Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, June 16, 1994 TAG: 9407120060
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: BETH MACY STAFF WRITER
DATELINE: LENGTH: Long
\ Define the high-risk neighborhoods and throw as many strategies at them as possible. Make sure the leaders in those communities back you up.
Concentrate on costs. Show how much money can be saved in the long run if prevention plans are implemented now.
Expect a big fight over abstinence-based vs. abstinence-only sex education. But don't expect to please everyone.
That's the advice from Jo Kelly, executive director of the Mecklenburg Council on Adolescent Pregnancy in Charlotte, N.C., and co-author of one of the broadest and most ambitious pregnancy prevention plans in the country.
Last year, the city, county and school board there banded together to pass a resolution to reduce teen pregnancy by 50 percent by the year 2000. Then, in five months, a group of 14 professionals who work in the field of teen pregnancy came up with a 53-page plan.
It was controversial, and there were re-writes, but officials stuck behind it - and now the plan is in the beginning stages of implementation.
``You really need the backing of the governing bodies early,'' Kelly advises. ``And then you have to keep pounding away in hopes that the people who have authority to make the decisions are also well-educated.
``The facts here are that three children give birth every day in Mecklenburg County, and you can't just tell them, `Don't do it.'''
The Council - which is parallel to Roanoke's volunteer-run Better Beginnings Coalition, only it has five staff members - began by breaking down the area teen-pregnancy statistics by Zip code. ``That really helped give the focus because then we could go to those elected officials in those Zip codes and say, `Look, this is your problem.'''
Next, they defined four target populations: abstinent teens, sexually active teens, pregnant or parenting teens and their children. Different strategies were proposed for each group, except for the children - ``who are so super high-risk, we needed to throw everything at them.'' The strategies include:
nHire case-management workers to work with all pregnant teens, teen parents, children and their fathers at a cost of $8.2 million over seven years. Although the county is paying for additional school nurses next year, she says, the overall case-management system ``is a mess, a hodgepodge. We have a little program that carries a few kids till they're 2 months old. And that doesn't get it. We want that kid covered till he's in school.
``For now, we're beefing up what we've got till we see what comes down the road in terms of welfare reform,'' she adds. President Clinton has talked about limiting AFDC payments to two years, as well as cutting off benefits to welfare mothers who have subsequent children.
States such as Virginia, West Virginia and Florida are beginning to institute workfare programs, where recipients work in exchange for benefits. Virginia's pilot welfare reform program also calls for limiting welfare to two years and capping benefits if a woman has another child while getting public assistance.
Roanoke has two case-management programs for pregnant and parenting teens, but they reach only a fraction of the targeted population.
Launch a $1 million-a-year media blitz stressing abstinence, male responsibility and parental involvement. Virginia has also purchased a similar campaign, but so far it has been marginally implemented in Roanoke.
Open up community centers - ``beacons,'' they're called - in high-risk Zip code areas in afternoons, evenings and weekends. Beacons could be schools, churches, rec centers, city-owned or any other pre-existing buildings. ``The key is prevention - keeping 'em busy,'' she says. Beacons in high-risk neighborhoods will contain family-planning clinics.
It's important to survey the neighborhoods before the proposals are made, so the plan dovetails the residents' wishes. ``You can't just be the do-gooder going in and saying, `This is what you need to help yourself.' The neighborhood organizations, churches, housing-project councils have to have input and be involved in running the services. But they have to ask you for it; they have to want it.''
Roanoke has the West End Center for recreation and an adolescent-health clinic at Hurt Park.
nRevamp the sex-education curriculum to cover kindergarten to grade 12; all instructors must be trained. Of the eight middle-school curricula proposed, seven are abstinence-based - meaning, they stress abstinence but also discuss birth control. None teach only abstinence.
An eighth-grade program, for instance, teaches the benefits of abstinence the first semester, then discusses condoms, contraceptives and sexually transmitted diseases the second semester.
``We're in fights about that right now,'' Kelly says. Abstinence-only groups formed to oppose the initial plan. So the draft was changed to allow families to exempt their children from any part of the sex-ed curriculum and to review all materials and teacher training.
After the first wave of controversy, the planners also changed the title, ``A Community Strategy to Reduce Adolescent Pregnancy and Sexually Transmitted Disease in Mecklenburg County,'' to include the words, ``to Encourage Abstinence and ... ''.
School-based clinics were not in the plan ``because we tried that a couple years ago and ended up with one - but it is not anywhere near the schools,'' she says.
Roanoke does have two school clinics, where birth control prescriptions, but not actual contraceptives, are dispensed. Its sex-ed curriculum, currently under review, has been criticized for inconsistent implementation.
nFund incentives that offer child-care subsidies, scholarships or even cash for teens who avoid sex or use contraceptives. The group is considering adopting Greensboro's ``Dollar-A-Day'' program, which pays teen mothers one dollar for every day of the week they have not conceived a second child.
The teens also attend weekly meetings, which include social time, snacks and information about family planning, goalsetting, contraceptives and parenting. Fifteen percent of the Greensboro teens became pregnant while in the program - compared with a national repeat-pregnancy rate of 30 to 60 percent within a two-year-period for teen mothers.
In Northwest Roanoke, where no such program exists, close to half of the teen births in 1992 were to women who already had children.
The total cost of Mecklenberg's plan is estimated at $16 million over seven years, but could save $42 million in other public costs, planners say. Each governing body has taken responsibility for implementing and financing various parts of the plan. The council is also raising money from the private sector and applying to national foundations for grants to start the neighborhood beacons.
``You can't please everyone and you have to keep the kid in focus,'' Kelly advises. ``And the problem: It costs us $32 million a year in our county in AFDC, food stamps and Medicaid for families of pregnant teens. We know they drop out. And we know it's the root cause of a lot of the social ills we have.
``Kids having kids, it just perpetuates. So you have to keep putting the facts out there and saying, `Now then, what can we agree on?'''
by CNB