Evidence-Based Approaches to Teen Pregnancy, HIV and STI

Evidence-Based Approaches to Teen Pregnancy, HIV and STI Prevention Work

By Tasha Toby
Senior Analyst, Adolescent Health, National Association of County and City Health Officials 

Many working in the field of public health understand that the success of many public health programs and initiatives can be attributed to strong collaboration between key players from differing, but relevant, sectors. In many of the past discussions that have occurred between National Association of County and City Health Officials (NACCHO) and AMCHP staff members regarding the implementation of evidence-based teen pregnancy and teen HIV/STI prevention program, the need to foster collaboration, specifically between local and state health departments, always seemed to be the dominant topic of the discussions. Realizing that both organizations could work together to address the issue, in March 2008 (with funding from the Annie E. Casey Foundation) NACCHO and AMCHP embarked on a collaborative project designed to promote the formation of collaborations between local health departments, state health departments, and community-based organizations to address the incidence of teen pregnancy and teen HIV/STI infection at the local level. The collaboration was called the “Moving from Interest to Action Initiative.” 

Using a request for applications process, five “State-Local Teams” were selected to receive financial and technical assistance from NACCHO and AMCHP to support their collaborative efforts to work toward implementing an evidence-based program to address teen pregnancy and HIV infection at the local level. State-Local Teams were comprised of: one local health official/staff member working on adolescent health issues (NACCHO representative), one state health official/staff member working on adolescent health issues (AMCHP representative), and one representative from a community organization in the geographical area that the local health department (LHD) and state health department (SHD) team were interested in targeting. After reviewing submissions from 10 state and local partnerships from around the country, five state teams from the following states were selected to focus their collaborative efforts on addressing the specific teen pregnancy and HIV/STI prevention issues:    

·         Team Colorado focused efforts on increasing access to evidence-based teen pregnancy and HIV/STI prevention programs and resources for youth residing in Durango schools in rural southwest Colorado (an area considered to be isolated) experiencing high rates of teen births and STIs. The team consists of members from the Colorado Department of Public Health & Environment, the San Juan Basin Health Department (SJBHD) and the Colorado Organization on Adolescent Pregnancy, Parenting and Prevention.  

·         Team Maine took on the challenge of gaining entrée into Portland’s Somali community in order to begin the groundwork necessary for implementing evidence-based teen pregnancy and HIV/STI prevention efforts aimed at parents of this immigrant population. The team consists of members from the Maine Center for Disease Control and Prevention, the City of Portland Health and Human Services Department and Planned Parenthood of Northern New England. 

·         Team Minnesota chose to focus its efforts on implementing evidence-based programming, such as the Teen Outreach Program, in Richfield, MN, an area with a high teen birth rate and STI incidence, and abstinence-only school-based education. The team consists of members from the Minnesota Department of Health, the Bloomington Public Health Department and The Storefront Group. 

·         Team Missouri decided to focus its efforts on Mississippi County, which has the third highest teen pregnancy rate in the state along with a teen STI incidence rate higher than the state average. The team will work together to develop a coordinated plan for implementing an evidence-based teen pregnancy/HIV/STI prevention program in the county in an abstinence-only environment. The team consists of members from the Missouri Department of Health and Senior Services, the Mississippi County Health Department and the Community Alliance Against Adolescent Pregnancy (CAAAP).  

·         Team South Carolina focused its efforts on opening a teen health clinic in the rural areas of Johns Island and Wadmalaw Island. In addition to providing reproductive health care services in this geographical area of high need, the Team will also explore options for providing evidence-based teen pregnancy and HIV/STI prevention programming out of the clinic. The team consists of members from the South Carolina Department of Health and Environmental Control (SC DHEC), SC DHEC Control Region 7 and Communities in Schools of Charleston (CIS). 

