This report is presented by Northwestern University, Center for Healthcare Equity – Institute for Healthcare Studies, in collaboration with Chicago State University and The Chicago Department of Public Health. The report was made possible with support from the Aetna Foundation and Aetna, Inc.

Teen Pregnancy Prevention Initiatives in Chicago

1. Chicago Department of Public Health

Currently, CDPH does not have any specific initiatives focused on reducing teen pregnancy. However, teen pregnancy prevention education is integrated into its existing STI/HIV/AIDS prevention programs and partnerships with Chicago Public Schools and other community based organizations. CDPH clinics also offer family planning clinical services and education for low-income women of child-bearing age.

Adolescent Health Program

The Adolescent Health Program (AHP) is a services unit under the Community-Based Services Section of the Division of STI/HIV/AIDS within the Chicago Department of Public Health. The primary goal of the AHP is to reduce the rates of STI/HIV/AIDS disease among Chicago adolescents ages 12–24 through education, health screening, and treatment. The program targets youth in high morbidity areas for STI/HIV/AIDS, communities with a large reentry population, and other settings where adolescents are engaged in high-risk sexual behavior, such as juvenile incarceration facilities. AHP provides education, training, and technical assistance to a variety of youth-serving organizations on various STI/HIV/AIDS prevention strategies, including: (1) condom use and negotiation skills, (2) abstinence, (3) postponement of sexual activity, and (4) peer training. AHP also offers STI/HIV/AIDS education and testing at CDPH’s specialty clinics. AHP has established partnerships with Chicago Public Schools, Cook County Juvenile Temporary Detention Youth Center of Chicago, and various youth-focused coalitions such as the Better Boys Foundation, Illinois Youth Center, Connect 2 Protect, and the YMCA.

Family Planning Program

Since 1965, CDPH has been providing family planning clinical and education outreach services for low-income women of child-bearing age who are residents of the city. CDPH targets economically challenged community areas that have high rates of teen births, infant morbidity and mortality, and STIs. Clinical services include physical examinations, laboratory tests, health education/counseling, STI/HIV screening and treatment, and prescription of birth control methods. Clients receive services regardless of their ability to pay. During the calendar year 2009, CDPH provided 11,999 family planning service visits to 6,621 clients. Of these, 2,384 (36%) were new to the program, and 4,237 (64%) were continuing clients. One hundred and eighteen (2%) of the clients were adolescents age 17 years and younger.

Family Planning Program staff provides community outreach education on topics such as: substance abuse; anatomy and physiology of the male and female reproductive systems; STI/HIV prevention; birth control methods; and the recognition and prevention of sexual coercion. During 2009 the staff provided 31 community outreach sessions to 1,532 participants in public schools and community agencies and to family case management staff.

The participants who completed the customer satisfaction surveys reported an average of 96% satisfaction with these presentations.

CDPH/Chicago Public Schools STI Collaboration

This collaborative effort began in fall 2009 under an intergovernmental agreement between CDPH and CPS and in partnership with the CPS, School-Based Health Centers (SBHC), and other community partners. The purpose of CDPH/CPS STI project is to reduce the spread of sexually transmitted infections among teens and adolescents in Chicago by establishing a voluntary, expanded STI education and screening project for all 11th and 12th grade students in selected CPS high schools. The group conducts STI prevention and screening in CPS high schools, including alternative and charter schools.

The project consists of health education, voluntary screening for chlamydia and gonorrhea, provision of test results, and assurance of timely treatment and follow-up.

The project has been implemented successfully in three Westside high schools. Four hundred students were educated, and almost 280 received STI screening and counseling services. Of these students, 10–12% tested positive for an STI and 100% of these were successfully treated. These students also received an HIV test through the school-based health centers. The partners plan to expand the education, counseling and screening activities to other Chicago schools with special emphasis on schools that have high youth morbidity rates from gonorrhea and chlamydia.

