Purpose for the program: 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. 

Proposed change: 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.

Implementation, outcomes and evaluation: 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 young people 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. Delaware's plan helps individuals assess their personal health concerns and set goals to help them achieve healthy pregnancies, when and if desired.  The Teen Plan (My Life. My Plan) was developed with input from teens to ensure the messages were empowering and resonated with the needs of the adolescent audience. The campaign utilizes innovative social media strategies to meet needs where they are.

Implications for nursing practice: This primary prevention model of care incorporates preconception care into its service structure by allowing nurses to assist in providing resources and tools to help people begin setting healthy goals earlier in the life cycle. 

Keywords: teen, teen pregnancy, reproductive lifeplan, preconception care, primary care