Morris Heights Health Center and Changing the Odds continue to make an impact on our community.
Changing the Odds in the Bronx: A Teen Pregnancy Prevention Initiative
Overview: The Bronx has the highest poverty rate in New York City, and, as a result, is ecologically disadvantaged across social, economic, and health indicators. Almost 40% of all children living in the Bronx live in poverty.1 In a ranking of 62 counties across New York State, the Bronx ranks last for health outcomes (62/ 62), health factors (62/62) and social and economic factors (62/62).2
Adolescents living in high poverty neighborhoods are three times more likely to become pregnant and are at greater risk of dropping out of school.3,4 The Bronx is no exception: it has the highest teen pregnancy rate in New York City — a rate that is 45 percent higher than the national rate.5 Of particular concern is that the high rate of pregnancy disproportionately affects Black and Hispanic teens. In 2011, the pregnancy rate among Black teens aged 15-19 in New York City was 110.2 per 1,000 females; among Hispanic teens aged 15-19 it was 87.0 per 1,000 females.5 In contrast, the pregnancy rate among White, non-Hispanic females aged 15-19 living in New York City was 23.0 per 1,000 females and 17.1 per 1,000 Asian and Pacific Islander females aged 15-19.6 Furthermore, and related to the Bronx teen pregnancy rate, 31% of high school students in the Bronx drop out of school — more than double the national average (15%).6
Program Description: Since 1981, Morris Heights Health Center (MHHC) has been a major provider of health care in the Bronx. Through its School Based Health Center (SBHC) network, MHHC provides more than 10,000 school children in 16 high-risk elementary, middle and high schools with comprehensive medical, behavioral and dental care. For many of these children who are uninsured, the services provided at the SBHCs are the only care they ever receive. The SBHCs also provide confidential sexual and reproductive health care services.
In 2010, the U.S. Department of Health and Human Services Office of Adolescent Health awarded MHHC a multi-year grant to implement the Changing the Odds project. Changing the Odds is a partnership between MHHC and the New York City Department of Education to implement the evidence-based Teen Outreach Program® (TOP®) in 12 middle and high schools in the Bronx, reaching nearly 300 6th and 9th graders each year. The goals of TOP® are to engage youth ages 12 to 18 to practice healthy behaviors, learn life skills and have a sense of purpose in their lives. TOP® has been shown to be effective at preventing teen pregnancy and reducing school suspension and course failure.
Program Impact: During the 2011-2012 school year, the Changing the Odds project reached approximately 300 students in 6th, 7th, 9th, and 10th grades with TOP®. Of the students served, 57% were female, 48% were Latino, and 52% were African American. By 2015, over 500 at-risk youth in the Bronx will receive this evidence-based teen pregnancy prevention intervention, improving their chances of graduating from high school and avoiding early parenthood.
Overall, TOP® participants reported:
The program made them more likely to use a condom (70%), to use birth control (58%), and less likely to have sex (47%).
The program helped them make good choices about their health and well-being (86% of 6th graders and 86% of 9th graders).
The program had a positive impact on their academics.
77% of 6th graders and 69% of 9th graders said that their participation in TOP® helped them get good grades.
90% of 6th graders and 85% of 9th graders said that their participation in TOP® helped them think about what they could accomplish in the future.
Greater use of the school based health centers for sexual health services.
In addition, several assistant principals noticed striking changes in the behavior of some students as a result of the Changing the Odds project. One example involves Shanice*, a 6th grade student, who was normally in an “inclusion” class — a classroom with three instructors to provide one-on-one instruction to struggling students and manage challenging behavior. Shanice exhibited much of the behavior that was common in that class: verbal and physical outbursts and inability to focus on academic work. However, once Shanice started participating in TOP®, her behavior improved dramatically. Because TOP® emphasizes a safe and supportive environment and Shanice was in a TOP® club where there were less behaviorally-challenged students, Shanice learned what behavior was expected from her and started to meet those higher expectations. Her behavior not only improved in TOP® club, but also in her other classes. As a result of her improved behavior and her increased ability to attend to her studies, she has been moved from an inclusion class to a general education class, much to the surprise and delight of her teachers.
Contact Information:
Estelle M. Raboni, MPH, MCHES
Title: Program Director
Organization: Morris Heights Health Center
Phone: (718) 483-1270 ext. 8152
Email: eraboni@mhhc.org