Families with teens and adolescence are faced with many social issues as well as common health problems. There are families within our society that comprise a special aggregate known as at-risk teens. One problem or concern that exists for this aggregate group is early pregnancy. The rate in which adolescent females are giving birth in the United States (U.S.) has decreased over the past few years. However, the U.S. teen pregnancy rate continues to be as much as nine times higher than other developed countries (Morbidity And Mortality Weekly Report, 2011). Every community in the United States (U.S.) is comprised of families. Although each family has a different set of values, morals and cultural beliefs, many family units involve teenagers. Each family unit has the potential to be exposed to or become a part of the phenomena of unintended adolescent pregnancy. The U.S. teen pregnancy rate continues to be as much as nine times higher than other developed countries (Morbidity And Mortality Weekly Report, 2011). Statistical information regarding this aggregate group illustrates the frequency of teen pregnancy in the United States as well as in the African-American community. Increased rates of teen pregnancy also increases the occurrence of preterm birth, infant mortality and, low birth weight. Moreover, adolescent females who give birth are more likely to experience socioeconomic hardships including but not limited to failure to complete high school education, low socioeconomic standing (Morbidity And Mortality Weekly Report, 2011). The offspring of adolescent parents tend to have poor health, low cognitive development, experience low educational achievement and, offspring experience increased rates of adolescent pregnancy (Jutte, Roos, Brownell, Briggs, MacWilliam & Roos, 2010). Negative health risks and outcomes are not limited to infancy. Studies have shown that mortality rates of children between the ages of six thru seventeen years old, born to adolescent females, was increased. Moreover, the increased rate of hospitalization of these children continued through adolescence (Jutte et al., 2010). Community Health Plan Overview
Advocacy is the use of information and resources to create organized changes that influence the way community members or aggregates live. The intention of advocacy is to address the quality of life for both aggregates as well as community members (Stanhope & Lancaster, 2010). Christoffel’s conceptual advocacy framework is used to categorize the advocacy efforts community health nurses can take. The conceptual framework for advocacy occurs using three stages: information, strategy and action (Stanhope & Lancaster, 2010). This concept aligns the stages sequentially however, in daily practice, the stages occur simultaneously. The information stage describes the activities utilized to define, describe and measure the health problem. The strategy stage refers to the use of acquired data and information to identify areas requiring change or intervention for the improvement of health. The action stage is the activities used in implementation of strategies (Stanhope & Lancaster, 2010). Christoffel’s conceptual advocacy framework is a useful tool for creating an action plan for the prevention of pregnancy among the aggregate group, at risk teens. The community health nurse would utilize the three stages of the conceptual model to create and execute activities. First, during the information phase, the community health nurse will conduct research to identify and gather data regarding the at risk adolescence. The data collected will consist of details regarding the health concerns of early pregnancy, the patterns of occurrence of early pregnancy as well as identified risks. Moreover, this phase will outline program efficacy at each level of prevention as well as barriers to the effectiveness of programming. During the strategy phase the community health nurse will disseminate the data gathered to professionals, professional organizations, individuals and others who are directly or indirectly affected by or affiliated with the aggregate group or the health concerns. This information released will outline objectives as well as establish timetables. Moreover, the release of information will assist in the mobilization of organizations and groups to aid in the development of methods to promote needed changes. This stage will produce the information required for policy statements, educational campaigns in the media and print campaigns regarding the at risk teen and early pregnancy. Finally, the action stage of the action plan will consist of the community health nurse implementing specific strategies for the purpose of changing attitudes, changing health habits and allocating resources that can have a positive effect upon early pregnancy among adolescence. The community health nurse will engage members of the political arena and educate regarding the aggregates health issue and needs. Moreover, the community health nurse will gather the necessary financial resources needed for programing. In addition to securing resources, the community nurse will specify tactics and created detailed outlines of the various timelines associated with the program. Social Marketing
Providing community health programs to a community or aggregate is a step in the right direction. However, the community or aggregate must understand the importance of health related behaviors as well as the need for participating in the interventions designed to change negative health behaviors. Social marketing provides the tools necessary to motivate the community or aggregate toward health promotion and prevention activities and programs (Aras, 2011). Social Marketing is vital to the success of any community advocacy program. Social marketing is the process of using marketing principles and techniques to allow program developers create, communicate, and deliver value and to influence stakeholders behaviors that benefit the health of or fulfill the health needs of a community or aggregate (Aras, 2011). The success of social marketing of a community advocacy program is dependent upon the development of the right product to fulfill the health needs associated with the community or aggregate identified. Moreover, offering programs at the right price, in the right place, with the right strategy for promotion, and with supporting policies influences the success of advocacy programs (Aras, 2011). The right product to fulfill the health needs associated with the aggregate, at risk adolescents, includes the offering of health promotion behaviors, description of the benefits of those behaviors, and the offering of supportive services to facilitate the use of new behaviors. While at the same time, the price of the program describes the adolescent’s cost of changing health behaviors or implementing interventions. Offering programs and services to the adolescent in the right place includes offering services in places of convenience as well as places within their comfort zone. Moreover, the right strategy for promoting services to adolescents includes communicating the purpose of the program that makes it familiar, acceptable, and desirable to them. Measurable outcomes
Assessments to measure the outcome of learning include formative and summative assessments. Formative assessments are used to adjust or modify the learning and instructional environment during the implementation of a program. While at the same time, summative assessments are designed to evaluate the knowledge or lack of knowledge of the program participants (Pellegrino, 2010). Associated behaviors and risk factors that contribute to teen pregnancy are numerous. Risk factors for early pregnancy include demographic factors, sociocultural factors, psychological maturity and, cognitive maturity. Associated behaviors that increase risk for early pregnancy include early sexual activity, substance use and abuse, violence and peer influences (Talashek, Alba & Patel, 2006). Measurable outcomes for the adolescent pregnancy prevention program include the reduction in early sexual activity and the reduction of substance use and abuse among program participants. Formative and summative assessment that can be utilized for the evaluation of program outcomes include end-of-unit quizzes, end-of-program tests, criteria and goal setting, and self-assessment (Pellegrino, 2010). End-of-unit quizzes allow program facilitators to evaluate the knowledge and education gained by program participants following each phase of instruction. Moreover, these quizzes offer the opportunity to identify and readdress concepts that were not fully grasped. Program facilitators can administer end-of-program tests to determine the knowledge gained and the extent of behavior changes implemented by program participants at the time of program conclusion. This assessment allows facilitators to determine of program participants have gained the necessary tools needed to continue health promoting behaviors. Criteria and goal setting with program participants involves them in the instruction and learning process by generating clear expectations. Furthermore, self-assessment allows the program participant to reflect upon past, present and future health related behaviors which will increase the level of involvement in learning activities. Impact on Public Policy
The success of a teen pregnancy prevention program will impact public health policy. The impact includes but is not limited to increased public education regarding sexually transmitted disease, increased public offering of contraceptives as well as increased accountability for states to prevent teen pregnancy. Conclusion
Although the teen pregnancy rate in the U.S. continues to be high compared to its counterparts across the globe, great strides are being made to eradicate this epidemic. The use of teen pregnancy prevention programs is essential for the identification of risk factors and behaviors that increase the adolescent female’s likelihood of early pregnancy. Moreover, prevention programs promote the use of interventions and strategies that reduce risk factors and behaviors that place adolescents at high risk for early pregnancy. Pregnancy prevention programs in the community provide teaching and education for both teen and parents to maximize health and wellbeing of the family.
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