Population Aggregate:Pregnancy in Robeson CountyAshley Creech, Kayse Edwards, Sara Kerns, and Jennifer Knott :Population Aggregate:Pregnancy in Robeson CountyAshley Creech, Kayse Edwards, Sara Kerns, and Jennifer Knott


Learning Objectives :Learning Objectives Define the aggregate of pregnancy in Robeson County. Describe the health profile of the pregnant population in Robeson County. Describe the healthcare considerations of the pregnant population in Robeson County. Analyze the problems/needs that are specific to the pregnant population in Robeson County & the associated stigmas.


Learning Objectives :Learning Objectives Identify the barriers to health care access that are faced by the teenage pregnant population in Robeson County. Identify factors that place female teenagers at an increased risk of becoming pregnant. Identify the levels of prevention associated with the teenage pregnant population in Robeson County, addressing the programs and services that are available to this population.


Learning Objectives :Learning Objectives Implement the role of the community health nurse with the teenage pregnant population in relation to the steps in the nursing process.


Definition of Aggregate :Definition of Aggregate Pregnancy: the term used to describe when a woman has a growing fetus inside of her; and, in most cases, the fetus grows in the uterus (National Institute of Child Health and Human Development [NICHD]) Condition lasts approximately 40 weeks, or a little more than 9 months Starts with the beginning of the female’s last menstrual period and lasts until childbirth Confirmed by a positive pregnancy test that detects human chorionic gonadotropin (hCG) hormone in blood or urine, which is only present when a female is pregnant


Definition of Aggregate :Definition of Aggregate Our population aggregate = all females in Robeson County who are pregnant Total in 2007 = 2,608 females


Health Profile of Aggregate :Health Profile of Aggregate Of the total number of pregnant females in Robeson County in 2007, RACE: 62% = Minorities 36% = Caucasian AGE: 35% = Ages 20-24 23% = Ages 25-29 19% = Ages 15-19 MARITAL STATUS: 68% = Unmarried 32% = Married EDUCATION: 12% = None or Elementary 36% = 4 Yrs. HS INCOME: High rate of POVERTY in Robeson County HEALTH PRACTICES (PRENATAL CARE): 28% = Didn’t begin prenatal care until 2 months of pregnancy 27% = Didn’t begin prenatal care until 3 months of pregnancy


Health Profile of Aggregate :Health Profile of Aggregate Of the total number of pregnant females in Robeson County in 2007, HEALTH CARE PRACTICES (MATERNAL SMOKING): 83% = Didn’t smoke 17% = Did smoke HEALTH CARE PRACTICES (MATERNAL WEIGHT GAIN): 20% = gained 10-19 lbs., 30-39 lbs., & 40+ lbs. 26% = gained 20-29lbs. MEDICAL HISTORY: 49% = Had one or more medical problems this pregnancy


Healthcare Considerations of Aggregate :Healthcare Considerations of Aggregate Physical issues: Body changes, digestive difficulties, stretch marks and other skin changes, inability to take several medications Psychosocial issues: Emotional roller coasters, extreme fatigue, sexual intercourse considerations, stress Economical issues: Rising costs of maternal healthcare services, maintaining good maternal health while working, lack of health insurance


Aggregate-Specific Problems/Needs & Associated Stigmas :Aggregate-Specific Problems/Needs & Associated Stigmas #1) Teenage Pregnancy = Pregnancy among females ages 15 to 19 -Robeson County ranked 5th in the state for their rate of teenage pregnancy in 2007! -Why? -Limited recreational activities in Robeson County for teenagers -Lack of education about prevention (Abstinence only school policy) -Attitudes and behaviors of teenagers -Mother was pregnant as a teenager STIGMA: Frowned upon according to the norms, beliefs, and values of society #2) Inadequate Prenatal Care -Prenatal care provides monitoring and support for pregnant women and should be utilized to promote a healthy pregnancy! -Most pregnant women in Robeson County are not beginning their prenatal care until they are 2 and 3 months pregnant! -70% of pregnant teens do not get adequate prenatal care! STIGMA: Poverty and little or no education


Barriers to Healthcare Access for Pregnant Teens :Barriers to Healthcare Access for Pregnant Teens Lack of parental involvement in teenagers’ lives Lack of knowledge about services that are available to them Lack of financial resources (80% of teenage mothers eventually rely on welfare services; High poverty rate in Robeson County) Lack of means of transportation Lack of healthcare facilities (More healthcare facilities in north Lumberton than in south Lumberton) Gap in healthcare access among African American teenagers in Robeson County FEAR of having to tell their parents in order to be seen in a doctor’s office


