In-class Assignment 1

GROUP 1 Albert Aguilera Rebekah Belman Elaina Cardoux Pravjot Dosanjh Berenice Vega HS 131 Thatcher MWF 11-12 10 October 2008 ASSIGNMENT 1 RESPONSIBILITY I – ASSESSING COMMUNITY HEALTH ISSUES Phase 2 – Epidemiological Assessment • Sexually active teenagers (California) o 1/4 of 9th graders reported having had sexual intercourse, compared to 58% of 12th graders. 39% of females were between the ages of 15-17 61% of females were between the ages of 18 &19 80% of teen pregnancy occurred outside of marriage Nationally, Fifty-seven percent of pregnancies are among 15-19-year-olds, compared with 64% among all women ( 20 and older). In California alone, 111/1000 births were to girls between ages 15-19. This number is increasing; the only way to alleviate the issue is by offering responsible sexual behavior courses in high school. Although, abstinence is the only way to prevent to unwanted pregnancies and STIs 100%. Studies have proven how ineffective abstinence-only education is. Having a Responsible Sexual Behavior program that will demonstrate to students how to properly use contraceptives and where to get them will decrease the risks of unwanted pregnancies and STIs.

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STI incidence and prevalence rates o Fresno County ( California Department of Public Health)  Ages 15-19 STI Chlamydia Gonorrhea Syphillis

Rate (per 100,000) 1406.2 243.1 57

o “Nationally Representative CDC Study Finds 1 in 4 Teenage Girls Has a Sexually Transmitted Disease”1

o “The most common STI was cancer- and genital wart-associated HPV (18.3%), followed by chlamydia (3.9%), trichomoniasis (2.5%), and HSV-2 (1.9%). Among the teenage girls who had an STI, 15 percent had more than one.”2 o The needs assessment at Fresno High School reports that the presence of Chlamydia are at 9% than those reported by the state of California and the CDC. •

Pregnancy rates o 86 out of 1000 pregnancies were between the ages of 18-19 (86:1000) 25:1000 pregnancies were between the ages of 15-17 in California. Break down between ethnicity/race Hispanics- 86.2:1000 pregnancies black- 53.3:1000 Whites- 20.2:1000 Asian12.6:1000

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Information regarding other issues at national level for adolescents ages 13-18. Drug Use: Illicit drug use by the Nation’s adolescents is declining for almost all specific types of drugs. When data for 8th-, 10th-, and 12th-graders are combined, they show that overall, past-month illicit drug use declined by 24 percent between 2001 and 2007, dropping from 19.4 percent to 14.8 percent. The downward trend in illicit drug use has been driven largely by declines in marijuana smoking. Violence: Violent crimes are committed by teens every year. The National Youth Violence Prevention Resource Center (1) provides these statistics on teen violence regarding violent crimes: • In 2000, about 1,561 youth under the age of 18 were arrested for homicide. • In 2000, nine percent of the murders in the United States were committed by persons under the age of 18. • One in ten teens arrested has been engaging in a violent activity that could have resulted in the serious injury or the death of another person. Suicide:

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http://www.cdc.gov/STDConference/2008/media/summaries-11march2008.htm http://www.cdc.gov/STDConference/2008/media/summaries-11march2008.htm

We often neglect suicide in our examinations of teen violence. However, suicide is violence against oneself and deserves very real consideration. Two teen violence statistics to think about regarding suicide (1): 1. The third leading cause of death among teens is suicide 2. Over the past year, one in 11 high school students admit to having made a suicide attempt. Obesity: The percent of children and teens who are overweight also continues to increase. Among children and teens ages 6-19, 15 percent (almost 9 million) are overweight according to the 1999-2000 data, or triple what the proportion was in 1980. In addition, the data shows that another 15 percent of children and teens ages 6 to 19 are considered at risk of becoming overweight. When compared to National rates for drug use, violence, suicide, and obesity, pregnancy rates and STI’s prevalence where higher than national and state rates for students at Fresno High School. This makes the development and implementation of a Responsible Sexual Behavior Program of outmost importance to the people of Fresno High School. Phase 3 – Behavioral and Environmental Assessment • Behavioral o Sexual Activity • Number of sexual encounters • Number of sexual partners o Condom usage rates • Condom usage / sexual encounter • Proper condom usage procedure o Self-efficacy • Environmental o Depictions of sex in surroundings. • Friends • Media • Cultural Influences o Prevalence of STI’s in area. o Access / availability to Students Phase 4 – Educational and Ecological Assessment • Predisposing o Collectivistic cultures that historically do not discuss sexuality within family units. o Sexuality seen as taboo topic. o The only option presented to sexual intercourse is abstinence, with no other educations on alternatives or safety precautions. o Knowledge of responsible sexual behavior is not available to population.

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Reinforcing Factors o Peer-pressure; Everybody is “doing it.” o Sex forbidden by family or religion may encourage rebel mentality. “I’m going to do it because I was told not to do it.” o How sex is portrayed in media. “Teenagers are expected to have sex on Prom Night.” o Opportunities available to population. Enabling Factors o Lack of knowledge about consequences of sex. o Lack of knowledge about alternatives to sex and/or responsible sexual behavior. o Availability of condoms/contraceptives. o

Phase 5 – Administrative and Policy Assessment • Time o Program to be implemented during school hours. o One quarter during Freshman orientation courses. o Two week mini-course during Sophomore, Junior, and Senior years to reinforce and update. • Personnel o Sex Education Professional or volunteer from local organization such as Planned Parenthood. • Funds o Acquire funds from LHD, SHD, or CDC to implement responsible sexual behavior. • LHD, City Council, Board of Trustees, and Planned Parent Hood are local organization that will influence program. • Barriers – Community perception of programs that promote responsible sexual behavior when compared to abstinence-only programs. • Resources (time, personnel, and budget) that might be needed to develop and implement a health education program related to your health topic and target population. Identify local politics/organizational systems that may influence program implementation.