A windshield survey was done on the community of Sparta, Michigan. When looking at the information compiled in the survey, it is found that there is an issue of high rates of teen pregnancy. In Kent County the teen pregnancy rate is 44.4% while the Michigan rate is 41.1% (Michigan Department of Community Health, 2015). The contributing factors for these increased percentages is also brought to attention. These are increased rates of unmarried partners, and higher rates of single parent households. With this in mind, a problem statement is formed; Teenagers of Sparta, Michigan are at risk for pregnancy due to lack of education, poverty, and rape in their community. The health promotion model is then conformed to address teen pregnancy. Groups affected by teen pregnancy is then looked at. The resources for teen pregnancy in Sparta are identified. It was determined that there is a need to try to change the rate of teen pregnancy within Sparta. Education on contraceptives and pregnancy was found to be lacking. Areas in which more education could be implemented include the local schools. A SMART goal is then identified, to decrease the number of teenage pregnancies in the Sparta area by five percent in two years. Based on the SMART goal, interventions are then suggested to help achieve the end result. Finally, the evaluation process is explained.
Windshield Survey: Sparta
The township of Sparta, Michigan is located just north of Grand Rapids with a population of 4,203. This small community is made up of friendly neighborhoods, rich agricultural landscapes, local businesses, and community coordinated events. Within the limits of Sparta one can find shopping, dining, health and wellness services, local pubs, and many widespread community events, festivals, and fairs (Village of Sparta, Michigan, 2015). A windshield survey was done on the community of Sparta, Michigan. When looking at the information compiled in the survey, it is found that there is an issue of high rates of teen pregnancy. In Kent County the teen pregnancy rate is 44.4% while the Michigan rate is 41.1% (Michigan Department of Community Health, 2015). The contributing factors for these increased percentages is also brought to attention. These are increased rates of unmarried partners, and higher rates of single parent households. With this in mind, a problem statement is formed; Teenagers of Sparta, Michigan are at risk for pregnancy due to lack of education, poverty, and rape in their community. The health promotion model is then conformed to address teen pregnancy. Groups affected by teen pregnancy is then looked at. The resources for teen pregnancy in Sparta are identified. It was determined that there is a need to try to change the rate of teen pregnancy within Sparta. Education on contraceptives and pregnancy was found to be lacking. Areas in which more education could be implemented include the local schools. A SMART goal is then identified, to decrease the number of teenage pregnancies in the Sparta area by five percent in two years. Based on the SMART goal, interventions are then suggested to help achieve the end result. Finally, the evaluation process is explained.
Benchmarks and Local Data
Sparta is a rural community that consist of 92.5% Caucasian, 4.2% Hispanic and 1.2% African American’s (City Data, 2015). In Sparta, Michigan, the estimated median household income is $41,932, which is lower than the estimated median household income in Michigan which is $46,859 (City Data, 2015). When breaking down the crime rates, Sparta has a lower average crime rate for all categories except rapes and thefts. Sparta reports a rate of 143/100,000 rapes in 2012, while the U.S. rate is 27/100,000. Sparta reports 2,128/100,000 thefts, while the U.S. rate is 1,974/100,000 (City Data, 2015). Statistics could not be found for pregnancy rates of Sparta Township specifically, but in Kent County the teen pregnancy rate is 44.4% while the Michigan rate is 41.1% (Michigan Department of Community Health, 2015).
A contributing factor to the higher rates of teen pregnancy may be that Sparta has a higher rate of unmarried partners who live together compared to Michigan. Sparta has a rate of 8.3% whereas Michigan has a rate of 6.4% (City Data, 2015). Other factors may include the amount of single parent households in Sparta, which is 22.56%, which is about 5% higher than Michigan (Sparta, Michigan data snapshot, 2015). Also, while doing a windshield survey there were few local medical facilities or community health buildings in which teens could seek proper information. When looking at other data provided about Sparta, the rate of rapes is considerably higher and this could also contribute to the teen pregnancy rates.
