Sharon Rodine: Thanks Terri. Thanks Connie. 
Thanks everybody for being here. 

Isn't this fabulous? To look out on this many people who've come today to talk about this topic. 
We're doing some preaching to the choir out there 
so a lot of the folks that have helped put together the data 
that you see handed out. And that work on the efforts we're going to be talking about 
are out there in the audience. So this is a wealth of talent here. 
If we could just lock the door and spend the day here...

We can fix this date on this issue but anyway, 
and then we'll go across to the capitol and see what we can do with it, okay. 
You have a handout. Trees die when I go to meetings and I'm so sorry about that 
so I hope I can get the emails from Connie so I can send you electronic things in the future 
if you don't already get stuff from Sharon. 

And I'm not going to go through this today. What I put together is a packet of key information. 
It's all on our website, TheHealthyTeens.org. 

I told somebody one page that may have these fact sheets died, you know, recently. 
So we're getting it back up. They should be under the fast fact section of TheHealthyTeens.org website. 
Download whatever you want. We're putting more 2013 information up there. 
So, what I want to do quickly in my few minutes is talk about the issue overall. 
Just a quick snapshot. Give a little context and the 
wonderful colleagues here are going to be talking about some exciting program models, 
evidence-based programs, and services and good things that are happening across the state. 
Often on oh so many, on way too many issues related to children, 
health, education, child welfare - yada, yada, yada, - we rank not well. You know? 
It's not a pretty picture. But there are some good things happening. 
And this gives us a chance to look at the facts and the data 
and then talk about some of the good things that are happening. 
So quickly I'm going to run through this. I'm a techno dummy. Stick with me here. 
We'll see if this works. A few key facts. Numbers tell part of the story. 
And the little handout I had out there are all the slides there and we'll have it on our website. 
In 2013 there were 5,376 births to Oklahoma girls age 19 and younger. 
There's usually about, you know, 70 or so that are 10-14. 
1/3 are usually are the 15-17 year olds. 2/3 are the older teens - 18-19 year olds. 
Whose working with them? Who's focused on them? Do we know who they are? Where they are? 
What they're doing? How to reach them? Some real work we need to do there. 
One out of every five is usually a teen who's already a mother. 
About 20% are subsequent births. Over 1/3 occurred in two counties: Oklahoma and Tulsa. 
Your metro areas. So as we look at priorities for investing of resources. 
You know, looking at your metro areas if we can drive the numbers down there 
we can drive them down across the state and we've got some wonderful things here. 
Kimberly's here with Tulsa, George Kaiser Family Fund. 
Penny is back there with the Adolescent Health and Wellness Now initiative in Oklahoma City. 
So we've got some great things happening in some urban areas here that are wonderful. 
And three out of every five births occurred in 12 counties. 
So really if we're going to look at the data and look at where we invest, 
it's not that we don't want to invest everywhere. We do. 
We want the best practice, best policies, best things for our young people everywhere. 
But if we want to reduce; if we're serious about reducing numbers, 
we've got to look at where the numbers are. Rates tell the other part of the story. 
So it's numbers and rates. Rates are the number of females in a particular age group. 
Same age range. And when somebody just says, "What's the teen birth rate in Oklahoma" 
they're talking about 15- to 19-year-olds usually. 
We break them out by younger teens, older teens that are data 
but that's the general range and when you look at the county levels particularly, 
or you look at zip code levels which we'd like to get from metro areas, 
you need to look at both numbers and rates. Example. McCurtain County. 
78 was the rate. That's only 86 births. Compared to Oklahoma County. 
This probably has a little red thing on it but I'm just going to point, okay? 
You okay with following my hand? 
Oklahoma County had a lower rate than McCurtain County but it was 1,186. 
So we've got to help people understand that it's rates and numbers that we look at. 
Both tell part of the story. You look at 18- and 19-year-olds. 
Harmon County, off the chart in terms of the teen birth rate. For older teens it's five births. 
Get a few people and chaperone all (laughs) the 13 kids in Harmon County or something like that, right? 
Oklahoma County, you know, less almost half of reduction - 
50% almost of Harmon County - but it's 819 births. 
So we've got to look at births and numbers. Birth rate comparisons. 
I thought this was interesting. I went back to 1992, back in the day, 
and compared the rates and numbers to 2012. 20 years for North Carolina. 
I'm going to move over here if you don't mind. North Carolina, South Carolina and Oklahoma. 
We used to be right together. Those three states almost triplets in terms of teen birth rates. 
In 1992 North Carolina ranked 37th, South Carolina ranked 38th, Oklahoma ranked 39th. 
Advance 20 years. North Carolina's dropped from 69 per rate to 32, 31. 
South Carolina's dropped from 69 to 36. We've dropped 47. 
