Documente Academic
Documente Profesional
Documente Cultură
in Reducing Teen
Pregnancy
By Jaime Munoz, Rebecca Griesse, and Phil Basso
O c to b e r 2 0 16
Policy&Practice
25
Jamie Munoz
is administrative
manager II at the
Orange County
Social Services
Agency's Children
and Family Services
Division.
Rebecca Griesse
is senior manager
of Programs at The
National Campaign
to Prevent Teen
and Unplanned
Pregnancy.
26
Policy&Practice
O ctober 2016
1. C ontact th e e x p erts
In addition to the John Burton
Foundations expertise in Californias
transition age youth in foster care,
the American Public Human Services
Associations expertise in organiza
tional change and effectiveness, and
The National Campaign to Prevent
Teen and Unplanned Pregnancys
expertise in pregnancy prevention,
the California Foster Youth Pregnancy
Prevention Institute also enlisted teen
reproductive health law expertise
from the National Center for Youth
Law, pregnancy and parenting among
foster youth data expertise from
the Childrens Data Network, and
evidence- based intervention exper
tise. These helped clarify urgency and
authority to act and, thereby, facili
tated responsibility to act.
These were especially critical during
the formative stage to inform policy
development and strategic planning,
and to solidify local internal and
external support. For example, these
helped answer questions like...
What is the prevalence of pregnancy
and parenting among youth and
young adults in care compared to
their peers not in care?
How do we compare with other
counties?
What is the cost of doing nothing?
What is the cost of doing something?
What are contributing factors?
What are tried-and-true
interventions?
What are the rights and responsi
bilities of youth, their parents, and
child welfare services, and under
what conditions do they exist? In
California, we were supported by the
passage in 2014 of Senate Bill 528,
3. Get th e fu ll p ictu re
At the beginning, we were so singu
larly focused on reducing pregnancy
and sexually transmitted infection that
we confused this with our end goal.
We then realized that pregnancy pre
vention was a breakthrough strategy
to realize improved successful tran
sition to adulthood outcomes (e.g.,
education, employment, income, and
childrearing). See Figure 1, which
presents this strategy from a social
determinants of health lens.
We integrated strategies throughout
child welfare practice by providing
common ground, shared resources,
cohesion, and deeper anchoring of
the interventions. For example, we
strengthened existing strategies that
help youth and young adults anchor
a future outlook through access to
services and normalcy activity consis
tent with the Youth Thrive Framework,
including interventions focused on
sexual and reproductive health.
4. C om plete a r e a d in e ss
a s se ss m e n t
Assess the political landscape, key
stakeholders (e.g., internal and external
leadership, social workers, youth,
parents, foster and kinship caregivers),
and accessible resources to identify
quick wins to galvanize momentum,
identify minefields, determine
first steps, and develop a malleable
F ig u r e 1: P r e g n a n c y P r e v e n t io n a s a B r e a k t h r o u g h
S t r a t e g y f o r S u c c e s s fu lT r a n s itio n to A d u lth o o d
Physical Environment
Health Behaviors
5. Id en tify an d cu ltiv a te
d e d ic a te d le a d e rs
r (A)(WwW(*
E d u c a t io n
J o b S ta tu *
F a m ily /
S o c ia l
S u p p o rt
In c o m e
C o m m u n it y
S a fe ty
J 5 ) ife?
T o b a c co U se
D ie t &
A lc o h o l U v e
S exual
Health Care
A c c e s s to C a re
Q u a lit y o f C a re
t r e e im tM u te f o r C teiical S y s te m * in ip tu s e n u rn t. G o in g B eyond
n c a i W a il* S o lv in g C o m p le x P ro b le m * ( O c to b e r 2014)
T h e B r id g e s p a n G ro u p
F ig u r e 2 : S t a r t i n g P o in t s
Training
Reasonable &
Prudent Parenting
Resource Guide
Standard
Resource Guide
Data Collection
Medical Provider
Report w ith
prompts for
Improved Practice,
Improved Outcomes
reproductive
health, HPV &
OBGYN referral
Youth Engagement
Resource Guide
PHN
In-Home Visitation
Planning Conference
for Expectant/New
Parents
Askable Adults
O ctober 2016
Policy&Practice
27
6. P ractition er to o ls
are e ss e n tia l
These require significant frontload investment but yield a favorable
return in the form of policy and
practice fidelity. We produced a
reproductive and sexual health
policy, a reproductive and sexual
health resource guide, youth consent
rights notification, a medical provider
report with reproductive and sexual
health prompts, and training for
social workers (with separate modules
on policy, soft skills, and technical
skills). These tools were heavily vetted
by the Steering Committee and with
subject matter experts. These tools
were also developed through an
iterative process to reduce them to the
simplest essentials.
