North Carolina has experienced record declines in its teen pregnancy and teen birth rates. However, many communities and many populations still experience disparately high rates of teen pregnancy and teen birth. In 2010, we launched a novel demonstration initiative to address teen pregnancy in Gaston County, North Carolina. The Gaston Youth Connected initiative took a multi-pronged approach to help the community address longstanding problematic teen pregnancy and teen birth rates by using an array of evidence-based approaches. After five years, the initiative resulted in significant health gains for Gaston County — and provided major lessons for how North Carolina can approach teen pregnancy prevention.
How Gaston Youth Connected Changed a Community - and New Lessons for North Carolina is a supplemental report on the State of Adolescent Sexual Health that details:
- Major components of Gaston Youth Connected and how they worked;
- Lessons learned that can serve other communities; and
- How North Carolina is building on the lessons of Gaston Youth Connected.
October 15th is Spirit Day, a day to go purple and show that you support LGBT youth – and SHIFT NC is proud to be an official participant.
SHIFT NC exists to help young people grow up healthy, specifically by helping adults understand and support adolescent sexual health. This includes making North Carolina a safer, more inclusive, more supportive place for LGBT youth.
Nearly 1 in 5 North Carolina middle school students and 1 in 10 high school students have been the target of bullying because someone thinks they’re lesbian, gay, bisexual, or transgender.
The national data is more thorough and similarly disturbing:
- More than 75% of LGBT youth experience some sort of harassment at school.
- More than half experience harassment from a teacher or school administrator.
- Most LGBT students who experience harassment at school don’t report it because they fear that it’ll be ineffective – or worse.
We’re committed to helping make North Carolina a better place for our LGBT youth, on #SpiritDay and beyond.
As a part of this year-round commitment, we:
- Train school personnel all across North Carolina on how to be an ally to LGBT youth
- Help schools develop strong policies, practices, and procedures to prevent and respond to bullying
- Work with health educators and healthcare providers to help them understand that LGBT youth need the same access to confidential, nonjudgmental information and health care – including contraceptive access – that all young people need
- Work to make health information and health education inclusive
We hope you’ll join us by signing on to go purple today and showing LGBT youth that they have your care and support.
A new school year means new teachers, new classes, and – for some North Carolina students – new sex ed. If you’re a parent, you should know what to expect.
North Carolina Schools: Leading the Way
Since the 2010-11 academic year, North Carolina schools have been required to provide students in grades 7-9 with comprehensive sex education, or what the schools call Reproductive Health and Safety Education. Overall, in these grades, students should learn medically accurate, age appropriate information about:
- All FDA-approved methods of contraception
- Ways to avoid HIV and STDs, including HPV
- Relationships, including how to avoid/prevent abuse, violence, and sexual assault
These baseline recommendations fit nicely with what we, along with experts from organizations like the American Academy of Pediatrics, recommend for students in this age group. You can check out the full set of Essential Standards that students are supposed to learn in Reproductive Health and Safety Education.
North Carolina’s sex ed law (which passed as the Healthy Youth Act) is the good news… Unfortunately, not every school follows the law. In some cases, schools haven’t had the resources to train teachers and buy new teaching materials. In other cases, administrators are afraid of controversy – even though about 90% of parents want their kids to get the information included under the new law.
At APPCNC, we work with school systems to help them update their policies, practices, and procedures so that they can meet the new standards, and ultimately provide students with a great education. In a workshop called “Awkward to Awesome”, we train teachers to feel comfortable answering the craziest question a 7th grader can muster. We help schools examine different lesson plans and curricula to see what fits both the law and their local community. We also help get everyone in a school system on the same page – so teachers feel supported by their principal; so principals feel supported by their central office, and so no one feels heartburn about getting students important health information.
Your Role as a Parent
North Carolina’s sex ed law specifically encourages parent participation – but it varies from district to district. If your child’s school offers a parent night, we encourage you to go. Your child may also have homework that encourages you to share your thoughts and values about sex and relationships. Do it. It’s important.
If you’re uncomfortable with the sex ed that your child is being provided, you can opt them out. However, we encourage you to talk with the teacher first to try to understand what’s being taught. Always know that:
- Comprehensive sex ed will help your child stay healthier.
- Students who receive comprehensive sex ed stay abstinent longer and are far more likely to be safe and responsible later in life than students who get no sex ed or abstinence-only sex ed.
