Nursing Teen Pregnancy Prevention Program

Teen Pregnancy Prevention Program Dotlyn Robertson

NUR/598

Abstract

The issue of controlling and preventing teenage pregnancy is a major problem in society. Teenage pregnancy is a significant health issue that plagues our nation and communities. Community and public health nurses are faced with the challenge of addressing teen pregnancy, a monumental health issues that affect vulnerable populations in society. Effectiveness of healthcare interventions depends in part, on the approach that is taken in addressing the presenting issues (Shi & Stevens, 2005). Factors that contribute to teenage pregnancy span socioeconomic, cultural, and psychological issues that are perpetrated by individual characteristics (of the teenagers), peers, family members, and the greater society (Maurer & Smith, 2009). Data from the Centers for Disease Control and Prevention note that in 2009, more than 500,000 children were born to mothers of ages 15 to 19 years, at a rate of 45.5 per 1000 mothers (Centers for Disease Control and Prevention, 2010, para. 1). Teenage pregnancy, a public health priority for youths, is a multifaceted health issue that is influenced, in part, by socioeconomic factors such as peer pressure, low income of families, and the media (Maurer & Smith, 2009; The National Campaign, 2010). Likewise, teenage pregnancy also creates socioeconomic and health problems for teenage mothers, teenage fathers, their children, and society. Some of the effects of teenage pregnancy on the children of teen parents are prematurity, low birth weight, inadequate nutrition, child abuse, and replication of the patterns of school dropout. Teen pregnancy prevention programs that are based on appropriate theoretical frameworks play a vital role in the quest of optimal health and wellbeing for adolescents (Maurer &Smith, 2009 Nursing Teen Pregnancy Prevention Program).

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The proposal for this nursing research utilization project is to educate nurses on the importance of decreasing teenage pregnancy using evidence base research to implement education and training. Addressing the issue of teenage pregnancy requires healthcare workers to be cognizant of contributing factors to the issue and barriers to interventions, and to col aborating with stakeholders in the greater community (Maurer & Smith, 2009). A primary prevention approach can be used through a youth development program, in the community to reach teens, focusing on the overal prevention of teenage pregnancy. Providing teenagers with the necessary resources to develop skil s, learn responsibility, improve academic performances, develop constructive relationships, develop self-worth, and develop self-confidence, in order to become healthy and productive adults (USDHHS, 2010b).

The educational research utilization proposal project wil include supportive data from reliable research studies, an action plan on how to implement dif erent strategies to help healthcare providers come up with ways to address teen pregnancy. A post- test wil be given at the end of the presentation to measure and evaluate staf ef ort and interest in the proposal solution. Upper management and nurse educators wil work col aboratively through al the phases of the evidence base proposal educational program to help staf by providing support, and tools needed to reach the goal outcomes of the project proposal.

Section A: Problem Identification

Teenage pregnancy is a significant health issue that plagues our nation and communities. Community and public health nurses are faced with the chal enge of addressing teen pregnancy, a monumental health issues that af ect vulnerable populations in society. The purpose of this project is to explore a significant health issue that af ects a particular population, and describe a general approach that wil be taken to address the significant health issue.

Problem

The short term case management team (SCM) at Wel Care has identified a lack of current experience, comfort and competence in teaching and caring for the vulnerable population of pregnant teens in the community and has voiced concern at this lack of knowledge. Wel Care is one of the leading providers of services to vulnerable population of medicare and medicaid patrons in Florida. This problem is a serious concern for government, healthcare providers and communities in which these teens live. Teen pregnancy puts a financial burden on tax payers/government, their families and communities (FDH, 2013 Nursing Teen Pregnancy Prevention Program).