According to Muecke, “Community health nursing integrates the epidemiologic approach with the nursing process to make fundamental decisions about care at the level of the population as a whole (Muecke, 1984, para 3)”. The way we go about this is by formatting a problem statement. Our problem statement for Sparta is; Teenagers of Sparta, Michigan are at risk for pregnancy due to lack of education, poverty, and rape in their community. This is evidenced by lack of resources, high rate of unmarried couples, single parent households, high rates of rape, and low community income.
Health Promotion Model
“Health promotion can be defined as the process of empowering people to make healthy lifestyle choices and motivating them to become better self-managers” (Education Portal, 2015, para 4.). This model fits with bringing down the rates of teen pregnancy because we need to empower the teens to make healthy life choices for themselves. In this theory created by Nola Pender there are four assumptions. First, individuals will strive to control their behaviors. Secondly, individuals will work to improve their environment and themselves. Third, health professionals will comprise the interpersonal environment that influences individual behaviors. Lastly, self-initiated change of one’s self and one’s environment is essential to changing behavior (Education Portal, 2015). When evaluating these assumptions it’s easy to see why it is a good match for teen pregnancy. In most cases, teens are responsible for making choices that lead to pregnancy, and to lower the rates of teen pregnancy there needs to be education available to teach them how to advocate for themselves and prevent pregnancy.
Groups Affected By Teen Pregnancy
One group who is affected more often is the African American teens who have a rate of 88.7% compared to Caucasians who have a rate of 28.4% (Michigan Department of Community Health, 2015). Another group more at risk for teen pregnancy is children of single parent households. In Sparta, 22.56% of the households are single parent households compared to Michigan with a rate of 17.21% of the households are single parent households (Sparta, Michigan data snapshot, 2015).
When researching areas teens can go for help we used a mixture of the windshield survey and Google maps. In Sparta there is a Spectrum Health Medical Group that will see these pregnant teens if they are patients there. Another location they could visit for help is the Mercy Health Saint Mary’s Family Health Center in Sparta. If the teen has access to transportation there are many resources they can utilize in Grand Rapids, Cedar Springs, and Newaygo, but if they do not there are not adequate resources for them in the local area. Most resources these teens can utilize are in Grand Rapids Michigan which is approximately twenty minutes south of Sparta.
Evidence of Need
Community health nursing is needed in this area as evidenced by the high rate of teen pregnancy in comparison to other areas. As a nurse, one of our priorities for our patients is education. In Sparta, there is a lack of knowledge when it comes to risk factors and prevention of teenage pregnancy. It is our job to try to educate the community as much as we can about the risk factors that contribute to teenage pregnancy. Also to make sure that the teenagers are adequately informed on birth control, safe sex, and resources that help with sex education and pregnancy.
Disciplines and Community Groups
School is an important place to ensure teenagers are getting education on safe sex and pregnancy prevention. Local doctors offices and health centers also help educate by talking to their teenage patients and providing them with education materials and resources. Being a highly religious area, churches can participate in educating the teens and provide help if they do become pregnant. Youth groups may promote abstinence, healthy communication about sex, and safe sex in a non-threatening environment. A community group who may help decrease the rate of teen pregnancy is an agency such as Big Brothers Big Sisters where the teen can have a mentor to help them make healthy life choices. Their mission statement states “Provide children facing adversity with strong and enduring, professionally supported one to one relationships that change their lives for the better, forever”(Big Brother Big Sisters of America, 2014, para. 3). If a teen does become pregnant, they may utilize disciplines such as social workers or case managers to help them find resources for themselves and the baby.
As community nurses in the town of Sparta we are concerned with the above normal rates of teen pregnancy. Our goal is to decrease the number of teenage pregnancies in the Sparta area by five percent in two years. Our team will track this data by obtaining all of the birth records in Kent County and reducing the number down to just Sparta residents. The team feels that this is an attainable goal. Further assessment will be required at the two year mark to compare our data and make changes to the program as needed. This group of community nurses takes full responsibility in initiating the training and starting any training or providing any resource needed to obtain this goal.