- Comprehensive sex ed does not encourage early sexual activity and won’t make your child more likely to have sex.
Finally, show your child’s teacher and principal that you support comprehensive sex ed. Fear of controversy is a big barrier to great education. Your vocal support can help make things better for everyone.
Note: In May 2015, the Adolescent Pregnancy Prevention Campaign of North Carolina (APPCNC) became SHIFT NC (Sexual Health Initiatives For Teens).
In a hilarious post making the Facebook rounds, BuzzFeed asked their staffers to share “the wrongest thing they thought about sex.” We thought it would be amazing to do the same thing with our staff!
Each year we train hundreds of sex educators in North Carolina. One of our most popular trainings is called Awkward to Awesome – a bootcamp on how to teach sex ed. It covers everything from basic reproductive anatomy to a primer on birth control methods to how to answer the craziest question a 7th-grader can lob.
So, in part, BuzzFeed’s viral post looks a lot like our day-to-day. We grew up with similar misconceptions, but we became the trainers of teachers. Those teachers grew up with myths, but they now have to provide medically accurate sex ed. And a whole new generation of young people is walking around with some of their own wrongest ideas.
In part, believing funny falsehoods about sex - later to learn otherwise - is just part of growing up. But how can you process how a condom works if you think a man ejaculates for the duration of sex? Why would you use birth control if peeing after sex prevents a pregnancy? Our job is to build up a North Carolina that can help young people replace their myths with safe, accurate, helpful information about sex, reproduction, and their bodies.
So, here are the wrongest things APPCNC staffers believed about sex (and now obviously know better)!
1. Sex is a laying down hug between two people
2. I thought sex happened “hot dog in a bun” style
3. You could see a boy’s penis moving around inside your stomach during sex
4. If you pee after you have sex, you can’t get pregnant. (Also, sex standing up = no babies!)
5. Sex only happens on wedding nights
6. We (females) only have two holes
7. Friends told me a penis looks like a ponytail
8. I thought tampons would get lost in my vagina if I pushed too far
9. I thought if I went swimming on my period it would stop the flow
10. When I was very young, I thought maxi pads were designed to write cool stuff on and stick on your wall – and then pull them off. (Clearly I had older sisters.)
11. Wearing a maxi pad would make you get your first period. Maxi pads are really perplexing to kids.
12. I was the only girl curious about sex. Sexual curiosity was just for boys.
13. If I didn’t “think gay thoughts” – then it meant that I wasn’t gay.
14. I thought female orgasms were just something "Cosmo" made up – like flat abs in 4 days.
And just to cap it off... Here are 5 questions we've gotten from young people this month. Proof that young people still - even in the age of Google - need a lot of help getting accurate info about sex.
I can't get pregnant if I have sex in a hot tub.
You can contract ‘blue waffle disease’ as an STD.
I’m only in puberty from 10 to 12 – right?
I can’t get an STD if I have unprotected anal sex and I’m a woman.
Can I get pregnant if I pee after sex?
This week we’re presenting a poster* at the national Office of Adolescent Health’s Teen Pregnancy Prevention Conference. We’re really excited about it so we want to share on media like Twitter and Facebook. However, the poster covers two really complicated topics – race and sexual health – that we don’t dare distill down to 140 characters without having some backup info. So here’s what’s up:
View the poster in PDF format.
Back in 2010, the pregnancy rate for African-American teens was 60% higher than the rate for White teens. Also in 2010, we launched Gaston Youth Connected, a community-wide initiative to reduce teen pregnancy 10% by 2015. The initiative looked at disparities, but did not seek to specifically address pregnancies in young women of color.
In 2012, the African-American teen pregnancy rate was 1.7% lower than the White teen pregnancy rate, closing a long-standing gap and making Gaston County one of only four North Carolina counties where the African-American teen pregnancy rate is lower than the White rate.
A lot of the things that impacted this shift started before Gaston Youth Connected did. Let’s be clear: We’re not taking credit. Right now, we’re trying to understand what happened, why, and what (if any) role the project played.
One of the very first planning activities for Gaston Youth Connected was to work with community leaders to review GIS maps and locate teen birth “hot spots” in the county. Community leaders then identified potential program and outreach locations to coordinate efforts between residents, churches, and youth serving organizations.