They had a 54% decrease, 47% decrease, 32% decrease but in rates, 
in ranking state ranking in North Carolina they went from 37. 
They moved up, they got better. To 30th. South Carolina stayed about the same. 
Other states going up and down but their rate drop was dramatic. 
Oklahoma dropped from 39th to 49th. You know. Almost the bottom of the barrel. 
New Mexico was the worst. Had the highest teen birth rate in 2012. 
We missed that recognition by .2%. And for 18- to 19-year-olds we were the worst. 
We had the highest teen birth rate in the nation. I mean, "Ah!" 
I pulled a few other states. Georgia. Georgia dropped over that 20 year period. 54%. 
They went from 44th to 36th. California. 
The folks who help set this up were from California originally. The young people. 
And they said everybody here says terrible things about California. 
Said I'm going to praise that state today. 
In the 20 years they dropped 64% from a birth rate of almost 73 to 26. 
They went from 43rd - bottom ten - to 21st, above the national average. 
We can talk about why they do that. They do a lot of evidence-based programs. 
US average dropped by 51%. Some good news. Expanding collaborations in our big metro areas. 
We've got leadership from great funders and community organizations. 
Greater emphasis right now in those places and some other places 
on quality sexuality education and reproductive health services. 
Folks are going to talk about that. And we have new research and resources. 
We're working at the Institute with the Power Through Choices. 
Big federal research project. We're looking at a curriculum that is a multi-state project. 
Ten lessons that were developed with and for youth in 
foster care and other out-of-home placements. 
Some of the topics we're looking at meet the DHS Life Skills, Independent Living skills requirements, 
so we're eager when we finish the research to look at how we can begin incorporating 
what we know is good right here where we tested it. Promising programs. 
We have a strong evaluation from OU Health Science Center 
as well as mathematic and policy research. And we're in the fifth year. 
So we're finishing up the data collection. Stay tuned for results. 
It's going to be very exciting. Need. Here we go. 
I've got people in the room who could imitate me doing this right? (laughs) 
Lindsay could be. They could do the Sharon Rodine, here's what she says: 
"Data. Data, data, data!" I love... Thad's over there. He's the data king that I love, 
at OSDH. Accurate, timely, annual, relevant. Need it. Got to have it. 
Priority populations that are at the greatest risk need to invest there. 
Greater investment in programs that work or show promise. 
Strong leadership, partners, sustained commitment. Where's the issue of the, you know, moment? 
This has got to be there. It's a magnet for so many other issues. 
If we can reduce teen and unplanned pregnancies and births we can reduce 
a whole lot of other negative problems, issues, education, health, 
social service, child well-being, all sorts of things in the state. 
What we need to do is put what works to work in Oklahoma. I'll turn it over to Alice.
(APPLAUSE)
Alice Blue: Thanks Sharon and hello everybody. 
I'm from Tulsa so we don't get out a lot 
because Tulsa tends to think that we're the capital of the state.
(LAUGHTER)
Ms. Blue (continues): But we do come here on occasion 
so we can see beautiful places like this and also spend some time 
really sharing information that is very important and 
I have to tell you, from where I sit I feel like one of the luckiest people in the state. 
Just a little background. In 1989, we were trying to do in Tulsa 
something with a little grant money that came from the Feds. 
And we were looking at teen pregnancy prevention. 
And we found this guy called Michael Correra. He seemed to be doing great stuff. 
And we thought we would model a program not following him exactly as he preached it 
but kind of using Michael Correra's program as a model. 
That was the same time that Sharon Rodine was head of NOAP as I recall? 
And so we were able to try to put something together in Tulsa Public Schools. 
I made contact with this guy called Michael Correra. 
And he basically said something that most people would not say. 
He said, "You know, if you're going to do a program like mine, 
why don't you come and get trained with the people that I'm training?" 
And I was aghast. I said, "Well, how much will it cost? And what do I do?" 
And he said, "I want you to do it just to do it right. Come on to New York and train with me." 
That was my first inkling of what it was like to be with somebody who was really an evangelist 
and who really believed in what he did. And he didn't bother to find out 
who the community service council was, where Tulsa was, what's going on. 
He just wanted to make sure that if we're doing something, 
we're really following what he found to work. That was in 1989. 
Michael Correra started his program in 1984. In New York City. In Harlem. 
And the teen birth rate was just crazy at that point. And his program was born out of failure. 
That's what I think is probably the most interesting. He's a very cool guy. 
He's animated, he energetic and he's in his 70's and he's energetic 
so you can imagine what he was like in 1984. And what he found is the kids loved him. 
They just loved him. They thought he was cool. They called him Doc. He was doing sex education. 
And it had absolutely no effect on whether or not they got pregnant. 
