Leaders at Gaston County’s health department saw too many teens becoming parents before their time. So they addressed the problem head-on, with the help of teens themselves.
By Whitney Isenhower
Upon entering the Gaston County Department of Health and Human Services, there is a short hallway to the right with a door leading to a separate, private area. Here, appointment and conference rooms are colored with bright-blue and green walls and floors and visitors can sit on either patterned couches or red-orange chairs around tables.
In the waiting room, stacked fliers echoing this color scheme advertise the Teen Wellness Center.
“If it’s bright colors and more teen friendly, you just feel comfortable and more open,” said Roshini Amarasinghe, a junior at Forestview High School in Gastonia, who helped design the center along with other teens, health department staff and community members.
The center opened in April 2012, offering 12-to-19-year-old youth a space where they could get comprehensive health services, including physicals, immunizations and birth control and pregnancy testing.
It also has played a significant role in an initiative that has helped reduce the number of teen pregnancies in the county.
Teen Action Council
In addition to the health services the center provides, teens can meet with their peers and ask staff health-related questions.
High school students serve on a Teen Action Council, of which Amarasinghe is a member, that launched in May 2011. Along with health department staff and clinicians, interior designers and community members, teens on the council helped plan the center before it opened and gave tours once it did. The group also selected the colors; chose the name; and helped design the logo, fliers and other promotional materials.
There are also now three satellite centers in the county.
The council currently represents six Gaston County schools. Brittain Kenney, a teen-health advocate with the county department of health and human services, serves as an advisor on the council. Kia Thacker, a priority populations coordinator with the Durham-based Adolescent Pregnancy Prevention Campaign of North Carolina, manages the council. Thacker is based in Gaston County.
Teens apply to be on the council and are then interviewed. Its advisors recruit in local schools through guidance counselors. Council terms run from August to June, and members can re-apply to be on the council each year. Eleven students are members of the 2013-14 group; the council had 13 members in 2012-13 and 16 members in 2011-12.
“They have to want to work hard to make change in the community,” Thacker said of the council’s teens.
Gaston Youth Connected
The center is part of the Gaston Youth Connected initiative, which aims to prevent teen pregnancy in the county. APPCNC directs the initiative through a five-year, $5.8 million Centers for Disease Control and Prevention grant, which started Oct. 1, 2010. Seven other counties in the United States are implementing similar start-up projects.
Amarasinghe, who has been on the council since its first year, said she became interested in joining when her dad showed her a flier about it. She knew of 13- and 14-year-old girls who were pregnant.
“I thought that was crazy and I wanted to do something about it,” Amarasinghe said. “It’s something we need to raise awareness about.”
To do so, she hands out fliers about the Teen Wellness Center to peers and has hosted a pizza party at her home to talk with friends about safe sex and pregnancy prevention. Girls now come up to her asking advice, such as how to put on a condom.
The council also organized a pre-prom health fair in May 2013 and has hosted youth-group activities for World AIDS Day, an international event celebrated every Dec. 1. Amarasinghe was involved in a workshop for teens about how to communicate with their parents, which the overall program encourages. The center even has a separate waiting room for visiting parents and non-staff adults.
Decline in teen pregnancy
Since the initiative launched in Gaston County, teen-pregnancy rates have declined. According to the Gaston Youth Connected website, the rate dropped 28 percent in the program’s first two years.
According to Adolescent Pregnancy Prevention Campaign of North Carolina data, the pregnancy rate for white teenagers in the county was 41.4 per 1,000 15-to-19-year-olds in 2012, down from 52.5 in 2010. The Latina teen-pregnancy rate was 64.3 per 1,000 in 2012 for the same age category, compared with 73.3 in 2010. For black teenagers aged 15 to 19 years old, the 2012 rate was 40.4 per 1,000, compared with 84 in 2010.
Between 2010 and 2012, Gaston County’s teen-pregnancy rate improved from 28th highest among the state’s 100 counties to 48th.
“One thing we’ve tried to emphasize in the community is the rates are improving for everybody. They’ve just worked a whole lot faster to close that gap for African-American teens,” said Elizabeth Finley, director of strategic communications for APPCNC.
Gaston Youth Connected’s goal is to further reduce teen pregnancy in the county by 10 percent, Finley said. Programs in place to achieve this aim include providing sex education and opportunities for youth development, having clinical services and raising community awareness by working with adults to help them understand the need to address teen pregnancy.
She said more than 1,300 youth have gone through the initiative’s programs thus far. Sally Swanson, director of prevention programs with APPCNC, leads the initiative.
Finley said APPCNC chose to work in Gaston County because it has a fairly large population and met the criteria for having a high-enough birth rate. The rate requirement was 45 per 1,000 teens, and Gaston County had a rate of 59.9 per 1,000 15-to-19-year-olds in 2010.
Additionally, APPCNC had a previous relationship with the county’s health department and was aware of its existing pregnancy services.
There also were a number of partners representing nonprofit and other organizations to support the initiative, including the Gaston County Department of Health and Human Services, Gastonia Parks and Recreation and the Boys & Girls Clubs of Greater Gaston, Finley said. The CDC grant required at least 10 community partners for the project.
Visiting the Teen Wellness Center
After checking in at the center, teens are led by a staff member to a private room where a nurse practitioner sees them. Five practitioners rotate through the different center locations, but staff members try to schedule any needed follow-up visits with the same practitioner.
“We’ve just seen a large number of adolescents who otherwise wouldn’t be going anywhere else,” said Kim Hamm, a nurse practitioner with the department of health and human services who works at the center.
Once the medical part of the visit is complete, one of the center’s two teen-health advocates, Kenney or Leigh Yount, meets with teens to see if they have questions about their visit or other issues they want to discuss. An advocate will see teens first if nurse practitioners are backed up.
During business hours, either Kenney or Yount is usually out in the community doing outreach activities. These tasks involve attending sporting events, setting up a kiosk at the mall or going other places where teens are likely to be to tell them about the center, including where it is located and the services offered.
The advocates also give presentations at churches, schools and other sites, including on weekends and evenings.
“We’re looking for any youth who might have questions or need help,” Kenney said.
In addition to giving teens a health space geared toward them, the center allows for visitors to get care for a variety of needs in one place, versus visiting several providers and specialists in different offices, which can be the case in private practice.
“Kids now feel like they have a place that’s safe to go to and there’s continuity,” said Velma Taormina, medical director of the Gaston County Department of Health and Human Services. Taormina was part of the center’s initial planning committee. She still serves on a committee that meets to discuss center issues, including how to keep it active once the grant ends.
Teens will likely be part of that process. Finley said those who serve on the council have a lot of fun with the activities they plan and carry out, and their input has been central to this project.
“You cannot reach young people unless you listen to them and understand the issues that they’re facing and effective ways to get to them,” she said.