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_______________________________________
Dear reviewer,
Your changes and suggested edits were welcomed and taken into consideration. The following letter
will address your concerns.
Narrative
Weakness: You listed a number of sentence structure and wording issues throughout the narrative.
We have clarified or edited all of these, and hope that wording and syntax is clear. You also
indicated unfamiliarity with the Millennium Development Goals. While we appreciate that not
everyone is familiar with these, they are considered standard international health, human rights, and
development goals set forth by the United Nations in 2000 and feel comfortable referencing them as
they are an international standard.
Weakness: Throughout the paper We was used numerous times without identifying who
encompasses the we.
Response: In order to address this change, we was specified by clarifying in this way: We, at
Cincinnati Childrens Hospital This makes the we throughout the application clearer that it is
Cincinnati Childrens Hospital that is applying for the grant.
Weakness: While the number of teens having children has been shrinking in recent years, even
small numbers are unacceptable. Indication that problem is already being addressed and the
numbers are already going down. Im worried that this might work against you in being able
to show that this is a problem to be addressed.
Response: We appreciate your feedback, but we are emphasizing that there are still teens that have
children, and it is important to address all of them and not only some of them. Yes there has been a
decline in history, but at any point it could rise again. We want to prevent the rise from happening
and address the problem now. We also address other concerns such as lack of honesty and
transparency when teaching teens about sex, which we believe creates additional stigma and
promotes a lack of understanding that is unacceptable.
Goals and Objectives
Weakness: Is this feasible to expect a 100% participation rate in the pilot group? Is the pilot
group self selected or are they assigned? You might want to reduce the statistic to make it more
achievable. Also if this is an ongoing program then students may attend some sessions and not
others.
Response: We took your feedback and realized that it would be better to have 80% participation
rather than 100%. Ideally we want to have 100%, but there may be outside factors that occur that
prevent the 100% from being achieved. These factors include lack of attendance at school, loss of
interest by students, or parents changing their minds about allowing the child to participate. We will
take all measures to prevent these things from happening.
Regards,
Teen Talk team at Cincinnati Childrens Hospital Medical Center
Part One
Narrative
Adolescent pregnancy is an ongoing problem in the United States. We often focus on
healthy children, but often disregard sexual health, which needs to be addressed as well. This
type of education can be modified to be appropriate for specific age groups, but it is nonetheless
a critical part of teaching health to adolescents. Teens who have access to birth control and
appropriate sex education are less likely to become pregnant because we know that abstinence
only sex education has not proven effective at preventing teens from having sex (Kost &
Henshaw, 2013). In conjunction Cincinnati Childrens Hospital, the Teen Talk research team will
seek to prevent unintended and unwanted adolescent pregnancies by providing comprehensive,
informative, and age appropriate sex education to Cincinnati adolescents in a unique and
innovative manner.
While the number of teens having children has been shrinking in recent years, even small
numbers are unacceptable. Adolescent pregnancies not only impact the life of the teen parents,
but it also impacts the child and the family. In fact, it has become such a significant problem that
Millennium Goal #5 is working to address the issue (Holness, 2014). In the United States there
are about 34.1 pregnancies per 1000 adolescents (Peipert, Madden, Allsworth, & Secura, 2012).
In Ohio, there are a slightly lower number of adolescent pregnancies compared to the national
average, with 27.2 pregnancies per 1000 adolescents (The National Campaign to Prevent Teen
and Unplanned Pregnancy, 2015). Cincinnati Childrens Hospital is located in Hamilton County,
Ohio, and the state health department reports that there were 32.7 pregnancies per 1000
adolescents in 2010 (Ohio Department of Health, 2010). Statistics also show that teens who are
mothers are more likely to be depressed, are of a lower socioeconomic status (Hofferth, Reid, &
Mott, 2001; Maynard, 1997), have children that are in poor health, have less social support, are
more likely to be in unstable relationships, and are less likely to finish school (Maynard, 1997).
