District Health Department 10 Lake County Lake County

District Health Department #10 Lake County

Lake County Teen Pregnancy Group Project Tonya Allendorf, Karley Daniel, Michael Dugan, Gena Furgeson, Tracy Giraud, and Kathy La. Ponise Ferris State University

Lake County Lake county is a rural community with a population of 11, 498 (Census Bureau, 2013) located in the northwestern part of Michigan’s Lower Peninsula, 80 miles north of Grand Rapids. “Home to 200, 000 acres of public-owned land, Lake County is intersected by two major highways, US 10 and M-37” (Lake County Chamber of Commerce [LCCC], 2013). Lake County is a seasonal town that uses tourism as an industry (LCCC, 2013). The lakes offer wildlife and fishing opportunities, there are trails for motorsports, and several annual events throughout the summer months (LCCC, 2013). While Lake County has annual summer events, the overall health of the community depends upon the year-round industry of the area.

Community Strengths Community Assets Beautiful natural resources Safe community Collaboration between agencies and resources available Existing services Lake County Chamber of Commerce Satellite Health Clinic Lake County Health Department. Baldwin Family Health Center Teen School Health Clinic

Community Weaknesses No hospital in Lake County High ratio of patients to available primary care providers. Lack of health coverage High percentage of the population on Medicare and Medicaid. No public transportation Teen pregnancy rate of 68. 5 per 1, o 00 or 6. 85 percent 28. 6 % of teens 15 -19 have a repeat teen pregnancy (Hill et al, 2011, p. 43) High rate of smoking while pregnant High rate of child abuse/ neglect High poverty rates High unemployment rates Low rates of high school graduation Low percentage of continuing education and advanced degrees

Community Weakness Focus Area Teen pregnancy and repeat teen pregnancy “There is a strong association between teenage pregnancy and child well-being. Morbidity associated with children of teenage pregnancy includes pre-term birth, low birth weight, child abuse, neglect, poverty and premature death” (Harkness & De. Marco, 2012, p. 441).

Community Risks Potential risks • Lake County teens are at a risk for higher pregnancy rates due to it being a rural community. Teen birth rates in rural counties are 1/3 higher than the rest of the country, 43% in rural settings compared to 33% in urban ones (The National Campaign, 2013). • Teen pregnancy leads to high costs to taxpayers. Increased health care, increased foster care, increased incarceration rates, and lost revenue due to lower education and job status all add to taxpayer burden. In 2008, it was estimated that it cost $11 billion dollars in U. S. tax dollars due to teen pregnancy (Centers for Disease Control and Prevention (CDC, 2012). • Pregnant teenagers and their children have lower school performance, higher drop out rates, more health problems, higher incarceration rates, and unemployment (CDC, 2012). This can strain and be a drain on community resources. • Poverty is a cause as well as a consequence of early childbearing; approximately one quarter of teen mothers goes on well-fare within 3 years of the child’s birth.

Community Nursing Diagnosis Risk of pregnancy among teenagers in Lake County. Related to poverty, lower levels of educational attainment, high rates of confirmed child abuse and neglect, and a large percentage of children living in single parent households. As demonstrated by teen pregnancy rate at 68. 5 per 1, 000 and repeat teen births at 28. 6%.

Nursing Process Assessment Diagnosis Planning Intervention Evaluation

Project Overview Pregnant teens smoking Pregnant teens are ______% more likely to smoke than women between the ages of ____ and ____. Identify which teens in the area are most susceptible to _______. The following services are available in the area, however, the following barriers exist _______. The nearest hospital offering delivery services is in Osceola county _______ miles away and offers the following services______. However, ______services are lacking for those in Lake county. The nearest specialty care or NICU is located ____miles away. Evidenced based research states early prenatal care decreases pregnancy related complications by ______% (cite ref) The current resources available _________

SMART Goal The number of pregnant girls aged 19 and younger who smoke in Lake County will be reduced by 20% from 35. 1% pregnant teen smokers in 2010 to 28. 1% or fewer in 2020 (District Health Department #10, 2011).

Planning • Who – pregnant teens and teens in general in Lake County is the targeted population. • What – to reduce teen pregnancy in Lake County from 68. 5 % to Healthy People 2020 target of 36. 2%. • When – achieve target goal of 36. 2% in 7 years by 2020. • Where – Lake County in District Health Department #10

Planning continued • Why – to reduce the number of teen pregnancy. Reducing the number of teen pregnancies will benefit the community and individuals by reducing strain on resources, improving educational results, better economical opportunities, and improved health benefits. • How – by: – Assessment surveys and interviews to gather data. – Educational seminars and events to provide information and health promotion to teens, parents, and the community.