Teen pregnancy is a world-wide problem. Of al the developed nations the United States has the highest rates of teenage pregnancy and births accounting for approximately $11 bil ion per year in costs to taxpayers. In the state of Florida an estimated $600 mil ion is spent on pregnant teens annual y. According to the Florida Department of Health two-thirds of families started by teens live in poverty and nearly a quarter of teen mothers wil depend on welfare within three years of the birth. More often than not, these families are single-parent household; also children of teen mothers are more likely to have contact with the child welfare and criminal justice systems. According to the Florida Health department these pregnancies suggests that these negative reports suggest it is very important and necessary to focus on an evidence- based solution to help reduce teen pregnancy (FDH, 2013),

In the state of Florida, African American, Hispanic/Latino youth, and American Indian/Alaska Native youth experience the highest rate of teen pregnancy. Socioeconomical y disadvantaged youth of any race or ethnicity experience the highest rates of teen pregnancy and childbirth. In Florida the highest rate of teen pregnancy are among 18 to 19 year old fol owed by the 15 – 17 year-old age group. African American and Hispanic or Latino youths are more likely than white teen girls to have unprotected sex, thus exposing them to pregnancy. (OCFDH, 2013).

Support

Research has shown that teens who received comprehensive sex education were 60 to 70 percent less likely to become pregnant over those that received no sex education. According to Don Operario, a professor at Oxford University in England states studies provides “further compel ing evidence” about the value of comprehensive sex education and the “inef ectiveness” of the abstinence-only approach (Kohler et al, 2011). The United States Department of Health and Human Services (USDHHS) also outlines various teen pregnancy prevention programs such as the Teen Outreach Program (TOP) (USDHHS, n.d.). TOP, a national youth development program, educates teens on areas including communication skil s, identification of values, goal-setting, sexuality, and decision- making (USDHHS, n.d.). The USDHHS (2010) describes the Preventing Adolescent Pregnancy Program, an initiative of the Volunteers of America Los Angeles that aims, in part, to prevent teen pregnancy. In addition to focusing on skil s development in, and the motivation and support of, teens, the program also promotes participation of parents in sexuality education (USDHHS, 2010).

Objectives

The objective of the program is (a) Promote responsible sexual behavior, (b) Increase access to contraceptives, and

(c) Improve self-worth and self-esteem. The outcome objective for this project is for staf at Wel Care organization who attend the teen pregnancy educational classes to score a 90% or higher on the post-test after each training session in order to evaluate employee knowledge on the topic. Any employee who scores less than 90% on the posttest wil need to repeat the training session.

Solution

The way to reduce teen pregnancy is to implementing an educational training program to educate the staf in regard to confirmed teen pregnancy prevention program. Monthly educational sessions on teen pregnancy prevention wil be held in the fourth floor conference room. Other agencies involved in trying to solve teen pregnancy the Center for Disease Control (CDC). The CDC has put in place, Teen Pregnancy Prevention 2010–2015, and has partnered with the President’s Teen Pregnancy Prevention Initiative (TPPI), and the federal Of ice of the Assistant Secretary for Health (OASH) to reduce teenage pregnancy and address disparities in teen pregnancy and birth rates (CDC, 2010-2015). The goal is to equip staf members with as much information as possible, so they wil be able to address this significant health issue that plagues the teen population

Section B: Solution Description for Nursing Teen Pregnancy Prevention Program

Proposed Solution

The proposed solution to the problem includes an education project to train staf how to care for pregnant teens in the community. These wil include information, simulated practice and actual participation in education classes utilizing computerized learning modules and quizzes, to reinforce knowledge and skil s of preventive measure to address teen pregnancy. Education wil al ow for practice and reinforcement on real life observation and practice These wil help to solve the problem since the nurses themselves stated, practice and refreshers wil help them to stay on the “cutting edge” of delivering care and delivery. The goal of educational classes is to come up with a set of strategies aimed at reducing teen pregnancy as wel decreasing the financial burden on the community and to Wel Care.

Current Research Knowledge.

This solution is consistent with this longitudinal study results, carried out by Zabin, Astore and, Emerson, (1999).

