Teens Receive Education about Decisions (TREAD)
A Sex Education Program
Cyndi Carter
NUR/598
January 13, 2014
Dr. Maria Revell

Teens Receive Education about Decisions (TREAD)
A Sex Education Program
Working for the health department can be challenging. Managing the Title X Family Planning Program carries many federal restraints. The community’s awareness of the benefits and available resources through such programs as the Title X Family Planning Program are minimal. The purpose of this project proposal is to create a school-based educational sex education program that will serve to reach out and educate teenagers; Teens Receiving Education about Decisions (TREAD). Fagen, Stacks, Hutter, and Syster (2010) “Sexual health education (SHE) is an important strategy for promoting well-informed sexual decision-making and preventing unintended pregnancies and sexually transmitted infections (STIs) among adolescents. One promising approach for increasing adolescent SHE access is to institute school district policies that mandate high-quality sex education” (para. 1).
Section A: Problem Identification Sex education classes are not a mandate of Georgia school systems. The rising statistics and cost to the state are and will continue to grow without proper education. Centers for Disease Control and Prevention (2013) “A new Centers for Disease Control [CDC] analysis shows that half of all new infections occur among young people aged 15-24. The analysis goes on to show that sexually transmitted diseases (STDs) cost the American healthcare system nearly $16 billion in direct medical costs, placing both a significant human and economic burden on the United States” (para. 2). Many of the teenagers that are fortunate enough to hear about the Family Planning Services come for birth control but have very little knowledge and understanding about the risk, consequences, and even the dangers of STDs, and unintended pregnancy. Centers for Disease Control and Prevention (2013) “Recent data from the National Survey of Family Growth show no significant decline in the overall proportion of unintended births between the 1982 and the 2006-2010 surveys” (para. 4). During the year 2013, the number of clients seen at the Bartow County Health Department in Cartersville Georgia totaled 2,019; of that number only 242 clients were teenagers (S. Townsend, personal communication, December 27, 2013).
Support
Allowing a program design, through the Title X Family Planning Program, within the school system will provide a valid foundation of information for teenagers. A sex education program will allow teenagers to make educational and knowledgeable choices in regard to sexual behaviors. Teenagers need to know they have choices and that there are programs available to them that provide resources. Vamos, Daley, Perrin, Buhi, and Mahan (2012) “Although Title X has far-reaching public health impacts on communities, its services predominantly involve young, low-income women and other marginalized populations and focus on issues related to sexuality and reproduction” (p. 604). This aggregate group receives much of his or her information from friends, internet, and media sources.
Some Internet sites that can provide invalid information are; personal home pages, special interest sites, commercial sites, and social networking sites such as facebook, twitter, instagram, and vine. Media sources can range from books about sexual activity to commercial advertisements on the radio and television. An educational program that will provide information on puberty, body changes, sexual behaviors, and provide knowledge of credible recourses that are available, can be the conduit to reducing sexual risk. Knowledge is a key component when choices are made especially in regard to sexual activity. Obtaining consent from the Board of Health to proceed with the program will be the initial step, then consent from the Board of Education, and finally consent from the parents for his or her child to participate and given the option to opt-out of the program.
Objective
A measurable objective for a project answers five areas: who, what, how, proficiency, and when. a. Who: Teenagers whose sexual behavior choices are supported by credible and reliable information regarding risk, consequences, dangers, and receiving the benefits of gained knowledge. b. What: The intended behavior outcome is that teenagers will alter his or her sexual behavior activities and choices as a result of the program. c. How: Summative and formative tools will measure expected changes through pre- and post-surveys. d. Proficiency: The intended criteria of measured success are an increase in sexual education and sexual behavior knowledge among the teenage participants. e. When: The intended initiation of the program will begin September 2014 and rotate through one school a month throughout Bartow County Georgia.
Students will have an increased awareness of puberty, abstinence, sexual behaviors, the risk, consequences, and possible dangers associated with unprotected sex.
Proposed Solution The proposed solution to address the increase in teenagers with STDs, unintended pregnancies, and the rising cost of treatment and care can be altered by a school based educational program. A program that reviews puberty, body changes, abstinence, an understanding of protected and unprotected sex, and resources available to assist teenagers in making choices will be the beginning in changing the rising rates among teens.
Section B: Solution Description The proposed solution to increase teenage knowledge in regard to STDs and pregnancy can begin with an educational program. A program, Teens Receive Education about Decisions (TREAD), funded through the Title X Family Planning Program will address topics such as puberty, abstinence, the difference between protected and unprotected sexual behavior, risk of contracting STDs, unintended pregnancy, and community resources available for prevention and protection. Using PowerPoint slides, pamphlets, and interactive activities the participants will gain insight and a greater understanding of making healthy sexual behavior choices.
Current Research Knowledge
Current research illustrates that unintended teenage pregnancy and the transmission of STDs are increasing along with associated health care cost. Harper et al. (2010) “ Although the average age at first intercourse in the United States, at 17, is similar to that in other industrialized countries, U.S. rates of teenage pregnancy and STD are significantly higher and contraceptive use far lower than in those other nations” (p. 125). Educational programs are a necessity for health care providers to be advocates for this vulnerable group of young individuals. Without access to resources providing reliable and credible educational instruction, teenagers become victims to the risk that accompany sexual activity. Sabo, et al. (2013), “The workforce impact of community health workers is far-reaching in the realms of prevention and control of chronic and infectious diseases, the reduction of health care costs, and improved outreach, communication, and adherence, as well as in connecting clients to existing services” (p. 67).