To kick off the “Moving from Interest to Action Initiative,” in July 2008, NACCHO and AMCHP held a three-day training on evidence-based approaches to teen pregnancy and HIV/STI prevention for members of the selected five State-Local Teams in Chicago, IL. The training agenda included sessions on topics such as evidence-based practices, community involvement and garnering youth involvement from a number of subject experts from organizations such as Healthy Teen Network, Public/Private Ventures, Advocates for Youth and the National Campaign to Prevent Teen and Unplanned Pregnancy. In addition to having the opportunity to learn from and engage in dialogue with the subject experts, time was also built into the training for State-Local team members to start the process of developing an action plan to guide their teen pregnancy and HIV/STI prevention efforts in their respective communities and engage in dialogue with one another regarding their specific team efforts and strategies for addressing possible barriers that they may face. 

At the conclusion of the three-day training, participants mentioned gaining new insight on issues related to: working with different populations in their respective communities; implementing teen pregnancy and HIV/STI prevention programs; and identifying methods for improving system capacity at both state and local levels. Additionally, many of the State-Local teams reported that the training strengthened the quality of communication between team members and also increased their knowledge of resources and efforts related to teen pregnancy and HIV/STI prevention in their respective states, illustrating the success of the joint AMCHP-NACCHO training. 

hroughout the remainder of 2008, AMCHP and NACCHO provided support to the five State-Local Teams, helping them lay the groundwork necessary for launching an evidence-based response to the issue of teen pregnancy and HIV/STI prevention in their respective local communities. This financial and technical support from the NACCHO-AMCHP partnership helped the five State-Local Teams execute the following key accomplishments related to their local level efforts: 

Team Colorado

·        Securing funding for the teen pregnancy prevention initiative at the SJBHD

·         Including Bayfield youth in planning and future implementation of Team efforts

·         Gaining of support from key community stakeholders in turn leading to increased credibility from the neighboring larger school district, Durango Public Schools

Team Maine

·         Building relationships between the state and city of Portland on parenting issues relating to health, including productive discussions on how to approach reproductive health with immigrant populations

·         Establishing an on-going discussion group for Somali mothers on parenting 

Team Minnesota

·         Securing the help of a local communication and framing expert to help build greater public support and political will around the issue of teen pregnancy and STI prevention

·         Planning a Town Hall style meeting in Richfield to address how to frame the issue of teen pregnancy and STI prevention in the community 

Team Missouri

·         Missouri Adolescent Health Program’s drafting of a contract to provide funding to the Mississippi County Health Department’s to support the Team project

·         Expanding the local community coalition (CAAAP) to include new members committing to local efforts to address county teen pregnancy rates, which have increased

·         Planning of a Town Hall meeting designed to increase awareness and community buy-in for evidence-based approaches and programs

·         Forming a CAAAP subcommittee to advise strategic planning efforts in 2009 

Team South Carolina

·     Successfully securing grant funding, space, and furnishings for the teen clinic

·         Finalizing a Memorandum of Agreement between Communities in Schools and SC-DHEC for teen clinic operation 

During the State-Local Teams training, on technical assistance conference calls and in their final project reports, a number of the State-Local teams mentioned the positive impact that the “Moving From Interest to Action Initiative” has had on encouraging the formation of collaborations between LHDs, SHDs and community-based partners to address teen pregnancy and HIV/STIs in their communities. The Initiative’s impact of strengthening the level of communication and collaboration among local and state team members and agencies have been catalysts for implementing strategies collectively at both community and state levels, an aspect of the Initiative of which AMCHP and NACCHO are especially proud. 

Based off of the momentum of the project, AMCHP collaborated with NACCHO to submit an application for supplemental funding from the CDCs Division of Reproductive Health (DRH) and the Division of Adolescent School Health (DASH) to fund an enhanced version of the “Moving From Interest to Action Initiative.” In October 2008, AMCHP was awarded this DRH funding, to provide technical and financial assistance to State-Local Teams in the three states implementing projects under the DRH’s Science-Based Approaches Initiative. Project activities are currently underway with a new group of State-Local Teams.