In this study teen Voice/teen Choices, a prevention program aimed at reducing myths among adolescent concerning teen pregnancy. The Parent Child (PCC) is a not- for -profit based community agency that work with teens in the community to prevent teen pregnancy and maltreatment. Teen Voices/teen Choices utilizes teen choices utilizes teen parents as peer educators to teach other youths in the community. In this study by, Schaf er, Jost, & Lair (2008) outline ef orts implemented by the Pregnancy-Free Club to prevent repeat teenage pregnancy. The Pregnancy-Free Club focuses on tertiary prevention. The Pregnancy-Free Club (PFC) was started in 1998-1999 by public health nurses in col aboration with the school district and a community hospital with the goal to prevent repeat adolescent pregnancy. Among the ef orts of the PFC are education on contraception, development of constructive relationships, mentoring, and goal setting (Schaf er et al., 2008).

Feasibility.

This is a feasible solution that can be implemented in our practice. The idea of implementing this program has been discussed with the manager of human resource, the manager of the education department and the manager of our department. And al have given consent and a proposed budget to help provide tools to develop the program. Some of the ideas for a solution to the teen pregnancy prevention program came from the manager and staf . This is advantageous since grassroots ideas have a better chance of acceptance from the people who are to be af ected.

The manager of the Education department has been onboard from the inception of the idea and has made some suggestions and has offered to assist with the compilation of the information necessary. She is knowledgeable about Wel Care policies and procedures and guidelines related to community services. She has also solicited input from other staff in her department requesting information that is compatible to developing community projects.

The administration and the human resource department have expressed their approval of the project and have offered their support. Both entities have decided to allocate some funds earmarked annual y for education, on this project. The physical setting is very conducive to the project since teen’s frequent community centers in their areas. This proposed project, having a bottom up conception; a readily recognizable risk reducing role; the ability to fit into previously existing space; the advantage of ready funding; and the cooperation of the education department of multiple satellites, is extremely feasible.

Organizational Culture

Wel care prides itself as a leader in delivery of diverse care to a vulnerable population. Many items of policy are based on best practice guidelines and competencies as is required by HIPAA, Center for medicare & Medicaid Services (CMS) and Agency for Health Care Administration’s (ACHA). Wel Care supports and engage in community volunteer programs. The Wel Care system has been listed in the “US News & World Report” magazine’s as the most improved in delivery of services to a vulnerable population. The nurses, through the Wel Care Council are familiar with the formulation of company policy based on the input of the staf nurses.

Innovation, education and preparation are second nature to the Wel Care system. Wel Care values and continual y strives for improvements in patient delivery of services that wil give patients optimum care; by matching healthcare needs with service delivery capability. This project wil enhance service delivery capability to address a significant health issue.

Section C: research support Research Base

The purpose of this research study was to examine whether adolescent perceptions of teenage pregnancy change from a one-session program intervention of having teenage mothers discuss their pregnancy, labor, and parenting experiences with adolescents attending public school.

Research Design Used: Longitudinal study

Evaluation design of this program was a one-group pretest and posttest. This particular design is mostly used in randomized control trials or when comparison groups are not appropriate or cannot be implemented. The project was developed as a one-session intervention administered to teens from ninth through 12th grades by two teen mothers at the county public high schools.

Sample Size

Sample size consisted of students attending four public high schools in Washington County, Maryland, on the day of the program. Participants attend a coed health class, which was mandatory. The program was administered by a nonprofit community agency not associated with the educational system. Analysis was carried out on 126 surveys; one survey was discarded due to the participant only completing the posttest survey. Race was a nominal variable; however, because the majority of participants indicated Caucasian as their race, the variable was col apsed into a dichotomous variable of Caucasian and non-Caucasian. Based on categorization of, 12.7 percent (n = 16) of sample was not Caucasian and 85.7 percent (« = 108) was Caucasian; two participants did not indicate race.

Mean age of participants was 15.5 years. Half of the sample was male (51, 6 percent, n = 65), and 47, 6 percent was female (M = 60); one participant did not indicate gender (Zabin et al, 1999 Nursing Teen Pregnancy Prevention Program).

Setting

A rural county in western Maryland, Washington County. The program is a one-session intervention administered in ninth to 12th grades health education classes of the county public high schools.