These young women are also more likely to engage in risky behavior such as smoking, drinking
or drug use (Orr, James, & Reiter, 2008), and are more likely to miss prenatal visits than their
older peers (D'Angelo, et.al., 2002). By preventing adolescent pregnancy, we give adolescents a
greater chance at future success. Teen Talk will promote and implement age appropriate sexual
education in Oyler Community Learning Center (OCLC), targeting ages 10-19 years old,
building upon information already being provided to students to provide comprehensive sex
education.
At Cincinnati Childrens Hospital Medical Center (CCHMC), we are committed health
educators who strive to provide teens with appropriate, accurate, and accessible programs free
from stigma. We create a comfortable, confidential, and safe space for students (and a trusted
adult if they choose) to talk about the tough conversations. Ideally, everyone would wait to have
sex until ready, but we know that does not realistic. For this reason, we work to make sure that
teens understand safe sex practices. CCHMC has worked in addressing and preventing medical
conditions in children for 130 years, and strives to improve the overall health of children in the
area. CCHMC is applying for the grant to better address adolescent pregnancy prevention, and
improvement of sexual education. Dr. Paula K. Braverman, who will serve as the Principal
Investigator of the Teen Talk program, came to CCHMC in 2003 to serve as the Director of
Community Health Programs in adolescent medicine. The department for adolescent health has
been working to address all types of teen health concerns, including adolescent pregnancy, which
is why addressing comprehensive sex education is so important CCHMC.
Part Two
Goal 2. Teens and parents will feel more comfortable discussing tough subjects related to
sexuality in an honest and frank manner.
Objective 1. Within 2 months of program implementation, 10% of students will report that they
have used one of the provided strategies to try starting a conversation about sex or pregnancy
with an adult that they trust.
Objective 2. Within 6 months of program implementation, Teen Talk educators will provide all
participating parents/guardians with the materials they need to understand what students are
facing at school, and will guide them toward calm, honest, and personal conversations about sex
with their teens.
Part Three
Methods
The mission of the Cincinnati Childrens Hospital Teen Talk program is to reduce the
number of teen pregnancies in Cincinnati by educating teens and their guardians. Teen Talk
educators will focus on removing the stigma for adolescents that surround teen sexuality, sex
education, discussions of sex, and talking to trusted adults. Our target population includes
eligible students in grades 4 through 12 at Oyler Community Learning Center in Cincinnatis
Lower Price Hill Neighborhood. The demographics of this program will include approximately
635 students, with a racial and ethnic breakdown of 24.5% Black, non-Hispanic, 6% Multiracial,
and 64.5% white, non-Hispanic ranging from 10 to 19 years of age. The intervention will take
place during scheduled mandatory wellness classes at the school in which students are divided
into grades 4-6, 7-9, and 10-12 to maintain age appropriateness of content.
This program will include modified health classes, guest speakers, focus groups with
students, and will make every effort to involve parents/guardians in program activities. Students
will have the option to participate focus groups, one to one sessions, or to involve their
parents/guardians in their learning. Trust is important when it comes to working with teens, so
the students will have the choice to participate in this program with peers or with their
parent/guardian present. Any student or parent participating will sign a confidentiality waiver,
and the parent group will be kept separate from the teen-only group.
To develop and evaluate the Teen Talk program, Social Cognitive Theory will be used.
Social Cognitive Theory considers internal and external characteristics in addition to reciprocal
determinism. The internal factors focus on the individual characteristics such as self-efficacy,
behavior capacity, expectations, expectancies, self-control, and emotional coping. The external
characteristics look at vicarious learning, considering the situation, and reinforcement.
Reciprocal determinism states that the behavior, internal, and external factors all influence each
other. In the Teen Talk program, each participating student will have his or her own individual
perceptions about what the program is going to be about. The students may have similar external
factors within school, but outside of school the environment may vary dramatically. The Teen
Talk program accounts for the different backgrounds and influences that may have an impact on
the student, which is why it is a comprehensive approach.