And he realized that it wasn't enough to be cool 
and it wasn't enough to just educate kids on mechanics. 
He needed to give them and work with them on something that was much, much broader. 
And was long-lasting and made a long-term commitment. 
And he understood finally that kids are the ones that decide if they're going to 
be teen parents or not. And he said it kind of clunked him on the head 
and he realized at that point that he had to develop much more than just sex education, 
although sex education is vitally important. 
And so what he did is he worked on the premise of there are no such things as kids that are at-risk, 
that kids are at-promise. And, you know, we've gone through lots of language stuff 
but it's really interesting when today as I work with the Correra Program 
I run into parents who will say to me, "Well someone thought my kid was at-promise." 
Which is so different than somebody coming in because your kid's at-risk. 
So that was the notion that he had behind the program. 
And what he basically said is we have to circle the kids and we have to 
have them have goals and personal ambition. Along with sex education 
and finding out what happens if there is some of the consequences of having sex early. 
And he said, "Let's put together a multi-pronged holistic prevention program." 
And that's what we have today and what we have today in Tulsa. 
So you have the genesis of the program. Just in essence to explain 
what the program entails, there are seven components. 
And we'll talk about things like how many folks it takes to do this program. 
But if you could bear with me and follow the seven points. 
There's daily education for kids that need it through tutors and an academic advisor. 
And the academic advisors in our case have all been Teachers of the Year. 
They are outstanding teachers. They've develop an individual academic plan for each kid. 
And then they figure out the kids that really need the most work. 
And they triage and they work with these kids every day. 
We do employment called Job Club. Where we're dealing with kids 
we open a bank account for the kids. We talk about financial literacy, 
college and career and entrepreneurial activities. And that happens on a weekly basis. 
We have something called Family Life and Sex Education, where we are doing thorough, 
vetted, sex education that is very conscious of age and stage development. 
And we have pushed the limits, we think, within Union Public Schools 
and they have swallowed hard and they're hanging onto us and they're with us. 
As well there are one-on-ones. Because we know we give kids lots of education 
but they also need the relationship between the sex educator and the kid 
as they're really going through life crisis. You know, "Should I have sex? 
I mean, I've been in love with this guy for two and a half weeks." 
"And he thinks... you know, this is it." 
And they need to have these trusting relationships 
so we have that in Family Life and Sex Education. 
We also have Lifetime Individual Sports where we're teaching kids 
how to care about their body in sports that will last them a lifetime. 
So not team sports generally but could be tennis. It could be. 
We're doing archery. Because archery is very cool because of The Hunger Games. 
But we're teaching kids that by practicing sports, by doing it, 
by actually exercising those muscles and that determination every day 
that that will have an effect in everything else that they do. 
We do the same thing in self-expression where we're dealing with artists and 
people from the arts in Tulsa and having them work 
with our kids on something that's very intense. We did a program called Louder Than the Bomb, 
where we were doing spoken word. 
And the stuff that came out of the kids at eighth grade was monumental. 
But they had a chance to do that. And we have probably one of the crowning glories is 
we have a health navigator and we do vision and dental screening for every kid in the program. 
We find out the kids that have needed glasses for a long time 
that are not doing well in school because they've needed glasses and we get them glasses. 
And we get them cool glasses and they get to pick it out and they're bigger than these.
I mean, some of them, you know, will take up most of their face. 
But we want to make sure that what they get is the cool stuff, not the stuff that "poor kids" get. 
We have mental health services, we have a weekly power group 
and we also have folks that are leading the power group that are available for crisis management 
or any kind of short-term mental health needs. 
And so if you can imagine all these components wrap around the kids at Union. 
And let me just tell a little bit about Union. It is in Tulsa County. 
It is mostly Tulsa and a little bit of Broken Arrow for those of you that know Tulsa. 
Each grade is about 1,200 kids and that's a lot of kids. And so we take 20% of the kids. 
The recruitment that happens for the Correra Program is pretty interesting. 
We work with principals and counselors and teachers in the 5th grade 
so that we can get a list of kids that we are ready to work with. 
They actually do a one page narrative on each kid they're sending to us 
in the program, or that they're thinking that we will accept. 
And we try to hit the kids that we think we can have the most effect with. 
So that we know that since we do things in a group we're probably not 
a good program for a kid who's autistic. If there's excessive absence, 
they're not going to benefit from the program because they don't go to school enough. 
So we try to fit the program and the kids that are in the program. 
We take 220 kids per grade. We are, at this point, up to 850 kids who are in the sixth, 
seventh, eighth and ninth grade. So, this is our fourth cohort. 
And the staff that we hire at each grade stays with the kids 
from sixth grade until they graduate. And so, we are in the age of millennials. 
We are asking people to make a commitment. Not of one year but of seven years. 