Data Collection Instrument

Data was collected by using pre and post- test questionnaire. The instrument was a two-sided sheet of paper with the pretest and demographic questions on one side and the posttest questions on the other side. Thus, the pre- and posttests were easily matched yet anonymous. There were three pretest/posttest questions. Prior to the start of the session, participants were administered the instrument and instructed to complete only the pretest. Then, at the end of the program, the participants were instructed to complete the posttest. Demographic questions were only asked at pretest. The agency employee then col ected the forms. Permission was granted by the community agency to use the archived data, and the Committee on Research with Human Subjects at Shippensburg University approved this study.

Data Analysis

Data was analyzed using descriptive and inferential statistics. Descriptive statistics comprised of frequencies, means and medians fol owed by running paired sample t tests. In analyzing paired sample t test was used. Independent sample t test was used to identify gender dif erences (Minnick & Shandler, 2011).

Results

The results of the study showed a significant dif erence in the pre & post -test results between the sexes, in the manner they believe that having a child wil bind them in a relationship [t (122-3.58, p =.000} at pre-test- t test results at post-test by gender on whether having a baby wil keep them together [t (121.6) = -2.76, p = 0007}. The results were statistical y significant with both groups having an increase in knowledge (Minnick & Shandler, 2011). Internal validity

Because retesting was done in a relatively short period of time, it posed a significant threat to the internal validity of the study and therefore they could not of er a reasonable explanation for the improvement seen in the results, therefore they were unable to say if test would provide the same results in a dif erent location (Minnick & Shandler, 2011). Researches did not participate in collecting the data.

External validity: Because the participants were selected in a convenient manner, generalization of the results is limited. Also data was col ected by two peer review participants and agency personnel

Strengths / Limitations

Instrument that as used to col ect data al owed researchers to the best answers for the research study also sample size was adequate

The limitation in the design is the generalization of the results, and researchers were unable to say if the test would provide similar results in a dif erent location. The test was only one session intervention administered to ninth to 12th grade students and there were no comparison groups. Test was administered by two peer educators and agency personnel and 87.5 (108) percent of sample size was Caucasian (Minnick & Shandler, 2011 Nursing Teen Pregnancy Prevention Program).

Essential Components

The research question, the theory, the model, the data and use of the Data was instrumental in developing this research study.

Section D: Implementing the Plan

Change is an essential aspect of continuous improvement. The methodology use in any improvement requires that the change be introduce and the impact of the change needs to be measurable. Education should be used an instrument to fight teenage pregnancy. As stated by Berwick “every system is perfectly designed to achieve exactly the results it gets.” This project requires a series of activities that wil be used to solve a particular problem within a specific time frame.

Methods

This can be accomplished through training which is the first method that wil be used to implement the proposed solution. Additional y training of the staf to help eliminate teen pregnancy wil promote confidence in the staf , reduce stress and prepare them for the change. Support mechanism wil be in the form of advertisement for the project such as e-mail reminders, flyers, posters and evaluation of project at each milestone to determine if the plan is ef ective and been adhere to.

An important element of having a successful implementation of change is to have “buy in” and the trust of those the change wil af ect the most. According to Gilbert, J. (2011) states that staying focus on the change process and working toward it wil help build trust and success to the change process

Resources needed for the proposed solution’s implementation

The resources needed include developing a power point presentation, purchasing learning modules, labor, and the cost of staf (having nurses participate in training sessions) and the cost of implementing and using the products and equipment’s.

Methods for monitoring solution implementation

The initial measure wil be to look at the result of the pre and post test to determine whether there was a change after the didactic presentations. A quantitative review of the data wil be performed to determine its ef ectiveness. Implementing the program wil require several steps. To ensure the successful implementation of the program, observation of al staf involved during and after training wil be done. Participants wil be asked to complete a survey questionnaire upon arrival to the in-service to be completed after the presentation to document the success of the program. Another important method in the implementation process is the use of col aboration between staf members. Col aboration wil help the staf in reinforcing the propose change that wil be implemented and encourage them to discover their personal preferences. Another aspect of the implementation is to remain focus on the program goals; focusing on the goal of the change process wil help ensure commitment to the change. An important step to this process wil be to encourage feedbacks and appraisal of the program and this mechanism wil serve as an ongoing evaluation process for the program.