Table 1. Action Plan
Component
Description of
s
Tasks
Planning
Program
Developmen
Person
Assigned
The Director,
Coordinator, and
Health Educators
will meet with the
Principal, health/
wellness
instructors,
counselors,
relevant staff, and
other
administrators of
the Oyler
Community
Learning Center
(OCLC) to
establish dates and
times for
instruction, agree
upon course
content, ensure
necessary
equipment and
materials are
obtained to make
the Teen Talk
program available
to students.
Director,
Coordinator,
Health
Educators
Develop program
materials for each
Health
Educators,
Impact or
Outcome
Expected
To ensure that
school staff are
aware and agree
with all course
content that will
be presented to
OCLC students.
To ensure all
pertinent staff
from Teen Talk
and OCLC are
aware of
scheduling
changes and
confirm that
students are not
missing other
required classes
or activities to
participate.
Development of
tools that can be
Evaluation Strategy
Materials developed
will be created from
OCLC
Principal
utilized in other
settings for study
replication.
nationally tested
survey materials
geared toward teens.
Developing tools
that encompass
the following
topics: condom
use, negotiation,
healthy
relationships,
abstinence,
returning to
abstinence,
abuse, birth
control, how to
talk about sex
with adults you
trust, how to talk
about sex with
your partner, how
to give and
receive consent
for sexual
activities,
deciding when
you are ready to
have sex, and any
other topics the
students would
like to approach
as a group or
individual.
Students chosen by
the principal will be
approached by
Health Educators and
informed of
responsibilities of
being a Peer
Educator.
Health Educators
will report to the
Coordinator that
materials have been
delivered to parents
via weekly packets
and report how many
students returned the
signed paper.
Within 6 months of
program
implementation,
Teen Talk educators
will provide all
participating
parents/guardians
with necessary
materials.
Teen Talk
sessions
(Implement)
Health Educators
will work with
students during
their health and
wellness class
period over a
course of 8 weeks,
visiting each
classroom once
per week. The 8
weeks of courses
will be broken into
the following
general topics:
1: Healthy
Relationships
2: Biology and
anatomy of the
reproductive
system
3: Condom use
and negotiation
4: Defining rape,
abuse, and
consent, and
identifying risky
behaviors.
5: Sexually
transmitted
infections
6: Birth control
methods and
effective use
7: Talking to
adults you trust
8: Preventing
early pregnancy
for teens, goal
setting, and why
your future is
Health
Educators,
Peer
Educators
Students will
gain knowledge
of the topics
listed previously,
in addition to
topics brought up
in sessions.
Teens will feel
more comfortable
discussing
sexuality and
related topics
with each other,
their partners,
trusted adults,
and medical
professionals
because of the
information
provided during
Teen Talk
sessions.
Avoiding teen
pregnancy will be
tied into each
Teen Talk
session. By
providing
students with
topic specific
tools during each
session will
reinforce the
reasons to protect
yourself and your
partner from
pregnancy.
important
Health Educators
and Peer
Educators will
work together to
address the issues
that the students
feel are important
Evaluating
OCLC principal
will report the
number of new
pregnancies in the
school to the
research team.
New adolescent
pregnancies will
go down and teens
will become more
aware of
potentially risky
behaviors, safer
sex, healthy
relationships, and
other educational
benchmarks and
will invite a
parent/ guardian
attend a session.
Social Cognitive
Theory will be
incorporated to
see the impact that
the program had
on the internal and
external factors.
There will also be
an investigation of
the changes in
influences within
the school when it
comes to Teen
Talk
Director,
Coordinator,
Health
Educators,
OCLC
principal
Part Four
Key Staff
The Teen Talk program will require staff and volunteers in order to be implemented and
to be successful. Select staff members have already committed to participating in the Teen Talk
program, and the resumes for these individuals are attached in Appendix A. The search for
additional required staff is ongoing. The structure of the who the staff reports to is located in
Figure 1.