Planning continued – “How” – Creating a multidisciplinary team to research and implement policy and interventions regarding teen sexual behaviors, availability of health providers and centers, safe teen center “hangouts”, and education about the risks and pitfalls of teen pregnancy.

Implementation • Recognizing teens at risk and bringing attention to the subject. • Providing support and resources to assist teen’s with pregnancy process. • Going into county schools, middle schools and high schools and providing resources, education, and providing support. • Pushing for more sex education in schools, allowing more support and communication for teenage girls with school nurses, teachers, and other staff members. • Encouraging parents to talk to their teens about risks for teen pregnancy. • Showing Lake County teen’s statistics and how it can change their lives. • Allowing teen mothers to speak about their experiences, their ups and downs. • Teaching about condoms and other contraceptives, demonstrating the proper use and how they are used. • Speaking and educating on abstinence and peer pressure. Where and when would you turn to for help as a pregnant teenager.

Implementation continued • Collaborating and working with Lake County Agencies: • HELP, Pregnancy Crisis Aid, an agency that provides services and resources for unplanned pregnancies. • Lutheran Family Services of Michigan, provide resources, support, and individual tailored plans to families of all ages. • Lake County Department of Child Services, assists with many needs including WIC program (Woman Infant Child program). • Family health care teen health program, associated in Baldwin school districts.

Community Interventions Pregnant teens smoking Pregnant teens are ______% more likely to smoke than women between the ages of ____ and ____. Identify which teens in the area are most susceptible to _______. The following services are available in the area, however, the following barriers exist _______. The nearest hospital offering delivery services is in Osceola county _______ miles away and offers the following services______. However, ______services are lacking for those in Lake county. The nearest specialty care or NICU is located ____miles away. Evidenced based research states early prenatal care decreases pregnancy related complications by ______% (cite ref) The current resources available _________

Theoretical Support • A PAUSE (Adding Power and Understanding in Sex Education) is a program based on a Social Influences Theoretical Model where Social Learning Theory is a central component (Mellanby, Newcombe, Reese, & Tripp, 2011). • A teacher and a nurse educate the teens on anatomy, physiology, and health promotion in the middle and high school settings. • The teen mothers serve as mentors. • This ‘joined up thinking’ team approach works well. • The teens receive the factual information better from adult leaders. • The peer leaders are more effective in changing attitudes

Evaluation • A PAUSE is evaluated on a pre and post test. • The students answer a questionnaire regarding knowledge and attitudes during the first session and the last session of class. • The students answer the questionnaire anonymously to promote honesty. • Our goal of decreasing the amount of pregnant teen smokers by 20% in Lake county will be evaluated according the statistics in next years District 10 Annual Report.

References Centers for Disease Control and Prevention. (2012). The importance of prevention section. Retrieved from http: //www. cdc. gov/Teen. Pregnancy/About. Teen. Preg. htm District Health Department #10. (2011). Health Profile Chartbook: Lake County. Retrieved from http: //www. spectrumhealth. org/documents/Osceola_and_ Lake_Counties_CHNA. pdf Harkness, G. A. , & De. Marco, R. F. (2012). Community and public health nursing: Evidence for practice. Philadelphia, PA: Wolters Kluwer Health / Lippincott Williams & Wilkins. Hill, M. , Mullins, M. , Warner, L. , & Van. Ark, L. (2011). Health and healthcare landscape of Osceola and Lake counties: Research results from the 2011 community-wide health needs assessment (CHNA Report 11_28_11). Retrieved from Hope College, The Carl Frost Center for Social Science Research, A research project for Spectrum Health Reed City Hospital. Retrieved from http: //www. google. com/url? sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0 CDk. QFj. AB&url=http%3 A%2 F%2 Fwww. spectrumhealth. org%2 Fdocuments%2 FOsc eola_and_Lake_Counties_CHNA. pdf&ei=19 w 0 Uch. F 8 a. Fyw. GWj. ICAAQ&usg=AFQ j. CNFWbp. GAwo 5 ecn. IYTNGUh. Kyp. Wn. R 9 YQ&bvm=bv. 43148975, d. a. Wc