Theory of planned change

Planned change is putting a series of actions into place to achieve a predetermined goal. To achieve your pre determine goal, the propose plan must be flexible in meeting al of your participants at their starting point. The theory of planned change by Lewin (2011) states that the fol owing steps can be applied to help the transition of implementing the change and making it permanent. Lewin’s change theory provides a clear path for implementing change in the workplace. Lewin’s theory involves a three- steps process; the first step is the unfreezing preparing the organization and the staf to accept that this change is necessary, which involves break down of the existing status quo before implement a new strategy. The concept in this stage is learning replaces what we knew with what we are in the process of learning. This indicates that a change in behavior is required for ef ective change to occur. Lewin (2011 Nursing Teen Pregnancy Prevention Program) refers to behavior as “dynamic balance forces working in opposite directions”. The second stage is the freezing stage which involves a process in change in thoughts, feeling, behavior or al three that is more productive in the change process. In this stage communication is crucial as it al ows staf to give input and voice their concerns of the proposed change. It also examines the ways to transition and freeze the changes into place. The third stage of Lewin’s theory is refreezing. This final step is when the practice makes the change desired into a new and consistent habit. If this final phase is not accomplished, any change accomplished wil not be successful. For this project the final stage of refreezing wil be after evaluation of the solution, the program wil be in cooperated into practice and as an ongoing project with continuous evaluation annual y to update and implement new strategies.

Discuss the feasibility of the implementation plan

This plan is feasible through communication and getting management and staf and to understand and practice the measures that wil be implemented. This plan is also feasible because it does not require expensive technology and can be monitor on a daily basis. Communication for behavior change employs a strategic and systematic approach to the use of communication to ef ect changes in behavior that facilitate positive health outcomes (Academy for Educational Development, 2011).

Section E: Evaluate the Plan Evaluation Plan

The project is constituted of both a nursing and an educational component. Both disciplines include evaluations as integral parts of their processes. Evaluation is therefore an important part of this project.

Outcome Measure

The objective for this project is for staf at Wel care organization who attend the educational classes to be knowledgeable about teen pregnancy by scoring at least 90% or higher on the post- tests that wil be administered after each training session. The evaluation tools wil examine the degree of achievement of knowledge, skil s and attitudinal objectives. The questions wil be based on the training session handout title prevention of teen pregnancy, which wil be giving during the training sessions. The evaluation of attitudes wil measure the degree of improvement in the staf own perspectives of their level of confidence and acquired knowledge on how to ef ectively address pregnant teens.

Appendix A is an example of the pre -test tool which wil be provided to staf to assess pre-project and a post project knowledge levels. Appendix B is a post-test to be given at the end of the training session to measure participants’ level of knowledge of teen pregnancy.

Appendix C is the questionnaire to be given to staf to measure their comfort level in order to measure their perceptions of the educational material.

The Likert scale is an instrument that wil be utilized to measure the ef ectiveness of the program by measuring responses on a scale of zero to five with responses varying from not satisfied (zero) to very satisfied (five) (Polit & Beck, 2010). Actual outcomes wil be compared expected outcomes, as wel as with reported outcomes by other successful evidence-based teen pregnancy prevention programs, such as The Teen Outreach Program, in order to determine the ef ectiveness of the program (Summervil e, 2006).

The survey is a valid instrument that wil be utilized to gather information on staf competence and level of skil with addressing teen pregnancy based on the EBP guidelines. The criteria they use to classify the outcome are based on research studies on similar programs such as Teen Voice, Teen Choices, and The Pregnancy Free Club. Therefore, this is valid measure that can be used to test staf knowledge on the topic at the end of each training session. The outcome measure used is reliable because the training program wil use similar criteria to classify employee knowledge on the subject. This measure was an appropriate method to col ect staf ’s feedback because it al owed the education department to col ect information before the training session in order to evaluate outcome. Included in the evaluation process are the measurements of validity, reliability and the sensitivity of the tools used in the program. To achieve this goal and to demonstrate the appropriateness for use in the proposed solution, validity wil be ascertained by administering a post evaluation survey to staf . The results of this survey wil be given to the manager of the education department to review and performed an analysis of the content. After the review of data the questionnaire wil be administered to staf members to validate reliability and answers wil be analyze then. The decrease in the rate of teen pregnancy in the population wil serves as a measure in the reliability of the solution.

