CHIPR Initiative Changing the Face of Teen Pregnancy in Craven County

TOP Newsletter

Summer 2014 marks the end of program Year 3 for the Teen Outreach Program of Craven County, more commonly referred to as the TOP® Club of Craven County.  This collaborative intervention between The Center for Health Policy and Inequalities Research at Duke University and the Craven County Health Department is funded through the PREPARE for Success grant initiated through the Affordable Health Care Act.  This grant is administered through the North Carolina Department of Health and Human Services (DHHS) Women’s Health Branch.

According to the 2012 Craven County State of the County report, the pregnancy rate in 2011 for teenage women ages 15-19 in Craven County was 58.3 out of 1,000 women.  In 2012, Craven County ranked 24th across the state for teenage pregnancy.  However, for the past five years (2007-2012), Craven County has had the 14th highest rate of teenage pregnancies of all 100 counties.   Designed to positively affect this alarming trend, TOP® Club of Craven County helps youth develop important life skills through participation in weekly peer meetings with trusted adults, enrichment activities and integral service learning opportunities.  Major components of the program’s structure include values clarification, decision-making skills, and the dissemination of scientifically accurate information regarding both abstinence and contraceptive methods with an emphasis on the role that each plays in developing healthy behaviors.  The research element of this program, developed by the curricula creators and the NC DHHS oversight department, seeks to quantify the impact of the program on participants by anonymously surveying them on a yearly basis.  Surveys analyze students’ knowledge, attitudes, beliefs and behaviors regarding sexual behaviors and associated risks at the beginning and end of each program year.

This youth-oriented intervention compliments the rich legacy of addressing health disparities within CHPIR programming.  While CHPIR has established many programs around the world, this initiative is the first and only domestic CHPIR-sponsored initiative that addresses youth health disparities in the state of North Carolina.  TOP® Club fills a similar void for Craven County as the only community-based initiative to provide health education, including comprehensive sex education, to adolescents in the area.

TOP® Club of Craven County celebrates another successful year of programming, meeting or surpassing its established measurable objectives for Year 3.  Notably, the program’s recruitment efforts set the tone for this year’s success.  Increased community awareness and strengthened partnerships contributed to the program’s highest number of enrolled students since it began operation in 2012.  To date, TOP® Club has served over 200 Craven County adolescents, and surpassed its Year 3 enrollment goal of 80 youth by 11%. TOP® Club of Craven County is committed to also addressing ethnic disparities in the county’s teenage pregnancy rates.  Illustratively, over 75% of the students served through the program in Year 3 are youth of color.

Strong community partnerships have also supported the success of the program’s third operational year.  The New Bern Chapter of the Continental Societies, Inc. is represented on the program’s Community Advisory Council, and partnered with TOP® to facilitate two of the program’s four Year 3 enrichment activities offered to TOP® participants.  These activities, designed to cultivate student civic and social responsibility while building important life skills, expose participants to new experiences and offer exciting opportunities for self-discovery.  This year, TOP® Club participants celebrated the legacy of Dr. Martin Luther King, Jr. in New Bern’s Annual MLK Heritage Parade while holding hand-made signs to remember Dr. King’s vision with slogans including, “Justice for All”  and “End Racism.”

Learning through service to the community is an integral part of the TOP® program model.  This program component largely parallels the helper therapy principle, developed by Frank Reissman.  First published in a 1965 edition of Social Work, this frequently referenced model asserts that when a person helps or serves another person, that person gains an increased sense of self-efficacy, making the relationship beneficial for both the ‘helper’ and ‘helpee.’  Over the course of the TOP® 9-month program, students devote at least 20 hours to a service project that they design, implement, debrief and celebrate.  TOP® Club participants completed several inspired service projects in Year 3 that served vulnerable populations in the area, including:  animals, low-income elderly, homeless residents and youth with chronic illness.

Motivated by a passion to serve other youth in their community, the TOP® Club at New Bern High School, facilitated by CHPIR Project Coordinator, Genevieve Hunter, brought favorite childhood characters to life during a visit to the Vidant Maynard Children’s Hospital in Greenville, NC.  The group’s project also included a toy drive, through which they collected over 75 toys to benefit the hospital’s courageous young residents.

The success of TOP® of Craven County collaboratively working with partners has garnered positive attention from teen pregnancy prevention advocates at the state level.  The Adolescent Pregnancy Prevention Campaign of North Carolina, or APPCNC, is one such organization.  APPCNC began as a grassroots initiative in 1985 to address climbing teen pregnancy rates in Charlotte, NC.  Since then, the nonprofit organization has expanded its work to counties across the state to build capacity to prevent adolescent pregnancy through collaboration, advocacy and education.

With recent funding from the Duke Endowment, APPCNC is working to support and build on the success of TOP® Club operations in Craven County.   APPCNC is working closely with TOP® staff and community members with hopes of mimicking great strides made in other North Carolina counties. Notably, Gaston Youth Connected (GYC), an APPCNC sponsored program, has seen tremendous achievements since its inception in 2010.  According to GYC’s website, Gaston County dropped its teen pregnancy rate by 28% from 2010 to 2012 through this innovative initiative which unites stakeholders through the implementation of practical changes in the community.  Gaston Youth Connect has started a Teen Wellness Center at the Health Department and has teen peer educators out in the community making appointments for youth on smart phones and tablets.  CHPIR staff and TOP® facilitators Genevieve Hunter and Tova Hairston will do similar work with APPCNC this year to establish a community-wide coalition that will increase community awareness of teen pregnancy and prevention efforts.  The coalition will connect key stakeholders, including schools, support agencies and small businesses in a structured, joint effort to increase teen pregnancy prevention efforts and garner community buy-in to support the efforts of TOP® Club of Craven County.

TOP® Club of Craven County is looking forward to growth and expansion in Year 4, with supplementary funding from the Teenage Pregnancy Prevention Initiatives program (TPPI) through the North Carolina Department of Health and Human Services Women’s Health Branch. The additional funding will support current CHPIR staff positions in the program, and will provide for additional program facilitators.  With increased program capacity, TOP® Club will also add another site location in the county, serving students residing in rural Vanceboro and other parts of western Craven County. With a strong foundation, TOP® Club staff is excited to continue to reverse the trend of Craven County’s teenage pregnancy rate with increased support from state advocates, the Duke Global Health Institute and the Center for Health Policy and Inequalities Research.

What program stakeholders are saying about TOP® Club of Craven County:

“[Learning about abstinence in TOP] helped me… because it gave me information [about how] I would need to [say] no for when I get ready to have sex, like the risks [of teen pregnancy and HIV and STDs]
TOP® Club participant

“TOP is a club where kids can feel safe.  It’s designed so that people can talk about themselves in a safe environment.  It’s a group that can show you the ROPES …because no matter what situation you come from, everyone is equal!”
TOP® Club participant

“I love, love love, love, love  love TOP…seeing you guys interact with the young people that are involved in [TOP® Club]…has just been the most rewarding thing for me…, and then [seeing] the participation of the parents and how excited they were, and how much they absolutely love and respect what you guys are doing for them.”
-Sandi R., TOP® Club
Community Advisory Council member

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