolescents Action Learning Collaborative

12. Our strategy … • #1: Individual responsibility • across the lifespan • (“reproductive awareness”) • #2: Consumer Awareness • #4: Interventions • for Identified Risks • #8: Public Health • Programs and Strategies

13. Our strategy … Created partnership between Women’s and Adolescent Health Teams & ASTHO Worked with advisory group to shape the project Working with teams to support integration of guidelines Providing on-going financial and technical support Helping teams assess learning and revise strategies Helping teams evaluate their efforts Evaluating our efforts Analyzing implications for the broader community Disseminating results

14. State teams … Explore implications of taking CDC guidelines and transferring to practice Build partnerships Discover barriers and enablers of change Create strong, visible leaders/champions for this idea Create and implement action plans Assess learning and revise strategies Evaluate strategies Share learning

15. Participating states …

16. Successes • Tools & Resources • Reproductive life plans • Website for youth and young adults • Information dissemination • Awareness • Partnerships • PHA Symposium

17. Lessons Learned • It can be done!!!! • Framing can be challenging, but not impossible • Partnerships! • Youth voice • Males

18. Look to the Future …

20. Know Your Plan… Just One Click Away: South Carolina Adolescent Preconception Health InitiativeBreana Lipscomb, MPH SC Department of Health and Environmental Control 1331 Elmwood Avenue, Suite 140, Columbia, SC 29201 www.teenpregnancysc.org PH: 803-771-7700

21. South Carolina’s Team SC Campaign to Prevent Teen Pregnancy SC Department of Health and Environmental Control SC Department of Education Teen Health Center 1331 Elmwood Avenue, Suite 140, Columbia, SC 29201 www.teenpregnancysc.org PH: 803-771-7700

22. South Carolina’s Team SC Campaign to Prevent Teen Pregnancy SC Department of Health and Environmental Control SC Department of Education Teen Health Center 1331 Elmwood Avenue, Suite 140, Columbia, SC 29201 www.teenpregnancysc.org PH: 803-771-7700

23. Know Your Plan… Just One Click Away: South Carolina Adolescent Preconception Health InitiativeBreana Lipscomb, MPH SC Department of Health and Environmental Control 1331 Elmwood Avenue, Suite 140, Columbia, SC 29201 www.teenpregnancysc.org PH: 803-771-7700

24. South Carolina’s Team SC Campaign to Prevent Teen Pregnancy SC Department of Health and Environmental Control SC Department of Education Teen Health Center 1331 Elmwood Avenue, Suite 140, Columbia, SC 29201 www.teenpregnancysc.org PH: 803-771-7700

25. PregnancyPrevention Preconception Health

26. Population Left Behind • Older youth harder to reach and often “left behind” in health interventions • 94% of men and 86 of women 18-29 believe pregnancy should be planned • 86% of men and 88% of women 18-29 say it is important to avoid pregnancy right now • Only about 50% are well protected against pregnancy (Fog Zone, National Campaign to Prevent Teen and Unplanned Pregnancy)

27. Only Part of the Message… • Pregnancy prevention is only part of the message • Older youth also need to know how to stay healthy: • Nutrition • Exercise • Substance use • Reproductive life planning • Goal setting

28. Know Your Plan…

29. Know Your Plan… The Process ·          • Decided to target older youth • Partner with a health center in a high needs area to promote preconception health and pregnancy prevention • Gathered Team • Worked with AMCHP technical assistance • Outcome: • Brochure/ Flyers to Promote Preconception Health

30. Know Your Plan…The Research Literature Review Focus Groups (3 groups, 27 youth) Site Visit to health center serving target population

31. Focus Group Findings: Use internet and social media to connect with young people Images should be bold, colorful and eye catching Youth want to see people who “look like them” – age, race, gender Youth want to hear from other youths Celebrity culture is powerful Messages should emphasize the present, not the future

32. Focus Group Findings BROCHURES ARENOT THE ANSWER

33. Serendipity

34. Know Your Plan…The Collaboration SC Campaign was developing a youth website with pregnancy prevention focus Partnered with SC Campaign to include preconception health information Tested youth site with target population in December 2010

35. January 4th 2011 Launch www.carolinateenhealth.com

36. Know Your Plan…The Evaluation Website hits Friends and tweets Number of placements in health centers, colleges, and other youth gathering points Improvement and expansion of content

37. Know Your Plan…The Evaluation • January 4th – May 4th: • 3,222 unique visits • 19,257 page views • 67% new visits • 47 states • 58% of visitors visiting site directly; 32% referred from other sites, including Facebook, our corporate website, etc.; 10% referred from search engine

38. Know Your Plan…The Evaluation • Bounce rate: 38% • Average # of pages viewed: 4 • Length of time on site: 3:13 • Most viewed pages: • Teen Expressions • Know the Facts • Know Your Plan

39. Know Your Plan…The Successes • Strong Partnerships improved our product • SC Campaign’s website improved: • Youth testers liked having information about more general health issues • Less intimidating for youth • Opportunities for cross promotion • Great Support from AMCHP

40. Know Your Plan…The Lessons Learned Talk to target population Find partnerships Leverage other funds

41. Know Your Plan…The Challenges Stay Flexible Change the plan when needed Understand that web development takes time

42. Know Your Plan…The Next Steps • Promotion, promotion, promotion • Marketing: • Wallet cards • QR Codes • Distribute wallet cards to: • All public health centers in SC • Youth serving organizations • Community Colleges • Urgent Care Offices

43. Contact Me! Breana LipscombLIPSCOBN@dhec.sc.gov

44. Recommendations to Improve Preconception Health Among Young Women with Disabilities AMCHP Action Learning Collaborative , Team Members: State of Oregon Public Health : Bob Nystrom, & Emilee Coulter-Thompson,Contact: Julie McFarlane , Julie.M.McFarlane@state.or.us 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

45. Why Recommendations are Needed for People with Disabilities • 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

46. Defining Disabilities • 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)

47. Youth Sexual Behaviors

48. Safety and Victimization

49. The Oregon ALC Team Activities and Accomplishments • 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!

50. Feedback from Youth with Disabilities • 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)