Sunday, January 29, 2012

TOP takes a hard knock

Elizabeth Strother

Recent columns

From the RoundTable blog

There is no small irony in Gov. Bob McDonnell's plan to eliminate state funding for what remains of the Teen Pregnancy Prevention Initiative in Roanoke: Family Service's community service-oriented Teen Outreach Program.

The administration's proposed budget cuts $455,000 from TPPI programs in seven health districts across the state that have high teen pregnancy rates, explaining that the districts continue to have rates above the state average and deeming the initiative a failure.

Yet for 2010, Roanoke's rate fell to 42.8 per 1,000females 15 through 19 years old, a significant drop from 62.7 per 1,000 the year before. The rate was still double the state average (21.1 per thousand). But the city fell out of Virginia's top10 ranking of localities with the highest teen pregnancy rates for the first time since at least 1991, when it had the dismaying distinction of being No.1.

This decrease is an achievement worth building on.

Of course, one year doesn't make a trend. So many factors figure into the dips and increases in teen pregnancy rates and so many strategies are at work trying to bring the rate down that it's hard to assign credit for the decline. But that doesn't mean it's impossible to recognize a success.

The pregnancy rate among teens who have participated in TOP's leadership and community service training since 1990, when the Junior League of the Roanoke Valley brought the national program to Roanoke: near zero.

"We have had two or three students report getting pregnant in the last 20 years," Sarah Jane Lawrence said in an interview last week. She is Teen Outreach Program manager for the nonprofit Family Service of Roanoke Valley. It got $65,000 from the Virginia Health Department this year to work with teens in the school-based and afterschool program.

The TOP staff helps teenagers work with their peers to learn life skills that can help them avoid abusing alcohol or other drugs, getting pregnant or dropping out of school - one often leads to the next.

Sex education is a component, one the program arrives at "eventually," Lawrence explained, "in chronological, sequential order" in a curriculum that links what it calls "service learning" with career preparation and developing a value system, setting goals, making good decisions; if necessary, building self-esteem.

"The main issue it comes down to is: Avoid getting pregnant as a teen." Or, for males, getting someone else pregnant.

"The darling of our program," Lawrence said, "is service learning. We take kids out as a group to volunteer, get involved in the community and become empowered to set goals for themselves." They might work with children, elderly people, immigrants, homeless people, animals or the environment, and in the process build relationships with adult mentors, perhaps envision the rough outline of a life's work.

"It's helped me not to be a teen mom," Terry Smith, a senior at William Fleming High School, assured me last week by phone. "It opened my eyes to how hard they had it."

After volunteering at the SPCA and with Angels of Assisi, she knows what she wants to do with her life: "I always wanted to work with animals since I was young." So she plans to study criminal justice at Ferrum College and become an animal control officer.

TOP doesn't rely on testimonials, though, for evidence of the program's impact.

Cheri Hartman, recently retired director of youth development at Family Service and the "grandmom of TOP," hit Facebook to drum up opposition to the governor's plan to defund TPPI. She told me she takes particular umbrage to a spokesman's assertion that it has failed to document results.

"It's true there's not standardized evaluation across all seven communities, but in Roanoke, we use evidence-based evaluations and have documented results. Even back in 1990, we used research methodology on school attendance, dropout rates, pregnancies and captured statistical results. That's how the program grew."

Even evidence of success is not likely to save TOP's Health Department grant, though. It's the final piece remaining of what started as about $200,000 to help fund three programs in Roanoke: TAP's For Males Only, which did wonderful work teaching lessons in responsible fatherhood to males 12 to 19; the Roanoke Adolescent Health Partnership, which operated three adolescent health clinics in the city before going out of business; and TOP, which serves Roanoke and Roanoke County.

Carilion Clinic took over the clinics last year. Brooks Michael, who coordinated the TPPI grant, now is an adolescent health educator for Carilion Clinic Children's Hospital, doing much the same work as she did before. Now, TOP is likely to need a new guardian angel, as well.

"We are in our eighth or ninth budget reduction in the last four years," Jeff Lake, deputy commissioner of the Virginia Health Department, said in a phone interview. "We long ago exhausted efforts to find savings that wouldn't have some impact on our services."

In eliminating TPPI, he said, the department considered that it is not funded in every health district, only in seven localities with very high teen pregnancy rates; and the grants were not the only source of funding for family planning, "a core public health service in terms of our mission."

"It does not affect the availability of clinical services for teens for family planning services. It doesn't reduce a single available appointment the Health Department has to serve family planning patients."

TOP's beauty, though, is that it helps teens see reasons to plan their families.

Terry Smith, who was enrolled in TOP as a freshman, told me, "It gave us leadership skills and social skills, all the things needed not to become just another number" in the teen mom statistics.

Losing the grant will affect Family Service's ability to continue this particular service, Lake acknowledged.

But Roanoke has a history, he said, "of partnering among a wide range of community service organizations and the private sector to address community health needs. In a number of ways, Roanoke has been a model community."

"I'm confident the community will continue to find ways to make teen pregnancy prevention a priority."

I hope he's right.

Strother is on the editorial board of The Roanoke Times.

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