My Life, My Plan: Delaware's Reproductive Life Planning Tool for Teens

Background: Each year, approximately 1 in 5 teen births in Delaware are repeat births. The 2009 Youth Risk Behavior Survey data indicates that Delaware teens are more likely to have sex at early ages, have more frequent sexual activity, and have more sexual partners than teens in other states. Disparities persist – Black teens pregnancy rates are nearly twice that of white teens. The rate of teen pregnancy among Hispanics is higher than the national average. Preventing teen pregnancies is a key strategy in the state’s overall Infant Mortality Elimination plan. The combination of resources allocated to support the fight against infant mortality has enabled the development of new programs, systems and tools. Research concluded that adolescents and women of reproductive age needed more education about the factors that contribute to infant mortality. To facilitate positive behavior change, the Delaware Division of Public Health (DPH) and the Delaware Healthy Mother & Infant Consortium (DHIMC) needed to address motivations and barriers to healthy outcomes with a focus on the life-course perspective and goal setting. This primary prevention model of care incorporates preconception care into its service structure by providing resources and tools to help people begin setting healthy goals earlier in the life cycle. According to Prochaska and DiClemente’s Stages of Change Theory, individuals move through a continuum in order to change their behavior. Since adolescent females are less likely to be consciously participating in family-planning decisions, it is critical that this audience is reached during the “Precontemplation” stage with relevant messaging that motivates them to move forward towards the second stage, “Contemplation.” Addressing issues earlier in the continuum such as nutrition, immunizations, contraception and planning, will help women achieve optimal physical and mental health, prevent unhealthy pregnancies and preterm births. The CDC recommends a reproductive life plan as a tool to use in preconception care. This plan helps individuals assess their personal health concerns and set goals to help them achieve healthy pregnancies, when and if desired.

Program background: Members of the Delaware Healthy Mother & Infant Consortium (DHIMC) worked with DPH staff on strategy to develop an appropriate tool for teens. To promote awareness of personal health goals earlier in the life cycle, this resource guides the teenage audience, males and females, ages 15 to 17, through goal-setting and development of healthy habits. “My Life. My Plan” was developed by the Education & Prevention Committee of the DHMIC. This Teen Plan includes information about how to determine healthy goals, relationships, behaviors and resources.

Evaluation Methods and Results: The Education and Prevention Committee worked closely with key stakeholders, such as the Delaware Department of Education, to ensure appropriate content and develop methods of distribution. Over 200 teens participated in testing the materials through community centers, school-based health centers and youth councils.

Conclusions: As a result of this collaboration, “My Life. My Plan” is now part of the core curriculum in public middle and high school classes in Delaware.

Implications for research and/or practice: This educational tool was launched in January 2011 and is currently being evaluated for usability and effectiveness.