2. Chicago Public Schools

Although sex education is optional in Illinois schools and abstinence-only-until-marriage programs are the standard, Chicago public schools have been providing “age-appropriate and comprehensive” sex education (abstinence, contraception, and the prevention of sexually transmitted diseases) since 2006. Starting in fifth grade, students are educated on health topics including sexually transmitted infections and pregnancy.

In October 2010, Chicago Public Schools (CPS) were awarded more than $3.9 million in federal funding through the national Teen Pregnancy Prevention Initiative (TPPI).[16] TPPI favors implementation of evidence-based programs and programs providing medically accurate and age-appropriate comprehensive sex education over abstinence-only programs. Chicago Public Schools will implement the Chicago Teen Pregnancy Prevention Initiative using the Teen Outreach Program (TOP) model, reaching approximately 9,000 ninth grade students enrolled in almost 40 target schools per year. The overarching goal of this initiative is to reduce teen pregnancy by improving Chicago youth’s life skills, healthy behaviors, and community engagement.

The program includes plans for a condom availability program, a teen health hotline, community service programming, a youth advisory committee, and a social media campaign. The project also includes an independently conducted rigorous evaluation, with half of the students randomized into a control condition. Illinois Caucus for Adolescent Health and Planned Parenthood are subcontractors under the Chicago Public Schools grant.

3. Community-Level Programs

Teen Pregnancy Prevention Primary Program TP4[17]

Methodist Youth Services (MYS) is a nonprofit, nonsectarian child welfare agency that serves otherwise homeless abused and neglected or delinquent youth under the direction of the Illinois Department of Children and Family Services or the Department of Corrections. MYS is licensed by the State of Illinois and certified as a provider of Medicaid eligible services. The agency provides clinical and case management services to at-risk youth and families in each of its programs.

In collaboration with the Illinois Department of Human Services, MYS has initiated TP4, a teen pregnancy prevention program in the Pilsen community working in local area elementary and secondary schools. This innovative educational program is designed to engage young men and young women while strengthening the knowledge and communication skills of their parents. The male involvement and service learning curricula includes traditional elements of health education in which students receive positive messages of abstinence and safe sex practices.

Elev8 Chicago[18]

Elev8 Chicago (formerly Integrated Services in Schools) is a community-based initiative that seeks to transform the educational achievement and life outcomes of disadvantaged students in five Chicago middle schools: Ames, Marquette, Orozco, Perspectives-Calumet, and Reavis. Elev8 Chicago establishes networks of relationships among school and community partners to implement extended-day learning (e.g., after-school, Saturday, and summer programs); comprehensive on-site, school-based health services; and mentoring. The initiative also facilitates family access to a variety of income and social supports such as tax credits and healthcare coverage. Elev8 Chicago partnerships are shown in Table 4.

A primary objective of the Elev8 program is to provide adolescent-centered health services and education in school-based health centers. The health centers are part of a larger plan to address obstacles to academic success that are prevalent in low-income neighborhoods, including poor eating and health habits, depression, and risk-taking behaviors. Educational programs and on-site services are designed to encompass all aspects of health (e.g., physical and mental), with an emphasis on prevention.

Atlantic Philanthropies, an international foundation supporting the Elev8 program, has made comprehensive, age-appropriate sex education a requirement for funding. By doing so, the expectation is that all Elev8 students will know how to prevent pregnancy and sexually transmitted diseases, and have the ability to apply responsible decision-making skills with regard to their personal health by the time they graduate. Schools use a variety of approaches to provide sex education. For example, Perspectives-Calumet Middle School in Auburn Gresham offers comprehensive and age-appropriate sex education in seventh and eighth grades as part of its Healthy Lifestyles course. Teachers and health center staff co-teach the curriculum to students. Families are also provided with materials to help them talk with their children about sexuality in the media and are engaged in the schools’ sex education program through a parent seminar. Ames Middle School in Logan Square hired an external provider, the Chicago Women’s Health Center, to provide sex education to its students rather than assign it to a health or science teacher.

Other community-based programs and initiatives to reduce teen pregnancy in Chicago are found in Appendix 6.