Though only 20% of Gaston County’s teen population is African-American, the disparity in teen birth rates caused the project to locate services in “hot spots” that happened to be in largely African-American communities. As a result:
- 57% of participants in evidence-based programs were African-American
- Half of program partner organizations primarily serve African-American youth and programs were offered in six predominantly African-American churches
- 16 of 20 program facilitators were African-American
- 30% of Gaston County’s African-American female teens are covered by a highly effective contraceptive method that they selected and received at the Gaston County Health Department
- 20% of the Gaston County Health Department’s contraceptive-seeking teen clients chose an IUD or Implant (the two most effective methods), double the percentage at similar clinics statewide
In the community…
- Of the project’s nine youth-and-parent Let’s Talk Month events, 44% of participants were African-American
- Two of the three project leadership teams overrepresented African-Americans in the community based on general population percentages
You have to provide really good services that work for people. (This might seem like a no-brainer…) For example, the Gaston County Health Department made a really concerted effort to train their docs to counsel to the most effective methods. They also took significant steps to become more adolescent friendly. The fact that 30% of the African-American teen population used the GCHD to access great birth control speaks volumes.
Actually connecting people to services matters. We're not talking about program flyers here. You have to make a concerted effort to connect people to programs and services. You have to think about where they are, who they want to hear from, and what they want and need.
Use data to drive your work. Again, we didn’t set out to impact the African-American teen pregnancy rate; we set out to get services into teen birth hot spots. Identifying these hot spots let us find the people who might need the most services, and then help them get the services they might want and need.
*You may be asking, “What’s a poster?” A poster is way to show off your research or program results at an academic event. They usually include an overview, some data, some results... As a communications person, I have fun making them but cannot fully explain why they are a thing.
Although our name says “teen pregnancy prevention”, we spend an awful amount of time thinking about overall sexual health. April, it turns out, is a pretty big month for sexual health awareness!
April is Child Abuse Prevention Month
When people try to connect child abuse and teen pregnancy, they often fall back on the myth of the terrible teen parent and assume – falsely – that young parents are destined to be bad parents. Really, the connection works the other way: Most young people who become sexually active before age 15 report that their earliest sexual experiences were nonconsensual, often in the form of child sexual abuse. We also know that young people who experience high numbers of adverse childhood experiences become sexually active at a younger age than their peers who had safe, nurturing childhoods – and that early sexual activity can correlate with lower contraceptive use and relationships with an unhealthy age gap. Learn more about how to raise awareness.
April is STD Awareness Month
Helping young people understand, prevent, and treat sexually transmitted diseases pretty clearly falls in the sexual health wheelhouse. In fact, many of the evidence-based programs that help young people avoid an unplanned pregnancy were originally designed to help people avoid HIV. The overlap between preventing STD transmission and unplanned pregnancy has another intersection: the health care system. When pediatricians, OB/GYNs, and other clinicians take a patient’s sexual health history – something they should do at every visit, according to best practices in adolescent care – they have the ability to talk about a patient’s birth control needs, their need for any screening, and potential risks. Similarly, when we normalize seeking sexual health care, we make it easier for young people to prevent both unplanned pregnancy and STDs. Learn more about how to raise awareness.
April is Sexual Assault Awareness Month
There are so intersections between sexual assault and pregnancy, from the obvious (pregnancy resulting from an assault) to the more complex (polyvictimization of young parents). There are also big overlaps in prevention. Young people need education and practice to develop a healthy respect for others and boundaries, the ability to grant and understand consent, strong communication skills, and a network of supportive sexual health resources. Likewise, we need to address cultural trends that diminish sexual health in our communities: rape culture, toxic gender stereotypes, harassment and bullying, and stigma around sex and sexual health. Learn more about how to raise awareness.
So, April may not be named Sexual Health Awareness Month, but we’re happy to see so many working to raise awareness for individual components of sexual health. We also hope you’ll gear up for Teen Pregnancy Prevention Month in May.
If you feel a little over-aware, take a minute to celebrate National Humor Month.
It wouldn’t be December without a plethora of Year in Review posts! For us in the sexual health and pregnancy prevention world, 2013 has been a year with many victories and even more changes. With fewer young people getting pregnant now than ever before, it would be easy to simply call the year another victory. However, we think this year will be remembered as something different: The Year of the Shake-up. Check out our 2013 highlights and lowlights to see what we mean.