Risk Factors for Pregnant Teens :Risk Factors for Pregnant Teens Living in a disorganized community Having parents who are separated or divorced Being physically abused by family members Having family members who abuse substances Having family members who model early sexual intercourse or childbearing Having older peers Making poor grades in school Abusing drugs or alcohol Experiencing early menarche Being an African-American Having a paying job and working more than 20 hours per week


Levels of Prevention :Levels of Prevention PRIMARY: -Family Planning Services at Robeson County Health Department -Teen Outreach Program at Robeson County Health Department SECONDARY: -Adolescent Pregnancy Prevention Program at Robeson County Health Department


Family Planning Services :Family Planning Services Offers classes to individuals wishing to plan and space their children in order to improve their own health and the health of their family Includes a comprehensive examination of the reproductive organs and screens for several health problems Class is educational: Educates on all forms of birth control, most sexually transmitted diseases (STDs) and how to prevent them, Participants must attend the class before being scheduled an appointment at the health department The method of contraception that is chosen by the participant will be provided at a cost that is based on income Saves $4.3 billion in public funds


Teen Outreach Program (TOP) :Teen Outreach Program (TOP) Grant-funded program Promotes positive adolescent development helping teens to develop communication, decision-making, and goal setting decisions Helps teens participate in community service projects which helps them develop confidence, learning skills, and positive self-esteem Proven effective by a 33% lower rate of teen pregnancy


Adolescent Pregnancy Prevention (APP) :Adolescent Pregnancy Prevention (APP) A way to strengthen preventative services that are available to adolescent parents in Robeson County Over 90% of the adolescent parents that have participated in this program have not experienced a second repeat pregnancy while in the program


Community Nursing Diagnoses :Community Nursing Diagnoses #1: Risk of knowledge deficit among adolescents ages 15 to 19 in Robeson County related to: A. Safe sex practices B. Services that are available to them #2. Risk of inadequate access to healthcare among adolescents ages 15 to 19 in Robeson County related to: A. Lack of transportation B. Lack of health insurance or adequate finances


The Plan for Intervention :The Plan for Intervention Target population: Females from age 15 to 19 in Robeson County Objectives: Upon completion of the nursing intervention, the target population will be able to: A) Describe the prevalence of teenage pregnancy in Robeson County; B) Identify precautions that should be taken in order to practice safe sexual behavior; C) Demonstrate the ability to make an informed decision about which form of contraception will be best for them; and D) Describe the programs and services that are available to them through the Robeson County Health Department


The Plan for Intervention :The Plan for Intervention Method: INTERNET MYSPACE -MySpace has been proven to be highly utilized by our target population as a means of interacting and connecting with friends -Females have been proven to use MySpace more frequently than males Information included: -The variety of contraception methods and their characteristics -Different forms of STDs and how to prevent them -Real life scenario of a pregnant teenager


The Plan for Intervention :The Plan for Intervention Time Frame: November 13, 2008 – End of the semester Plan for Evaluation: -Profile Views -Poll Short-term Goals: -Increase the awareness of the issue of teenage pregnancy in Robeson County among teenagers ages 15-19 -Increase their knowledge of prevention methods they can use to prevent pregnancy Long-term Goals: -Potentially decrease the rate of teenage pregnancy in Robeson County


Problems Encountered in Planning :Problems Encountered in Planning Problems related to accessing our target population: -Robeson County’s school policy of “ABSTINENCY ONLY” sex education -Subject matter of teaching plan


Community Nursing Intervention :Community Nursing Intervention EDUCATOR -MySpace Webpage http://www.myspace.com/teenpreggorobco ADVOCATE -Advocating at the State Level Letter to legislature


Evaluation :Evaluation Number of Profile Views As of Tuesday, November 18, 2008: -36 people have viewed our MySpace profile Number of Friends As of Tuesday, November 18, 2008: -We have 11 friends on MySpace Poll: Was the information on this website helpful? As of Tuesday, November 18, 2008: -There were no votes related to the poll


Evaluation :Evaluation Unfortunately, we will be unable to evaluate the achievement of our long-term goal during this project. The time-frame limits of this project make this impossible to do within this semester.