And we have had not a lot of turnover. I mean we've really are treating this 
as if it's the best job you'll ever have. But you have to stick with these kids. 
And so we have staff that's hired every year. We have a new cohort of 220 kids every year. 
And at this point we have about 45 full-time staff members. 
So around each cohort there are two sex educators, two full-time licensed counselors, 
a job club specialist, and someone that will do sports and a self-expression with the kids. 
Alongside our health navigator. 
We also know that parents are really an important piece of any program. 
And we have something called a Community Organizer. The person 
who is the community organizer is basically there for parents. 
We know that our parents are going to get stuck at the end of a month 
because there's not enough money to pay for rent. There's going to be food needs, 
there's going to be employment needs and we have somebody whose job it is 
to reach out to parents and help them with referrals. 
We also understand that parents are actually the best educators of our kids 
but when we talk about sex education, 
parents have about as much sex education training as their kids have. 
And so we run a semester long, every other week, parent-family life and sex education class 
once a week. And we have parents doing things like 
building genitalia out of candy as we're explaining, 
you know, so they kind of decide which pieces of candy they're going to eat 
and which pieces they're going to build with. We have them learning 
basic things about sex education and we talk about the importance of them 
expressing their values to their kids. We help them become sex educators in their home. 
And they giggle and they're excited about that and at one point we had condoms 
and woodies and they were afraid the kids were going to see them do it 
and so we had to make sure and put it away before their kids came. 
We're in this so totally with the kids and with their families 
that we feel that we're a satellite family. That we are there for them 
and we're there for them in the long-term. Okay, so it sounds like 
the kind of program that you want to do. So what about, how do we know the program works? 
We are... the Corerra program is the top-tier evidence-based program. 
They had a large, multi-site, randomly controlled trial. 
It is really the only program that we know right now that has proven to reduce pregnancy by 40%, 
at least if everything goes according to the random controlled trial. 
And it's been around for a long time. So, we do care about the data. 
This is something that we do not take for granted. 
One of the questions you might ask is, "What do you do about evaluation on an ongoing basis? 
How do we know that we are doing well?" 
We have outside evaluators coming once a year to evaluate kids' knowledge and behaviors. 
So we're able to really basically check to see how we're doing. 
We have a comparison group. It's a quasi-experimental study of 
kids who are one grade ahead of the grade that we started with. 
So we can basically compare how our kids are doing versus kids who did not get the Correra program. 
And again, this is a comparison study. This is not a random sample. 
But it's a way that we, at least keep up with what's going on. 
How many of you have heard of Union Public Schools? Okay. So they're known. 
A question that I'm asked is, "Why didn't you go to Tulsa Public?" 
And I now have two answers. The first answer is it was offered to Tulsa Public 
and Tulsa Public felt a little overwhelmed and even though we were offering them 
$1,000,000 worth of program, they decided not to take it. 
So we went to Union Public Schools. What we've since found out is that, 
as Sharon talked about, you really have to look at where the concentration 
of teen pregnancy is and the second highest zip code is completely within Union. 
And the rest of them are relatively high but we know we are targeting kids 
who would easily become a statistic. And we hope we're getting the right kids. 
We do what we can in order to see if that happens. 
In terms of the significance, at least statistically, in terms of the Correra program, 
based on their top-tier study, pregnancy was reduced up to 50% in the communities that were studied. 
Teens delayed initiation of sexual intercourse. Teens used contraception more conscientiously. 
They had more bank accounts, they had more employment experience, they had higher PSATs. 
Those were significant. What I find interesting about the program: 
it has its effect mostly on girls and not on boys. Which is interesting. 
So, when you're asking for kids who are at-promise, 
you usually get a bunch of boys that are sent to you. 
"Please take these kids. Please take these kids." 
We try to make sure that our program is pretty equal in terms of distribution 
by race but especially by gender. We want to make sure this isn't a 
mostly male program and that we have at least a few more percentage of females. 
Another question I'm trying to anticipate what you guys would ask 
and I will be open for any questions is would be about cost of the program. 
And if everything goes according to schedule, we began where the cost per student was 
a little bit over $3,000 per student. At this point, we are down to $2,700. 
Actually, $2,809. And by 12th grade if, everything again goes as expected, 
we'll be down to $2,363 dollars per kid. So there should be some cost saving 
over the full complement of the program. I'm not supposed to speak more than ten minutes.
(LAUGHTER)
Ms. Blue: So I will have time for any questions that you have. 
I think that's actually the most important stuff. Go ahead.
Audience Member: Is that cost per student or four years?
Ms. Blue: Per student
Audience Member: Which covers the four year period?
Ms. Blue: No. Per student, per year. 
And the idea is that the cost goes down.