Teen pregnancy hits record lows! When we released the 2012 teen pregnancy rates this fall, they showed a 62% decrease in North Carolina’s teen pregnancy rate since 1990. Back then, more than 10% of the state’s teen girls got pregnant in a single year. Now, it’s under 4%.
The elimination of the pregnancy gap between White and African American teens in Gaston County. Teen pregnancy rates have improved for all racial/ethnic groups both statewide and in Gaston County. However, the Gaston County data illustrates that widespread participation in evidence-based programs, clinical services, and community engagement can close a longstanding historical disparity.
The North Carolina General Assembly reinvests in prevention programs. Despite record cuts to health services, the NCGA continued to allocate federal dollars to the state's Teen Pregnancy Prevention Initiatives. These successful, evidence-based programs provide pregnancy prevention and teen parent support programs in some of North Carolina's highest-risk communities.
The ACA’s contraceptive benefit takes effect. Teens pregnancy has declined primarily because more sexually active teens use contraceptives and because use of foolproof methods like IUDs and the Implant is increasing. Teens whose families pay for private insurance now have access to the most effective methods without traditional cost barriers. And, new research shows the regulations are indeed increasing access.
EC goes OTC. Through a combination of lawsuits and FDA decisions, Plan B One-Step was made available over the counter without the traditional arbitrary age limits. The change has been a mixed bag. Not every store carries it (ahem, Target) or stocks it according to the law (we’re looking at you, Kerr Drug). However, the change created a great current event to help educate teens about birth control and their rights.
The Shutdown and the Sequester. For nearly a month, successful, important teen pregnancy prevention programs stopped because of the federal government shutdown. Across the board, leading prevention organizations (including ours) have seen their budgets drop because of the sequester. Dear Members of Congress: There is one mighty eye roll waiting for you the next time you suggest teens lack the ability needed to act responsibly.
Legislators attacks minor's medical rights. Parents and the major medical societies agree that young people need the ability to access private medical care. In 2013, the North Carolina General Assembly tried to undo a 40-year-old law that protects doctor-patient confidentiality and would even require parents to get a notarized signature for each month’s birth control refill. Luckily, this bill died.
North Carolina adds abortion to sex ed. Parent's widely favor medically accurate sex ed that covers both abstinence and birth control (what North Carolina currently provides). However, a new law now requires schools to teach questionable information about abortion during sex ed - a move that could undermine parent confidence and teacher comfort. (We should mention that teen abortions are rare and dropped to an all-time low when pregnancies did.)
Faux controversies over contraception. 99% of sexually active women have used contraception, parents widely favor their children having access to and learning about it, and it’s been the leading reason teen pregnancy has declined. However, uneasiness about sex and modernity have made it an easy target. Even companies that traditionally provided health insurance that covered birth control are suing to revoke that coverage. This lowlight will last well into 2014.
So why is this the Year of the Shake-Up? All of our successes - including that 62% decline in teen pregnancy - happened under a different paradigm. But we don't know what the future will look like. New rules to increase contraceptive access should help prime us for more success. On the other hand, 2013's lowlights could easily become lurking factors that undermine our progress. Birth control access could shrink. Funding cuts could eliminate programs. Helpful policies could change.
We don't know what things will look like in five or 10 years - although we are optimistic - but we think 2013 will leave a visible mark. As we approach the New Year, we are thankful for all your help, hard work, and support. We wouldn’t see this level of success without you at our side. And we’re counting on you in 2014.
The Centers for Disease Control and Prevention released national teen pregnancy numbers through 2009. The data shows a remarkable 44% decline in teen pregnancy between 1990 and 2009. That’s great news!
Here’s even better news:
North Carolina – a historically disadvantaged state on many public health markers – outpaced the nation by declining 47% during the same period. What’s more, North Carolina continued the trend by declining an additional 30% between 2009 and 2012. (NC teen pregnancy data is available through 2012, while national data is only available through 2009.)
Unfortunately - at least for us data nerds - there’s not a great way to compare North Carolina and national data beyond looking at the rate of progress. The North Carolina State Center for Health Statistics is one of the best state data centers in the country. Their data, however, does not include an estimate of early miscarriages like the CDC does, making any comparison between state and national data an apples-and-oranges task.
Keep up the great work!
Last night, my daughter and I had her first talk. It was about "beebs".
99% of adult women in America have used birth control at some point in their lives.Let's cut through the faux "controversy" and give credit where it's due.