Staff Information
Director (.25 FTE: grant funded). Dr. Paula K. Braverman is the director of the Teen Talk
program at Cincinnati Childrens Hospital. She attended Yale Medical School and completed her
residency at Yale-New Haven Hospital. Following her residency, she did a fellowship at
Cincinnati Childrens Hospital. Her first 16 years of practice were spent at St. Christophers
Hospital for Children in Pennsylvania. During this time, she received a certification in Pediatrics
and in Adolescent Medicine. Dr. Braverman has served at the director of community programs
in adolescent medicine since 2003 as well as being the medical director at the Hamilton County
Juvenile Court Youth Center. As the director to Teen Talk, Dr. Braverman will lead the program,
hire staff, oversee the volunteers, and coordinate the budget.
Coordinator (1.0 FTE: grant funded). The Teen Talk coordinator will be hired prior to
beginning the program. The Teen Talk staff is seeking an individual that has a Bachelors degree
in Public Health, Education, or in a related field with at least 5 years of experience. The
coordinator will oversee all of the educational programs and will lead the volunteers. The
coordinator and the director will work closely together to ensure that the program stays on track
and the budget is maintained.
Health Educators (1.0 FTE: grant funded). Shakeyrah Elmore, Brittany Luipold, and Martha
Walter are the current health educators. All have a Bachelors degree and are in progress of
completing a Masters of Science in Health Promotion and Education with an emphasis in
Community Health. There will be one more health educator hired. The health educator will
have at least a Bachelors degree in health education or in a related field. A Masters degree is
preferred for this position. The Health Educators will be leading the program in the Oyler
Community Learning Center and instructing the volunteers about what their role is and how
important they are for the success of the program. Health Educators will be reporting to the
coordinator and working with the administrative staff to ensure compliance with program
standards and school policies.
Administrative staff (0.50 FTE, grant funded): The administrative staff will be hired and will
work on a part time basis preparing and assembling materials for the Health Educators. There
will be one person hired that has at least a high school diploma and at least 1 year of clerical
work experience. The administrative staff will be in charge of answering any questions that the
volunteers may have and will assemble all materials used by Health Educators in Teen Talk
programming.
OCLC Principal (0.10 FTE, in-kind, funded by CPS): The Oyler Community Learning Center
Principal will be the one that is currently employed by the school. The principal will report to
the administrative staff about the number of pregnancies that are in the school in addition to
anything else the Health Educators need to know. The administrative staff will be the main
contact between the principal and the Health Educators in order to meet the various schedules
and to have the information obtained in a consistent way. The principal will also be available to
make sure that the peer educators are reporting the information as presented and addressing any
issues that may occur in the school.
Peer Educators (As needed, student volunteer basis). These student volunteers will be
recruited from the Oyler Community Learning Center and will serve as peer educators. They
will be able to provide information about Teen Talk when the Health Educators are not in the
building. Two students per grade level will be recruited after identification by teachers as leaders
in their class. The volunteers will receive additional information about the Teen Talk program,
enabling them to answer questions posed by fellow students if the Health Educators are not on
site. Peer Educators will be given additional instruction on sensitivity and confidentiality to
ensure privacy of all students.
