Monday, February 19, 2018

Teen births, health targeted in new pilot program

By Glenn Evans
Dec. 21, 2017 at 12:15 a.m.

Two Gregg County health care providers have been chosen among seven statewide as part of a pilot program to help reduce teen pregnancy rates and get more adolescents into primary care.

At 50.2 babies born annually to every 1,000 girls ages 15 to 19, Gregg County far outpaced the state rate of 33 per 1,000 in 2015.

Put another way, that's a teen birth in the county every two days, according to Texas Department of State Health Services data cited by the nonprofit advocacy group the Texas Campaign to Prevent Teen Pregnancy.

The national average that year was 22.3 births per 1,000 born to mothers in the age range.

The Texas Campaign to Prevent Teen Pregnancy, a nonprofit agency in Austin, is expanding its focus beyond pregnancies with the Texas Youth Friendly Initiative. To that end, the agency has announced Wellness Pointe and Special Health Resources of Texas among providers it hopes will serve as models for a statewide outreach to all Texans ages 11 to 19.

"It is a pilot program," agency spokeswoman Molly Clayton said. "It is really about having a collaborative approach to improve adolescent health care across the state. ... There's all kinds of health outcomes that will ideally be improved."

And there's room for improvement.

State health services reported in 2015 that 95 Gregg County teens were diagnosed with gonorrhea and 286 with chlamydia.

The department also reported 25 babies born prematurely in the county to teens, and 36 percent of high school juniors in the multicounty Northeast Texas health district was overweight.

Clayton said the Gregg County clinics were not chosen because adolescent health care is particularly poor compared with other counties.

Foundations that support this and other campaign initiatives, she said, directed the nonprofit agency to target East Texas, Central Texas and the Gulf Coast simply because that's where the donors live, she said.

"We're hoping that by having two clinics in the same community that they can learn from each other," Clayton said. "We know that they are very passionate in terms of providing quality health care."

Dionne Kittrell, director of clinical operations for Special Health Resources of Texas, said the program isn't just about pregnancy, but "access to care."

"The program is comprehensive health, so it includes things like increasing the routine health visits."

The Longview clinic will carry the pilot in the city, while fellow federally qualified health center Wellness Pointe will serve Kilgore in the pilot program.

"The Texas Youth Friendly Initiative is about applying nationally recognized best practices and standards to our patient population," said WellnessPointe CEO Chad Jones said Tuesday. "We already have a large pediatrics service line but how do we continue to make it better and more engaging for our adolescent population."

Kittrell said the Longview clinic could be up and running by late winter. Grants from the Texas Youth Friendly Initiative were for $5,000, and Kittrell anticipates her agency will be spending some of its own funds for the 18-month pilot.

"The first thing is data collection," she said. "Once we've got that data, we're going to sit down and plan all that we're going to do."

Kittrell said the program will resemble any primary care setting, only for younger patients — right down to the magazines in waiting rooms.

"In our particular one, we're going to hope to partner with some of the schools in the area and do some education," she said.

It's a two-way street. Doctors, nurse practitioners and other providers need education on how to interact with the adolescent community, Clayton said.

"Some of this is so simple as having a friendly and welcoming face when you walk in the door," she said.

Other challenges are tougher, including legal ones. Clayton said a 17-year-old woman can get state-sponsored health care for her child, " but she can't, for example, get a birth control pill or other form of contraception."

Texas is one of two states that bar the use of public funds for contraception for minors.

The Texas Family Code is strict in how physicians, counselors or other professionals may interact with minors.

For instance, someone 16 years or older can consent to medical, dental or psychological care without parental consent only under one of seven scenarios — including being unmarried and pregnant or at least 16 and living apart from parents or a legal guardian.

"So, a lot of providers are nervous about seeing adolescent youth," Clayton said. "We're working to kind of clarify the legal environment for those providers."

Her boss, Texas Campaign President and CEO Gwen Daverth, is quoted in a statement as saying that complicated Texas laws prompt doctors to report often that they don't understand " under what circumstances they are allowed to treat youth, which blocks many young men and women from accessing care."



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