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Current Trends Pregnant Adolescent Group for Education and Support -- Illinois

Based on data indicating that 30% of all births in North Chicago were to teenagers (1), staff from the Nursing Division of the Lake County Health Department, together with a North Chicago High School social worker, developed and implemented a program called Pregnant Adolescent Group for Education and Support (PAGES). Initiated during the 1982-83 school year, PAGES was designed as a school-based program to reduce some of the problems associated with teenage pregnancy, such as lower levels of educational achievement, low birthweight infants, and increased potential for child abuse and neglect. The PAGES model combines educational and social support strategies with the goal of increasing the likelihood that teens will deliver healthy babies and remain in school.

Pregnant students participate in the PAGES program during the regular school day. Over the course of the program, PAGES staff give 21 presentations on topics that include labor and delivery, nutrition, antepartum and postpartum care, infant bonding and stimulation, and early child care. These presentations are supplemented with weekly group sessions designed to build feelings of support and self-esteem. In addition, each PAGES participant is visited at home by a Community Health Nurse, who reinforces the PAGES learning process and offers individual support and referrals to the teenager and, if indicated, to her family. Participants are required to receive concomitant medical care through either a private physician or the county prenatal clinic.

When PAGES was first initiated in North Chicago, 12 students participated in the program. Eleven of these students either remained in school during and after their pregnancy or returned to school after giving birth. During the 1985-86 school year, a total of 48 students in North Chicago participated in PAGES. Forty-seven of these returned to or remained in school after childbirth. Thus, while some studies indicate that two-thirds of pregnant teens drop out of high school (2), the school retention rate for PAGES was approximately 93%.

In 1985, Waukegan, Illinois, adopted the North Chicago PAGES program. Waukegan has a disproportionately high number of teen births (16% of all births, compared with 13% in the county and 9% in the state, as of 1984) (3). The Waukegan PAGES program began during the 1985-86 school year and served a total of 25 students. The program added 24 more pregnant teens during the 1986-87 school year. As of February 1987, all 49 participants (100%) had remained in or returned to school.

The program expanded during the 1986-87 school year to a third community, Zion, Illinois, where 15 additional pregnant teens were enrolled. This expansion, plus the addition of seven more teens in North Chicago, brings the total number of pregnant teenagers who have been served or are currently being served by PAGES to 119. Sixty percent of these are black, 25% are Hispanic, and 15% are of other races. The percentage of all participants remaining in school rose from 92% for the 1982-83 and 1983-84 school years to 100% from 1984-85 through 1986-87. Since 1984, only one (2%) of 65 babies has had a low birthweight. The expected rate of low birthweight babies in North Chicago is 8.7%.

Further information on the development and implementation of the PAGES program can be obtained by writing The PAGES Program, c/o Karla E. Smith, Maternal Health Supervisor, Lake County Health Department, 3010 Grand Avenue, Waukegan, Illinois 60085.

The PAGES program is partially supported by a grant from the Foundation of the March of Dimes. Reported by: SR Potsic, MD, MPH, S Bekenstein, MSW, MH Carter, MPH, M LaRoche, MSN, KE Smith, RN, MSN, Lake County Health Dept; BJ Francis, MD, State Epidemiologist, Illinois Dept of Public Health. Behavioral Epidemiology and Evaluation Br, Div of Health Education, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: This preliminary analysis of the effects of PAGES suggests that a program which combines educational strategies, social support, and preventive care can reduce problems typically associated with teen pregnancies.

The acceptance of PAGES by local school personnel is attributable to the growing recognition within local communities of the fiscal and social costs of teenage pregnancy. The flexibility with which each school is approached gives school personnel a measure of ownership and control of the program and may partially account for the attractiveness of PAGES. Initial discussions with school personnel are based on the individual characteristics and needs of each school. The relatively low cost of the program is particularly appealing. New staff have been hired and priorities have been reordered within the Lake County Health Department to allow for adequate PAGES staff support. PAGES relies on the known problems of teen pregnancy--lost educational opportunities; low lifetime economic potential; increased risk of child abuse and neglect; and increased health risks, such as low birthweight and prematurity among infants and prolonged labor among pregnant women (4,5)--as the guide for program and curriculum development and program marketing.

In recognition of its achievements, the Lake County Health Department was one of 56 health programs receiving the 1986 Secretary's Award for Excellence in Community Health Promotion from the Department of Health and Human Services.

References

  1. Illinois Department of Public Health. Report of births by place of residence, type of birth, birthweight and illegitimacy. Springfield: Illinois Department of Public Health, 1981.

  2. March of Dimes. Facts you should know about teenage pregnancy. White Plains, New York: Foundation of the March of Dimes, 1985.

  3. Illinois Department of Public Health. 1984 birth and death statistics. Springfield: Illinois Department of Public Health, 1986.

  4. Children's Defense Fund. Preventing children having children. Washington, DC: Children's Defense Fund, 1985.

  5. Burt MR. Estimates of public costs for teenage childbearing: a review of recent studies and estimates of 1985 public costs. Washington, DC: Center for Population Options, 1986.

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