Figure 1. Management Chart
Director
.25 FTE, Grant Funded
Reports to the Grant
Agency
Coordinator
1.0 FTE, Grant Funded
Reports to the
Director
Health Educators
1.0 FTE, Grant Funded
Reports to
Coordinator
Administrative Staf
.50 FTE, Agency
Funded
Reports to
Coordinator
Peer Educator
.50 FTE, Free
Reports to Health
Educators
Part Five
Table 2. Expenses
Budget Items
Personnel
Director
Coordinator
Health Educators (3)
Administrative Staf (2)
OCLC Principal (in-kind cost)
Peer Educators (16)
Total personnel costs
Supplies
Printing materials
Facility (in-kind cost)
Office Supplies
Incentives
Total supplies cost
Services
Telephones
Photocopier
Consultants
Total service cost
Travel
Gas for travel
Total travel cost
Total direct cost
Indirect Cost (20% of direct costs)
Total budget estimates (amount requested)
In-kind cost
Total Budget estimate with in-kind cost
Hours
.25 FTE
1.0 FTE
1.0 FTE
.50 FTE
.10 FTE
.50 FTE
Rate
$20, 000
$65,000
$50, 000
$20,000
Totals
$20, 000
$65, 000
$150,000
$40,000
$0
$0
$140,000
$5,000
$0
$1,500
$2,000
$8,500
$45/hour
$200
$120
$180
$500
$500
$149,500
$29,900
$179, 400
$4,000
$183,400
Table 3. Timeline
Task
YEAR 1
Month 1 -2 (July August)
**Before School Starts to ensure
there are no scheduling conflicts
Planning
Month 3- 5 (September November)
Program Development
Month 11-12
Evaluation
YEA
R2
YEA
R3
References
D'Angelo, D. V., Gilbert, B. C., Rochat, R. W., Santelli, J. S., & Herold, J. M. (2002).
Differences between mistimed and unwanted pregnancies among women who have live
births. Perspectives on Sexual and Reproductive Health, 36(5), 192-197.
Hofferth, S. L., Reid, L., & Mott, F. L. (2001). The effects of early childbearing on schooling
over time. Family Planning Perspectives, 33(6), 259-267.
Holness, N. (2014). A global perspective on adolescent pregnancy. International Journal of
Nursing Practice, 0(0), 1-5.
Kost, K., & Henshaw, S. (2013). U.S. Teenage Pregnancies, Births and Abortions, 2008: State
Trends by Age, Race and Ethnicity. New York, NY: The Guttmacher Institute.
Maynard, R. A. (1997). The study, the context, and the findings in brief in Kids Having Kids:
Economic costs and social consequences of teen pregnancy. In Maynard, R.A., Kids
having kids (pp. 4-17). Washington D.C.: Urban Institute Press.
Ohio Department of Health, Center for Public Health Statistics and Informatics. (2010).
Pregnancy. Retrieved March 15, 2015, from
http://www.odh.ohio.gov/healthStats/disparities/pregnancy.aspx
Orr, S., James, S., & Reiter, J. (2008). Unintended Pregnancy And Prenatal Behaviors Among
Urban, Black Women In Baltimore, Maryland: The Baltimore Preterm Birth Study.
Annals of Epidemiology, 18(7), 545-551.
Peipert, J. F., Madden, T., Allsworth, J. E., & Secura, G. M. (2012). Preventing Unintended
Pregnancies by Providing No-Cost Contraception. Obstetrics and Gynecology , 120 (6),
1291-1297.
The National Campaign to Prevent Teen and Unplanned Pregnancy. (2015). Ohio Data.
Retrieved March 20, 2015, from http://thenationalcampaign.org/data/state/ohio.
Appendices
Appendix A
Resumes
Martha Walter
University of Cincinnati Physicians/Cincinnati Health Department
3101 Burnet Avenue
Cincinnati, OH 45229
C: 513.519-9552 O: 513.357.7485
Education
University of Cincinnati, McMicken College of Arts and Sciences, Cincinnati, OH
Master of Science, Health Education and Promotion
Expected graduation December 2015
University of Cincinnati, McMicken College of Arts and Sciences, Cincinnati, OH
Bachelor of Arts of International Affairs, Certificate of International Human Rights
September 2006 December 2010
Professional Experience
University of Cincinnati Physicians/Cincinnati Health Department
Reproductive Health and Wellness Program
Administrative program coordinator
March 2012-Present
Coordinates educational materials for clinical and outreach services
Assists with ensuring Title X funding compliance
Coordinates with pharmaceutical companies to purchase all forms of contraception on the market
Maintains Cincinnati Health Department contracts with grant funded partners
Project lead on supplemental grants
Administrative assistant
October 2011-March 2012
Performed basic administrative duties and data entry
Maintained relationships with grant partners
Trained grant partners on data entry program
Grants
In Progress
Reproductive Health and Wellness Program
Jennifer Mooney, PhD (PI)
7/1/11 2/28/16
Funded through Federal Title X of the Public Health Service Act, Maternal and Child Health Block Grant
and general revenue funds.