7. Youth n e e d a sk a b le
a d u ltsThe m ore
th e b etter
Some will be naturals and most
will benefit from training and support
to develop the comfort and skills of
an askable adult. They can include
parents, family members, social
workers, judicial officers, courtappointed special advocates, foster
and kinship caregivers, transition-age
youth service providers, and attorneys.
Your plan should include strategies
9. H ealth y sex u a l
d e v e lo p m e n t is n o t
a ll a b o u t sex
It is important to attend to the
foundation of healthy sexual devel
opment by developing healthy
relationships with peers and adults
shaped by normalcy activity (see
http://www.aecf.org/resources/
what-young-people-need-to-thrive/)
F ig u re 3: P re g n a n c y P re v e n tio n as a B re a k th ro u g h S tra te g y fo r
S u c c e s s fu l T ra n s itio n to A d u lth o o d - A n o th e r V ie w
Youth/young adults
engage with
sexual/reproductive health
"askable adults"
Fewer youth/
young adults have
resources.
mistimed/unintended
pregnancies that
may inhibit their path
to socio-economic
securityto
Youth/young adults use the
successful transition
to adulthood.
contraception to decide
to prevent STI.
40
11. D o n t fo r g e t th e m a le s
It is important to counteract the
societal bias to primarily target
females in pregnancy prevention
strategies. Interventions and outreach
should actively engage both males and
females.
O ctober 2016
Policy&Practice
41
T E E N P R E G N A N C Y c o n t in u e d f r o m p a g e 41
www.ocwomenshealth.org
- Teen Reproductive Health Policy
Brief: https://drive.google.com/file/
d/0BzP6_yQYcZh6WkFOTGO2 UUxXRO U/
view?pli=l
http://adolescentaids.org
- The Deal (teen lifestyle zinewith real
http://adolescentaids.org/youth/deal.html
Annie E. Casey Foundation: www.aecf.org
- What Young People Need to Thrive:
http://www.aecf.org/resources/
what-young-people-need-to-thrive/
BridgespanGroup: www.bridgespan.org
reform/child-welfare/youth-thrive
- Expectant & Parenting Youth
in Foster Care: http://www.
cssp. org/reform/child-welfare/
expectant-parenting-youth-in-foster-care
- Get R.E.A.L.: http://www.cssp.org/
reform/child-welfare/get-real
Child Trends: www.childtrends.org
www.thenationalcampaign.org
- Child welfare resources for CWS
thenationalcampaign.org/data/landing
2. Midwest Evaluation of Adult Functioning
of Former Foster Youth, http://w w w .
chapinhall.org/research/report/midwestevaluation-adult-functioning-formerfoster-youth
42
Reference Notes
www.jimcaseyyouth.org
- Compilation of adolescent brain
childtrends.org/5-things-to-knowabout-intimate-partner-violence-andreproductive-health/
www.datanetwork.org
- Research briefs related to pregnancy
Policies
- Orange County, CA: http://ssa.ocgov.
com/civicax/filebank/blobdload.
aspx?BlobID=46977
- Los Angeles County, CA: http://policy.
dcfs.lacounty.gov/content/Youth_
Development_Reprod.htm
- Santa Clara County, CA:
http://escholarship.org/uc/
item/48p3r3hl#page-l
- New York City, NY: http://www.nyc.
gov/html/acs/downloads/providers_
newsletter/novl0_2014/141029_
Sexual_&_Reproductive_Health_Care_
signed.pdf
- Dissertation: http://escholarship.org/uc/
item /48p3r3hl# page-1
October 2016
4.
Child%20Welfare/Cumulative%20
Teen%20Birth%20Report.pdf
http://www.chapinhall.org/research/
report/findings-california-youthtransitions-adulthood-study-calyouth
C L IE N T S A F E T Y c o n t in u e d
fro m p a g e 2 9
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