According to the 2018 Minnesota adolescent sexual health report, teen pregnancies and birth rates in the state are at an impressive historic lows (Farris, Austin & Brown, 2018). The teen pregnancy rate among 15 to 19 year olds has declined by 71% from 1990 to 2016 (Farris, 2018). In addition, the teen birth rate has declined by 65% during the same period. Communities of color have had the highest decrease (Farris, 2018). However, despite the great milestones, there are still some challenges to be overcome even in the face of commendable healthy choices teens are making.
One of the challenges is that disparities continue to persist by geography, race/ethnicity, sexual orientation and gender identity. For example, sexually transmitted infections (STIs) continued to increase over the last decade among this population. According to the report (Farris, 2018), although sexually transmitted infections accounted for 7% of the population in Minnesota, adolescents ages 15 – 19 accounted for 25% of chlamydia and 18% of gonorrhea in 2017. In addition, the STI rates are disproportionately high for communities of color with the rates of chlamydia and gonorrhea being highest among the black youth followed by the Latinas and then American Indian youth.
The rate of gonorrhea is 33 times higher in black youth while Chlamydia rate is 9 times higher for black youth compared to the rate for white youth.
Sexual harassment, dating violence as well as sexual abuse continue to persist among Minnesota youth. Statewide, almost 14% of Minnesota youth reported experiencing violence in their dating (Farris, 2018).
According to the US Census Bureau, all race groups have grown within the state between 2010 and 2019, distributed unevenly across the state.
This is equivalent to as many as 5 times people of color compared to non-Hispanic white with the fastest group being black African who grew by 29% adding about 80,000 people (Farris, 2018). The Asian race is the second fastest growing population, which added 29% that is equivalent to 64,000 people followed by the Hispanic group, which grew by 20% adding 50,000 people (Farris, 2018). People of color tend to live in the metro areas compared to the rural areas. To meet the ongoing sexual and reproductive challenges, there is a need to tailor the messages to meet the unique needs of the youth from different backgrounds such as sexual minority, transgender, and gender diverse youth while promoting the importance of barrier methods to protect against STIs. In addition, the youth need a platform that provides comprehensive, medically accurate and age appropriate materials to teach sexuality education that incorporates healthy relationships, gender and sexual orientation. Many of the current program’s focus is on changing individual behavior that leads to pregnancy or STIs. To address the disparity that is evident in the state, a newer approach is needed that takes into account the social determinants that account for the disparity and lead to poor health. Increased rates of pregnancy have been associated with poverty, residential segregation, unemployment and lack of accessibility to health care services (Farris, 2018). These determinants of health have to be addressed if we are to see a decrease in the number of STIs and partner violence.
Clearly describe/define the innovation/technology and how it will be utilized with the at-risk population. Examples of innovation could be: a new piece of technology, a new ‘app’, distributing smart phones for appointment reminders, etc. Be creative–think about how/what technology could be utilized in health! nDescribe the innovation/technology and how it will lead to breakthroughs in health and/or health care accessibility.
Studies show that more than 90 percent of teens are more online with technology than any other age group (Collins, Martino & Shawrand, 2011). In addition, media technology continues to evolve with newer devices that allow for online activities. Two-thirds of youth ages 8 to 18 years own their own cell phone equivalent to an estimate of 71 percent ownership (Collins, 2011). Although there have been concerns regarding the social influence of media technology on risk behaviors, others see the potential of the newer media in extending the reach for youth and in removing time and place constraints. As such, the same technologies could be used to provide sexual health interventions given its broad reach and high interest levels among teens.
In a review of computer-based studies that targeted not only the youth but also other demographics, found strong evidence to support the use of these platforms with a suggestive trend that they may work even better among young people (Collins, 2011). An app to address sexual and reproductive health including pregnancies and sexual transmitted diseases will be available to teens ages 9 to 19 in Minnesota with the funding from this grant. The teen will have to download the app into their computer or cell phones to access information and have their questions answered. The app will provide information on sexual and reproductive health such as body changes, hygiene issues, STI protection, HPV vaccine and family planning. The app will also be interactive such that the teen could also communicate with a health care provider that could provide personal consultation virtually or send a signal to their friends or security system when in a potentially violent partner situation. Though the app is intended for the minority teens in the metropolitan areas, the advantage is that other teens from rural areas will be able to benefit from the services if they have access to the app thereby providing increased access to sexual and reproductive health services for rural population teens.
This grant will provide the funding for the establishment of the app in Minnesota State as a pilot project to determine its effectiveness in behavior change. The outcomes of the project will be the downward trend of the STI cases as well as partner violence among the teen populations. Lessons learned from the project will help inform the project before its replication nationwide.
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