City of Cincinnati Department of Health/UC Physicians
$3,800,000.00
Role: Administrative Coordinator
Contraception Uptake among High Risk Populations: Improving Reproductive Health Services offered in
Public Health Systems
Jennifer Mooney, PhD (PI)
3/31/14 3/31/15
Funded through the Center for Clinical & Translational Science & Training.
$20,000.00
Role: Research Assistant
Completed
Bedsider.org Pilot Grant
Jennifer Mooney, PhD (PI)
8/1/12 4/30/13
National Family Planning & Reproductive Health Association
City of Cincinnati Department of Health/UC Physicians
BRITTANY LUIPOLD
212 Country View Drive | Harrison, Ohio 45030 | 513-218-3852 | Luipolbn@mail.uc.edu
PROFESSIONAL PROFILE
Professional Educator with two years' experience educating in both a classroom and public setting. Team
worker that has educated individuals of diverse educational and socioeconomic levels for five years, with
proven success in adapting to unique learning styles and techniques to fit the needs of each individual.
EDUCATION
Masters of Science, Health Promotion and Education
University of Cincinnati, Cincinnati, OH
Emphasis on Community Health
Bachelor of Arts, Educational Studies
Thomas More College, Crestview Hills, KY
Major: Educational Studies
Associate of Arts: Psychology
Associate of Arts: Sociology
ACHIEVEMENTS
Deans Honor List at Thomas More College
Presenter at the Kentucky Association of Teachers Educators (KATE) Conference:
o Paper Presenter Award
Member of Psi Chi The International Honor Society in Psychology
SKILLS & ABILITIES
Develop creative learning approaches
Create a positive learning environment
Child Abuse and Neglect Recognition certifiedValid until January 2016
EXPERIENCE
June 2006 to Present
Legal Assistant
Slovin and Associates Co., LPA
Worked as a team with attorneys, administrative assistants and fellow legal assistants
Produced legal documents and completed data entry utilizing Microsoft Word and Excel in addition to
legal software
Gave one-on-one attention to children while maintaining overall focus on the entire group
SHAKEYRAH ELMORE
2488 Holt Avenue. Columbus, OH 43219
614-483-8644
elmoresa@mail.uc.edu
EDUCATION
Master of Science, Health Promotion and Education
University of Cincinnati, Cincinnati, Ohio
GPA: 3.892/4.0
Minor: Psychology
Certificate: Substance Abuse Prevention and Diversity Studies
_EXPERIENCE
Community Health Educator
The Center for Closing the Health Gap of Greater Cincinnati, Cincinnati, Ohio
Develop, plan, and evaluate health programs aimed at addressing racial and ethnic health disparities
Regularly research and acquire information and materials on health disparities and relevant public health
topics for the resource center
Assess community health needs and program outcomes by collecting and analyzing survey data, and other
local quantitative and qualitative data.
Tutor/Program Coordinator
Planned and implemented programs and activities that develop social, mental, and physical health
Worked with students with learning challenges to help make learning enjoyable and desirable
Worked with Residential Advisors and Residential Coordinators to provide a safe living environment for
students living in the residence hall.
Maintained and secured the building by checking student identification, assisting with lock outs, and
contacting police in the event of an emergency.
Excellent job! Yall are on the right track and Im excited to see the final submission! 9.5/10