1. A Community-Based Approach toTeenage Pregnancy Prevention Leisa J. Stanley, PhD(c),MS Associate Executive Director Healthy Start Coalition of Hillsborough County CityMatCH Conference Pittsburgh, PA August 23-25, 2003

2. Project Partners • Healthy Start Coalition • Leisa J. Stanley, PhD(c), MS Associate Executive Director • Pamela Sullins, RN, Director of Development • John Harris, MPA, Information Systems Manager • Hillsborough County School System • Mary Ellen Gillette, RN, Former Director of School Health and Social Services • Hillsborough County Health Department • Faye Coe, RN, Assistant Community Health Nursing Director • Tampa Bay YMCA • Bobbi Davis, PhD, Grants Administrator • Renee Rivera, Program Manager, Success Centers

3. Coalescing the Community – What we did to make teenage pregnancy prevention a priority • Child Watch • October 1994 • 30 key community & business leaders • Speech – “Facts versus Myth of Teenage Pregnancy” • Site Visits • Report – State of Teenage Pregnancy in Hillsborough County

4. Teen Pregnancy Prevention Initiative (TPPI) • 1995-1996 community planning • 68 community agencies • Developed model for teenage pregnancy prevention • Primary – prevention of first pregnancy • Secondary – prevention of second pregnancy and healthy pregnancy outcome • Tertiary – finish school, child care, job training/placement

5. TPPI MODEL Teenage Pregnancy Prevention Intervention SECONDARY TERTIARY PRIMARY School Health Mental Health l ESPDT Positive Youth Development Programs • Curriculum • Project Achieve • ENABL • Human Growth and Dev. • AIDS Education • Life Management GED Job Training After School Programs SCHOOLS Care Coordination School Athletics Childcare Early Sexual Abuse ID and Intervention Education Support/ Tutoring Programs Parenting Mentoring Programs Sibling Programs Youth Shelters Home Visitation Program Healthy Start, etc. Parenting Early Substance Abuse ID and Prevention Community-Based Medical WIC Male Responsibility Programs

6. Child Health Investment Project (CHIP) • 1996-1997 - advocacy • Need to secure hub of model in school system • Involvement of same agencies as in TPPI • Nurse in every school • Identification of at-risk youth in school • Referrals out to community-based agencies • Contact for community to become involved in schools • Linkage of students with health insurance/medical providers

7. Advocacy for TPPI/CHIP • Briefing papers/proposals/presentations supported by data and research • Written endorsements from 15 key agencies • Editorials in two major papers • Tampa Tribune • St. Petersburg Times • Presentations to key funders • School Board • County Health Plan • Board of County Commissioners • Local children’s services council – funding priority • Legislative Support • Special local bill to fund school nurses - $500,000

8. Primary Prevention - 1998 • YMCA – Success Centers • Four Success Centers • Location selected by zip code and school district based on teen birth rate in that area • After school program and all day summer program • Served 297 youth in the 5th-9th grades • Services/educational areas (11,378 contacts) • Gender Specific (2625 contacts) • Developmental (4562 contacts) • Community Service (840 contacts) • Educational/Vocational (2676 contacts) • Progress Meeting (668 contacts)

9. Primary Prevention - 1998 • School System – Prevention Specialists • Five prevention specialists in ten middle schools • Same areas as Success Centers • Teach ENABLE curriculum to 2800 6th graders • Provide individual and group counseling to 405 middle school students (6th-8th grades) • 3095 contacts • 1091 individual contacts • 2044 group contacts • Gender Specific (536 contacts) • Educational/Vocational (584 contacts) • Developmental (1158 contacts) • Community Services (384 contacts) • Progress Meeting (210 contacts)

10. Secondary and Tertiary Prevention - 1998 • Healthy Start - Intensive Teen Parenting Program • 4 community health nurses + 1 social worker • Minimum of bi-weekly home visits or school visits • Services • Served 356 pregnant and parenting teens (<= 16 years old) • 6000 services provided • 2151 face to face encounters; 708 non face to face encounters • Education provided included family planning, parenting education, breastfeeding education & smoking cessation • Education and referrals regarding completing school/GED • Securing subsidized child care – Internet Parenting Class

11. Outcomes • Reduction in Teenage Live Birth Rate • 10-14 year old – 35.5% reduction • 15-17 year old – 31.4% reduction • Repeat Live Births – 6.9% reduction • Reduction in Low Birth Weight Births to Teens • Reduction in Infant Deaths to Teens • 5 pregnancies this past year for females enrolled in primary prevention programs. 1 dropped out of school.

12. Advocacy & Fundraising • Funding Issues • Workforce Alliance Board – 67% budget reduction • Local Children’s Services Council • County Commission • Advocacy • Newspapers (press releases, editorials and Letter to the Editor) • Elected officials • Presentations and office visits • Presence at board and county commission meetings • BOCC voted to fund 50% of need in partnership with local Children’s Services Council funding other 50%

13. Evaluation Framework • Empowerment Evaluation Model • Included all of our partners (continuous) • Outlined data to collect and what to measure • Evaluation Components – Logic Model • Process Indicators (demographics;services) • Interim Indicators – pilot this fall (attitudes; beliefs) • Outcome Indicators (pregnancies; juvenile justice) • Key to advocacy and fundraising