Feasibility in the Workplace The Title X Family Planning Program is a federally funded program. The feasibility of integrating an educational program through the Title X program is both realistic and cost-effective. Vamos et al. (2012) “Family planning services are critically important in reaching several public health goals, including but not limited to the following: facilitating proper birth spacing; preventing unintended pregnancies and sexually transmitted infections; and supporting women’s autonomy in choosing if, when, and how many children to bear” (p. 603). The Bartow County Health department in Cartersville Georgia utilizes each Friday to follow up on patient reports, make phone calls, schedule appointments, and review lab reports. Implementing the educational program, TREAD, one Friday a month throughout the seven middle and high schools within the county will permit an opportunity to present the educational material and provide resource information.
Community Culture and Resources Healthy People 2020 is about health prevention and one indicator is reducing the spread of infectious disease. Healthy People.gov. (2013) “Promote healthy sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications” (para. 1). Sexual activity among teenagers is occurring at earlier ages than in the past. There have been educational attempts to introduce abstinence-only programs within school systems but this type program has been ineffective. Harper et al. (2010) “However, several rigorous studies have proven abstinence-only education to be ineffective at reducing sexual behaviors and outcomes” (para. 1). This nationwide issue needs to be addressed and high quality educational programs will be the cornerstone of increasing knowledge and decreasing the risk of STDs and unintended pregnancy among teens.
Conclusion
Unintended pregnancies and STDs are increasing among the teenage population. Interventions are necessary to increase teenager’s awareness of his or her choices in regard to sexual behaviors. An educational program will provide him or her with the proper knowledge about his or her body changes, abstinence, and the right to have choices about sexual behaviors. This type of program will allow teens to receive education about decisions (TREAD). Healthy People.gov (2013), “There is growing empirical evidence that well-designed youth develop interventions can lead to positive outcomes” (para. 5).

References
Centers for Disease Control and Prevention. (2013). CDC Features – April is STD Awareness Month. Retrieved from http://www.cdc.gov/features/stdawareness/
Centers for Disease Control and Prevention. (2013). CDC – Unintended Pregnancy Prevention – Reproductive Health. Retrieved from http://www.cdc.gov/reproductivehealth/unintendedpregnancy/
Fagan, M., Stacks, J., Hutter, E., & Syster, L. (2010). Promoting Implementation of a School District Sexual Health Education Policy. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821868/
Harper, C., Henderson, J., Schalet, A., Becker, D., Stratton, L., & Raine, T. (2010, Jun). Abstinence and teenagers: prevention counseling practices of health care providers Serving high-risk patients in the United States.. Perspectives on Sexual & Reproductive Health, 42(2), 125-32. doi:10.0363/4212510
Healthy People.gov. (2013). Healthy People 2020 – Improving the Health of Americans. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=37
Healthy People.gov. (2013). Healthy People 2020 – Improving the Health of Americans. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=2
Sabo, S., Ingram, M., Reinschmidt, K., Schachter, K., Jacobs, L., de Zapien, J., Robinson, L., & Carvajal, S. (2013, Jul). Predictors and a Framework for Fostering Community Advocacy as a Community Health Worker Core Function to Eliminate Health Disparities..American Journal of Public Health, 103(7), 67-73. doi: 10.2105/AJRH.2012.301108
Vamos, C., Daley, E., Perrin, K., Buhi, E., & Mahan, C. (2012, Nov.). Political Contexts Surrounding Title X, the National Family Planning Program, Over the Past Four Decades: Oral Histories with Key Stakeholders in Florida.. Journal of Midwifery & Women’s Health, 57(6), 603-13. doi:10.1111/j.1542-2011.2012.00248.x