Audience Member: And I'm so impressed because (inaudible) county?
Ms. Blue: I think it's available any place that's willing to have it. 
Dr. Correra would really like to get it as he says, "into the water supply." 
We have been very lucky. We were funded out of the SIF; Social Innovation Funding for three years, 
a  public/private venture. And we were aided heartily by the Kaiser Family Foundation. 
After three years, we're in the process of really 
trying to get as much money as we can from various places. 
And the Kaiser Family Foundation has been able to really help us with the program, 
with the understanding that we will be off and running, not totally on our own, 
but significantly on our own. Yes?
Audience Member: If someone gets pregnant while in the program are they asked to leave the program?
Ms. Blue: No. Our feeling is that once a Correra kid, always a Correra kid. 
And we have had. We had a seventh grader get pregnant last year 
and after taking some time off, she's back 
and we feel that it's really important for her to be able to continue with her cohort. 
That we know that we're doing a secondary prevention. That, you know, 
the kids life was hard enough and we're not going to make it tougher. 
On the other hand, we just had an incident where someone said, 
"Well, we have another kid who's not in the Correra Program who's parenting. 
Should the kid be in the program?" My gut response was 
no, because I think that once you open a door to that it becomes the parenting program 
as opposed to the prevention program. Yes?
Audience Member: My question is on the career component. 
You said that it did show a high success rate as far as reducing the number of teen pregnancies 
of up to 40% (inaudible). I wanted to find out if this program, what is it compiled of? 
Is it just teaching goals and giving examples or are you actually getting jobs for young people? 
Because many of them feel the reason they get into these adult situations 
is because they want to feel mature.
Ms. Blue: Right. Great question. We start with sixth graders. 
So we know that they're not going to have jobs. 
They can have experiences in service learning but not jobs. 
What we do is we pay kids for every hour that they're in Job Club. 
So it's a stipend and it goes straight into a bank account and every kid opens a bank account. 
And it often times that's the first bank account in that family. 
And so we're teaching financial literacy and moving them along. 
Pushing colleges and pushing entrepreneurial stuff. However, now that our kids are in ninth grade, 
some of the things that we're doing in our Job Club is worker's permits. 
And again an individualized plan of, "What are you interested in? 
What are we going to have for you?" with the idea that once they're of age, 
they'll be doing some shadowing, internships and part-time jobs. 
So we feel that that's really important. I mean, you have something again that you're looking towards.
 You've got a goal. You've got an ambition. So we think that... 
Why do kids want to be in this program? Because they get money. 
"Oh, we get money and we get a bank account." Why do parents want them in the program? 
Because, you know, they get healthcare. We manage issues that are intractable to families. 
You know, we're not documented and my kid has such severe acne 
that she hides in the bathroom instead of going to class. 
Well, we're able to get dermatologists to see the kid and 
we'll help pay for the medication and we get pro bono work from the doctors. 
so people have ceased liking to see me at like, dinner parties.
(LAUGHTER)
Ms. Blue: Yes?
Audience Member: Have you noticed in the integral domino effect in regards to students 
that are in this program and how they relate to their friends that may not in the program?
Ms. Blue: Yes. It's really interesting when you walk into a room. 
And we're talking about real issues. I mean we're talking about, you know, 
the various parts of a penis and there's a big penis on the board. And the kids don't giggle. 
They don't titter. And then they tell us that they're talking to their friends as, 
you know, they're giving them advice, they're telling them what kind of birth control works. 
So they have become empowered. That doesn't mean that they're always following the things themselves 
but they become empowered to become the experts in their own little social circles. 
That's a good question. Other questions? 
I urge you - We are open for... we try to do tours about once 
every month or once every month and a half. The kids are really good about 
talking about you know how they've changed totally since they were a little kid last year.
(LAUGHTER)
Ms. Blue: We have parents coming and talking about the impact of the program. 
We take people to see the classes and to hear the kids. 
We would love folks from Oklahoma City to see what's going on. We're really happy with this program. 
Can I tell you the best part is I have folks that work full-time who actually have said, 
"Alice, this is the best job I've ever had. This is what I really wanted to do. 
I can service kids. I can visit them if I want at home. 
I can do basically whatever I need to do and I don't have to do a ton of paperwork." 
We have an information system, but it's not, you know we're not... 
You know what it's like out there and they can actually work with kids. 
And they do it. Are there any other questions? 
Well, if you think of any, we'll answer them. Thank you.
(APPLAUSE)
Amy Terry: Hello. On March 23rd of 2010 the President signed into law 
The Patient Protection and Affordable Care Act. The act amended Title V of the Social Security Act 
to include the Personal Responsibility Education Program, otherwise known as PREP. 
The PREP program, the purpose is to reduce teen pregnancies 
and prevent sexually transmitted infections as well as AIDS and HIV. 