Since this appears to be a community problem the team felt the problem should be dealt with by starting at the base of the problem. The team felt that there was a huge demand for increases in education for both the teenagers and parent/s as well as the school’s sex education program. Initially we would like to assess the content of the junior high and high school sex education making sure that it covered the information we wanted, mostly pertaining to methods of contraceptives and places they are able to obtain them. One study showed that educating on abstinence as well as other contraceptives and not just abstinence, had the lowest rate of teen pregnancy, 56.36 in 1000 girls from ages 14-19 (Stanger-Hall, & Hall, 2011, para 13). As part of our school curriculum we wanted to address the right way to use each contraceptive as well. Since we were going to possibly be altering the curriculum before it was finalized we wanted the support of as many parents as possible. The team felt that informing the parents prior to the change would allow for any questions they may have and would let us properly answer those questions. In order to do this we would like to host a series of information sessions at the public high school allowing the parents to see our powerpoint. Secondly, we assumed that if the families in Sparta were going to the doctor they were using the clinics close to town, which left them with few options. However, with few options that left us with less work to do. The team wanted to inform the local doctors of this health issue, explain to them our goals and set some resources in place at each clinic. In each clinic we would like to have multiple forms of birth control available as well as pamphlets available for the teens to read. Thirdly, we felt that the town of Sparta had limited local resources to aid us in this problem. The county has good resources but if the student was not mobile it would be difficult for that teen to get to the Kent County Health Department. The team had two thoughts on how to remedy this problem. First we would ask the Health Department if they could spare some supplies to give to our local doctors offices or that we could use and pass out on our own. If the Health Department was not receptive to this we would like to set up a system of volunteer drivers that could take the students down to the Health Department. Lastly, if we could get the resources we would like for the High School to allow us to run a clinic on our own after school that would allow us to answer questions, provide information and provide birth control as well as private sessions if needed.
The team from Sparta set a goal of evaluating the results of work two years after implementation. We hoped to achieve a minimum decrease in pregnancies by five percent in that time frame. In order to compare the rates we would consult the Kent County Health Department and figure out how many teenage births Sparta had in the last ten years. We would then put the ten year average up against the rates we had in our two year window. If the trend appeared to be heading in the right direction we would like to continue our program as allowed adding or deleting pieces as needed. If the program appears to not work we may have to reanalyze our methods. The Sparta team is confident that if allowed to implement even part of the suggested plan in two years time we will achieve our goals.
Big Brothers Big Sisters of America. (2014). Changing perspectives changing lives. Retrieved from http://www.bbbs.org
City Data. (2015). Sparta, Michigan. Retrieved fromhttp://www.city-data.com/city/Sparta-Michigan.html
City Data. (2015). Crime rate in Sparta, Michigan (mi): murders, rapes, robberies, assaults, burglaries, thefts, auto thefts, arson, law enforcement employees, police officers, crime map. Retrieved fromhttp://www.city-data.com/crime/crime-Sparta-Michigan.html
Education Portal. (2015). What is the health promotion model?-definition and theory. Retrieved from http://education-portal.com/academy/lesson/what-is-the-health-promotion-model-definition-theory.html
Michigan Department of Community Health. (2015). Teen pregnancy rates by county. Retrieved fromhttp://www.mdch.state.mi.us/pha/osr/abortion/pregbycoteen.asp
Michigan Department of Community Health. (2015). Pregnancy trends. Retrieved from http://www.michigan.gov/mdch/0,4612,7-132-2944_4669_4681
Muecke, M. (1984). Community health diagnosis in nursing. Public Health Nursing,1(1), 27- 27.
Sparta, Michigan data snapshot. (2015). Retrieved from http://locallabs.org/sparta-michigan
Stanger-Hall, K. F., & Hall, D. W. (2011). Abstinence-Only education and teen pregnancy Rates: Why we need comprehensive sex education in the U.S.PLoS ONE, 6(10), e24658. doi:10.1371/journal.pone.0024658
Village of Sparta, Michigan. (2015). Living in Sparta. Retrieved from http://www.spartami.org