References continued Lake County Chamber of Commerce. (2013). History. Retrieved from http: //www. lakecountymichigan. com/history. html Lake County Chamber of Commerce. (2013). Michigan’s outdoor recreation paradise. Retrieved from http: //www. lakecountymichigan. com Mellanby, A. , Newcombe, R. , Rees, J. , & Tripp, J. (2001). A comparative study of peer lead and adult led school sex education. Health Education Research Theory & Practice, 16(4), 481 -492. Retrieved from http: //spen. org. uk/mymedia/ files/resource_pdfs/sexual_health/comparative%20 study%20 of%20 peer%20 led%20 ad ult%20 led%20 school%20 sex%20 education. pdf Olszewski, J. & Wisdom, K. (2004). Michigan surgeon general’s health status report: Healthy Michigan 2010. Retrieved from http: //www. google. com/url? sa=t&rct=j& q=&esrc=s&source=web&cd=1&ved=0 CDIQFj. AA&url=http%3 A%2 F%2 Fwww. michigan. gov%2 Fdocuments%2 FHealthy_Michigan_2010_1_88117_7. pdf&ei=19 w 0 Ucmh. F 8 a. Fy w. GWj. ICAAQ&usg=AFQj. CNEk. BBBTP_Osfd. Rkcty. Rn. Hfa. Bs. H 2 Mg&bvm=bv. 43148975, d. a. Wc

References continued The National Campaign. (2013). Teen childbearing in rural America (Science Says Number 47). Retrieved from http: //www. thenationalcampaign. org/resources/pdf/ss/ss 47_teenchildbear inginruralamerica. pdf United States Census Bureau, American fact finder. (2007). All sectors: Geographic area series: Economic-wide key statistics: 2007 economic census. Retrieved from http: //factfinder 2. census. gov/ faces/tableservices/jsf/pages/productview. xhtml? pid=ECN_2007_US _00 A 1 United States Census Bureau, American fact finder. (2010). Profile of general population and housing characteristics: 2010 demographic profile data. http: //factfinder 2. census. gov/faces/ tableservices/jsf/pages/productview. xhtml? pid=DEC_10_DP_DPDP 1 United States Census Bureau, American fact finder. (2011). Selected economic characteristics 2007 -2011 American community survey 5 -year estimates. Retrieved from http: //factfinder 2. census. gov/faces/ tableservices/jsf/pages/productview. xhtml? pid=ACS_11_5 YR_DP 03

References continued United Way of Jackson County. (2007). Pursuing hope for our youth: Summary of teen pregnancy prevention strategic planning 2006 -2007: Jackson county, Michigan. Retrieved from http: //www. google. com/url? sa=t&rct=j&q=&esrc=s& source=web&cd=5&ved=0 CEg. QFj. AE&url=http%3 A% 2 F%2 Fjacksondata. org%2 Fsites%2 Fjacksondata. org%2 Ffiles%2 FJCHDpregnancyprevention. pdf&e i=19 w 0 Ucmh. F 8 a. Fyw. GWj. ICAAQ&usg=AFQj. CNGU 6 le. JPVQo. P 1 WFDW 5 bvs. M 1 f 6 ESWA&bvm=bv. 4 3148975, d. a. Wc Wikipedia: The Free Encyclopedia (2006). File: Map of Michigan highlighting Lake County. svg. Retrieved from http: //en. wikipedia. org/wiki/File. Map_of_Michigan_highlighting_Lake_ County. svg. Wikipedia. (2013, March 19). Poverty in the United Sates. Retrieved from http: //en. wikipedia. org/ wiki/Poverty_line_in_the_United_States Zehnder-Merrell, J. (2012). Right start in Michigan and its counties-2012, Right start in Michigan 2012: A closer look at maternal and infant well-being. Lansing, MI: Michigan League for Human Services. Retrieved from http: //www. google. com/url? sa=t&rct=j&q=&esrc=s&source=web& cd=6&ved= 0 CE 0 QFj. AF&url=http%3 A%2 F%2 Fwww. milhs. org%2 Fwpcontent%2 Fuploads% 2 F 2012%2 F 04%2 FRSwith. Appendix. pdf&ei=19 w 0 Ucmh. F 8 a. Fyw. GWj. ICAAQ&usg=AFQj. CNGb. GI 97 M PM 92 lu 5 we 77 tji 1 SPIq 9 g&bvm=bv. 43148975, d. a. Wc