7/15/2016. Objectives. Health Disparities in General

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1 The Oneida Nation Community Health Department Assist Local Youth in Choosing the Best Healthy Lifestyle for a Better Future and Stronger Nation. Public Health Nurses Conference Stevens Point, WI August 3 rd, 2016 Presented by: Candi Cornelius, MSN, RN Oneida Prenatal Care Nurse Kala Kimberly Cornelius, MSN, RN Oneida Community Health Nurse Objectives Identify key action steps necessary to implement an appropriate health and sex education curriculum. Understand the function and impact health and sex education can have on public health outcomes. Understand the importance and significance of incorporating culture in health and sex education for diverse students. Identify the components of continued program development and evaluation. Health Disparities in General U.S. Centers for Disease Control and Prevention (2006). Can justify need for health improvement for all races. RACE HEART Disease Mortality CANCER Mortality DIABETES Mellitus Death STROKE Mortality HIV Death African Americans Hispanics Native Americans (4 th ) (4 th ) 39.2 (2 nd ) 34.6 (5 th ) 2.9 (4 th ) Asians Caucasian

2 OCHC Population Data Information on clients in Oneida Prenatal Care Program Target population are high risk pregnant women (not medically related) who have social, emotional, AODA, educational, or basic needs. Year Total Clients Teens (< age 18) 2011 (PNCCs 1 st year) 2012 (CTB started) 2013 (HGD started) 2014 (HGD continued) 2015 (1 st cohort-ctb x 3yrs) The Beginning: Provider Roles and Actions School Year: Oneida Prenatal Coordinator: o Offered education and prevention programming at Oneida High School due to high rates of teen pregnancies. o Created the Oneida Youth Provider Committee to gather local program information. o Reviewed new curriculum and volunteered to teach in the schools. Oneida Community Health Nurse: o Interim School Nurse for ONSS. o Participation in Youth Provider Committee due to prevention, communicable disease, and health education specialties. o Reviewed new curriculum and volunteered to teach in the schools. Oneida High School Principal: o Before new programming, requested current programs be acknowledged and any gaps identified. o Identified the need for more education about young men and women traditional roles and responsibilities. Oneida School Social Worker: o Agreed with the need for more health related programming for local youth. o Introduced an evidence based sexual education curriculum that she was trained in titled, Choosing The Best (CTB). The Beginning: Choosing the Best Curriculum School Year: Choosing the Best Mission: Educate teens on the health advantages of delayed sexual activity and empower them to make the healthiest choices, in order to reduce unplanned pregnancies and STDs, improving life outcomes for teens and their families. Research-based, abstinence-centered sex education curricula Curriculum meets Title V, A-H criteria Consistent education topics/concepts for grades 6-12 Ability to be tailored to include culturally relevant information Minimal to no training required to teach Easy to follow Leader Guide for teachers Student workbooks Parent involvement and resources 2

3 The Beginning: School System Approval Private Schools: o Oneida School had a statement in student handbook that sex education will be provided, which omitted the need for school board approval. o Need school administration approval. o Need to work with school scheduling staff (guidance counselor). o Courtesy to inform school board about specifics of curriculum. Public Schools: o Need school board approval. o Helpful to get parents and community members support. o Need to work with school scheduling staff. Implementation: Choosing the Best Timeline School Year: PNCC and Community Health Nurse met with school administration end of 2013 SY to discuss implementing new curriculum and received approval to start SY. First year Choosing the Best was implementing for all sixth grade students at Oneida Nation Middle School. Since this cohort did not have any previous human growth & development education, a crash course was given before starting curriculum. Teaching team consisted of 2 staff: PNCC and CHN. Planning team established to coordinate current and future classes. New Oneida School Nurse started and took on task of re-establishing human growth and development committee and classes at the elementary school, along with including traditional roles. Implementation: Choosing the Best Timeline School Year: School Nurse coordinated human growth and development classes in the 4 th and 5 th grades. Second year of Choosing the Best lessons: 6 th and 7th grade students at Oneida Nation Middle School. Teaching team expanded from 2 to 3 staff: PNCC, CHN, School Nurse. Planning team continues to meet. 3

4 Implementation: Choosing the Best Timeline School Year: School Nurse continued to coordinated human growth and development classes in the 4 th and 5 th grades. Third year of Choosing the Best lessons: 6 th, 7 th, and 8th grade students at Oneida Nation Middle School. First cohort now 8 th graders, graduate with 3 years of CTB lessons. Prevention grant provided incentives for students. Teaching team remained at 3 staff. Planning team continues to meet. Continued Program Development and Evaluation Teaching team developed pre and post tests to assess knowledge gained: 6 th grade pre and post tests 7 th grade pre and post tests 8 th grade pre and post tests Abstinence GR 6: 43% GR 7: 88% GR 8: 96% 4

5 Sexually Transmitted Diseases GR 6: 47% GR 7: 65% GR 8: 96% Male and Female Reproductive Anatomy GR 6: Male-21%; Female-0% (List) GR 7: Data not collected GR 8 PRE: Male-8%; Female-4% (Label diagram) GR 8 POST: Male-30%; Female-15% Types of Relationships GR 6: Data not collected GR 7: 36% GR 8: 96% 5

6 Models for Dealing with Peer Pressure GR 6: Data not collected GR 7 PRE: 96% (Stop-Think-Act); 81% (Set It-Say It-Show It) GR 7 POST: 92%; 88% GR 8 PRE: 79% (Show It Being Assertive) GR 8 POST: 73% Next Steps o Include Oneida High School staff in planning team. o Implement CTB for 9 th graders at the Oneida High School for school year. o Recruit more staff/teachers in order to continue to teach curriculum with additional grade levels. o Community Health Dept to host formal CTB training for teachers. o Redesign pre/post test for consistency of topics tested on for each grade. o Continue to collect data on teen pregnancy rates. o Coordinate with Wise Youth afterschool program to reinforce CTB concepts o Share information and data with surrounding schools that have a high population of Native American students. o Create a shared folder of information of how program is implemented in case of job changes. Resources Choosing the Best website: Cornelius, R. & Delgado T. (2014). Oral teaching: Traditional puberty teachings before European contact. Gossart, M. (2005). There s no place like home for sex education, adaption for American Indians. Planned Parenthood Health Services of Southwestern Oregon. Stern, L. (2014). Human Growth and Development: A resource guide to assist school districts in policy, program development, and implementation. 5th Ed. Wisconsin Department of Public Instruction, Student Services/Prevention and Wellness Team. Survey Monkey utilized for pre and post test data analysis. 6