Through PREP the Family and Youth Services Bureau awards 
grants to state agencies to educate young people 
on both the abstinence and contraceptive. 
During this timeframe Oklahoma County and Tulsa County's teen birth rate 
was the highest of that of the state. 
And of course with such a high population in this area, 
it was obviously the target for this collaboration to begin. 
So the Oklahoma Health Department started collaborating 
with the Oklahoma City Health Department and the Tulsa Health Department 
to join forces in the teen pregnancy prevention efforts. 
In 2010 the Oklahoma State Department of Health Maternal and Child Health Services was awarded 
the PREP grant. And they became responsible for administering and monitoring the grant in Oklahoma. 
The grant is completely federally funded. 
We contract with the Oklahoma City County Health Department and Tulsa Health Department 
to provide these services in the schools. 
Our target populations include African Americans, Native Americans, 
Hispanic youth ages 11 to 19 years of age in high school, middle school and alternative schools. 
However, we don't exclude anyone in the high schools and schools that we serve. 
The Oklahoma PREP projects use evidence-based curriculum 
from the Department of Health and Human Services list of 35 
to include Making a Difference, Making Proud Choices and Reducing the Risk. 
School administrators work with the PREP staff in order 
to choose the program which best suits their school's needs. 
Now Making a Difference is an abstinence-based model. 
And it's eight modules long with the goal to empower 
young students to make healthy decisions 
in order to reduce the risk of sexually transmitted infections, HIV and AIDS. 
It is intended for the younger youth in middle school. 
Making Proud Choices is a comprehensive eight module curriculum that gives adolescents 
what they need to reduce the risk of unintended pregnancy, sexually transmitted infections, 
HIV and AIDS. It is intended for high school students. 
Reducing the Risk is a 16 module curriculum 
with the primary focus of development of attitudes and skills that will help teens 
prevent pregnancies and the transmissions of sexually transmitted infections, HIV and AIDs. 
This program is intended for high school students. 
Three adult preparation topics are covered in Making a Difference, 
Making Proud Choices, and Reducing the Risk which include the healthy relationships, 
adolescent development and parent/child communication. 
Reducing the Risk also covers a fourth adulthood preparation topic 
which is Healthy Life Skills. We know that these programs work 
because they are evidence-based. And with fidelity to the program model 
results will be seen. I haven't had a chance to really talk so much on this 
but community partnerships are vital in teen pregnancy prevention effort 
and we have to combine our efforts in order to maximize resources. 
Though progress has been made, more work is needed to reduce teen pregnancy in Oklahoma 
and it's going to take all of us coming to the table to make a difference. Thank you.
(APPLAUSE)
Ayesha Lampkins: Good afternoon. Good afternoon.
Audience: Good afternoon.
Ms. Rodine: One more time.
Ms. Lampkins: Yes. Okay, one more time. Good afternoon.
Audience: Good afternoon.
Ms. Lampkins: Ah, okay I like that. 
So I'm going to be talking about what's going on in the rural counties 
because it is important that we focus on Oklahoma and Oklahoma County and Tulsa Counties definitely. 
But we can't forget that this is a state-wide problem. 
So there are things that are going on in the counties that we need to know about as well. 
And before I get into that, I'll also want to say that 
we're all aware that teen pregnancy does not happen in a silo. It doesn't happen by itself. 
There are lots of different factors.
Ms. Rodine: Well, it might in the rural area happen in a silo. 
(LAUGHTER)
Ms. Rodine. I just had to say that. I'm sorry Ayesha. Done
Ms. Lampkins: But there are lots of different factors that play into it, right? So, (inaudible) 
there's lots of different factors and so what you're hearing today 
is just a little tidbit of what we're doing from a few agencies across the state. 
There's a lot more that's being done and there's a lot more that can be done. 
So with that, in the rural counties basically Amy and I work very closely together. 
So she kind of helps oversee the PREP project 
and then I work more closely with those who are in the counties. 
And so in the counties - and I'm going to give you guys time to get this out 
because I'm a visual person. So if you get the one map that actually has 
some of the green areas highlighted, I'll give you time to flip through that - 
so in the counties, we have registered nurses who are actually trained to go in 
and present evidence-based curriculum 
so the same curriculum that Amy kind of already talked about: 
Making a Difference, Making Proud Choices, Reducing the Risk. 
And so we have nurses that go into schools and all of these nurses are employed by 
the Health Department. And so they go into 
the school systems primarily, but also other youth serving organizations 
like Boys and Girls Clubs and things like that, and they do this program. 
So we cover 22 counties in the state with this teen pregnancy prevention project. 
22 counties. And I had to get this out just because everyone always asks me where, 
so I'm going to do a quick run-down so you can follow along in your map. 