The continuum type questionnaires are simple to administer and easy to tabulate. These along with a pre and post event version along with periodic administration wil paint a vivid picture of changes in perception as the project progresses. Another important evaluator approach which wil be used is periodic min-evaluations in the form of computer based training sessions. These wil al ow fine tuning of the project as deemed necessary as the project progresses.

Evaluation of Data Collection

According to Changbum (2013 Nursing Teen Pregnancy Prevention Program) from the project management institute “Project management is the application of knowledge, skills tools, and techniques for project activities to meet project requirements” (PMBOK Guide, 3rd edition, project management institutes Inc., PN, 2005). This mean that project management is making the project happen from the initiation of the project, planning, executing and managing available resources with the aim of completing the project on time. Col ection of outcome measure data wil be continuous monitoring of the process of implementation and the outcome measures and assessing the correlation to establish the rationale that good processes can lead to good health care outcomes. Therefore a post-test design wil be used to evaluate the program. Information wil be col ected after each training session after the participants has completed the education program. This wil help determine the staf ’s knowledge and attitudes after they finish the educational program. The facilitator wil col ect post-test data while ensuring that al the questions are answered and then return the test to the education department for analysis. The facilitator must consistently be given the test right after the training sessions to avoid any alteration in the results.

Identify resources needed for evaluation.

A pilot study wil be conducted to col ect the data that is needed to evaluate this project, so only minimal additional resources wil be needed to evaluate this project. The education department wil have one week after each training session to analyze the data and to present its findings to upper management. The education department needs to be clear and precise about the data col ection process, and ef ective communication is vital when presenting both the data and the results.

Identify Possible Grant Funding’s

In terms of finances assistance wil be solicited from agencies such as the Center for Disease Control and prevention (CDC), Planned Parenthood and grants from federal programs such as Medicaid. Title X Family Planning Program (Title X) and the Temporary Assistance for Needy Families (TANF) (AMCHP, 2006). AMCHP (2006) note that Medicaid, Title X, and TANF place great emphasis on teen pregnancy prevention, and thereby invest significant amounts of dol ars to the venture of teen pregnancy prevention. Therefore this wil make the proposal a great fit for these sources (CDC, 2011b).

Discuss the Feasibility of the Evaluation Plan.

The above mentioned evaluation methods wil be very feasible to conduct because of the comparatively minimum amount of time necessary demanded from the respondents. Also the above mentioned evaluation methods wil be very feasible to conduct because of the comparatively minimum amount of time necessary demanded from the respondents. Of course the already proven support of the project by the stakeholders wil be very conducive to the gathering of data. The success of the teen pregnancy prevention program depends on healthcare knowledge levels and on the wil ingness of participants to use the information ef ectively. It is very important for staf members to change their behaviors, use commonsense, and take pro-active roles in addressing this significant health issue.

Section F: Decision Making Maintaining the Solution

While the project is expected to be of a limited duration, ef ects are expected to be indefinite. Once the initial set of staf have had the formal training sessions these wil be discontinued and only returned to if the need arises in the future. The information wil be available on the education department vault and wil continue to be available for the foreseeable future. Staf competency on preventing teen pregnancy wil be made available through Computer training classes program free to al employees.

Extending the Solution.

If al goes wel and the project is successful, as evidenced by meeting the objectives when evaluated, the formal project is expected to end in a little over 3 months. There are plans in place to extend the project; but if most of the objectives are met and there is a distinct possibility of meeting the balance given an extension of time, a limited extension of an additional month may be utilized. It is expected that those aspects of the project intended to be ongoing wil be sustainable with a minimum of maintenance. If the project is proven to be successful it is the intention of the education department to utilize the program at satel ite of ices which require comprehensive documentation of results. Representatives from the satel ite of ices are selected to observe the program during the training phase and give feedback.