And if it's too quick, get in touch with me afterwards and 
I'll go over it with you later or I can email it to you. 
So, if you start in the southwest part of the map 
- or for those don't like those kinds of directions, 
in the lower, left-hand corner of the state map - 
we are in Beckham, Greer, Harmon, Jackson and Tillman. 
And what I want you to see is it will correspond to some of those higher rates 
within the state. Then if you move towards Central Oklahoma: 
Pottawatomie, Seminole, Okfuskee, Hughes, Pontotoc, Pittsburgh, Latimer, Coal, 
Johnston, Carter, Jefferson, Love, Marshall. 
And then looking at Southeastern Oklahoma: McCurtain, Choctaw, Pushmataha, Bryan, Atoka Counties. 
So 22 counties are covered. So, it's quite a lot 
and all of those areas right now again, are covered by nurses who are trained 
in teen pregnancy prevention. And those areas were decided on 
based on their birth rates. So, the teen pregnancy prevention projects have actually been in place 
for several years. And once we received the federal funding for PREP, 
the decision was made within our agency to kind of align what was going on in the rural counties 
to make it similar to what was going on in PREP. 
So we took a look at the rates and we decided based on the rates at the time, 
where were those really high-need areas? 
And so those are the areas that have been targeted as far as the rural counties. 
So that's one of the things that we're doing and what's my time?
Ms. Rodine: You're good.
Ms. Lampkins: Okay. I just wanted to check. 
And then something else that we're doing as far as evidence-based practices is 
it is really, really important that youth have a voice in this. 
And so I think a lot of times we spend a lot of time talking to youth 
and at youth instead of working with them. And so one of the things that we're piloting right now 
in three counties across the state - Seminole, Lincoln and Pittsburg Counties - 
are public health youth councils. And these are councils that are made up of high school students 
and what they do is they give input on public health issues that are going on throughout the state. 
They review Health Department materials, projects, 
all of those things that would normally be directed towards youth. 
They have a chance to review those things and so we can get some honest feedback on, 
"Okay, yeah, we really don't use QR codes so don't put that on there," 
or you know, whatever it may be we can kind of get that youth perspective. 
But they also do a needs assessment. And in that needs assessment at the beginning of the year 
they identify in their community what are the top issues. 
And then they also identify what projects are already in place 
to kind of help address those issues. 
Now, without question the top issues in all three of those areas 
have always - well this is the second year of the pilot - 
is going to be those issues, again, that feed into teen pregnancy. 
So self-esteem issues usually rise to the top, especially when we're talking about our females. 
Relationship issues. Communication with parents has come up as an issue. 
And then just general reproductive health issues. And so we have facilitators. 
Adult facilitators that work with these young people. 
And they address those issues however they want to. 
So like in one county we had individuals who went in 
and they decided that they were going to teach reproductive health to their peers. 
Now, take yourself back to your 14-, 15-, 16-, 17-, 18-, 19-year-old self. 
And imagine standing up in front of a class of your peers 
and having to talk about sex. And teach them about sex. 
So it can be a little bit daunting, but they're doing a great job and we try to prepare them. 
So that's another avenue that we're trying to attack the teen birth rate across the counties. 
So again, we've got the teen pregnancy prevention projects across the state 
in all those rural counties. We have the public health youth councils 
that are being piloted in three counties. 
Audience Member: Which three?
Ms. Lampkins: Seminole, Lincoln and Pittsburg. 
And this next year we will expand. 
So, we have that going on and then also something that can't be overlooked as far as
 things that have been proven to work across the state 
is when our adolescents choose long-acting reversible contraception.
Ms. Rodine: Applause line.
(LAUGHTER)
Ms. Lampkins: And so that's something that has shown to be effective. 
And we have family planning clinics across the state through the Health Department system 
and also through contracted sites. We have 94 family planning clinics 
or contracted sites. And in 2012, females ages 15 to 19 
chose Larcs 26% of the time as their method of choice. 
In 2013, among that same age range it actually went up to 31%. 
So we're seeing an increase. So those are your IUDs, your hormonal implants, your Depo shots. 
And so those things are also known to be effective and so we're seeing an increase in those as well.
And then I just really wanted to again just re-iterate that 
we all just represent a small segment of what's going on in the state. 
Our tribal partners have teen pregnancy prevention, activities going on as well. 
There are some abstinence-based prevention efforts going on as well. 
And I'm sure that there's some smaller community efforts that we may not even be aware of. 
So I would encourage you if you think that you're aware of something that maybe we're not, 
to let us know. I would love, this is my big pie in the sky like vision: 
is to be able to have some type of directory or map 
that shows what's going on in the state of Oklahoma. Something comprehensive. 