Revising the Solution

Plans to revise an unsuccessful project solution wil mean going back to the beginning of the project and looking at the objectives. After which an assessment of the goals of the project, and what were the expectation of the staf . Also a timeline wil be developed for each stage of the implementing of the solution with evaluation to be completed in a reasonable timeframe. Additional y, the budget wil be reviewed to determine what has been spent and balance remaining to complete the solution. Another method wil be to review the lessons learned from the failed solution and look at he steps involved to find out where the solution went wrong. After assessing this, alternatives steps wil be develop and a new solution wil be revised. Also looking at the score on the post-test, if the participants score less than 90%, the education department wil review the questions missed the most and make any adjustment to program (Cutting, 2013 Nursing Teen Pregnancy Prevention Program).

Discontinuing the Solution

A project may be terminated for various reasons. Some of these reasons include that the project has been completed or the reason for the project cease to exist. However a project may be terminated because of unsuccessful solution. When this occurs the fol owing methods may be applied. The unsuccessful solution may be starved because admitting that the solution did not accomplish its goal would indicate failure therefore; the budget is slowly reduced until it becomes non-existent. Another method of terminating an unsuccessful solution is by consciously terminating the solution with management agreement because the solution has become obsolete and funds for the solution could be applied elsewhere. While based on al the elements like stakeholder approval and financial support that are in place, chances of a failure of the project is miniscule, however if the project does turn out to be a failure it wil be terminated. The periodic evaluations wil facilitate this termination if necessary but it is hoped that they wil instead highlight any need for adjustments and eventual y lead to success (Project termination. 2013).

Plans for work setting and professional feedback.

The best way to broadcast the project information and outcome is for the education department to publish the project results of the teen pregnancy prevention classes in the organization quarterly news-letter that is emailed to employees. The education department can also discuss the success of the educational program during town hal meetings through power point presentation to get feedback from other departments within the Wel care organization.

Conclusion

Evaluation is the final stage of a project. In this stage the project is analyzed for strengths and weaknesses. It is through evaluation phase that the researcher can learn from experience and better plan for future researches.

Evaluation also aids in proving the ef ectiveness of the project and to determine if the objectives had been met. Another aspect of project implementation is the various methods used in making decisions that wil af ect the project. These decisions can be made through various methods such as how to maintain, extend, revise terminate and obtain feedbacks on the proposed solution. Communicating results of the project to others is vital to the longevity of the project so is the implementation, design and data col ection to successful y complete a research project

Nursing Teen Pregnancy Prevention Program References

Academy for Educational Development. (2011). Behavior change communication. Retrieved, from http://www.globalhealthcommunication.org/strategies/behavior_change_communication. http://www.amchp.org/publications/AdolescentHealth/Documents/teenpregnancyreport.pdf.

A Guide to the Project Management Body of Knowledge. (2004).Third Edition (PMBOK Guides). Retrieve fromhttp://www.amazon.com/Project-Management-Knowledge-Edition-Guides/dp/193069945X/ISBN-13: 978. Centers for Disease Control and Prevention. (2011). Teen pregnancy prevention 2010-2015. Retrieved from http://www.cdc.gov/TeenPregnancy/PreventTeenPreg.htm

Cutting, T. (2013). How to real y fix a failing project. Retrieved fromhttp://www.projectsmart.com.uk/how- to=real y-fix=a=failing-proposal,html

Florida Department of Health in Orange County (2013). Retrieve from http://orchd.com/events/index.asp Gilbert, J. (2011). Leadership techniques to empower people during change initiatives. Retrieved from http://www.mma.org/…/339-nothing-stays-the-same-leadership-techniques-to-e…

Lewin, K. (2011). Change theory. Retrieved from http://www.currentnursing.com/nursing-theory/change- theory.html.

Maurer, F. A., & Smith, C. M. (2009). Community/public health nursing practice: Health for families and populations (4th ed.). St. Louis: Elsevier Saunders.