Because I think for too long we've worked in silos 
and everyone's kind of been very kind of secretive and like, "No, this is my project." 
Or you know, "This is my program." Where we really need to work together 
because as I said in the beginning this is a multi-faceted issue. 
So just giving students education and information is not enough. 
We know that knowledge is necessary but alone it's not sufficient for behavior change. 
So what else are we going to do? What else are we doing to make that change? 
So keep in mind that there are other things that are going on in the state. 
Also be aware that we've got to figure out how to get our males involved. 
Because it's not just about the females. 
And I think sometimes we focus a lot on the females, 
but as my momma used to say, "Girl, it takes two."
(LAUGHTER)
Ms. Lampkins: Okay? Two people. So how are we addressing this with our males? 
How are we teaching them and how are we reaching out to them in a language that they'll understand? 
Because as we know, from early age... I have a five-year-old and a two-year-old who are both boys. 
The way they process things and the way they understand things 
are completely different than females, right? 
And everybody just kind of chuckles. 
They either has boys or has girls and they can make the comparison. 
So, how are we reaching out to our young males 
and how are we getting them involved as well? 
And then lastly as far as things that are going on in the state. 
Support for pregnant and parenting teens is going on throughout the state as well. 
Because we also have a higher repeat birth rate among our teens as well. 
So what are we doing and what are some things that are in place 
and how can we further support those programs for those individuals, 
those teenagers who've already given birth, who have already become a teen parent
so that they don't have a repeat birth? And so what can we look at 
in order to make sure that we can do something about those rates as well? 
Because we're really high up there as well. 
So, that's my overview. I tried to condense it really quickly 
and I think we're going to take questions as a panel at this time. 
If anyone has any specific questions. 
Sorry, did I steal your thunder. I'm sorry. Okay, okay.
Ms. Rodine: Sir?
Audience Member: How many nurses do you have versus how many students that you are able to serve?
Ms. Lampkins: Right now we have five nurses. Yes. Five. 
One, two, three, four, five. They each cover multiple counties so four or five counties. 
What we're working on right now is trying to build infrastructure 
so that it's not just the Health Department nurses going in and doing a program one time. 
What we're really looking more at how can we train school personnel or other 
stakeholders within the community to be able to deliver this program 
within their own communities to make it more sustainable? 
And so that the community is taking more buy-in of their own issues. 
So, that's the answer to that question. I can't remember the reach we just 
had the recent numbers come out. I'm looking in the back at our different data people 
and they're all shaking their heads at me right now too. But I can get you that information. Yes?
Audience Member: On that map that you showed us there's two clusters where 
their rates are lower than the state average or even lower than the national average. 
Has anyone looked at that to see if there is something to that? 
Like what's happening in those counties in that area or is it just a fluke?
Ms. Lampkins: Right. And what we'd need to do. 
Because for this project we don't just look at one year of data. 
We look at several years and so I'd have to go back and see kind of where those counties fell.  
But like I said, I am certain that there are things going on that we do not know about. 
As far as any of the efforts from what we're doing up here, 
nothing other than that's already been spoken about. 
However, you know, is there some faith-based initiatives going on in that county? 
Possibly. Is there something else that's being done maybe through the school system? 
That's why, you know, we really need that comprehensive list 
and it's not to "big-brother" anybody, by any means. 
But how can we know that we're being effective if we don't already know 
1) what's going on, and 2) we don't want to step on each other's toes. 
Because it's kind of embarrassing. 
First of all, when you go into a school system and someone else has already been established there 
for five years. So, to answer your question we're not really sure. 
I'd have to back and look and see. But I'm certain that there's something else. 
And it may just be the communities protective factors that are already in place. Right. Yes?
Audience Member: I have a question. 
You said that an increase of 31% of females engagement are choosing the long acting okay. 
And so my question is for such things as Deprovera, is there parental permission required. 
Ms. Lampkins: No.
Audience Member: Okay, so is it the same for a boy?
Ms. Lampkins: Yes.
Audience Member: If the boy decides to do a vasectomy?
Ms. Lampkins: We don't do vasectomies.
Audience Member: What do they have that's long-acting for boys?
Ms. Lampkins: Right. And that is an area that needs to be addressed nationally. 
Thinking in terms of developing, maybe, long-acting contraceptives for males. 
Audience Member: (inaudible)
Ms. Lampkins: Great point. So, for our males, it's not going to be the long-acting. 
It's going to be for females. And again those are going to be the hormonal methods, 
shots, implants and things of that nature.
Audience Member: Thank you.
Connie Schlittler: We are out of time unfortunately. Let's thank our panel.
(APPLAUSE)
Ms. Schlittler: That was a wonderful presentation. 
I just feel like we got so much information in 60 minutes. Thank you guys so much.