Minnick, D.J., & Shandler, L. (2011). Changing Adolescent Perceptions’ on Teenage pregnancy; Children in Schools. Vol 33. Number 4.

Project Management Institute to Fund 2013 Research Projects (2013). Retrieve from http://www.pmi.org/en/About-Us/Press-Releases/Project-Management-Institute-to-Fund-2013-Research- Projects.aspx

Project termination. (2013). Retrieved from http://www.project-management-knowhow.com/project- termination.html

United States Department of Health and Human Services. (2010). Teenage pregnancy prevention: Summary of funded research and development programs for 2010. Retrieved from http://www.hhs.gov/ash/oah/prevention/grantees/research_2010_projects.html-1/

United States Department of Health and Human Services. (n.d.). Pregnancy prevention intervention implementation report. Retrieved from http://www.hhs.gov/ash/oah/prevention/research/programs/teen_outreach_program.html Wel Care Health Plans INC. The Wel Care health Plans (2009). Retrieve from https://provider.wel care.com/WCAssets/corporate/assets/PROV_2011_Medicare_Provider_Manual_NoticeFP.pdf Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. (9th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Wil iams & Wilkins

Schaf er, M., Jost, R., Pederson, B., & Lair, M. (2008). Pregnancy-free club: A strategy to prevent repeat adolescent pregnancy [corrected] [published erratum appears in PUBLIC HEALH NURS 2008 Nov-Dec; 25 (6): 579]. Public Health Nursing, 25 (4), 304-311.

Shi, L., & Stevens, G. D. (2005). Vulnerable populations in the United States. San Francisco: Jossey-Bass. Summervil e, G. (2006). Copy that. Guidelines for replicating programs to prevent teen pregnancy. Retrieved from http://www.thenationalcampaign.org/resources/pdf/pubs/CopyThat_FINAL.pdf.

Zabin, L., Astone, N, & Emerson, M, (1993), Do adolescents want babies? The relationship between attitudes and behavior, Journal of Research on Adolescence, 3, 67-86, doi: 10, 1111 /1532-7795, epl 1323966. Nursing Teen Pregnancy Prevention Program

Appendices

Read each statement below and choose the best response

The rate of teen pregnancy has gone down since
1. True
2. False
Approximately what percentage of teenage mothers does not obtain a high school diploma? 10%
20%
70%
90%
Teenage childbearing costs taxpayers approximately how much each year?
1. $50 mil ion
2. $500 mil ion
3. $1 bil ion
4. $11 bil ion
What are some measures parents, can take to prevent teenage pregnancy?
Is talking with your teen about sex a good idea?
1. True
2. False
Which one of the fol owing is not a good way to keep your teen involved?
1. Attend their sporting events or plays or of er to help with school
2. Al ow them freedom with friends, but also schedule family time
3. Give your child responsibility in the home – make a list of
4. Limit cel phone and internet usages.
Volunteering is great way to build self-esteem.
1. True
2. False
List 4 organizations in your community where teen can
Its ok only to be your teen’s
1. True
2. False
20% of teen mothers are pregnant again before two
True
False

Appendix B

Teen Pregnancy Post-test

(T-True or F – False

Date Name Department Program

T F 1. Teen mothers are twice as likely to die in childbirth.

T F 2. A child born to a teen mother is twice as likely to die before the age of one. T F 3. Teen mothers are twice as likely not to finish high school.

T F 4. One-half of al welfare payments go to families with teen mothers. T F 5. 20% of teen mothers are pregnant again before two years.

T F 6. 80% of girls who gave birth at age 15 or younger were born to teen parents themselves. T F 7. Most teen pregnancies happen by mistake – they were not planned.

T F 8. Teenage mothers are likely to be more-unhappy than other teens.

T F 9. Boys who impregnate teenage girls are pretty much of the hook if they choose not to be fathers. T F 10. Abstinence-only is the best educational program to reduce teenage pregnancy rates.

Appendix C

Please rate your level of confidence in providing information/care to pregnant teens No confidence Very Little Average Some Extremely whatever confidence confidence confidence confident